CHAPTER 7: PREGNANCY AND LACTATION Flashcards
What is the additional recommended intake of calories during 2nd trimester?
recommended that women consume additional 340 calories/day
What is the additional recommended intake of calories during 3rd trimester?
recommended that women consume additional 450 calories/day
What is the additional recommended intake of calories during lactation?
recommended additional 330 calories/day (first 6 months)
▪ Additional 400 calories/day after that
How many pounds are gained during the 1st trimester (total 3 months) of pregnancy?
2-4 lbs.
How many pounds are gained during the 2nd and 3rd trimester of pregnancy?
2-4 lbs. per month
What is the normal BMI of a pregnant woman after the total weight gain during pregnancy?
25-35 lbs.
What is the underweight BMI of a pregnant woman after the total weight gain during pregnancy?
28-40 lbs.
What is the overweight BMI of a pregnant woman after the total weight gain during pregnancy?
15-25 lbs.
What are the dietary recommendations during pregnancy?
o Limit caffeine intake to 300 mg/day or less
o 600 micrograms a day of folic acid (helps prevent neural tube defects)
o Iron supplements during pregnancy (remember vitamin C increases absorption) to get 27 grams
o Fish and shellfish should be avoided due to mercury levels
What education should be provided to a pregnant woman experiencing N/V?
advise to eat dry crackers or toast so they should focus on low fat carbohydrates to decrease nausea.
What other education should be provided to a pregnant patient?
o Avoid drinking water with meals ▪ Caffeine ▪ Fatty foods ▪ Spicy Foods o Can help to serve foods at room temperature or chilled ▪ Warmer hot foods give off more odor o Maintain good oral hygiene
What education should be provided to a pregnant woman experiencing constipation?
encourage to increase fiber and fluid intake
o Engage in physical activity to increase bowel motility
What is PKU?
Maternal Phenol Ketonuria
What should moms that have PKU avoid?
high protein foods
o So that means no meat, fish, poultry, eggs, nuts or dairy products
o They will also need to get their phenylketonuria levels taken throughout pregnancy (frequent blood tests); if mom has PKU, start diet BEFORE pregnancy
How does the weight of an infant change over the course of 6 months to a year?
birth weight will double by 6 months & triple by 1 year
When should breast milk be used?
exclusively for the first 4-6 months
When should you introduce a baby to solid foods?
once the baby can sit up and has good head control
What is the first solid food that is introduced?
iron fortified cereal
▪ After that we can introduce new foods ONE AT A TIME
** 1 new food for 5-7 days **
When should cows milk and honey be given?
not until the baby is 1 year old (honey increases r/f botulism)
How should a baby with cleft lip be fed?
feed them upright
How should breast milk be stored?
Can be stored for 5-8 days in the refrigerator
What should you do with unused breast milk?
any unused breast milk should be discarded
Why should you never microwave breast milk?
it kills the antibodies
How long can breast milk be frozen?
up to 6 months in regular freezer or 12 months in deep freezer
** Use thawed milk within 24 hours (never refreeze) **
What are some infant nutrition concerns?
- colic
- lactose intolerence
- diarrhea
- dehydration
What are the s/sx of colic and what education should be provided to mom?
- persistent crying for 3 hours or more a day, usually resolves around 3 months old + abdominal tension and legs drawn to belly
- If the mom is breast feeding, suggest eliminating cruciferous vegetables (cauliflower, broccoli, brussel sprouts), cow milk, onion, and chocolate (triggers)
What are the s/sx of lactose intolerance and what education should be provided to mom?
- gas, abdominal distention, diarrhea.
- You can try using a soy based or cosine hydrolysate (casein) formula
What is the frequent cause of diarrhea and what can be used to treat the baby?
- often caused by ROTAVIRUS
- Use an oral rehydration solution (8oz/loose stool) and notify PCP
What are the s/sx of dehydration?
Lethargy, sunken eyes, sunken fontanelles, decreased tears, decreased urine output, dried mucous membranes
How many pounds do children gain a year on average?
5 pounds
What foods are considered choking hazards for children?
- Popcorn
- Raisins
- Peanuts
- Bagels
- Grapes
- Raw carrots
- Hotdogs
- Celery
- Peanut butter
- Candy (fruit gel bites)
- Tough meat
How much juice should a child drink a day?
no more than 4-6 ounces/day
How much milk should a child drink a day?
no more than 24 ounces/day
What can the overconsumption of milk lead to in a child?
iron deficiency anemia
o Milk is low in iron
** Increase intake of iron rich foods (vit. C) **
_______ is important for bone development in children also because it helps with absorption of calcium
Vitamin D
What are some adolescent nutrition concerns?
Eating disorders begin during adolescence: o Anorexia nervosa
o Bulimia
What are some older adult nutrition concerns?
- They have lower BMR which means they require fewer calories because of their slower metabolism.
- Dehydration is common and is due to decreased thirst sensation as well as medication side effects
o Diuretics will really dry you up - Decreased absorption of B12, folic acid, and calcium
- Some have issues with chewing and swallowing
o Need to mince or chop foods to help minimize difficulty with chewing and we may need to thicken liquids for easier swallowing
When does osteoporosis occur?
Beginning at age 35 (bone loss)
Who is at a higher risk for osteoporosis?
white women
What education should be provided to patients at r/f osteoporosis?
o Pt who are at risk or have osteoporosis to increase their intake of calcium and vitamin D
o Engage in weight-bearing exercise (NOT SWIMMING!!)
o Limit alcohol consumption
How much protein is needed in the diet during pregnancy?
20%
How much fat is needed in the diet during pregnancy?
30%
How much carbs is needed in the diet during pregnancy?
50%
Why should you not prop the babys bottle?
it increases the r/f tooth decay
What schedule should you be on when breastfeeding?
feed every 3-4 hrs for 8-12x/day (wake the baby if you have to)
** watch for hunger cues **
What should be added to breast milk if exclusively breastfeeding?
iron supplementation at 4 months
What education should be provided to a mother about formula feeding?
- follow mixing direction
- throw out if left out >2hr
- feed <32oz/24hr unless directed by provider
When should a infant be eating 3 meals and 3 snacks a day?
by 8 months
How long can baby food be stored?
24hrs
What education should be provided to a mom whose baby is failing to thrive (inadequate growth)?
give them a high calorie, high protein diet and assess for physiological or psychological reasons
What education should be provided to a mom whose baby is experiencing constipation?
properly dilute formula
What are food jags?
ritualistic preferences for one food (this is common and self limiting in children between 3-6)
Children are at a r/f choking until what age?
4 years old
Who is at a r/f lead poisoning?
children <6 yo
Preschoolers dislike ______ but enjoy _______
strong tasting veggies (onions, cabbage); raw veggies as finger foods
What education should be provided to school aged children (6-12)?
to only eat when hungry (they need more calories, proteins and fluids; we should be concerned about them not eating breakfast and being obese or overweight)
What concerns are there about adolescence diets?
eating and snacking and skipping meals or eating nutritionally poor foods and/or not taking in enough iron and calcium)
