Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NU2101 > Health Promotion > Flashcards

Health Promotion Flashcards

1
Q

what is public health?

A

‘the art and science of preventing disease prolonging life and promoting health trough the organized efforts of society’

It seeks to identify risks to health and find the best way to minimize them, in order to give everyone the best chance of leading a healthy life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the role of the midwife in public health?

A

Good public advice is a fundamental part of a midwife’s role. Midwives need to promote family-centred care by meaningful conversations with women around healthy lifestyle choices in pregnancy, making every contact count. The small changes that a woman makes in her lifestyle choices will increase her chances of achieving a healthy pregnancy birth and baby.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is poverty?

A

‘… not being able to heat your home, pay the bills or buy the essentials for you children. It means waking up every day facing insecurity, uncertainty and impossible decisions about money.”

Poverty is a risk factor for disease and people living in poverty are more likely to have multiple morbidities and find more difficult to self-manage.

‘… the biggest driver for poor mental health’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

child in poverty are more likely to what?

A
  • Die in the first year of life
    • Have a low birth weight
    • Be formula fed
    • Become overweight
      Suffer from asthma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the child poverty scotland act’s aim?

A

Child poverty (Scotland) Act set ambitious targets for child poverty in Scotland. It mandated that by 2030 fewer than 10% of children should be living in relative poverty.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the impact of child poverty on mental health?

A
  • Finance worries
    • Anxiety and stress
      Social exclusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the impact of child poverty on health and wellbeing?

A
  • Poor living conditions
    • Unhealthy diet
      Substance misuse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the benefits to referral to financial inclusion?

A
  • Ensures families are receiving income maximization
    • Debt management
    • Advice on household energy suppliers, employability and training
    • Help mums access sure start maternity grants and healthy start scheme and secure financial entitlements such as child benefit
    • Promote people supporting each other
      Neonatal expenses to assist with the challenges of sick babies in hospital.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the responsibility of midwives in relation to financial inclusion?

A
  • Ensure poverty is presented correctly by reducing the stigma around poverty
    • Ensure more widely known access availability of help
      Refer any women, not only those on low income, the scheme is open to all families.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is financial wellbeing?

A

‘feeling secure and in control. Its knowing you can pay bills today. Can deal with the unexpected and are on track for healthier financial future.’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how do you calculate units in alcoholic drinks?

A

volume (ml) divided by 1000 x %alcohol by volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what does one unit of alcohol equal?

A

8g pure alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what does the average adult women drink per week?

A
  • Adult women drink on average 8.6 units/week. The UK Chief Medical Officer guidelines classify low risk drinking as less than 14 units a week.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what percentage of women drink above low risk level of alcohol?

A
  • Almost 2 out of 10 adult women (16%) drink above this low risk level of 14 units a week
  • A little bit more than 1 in 10 women (11.6%) had high scores in the AUDIT screening test, which indicates they have a drinking problem.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how many women will continue to drink in pregnancy?

A

4 in 10 in the UK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the estimation for every baby born with FAS?

A
  • It is estimated that for every baby born with FAS, there will be 9-10 other babies born with other disorder of the fetal alcohol spectrum.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

But also, women have lower levels of alcohol dehydrogenase, what is their role?

A

This enzyme is responsible for the metabolic breaking down of alcohol. If women have lower levels, they will be able to break down the alcohol more slowly than men, meaning that high alcohol levels will last longer in the bloodstream.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

women have 10% more body fat than men meaning what?

A

Women have 10% more body fat that men, which means that with the same amount of alcohol drink, the concentration of alcohol in blood for women will be higher. But also, women have lower levels of alcohol dehydrogenase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

drinking alcohol increases what?

A
  • Macrocytic anaemia will show as increased MCV in the full blood count.
  • Increase vulnerability to infection
  • Higher risk of accidents
    Higher rates of depression, anger, anxiety and misuse of other drugs.

Heavy alcohol intake in the mother is related with impeded absorption of folic acid, which can lead to birth defects.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

when may withdraw symptoms be present?

A

Withdraw symptoms may be present when alcohol tolerance and dependence have been developed: (like palpitations, agitation, tremors or convulsions)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is alcohols effect o milk production?

A

For breastfeeding, it is controversial if alcohol consumption is associated with shorter duration of breastfeeding. However, what it is clear is that acute alcohol consumption inhibits oxytocin secretion in the mother and hence affects the ejection reflex of breast milk with a decrease of 10% to 25% of milk production.
The following video shows you some of the long term effects of alcohol in the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is the impact of alcohol on blood?

A
  • macrocytic anaemia
  • weaker immune system
  • increase risk of DVT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is the impact of alcohol on the brain?

A
  • CNS suppression
  • Mental health
  • withdraw symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is the impact of alcohol on the heart?

A
  • hypertensive disorder
  • increase risk of stroke and heart attack
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is the impact of alcohol on digestion?

A
  • folic acid deficiency
  • malnutrition
  • dehydration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is the impact of alcohol on the liver?

A
  • increased risk of liver disease, pancreatitis and cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is the impact of alcohol on the reproductive system?

A
  • menstrual disorder
  • sexually transmitted infections
  • infertility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what is the impact of alcohol on the breasts?

A
  • increase risk of breast cancer
  • decreased milk production
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

the fetal alcohol spectrum disorder (FASD) term cover?

A
  • Fetal alcohol syndrome (FAS)
    • Alcohol-related neurodevelopmental disorder (ARND)
    • Alcohol-related birth defects (ARBD)
    • fetal alcohol effects (FAE)
      Partial FAS (PFAS)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

as pregnancy goes on how does alcohol impact the baby?

A

During the 1st trimester the connections between maternal and fetal blood is quite small and the placenta is still developing. Therefore there is a small chance of alcohol passing to baby.

However, later on in pregnancy, the connection between maternal and fetal blood is bigger and the placenta is developed. And the alcohol is more likely to pass to baby.

The impact of the alcohol on the baby and development will depend on what stage she is drinking alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is the impact of drinking in the first trimester?

A

Birth defects

  • Heart
  • Cleft lip and palate
  • Genital malformations
  • Kidney and urinary malformations
  • Facial distortions
  • Microcephaly
  • Small jaw
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is the impact of drinking in the second trimester?

A

Growth

  • low birth weight

Developmental Problems

  • Speech impairments
  • Short attention span and memory problems
  • Irritability in infancy
  • Hyperactivity in childhood and ADHD
  • Learning disabilities and difficulties
  • Delay in normal development
  • Risk of depression and psychosis as adults
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is happen in week 4 of pregnancy?

A

Week 4 - neural tube closure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what has happened in week 6 of pregnancy?

A

Week 6 - heart is beating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what has happened in week 9 of pregnancy?

A

Week 9 - kidneys are functional, face starts developing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what has happened week 10 of pregnancy?

A

Week 10 - lip and palate formed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what has happened week 12 of pregnancy?

A

Week 12 - genitals are formed, face is formed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what has happened week 13 - 28 of pregnancy?

A

Week 13 - 28 - Growth, organs are already developed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what has happened week 24 of pregnancy?

A

Week 24 - neurons maturation begins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what happens week 29- till birth?

A

growth and brain development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what has happened week 32-35 of pregnancy?

A

Brain activity increases and some cognitive functions start to happen (dreaming), Neurons starting migrating to develop the folded appearance of the brain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what percentages of women are obese and overweight?

A

Overall, 15% of the women worldwide are obese. When looking at overweight, up to 40% of women in the world have BMI over 25.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what is obesity?

A

Obesity is a condition in which there is an excessive body fat accumulation, with multiple pathological consequences for the health of the person. It is usually measured and described by the body mass index (BMI).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

is high BMI the only way to measure obesity?

A

However, it is important to notice that high BMI is not the only measurement of obesity and it needs to be interpreted with caution as it is not a direct measure of adiposity. In highly muscular adults, it may be less accurate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

in women what is a normal waist circumference?

A

80cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

what are the general risk of obesity to health?

A
  • VTE (especially if BMI>40)
    • Cardiac problems
    • Hypertension
    • Anaesthetic complications
    • Low oxygenation
    • Risk of gastric aspiration
    • Difficult intravenous access
    • Wound infection
    • Longer hospital stays
    • Vit D deficiency
    • Mental health issues
    • Infertility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

maternal impacts of obesity in pregnancy?

A
  • Gestational diabetes (BMI>30)
  • Pre-eclampsia (BMI>35)
  • Induction
  • C-section/instrumental birth
  • Labour dystocia
    PPH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

fetal and neonatal impacts of obesity in pregnancy?

A
  • Miscarriage
  • Premature birth
  • Stillbirth
  • IUGR
  • Abnormal FHR patterns in birth
  • Less likely to breastfeed
  • Macrosomia
  • Congenital anomalies (NTD and cardiac)
    Admission to NNU
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

why is anaesthetic complications important to keep in mind with obesity in pregnancy?

A
  • Anaesthetic complications are a very important risk to keep in mind: women with obesity have a decreased lung capacity, with leads to chronic low 02 levels. This chronic lack of oxygen can also compromise fetal oxygenation, making them more likely to experience growth restrictions and abnormal fetal heart rate during labour. Also, the increased stomach capacity and acidity of gastric contents puts them at higher risk of aspiration if they need general anaesthetic during labour. Difficult intravenous access can also difficult management of bleeding or shock in pregnancy.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what are women with a high BMI in pregnancy likely to be offered?

A

women with a high BMI have a higher risk of gestational diabetes. This is why GTT are offered to all women with a BMI over 30. They also have a higher risk of pre-eclampsia, and as we will see later, this may mean that women with BMI over 35 may be offered prophylactic aspirin during pregnancy.

Women with high BMI are also more likely to be offered induction, either because the increased risk of complications or because they are more likely to go post-dates.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

why are women with a higher BMI less likely to breastfeed?

A

less likely to breastfeed, and the reasons for this can be complex and involve both physical and sociocultural factors. From a physical point of view, they may have a lower milk production, which can be related with undiagnosed thyroid problems or the same insulin-resistance metabolic problems that increase their risk of diabetes. This same insulin-resistance metabolic changes can increase the risk of fetal macrosomia, that then increases the risk of shoulder dystocia and neonatal hypoglycaemia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

what are the neonatal outcomes of babies of women with higher BMI?

A

neonatal outcomes we know that women of high BMI have a higher risk of miscarriage. This is probably related with the metabolic and hormonal changes related with obesity, that also increase the risk of fertility problems. Probably this is also related with the higher risk of premature birth.

Stillbirths have been explained by the higher risk of abnormal cardiovascular problems in these women, but it may also be related with the chronic low oxygenation levels we discussed in the previous slide. This also increase the risk of IUGR or abnormal FHR patters during birth.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what deficiency are women with higher BMI likely to have?

A

The folic acid deficiency in women with high BMI increased their risk of neural tube defects. Other congenital abnormalities are also more common, like cardiac ones, but we do not know if this is related with obesity related changes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

women with higher BMI in relation to pre-eclampsia?

A
  • Limitations to appropriate size of cuff
  • May need different location

Finally, women with high BMI have a higher risk of pre-eclampsia, but our skill to effectively screen for this condition depends on the use of appropriate equipment. Large blood pressure cuffs should have a width of 40% of the circumference of the arm. And for some women with very large BMI, the large size of standard cuffs may not be enough. Sometimes, instead of placing the cuff in the upper arm, alternative locations, such the forearm may need to be used.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

what is the problem with fetal growth with women of a higher BMI?

A
  • Inaccurate SFH measurements (BMI>35)
  • Limitations of scan accuracy

When we try to monitor fetal growth: for women with BMI over 35, symphysis-fundal height (SFH) is unreliable to monitor fetal growth, so they will be offered serial growth scans. However, these scans are more likely to be underestimating or overestimating fetal measurements than in women with normal BMI. And considering that scan results are sometimes determinant to decide early induction, it is easy to understand why larger women have a higher risk of induction.

In women with very large BMI, abdominal palpation to assess fetal presentation can be very complicated or sometimes impossible, making these women more likely to require additional ultrasound exposure during pregnancy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

what does the preconceptional care for women with BMI >30 involve?

A
  • Assess other risk factors (especially if fertility treatment)
  • Diet advice
  • Weight loss advice
    5 mg folic acid 3 months before conception (to address their increased risk of neural tube defects)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

what does preconceptional consultations for women with higher BMI involve?

A

Ideally, these women should have preconceptional consultations, most likely with their GP, who will risk assess for other risk factors and comorbidities and should work with them in building a diet and weight loss plan before they plan their pregnancy. Many women with high BMI will require fertility treatment, and sometimes, this risk assessment means that they may not be eligible for treatment until they have improved their health and weight.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

what does antenatal care for women with a BMI >30 involve?

A
  • 5mg folic acid up to 12 weeks
  • 10mcg vit D supplement
  • Review by obstetrician but can remain under midwifery care
  • Exercise in pregnancy advice
  • Offer dietitian referral
  • GDM screening
  • VTE risk assessment
    Mental health risk assessment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

what does antenatal care for women with a BMI >35 involve?

A
  • Consultant-led care
  • Serial growth scans
  • If other PET risk factors, 150mg aspirin daily from 12 weeks
    Consider serial reweighing in 3rd trimester
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

what does antenatal care for women with a BMI >40 involve?

A
  • Birth in obstetric unit
  • At 36 weeks or earlier
  • Anaesthetist review
  • Tissue viability assessment
  • Manual handling assessment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

what should all higher BMI take supplement wise?

A

All women should continue with 5 mg folic acid up to 12 weeks of pregnancy, and use 10 mcg Vit D supplements for the rest of the pregnancy and the lactation period.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

in relation to weight what should we do with high BMI women?

A

All women should be advised about safe exercise in pregnancy and ideally offer dietitian referral. There is a lack of consensus on optimal weight gain during pregnancy, and this is why the focus should be on healthy diet more than prescribed weight gain targets. Actually, it is not uncommon for women with a high BMI to lose weight during pregnancy once.

However, women with BMI of 35 and over, especially those above 40, may be offered serial weight in the third trimester. The purpose of this is not really to improve outcomes in the mother, but to be able to have more accurate manual moving and handling assessments, that could impact the discussion around their birth options, p.e. about the use of a birthing pool.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

what are the intrapartum guidelines for women with BMI >30?

A
  • Ranitidine 8 hourly
  • Active third stage
  • CTG only if fetal concerns
  • Encourage mobility
  • Prevent pressure sores
    If c-section prophylactic antibiotics at time of surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

what are the postnatal guidelines for women with BMI >30?

A
  • Breastfeeding support
  • Continue on 10mcg vit D supplement while feeding
  • Plan to restart exercise
  • Mental health risk assessment
    VTE risk assessment and prophylaxis if other risk factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

what are the intrapartum guidelines for women with BMI >40?

A
  • IV access early in labour, considering sitting a second cannula
  • Inform anaesthetist on admission
    Birth pool usually contraindicated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

what are the postnatal guidelines for women with BMI >40?

A

Prescribe VTE prophylaxis for 10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

what medication should women with high BMI get in labour?

A

During labour, women with high BMI should be offered antiacid medication, like ranitidine every 8 hours, to reduce the risk of aspiration if GA needed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

what are the recommendation about PPH prevention for women with high BMI?

A

Due to the higher risk of PPH, all women should be offered active third stage. However, for women with BMI above 40, the RCOG recommends having IV access sited early in labour, considering even if second cannula may be desirable, as IV access in these women tends to be very difficult enough.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

is CTG routine in labours of women with high BMI’s?

A

CTG should only be used if there are fetal concerns. Considering that IA may be difficult to achieve in women of very high BMI, they are more likely to be offered internal fetal monitoring during labour, but there is not really evidence to support this practice, which have other risks associated.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

why is mobility important during the intrapartum period for women with high BMI’s?

A

Mobility is essential for these women, especially considering the increased risk of pressure sores if lying on bed for prolonged period of times. However, as we discussed before, due to concerns of moving and handling, birthing pool is usually contraindicated for women with very high BMI.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

what antibiotics are recommended to give to high BMI women is c-section is needed?

A

Due to the higher risk of wound infection, if a csection is needed, prophylactic antibiotics at time of surgery are recommended.

72
Q

how does mode of birth and high BMI relate?

A

In terms of mode of birth, obesity itself is not a contraindication for spontaneous normal birth. Actually, considering the risks of surgery for these women, csection should be avoided when safe to do. Although some research has suggested that induction of labour at term in obese women may reduce the chance of csection, the evidence of these papers is very flawed and with several bias and methodological limitations.

73
Q

who should be informed about a women with a BMI >40 when admitted to hospital and why?

A

The senior anaesthetist should be informed on admission of any women with a BMI higher than 40. Epidural may be more difficult to achieve and longer epidural needles may need to be used.

74
Q

how and why do we provide additional breastfeeding support to women with high BMI?

A

Postnatally, women with obesity required additional breastfeeding support: sometimes it may be in terms of position and attachment, but others it may be related with low milk supply. They should also continue with their vit D supplements while feeding. Bf problems can also contribute to poor mental health, and as these women have a higher rate of mental health problems, careful monitoring and assessment needs to continue after birth.

75
Q

women with a BMI >40 need postnatally?

A

Women with BMI over 40 also need VTE prophylaxis prescribed, as a score of 2 is already considered at risk postnatally. Women with lower BMI need to be reassess: any other risk factor will put them at high risk.

76
Q

what is the safe working load of the labour ward beds?

A

(213 kg – foot section 181 kg)

77
Q

how much weight a birthing ball can hold?

A

around 130 kg, depending on size).

78
Q

how much weight does theatre beds take?

A

around 180kg

79
Q

1 in ? women have a high BMI?

A
  • 1 in 2 women have a high BMI
80
Q

1 in ? women eat their daily 5 or more a day?

A

less than 1 in 4

81
Q

what percentages of babies are bottle fed from birth?

A

30%

82
Q

what percentage of babies are bottle fed by week for?

A

50%

83
Q

1 in ? babies are breastfed at 6 months?

A

1 in 4

84
Q

what is the impact of male and female hormone production?

A
  • Female –risk of infertility increases if underweight - overweight increase in complications such as gestational diabetes
  • Males- can affect steroid hormone production
85
Q

what are the main groups of the eatwell guide?

A
  • Fruit and vegetables
  • Potatoes, bread, rice, pasta and other starchy carbohydrates
  • Beans, pulses, fish, eggs, meat and other proteins
  • Dairy and alternatives
  • Oil and spreads
86
Q

what kcal per day should a man and woman have?

A

2000kcal woman
2500kcal men

87
Q

how many drinks should you have per day and what counts?

A

Drink 6-8 cups/glasses of fluid a day

Water, lower fat, milk, sugar free drinks including tea and coffee all count.

Limit fruit juice and/or smoothies to a total of 150ml a day.

88
Q

what else do you consider about nutrition and diet?

A
  • Alcohol
  • Weight
  • Smoking
  • Other micronutrients
    Folic acid
89
Q

What does folic acid do?

A
  • Folic acid, together with vitamin B12, is necessary to form red blood cells. A deficiency can reduce the ability of red blood cells to carry oxygen, this is called ‘macrocytic’ (large cell) anaemia.
    Together, both vitamins also help nerves to function properly.
90
Q

Folic acid for pregnancy and lactation ?

A
  • The foetus rapidly develops spine and nerve cells in the first few weeks of pregnancy.
    Inadequate blood levels of folate at this crucial time increase the risk of the baby’s spine developing a ‘neural tube defect’, resulting in spinal malformation called spina bifida.
91
Q

what is the folic acid recommendation?

A
  • Anyone considering pregnancy, and up to 12 weeks of pregnancy is advised to:
  • Take a folic acid supplement, or pregnancy-specific vitamin supplement providing 400μg every day
  • Eat a diet rich in folates and folic acid from foods naturally containing the vitamin and from fortified foods
  • During the whole of pregnancy and lactation, it is advisable to eat a diet rich in folate as requirements for the vitamin are higher.
92
Q

Some people take a higher dose of folic acid. Why?

A

You will need more folic acid (five milligrams (mg) a day) if your risk of having a baby with NTD is higher than normal. If you are at an increased risk, your doctor will need to prescribe the higher dose. You may be advised to take an increased dose if: you have had a previous pregnancy affected by NTD, you or your partner have NTD, you are taking certain medications for epilepsy, you have coeliac disease or diabetes, your BMI is 30 or more, you have sickle-cell anaemia or thalassaemia. Speak to your doctor if you think you may need a higher dose.

93
Q

what foods are good sources of folic acid?

A
  • Spinach, kale, Brussels sprouts, cabbage, broccoli
  • Beans and legumes (e.g. peas, blackeye beans)
  • Yeast and beef extracts
  • Oranges and orange juice
  • Wheat bran and other whole grain foods
  • Poultry, pork, shellfish and liver
    Fortified foods (e.g. some brands of breakfast cereals – check the label)
94
Q

what things are a risk in pregnancy?

A
  • listeria
  • salmonella
  • contaminants e.g. mercury
  • vitamin A
  • caffeine
95
Q

how do you avoid and take care around salmonella?

A

Raw shellfish Raw and undercooked meats Unpasteurised milk Raw or undercooked eggs without the Lion Code

Always wash hands after handling raw meats, store raw foods separately from cooked foods to prevent cross-contamination. Processed ice-cream made with pasteurised milk and eggs (i.e. from the supermarket) should be safe. UK eggs with the Lion Code can be served raw or lightly cooked.

96
Q

how do you avoid and take care around listeria?

A

Soft ripened cheeses including Brie, Camembert and some goat’s cheeses Blue veined cheeses e.g. Danish Blue All unpasteurised dairy products All types of pâte Soft serve ice cream from vans or kiosks

Ensure takeaway and cooked-chill ready meals are heated thoroughly and piping hot. Due to a listeria outbreak linked to smoked fish you should only eat smoked fish products that have been thoroughly cooked. Make sure they are steaming hot all the way through.

97
Q

how do you avoid and take care around contaminants?

A

Shark Marlin Swordfish

Limit tuna to four medium cans per week or two steaks. Eat oily fish, e.g. salmon, mackerel, sardines, no more than twice per week.

98
Q

how do you avoid and take care around vitamin A?

A

Multivitamin supplements containing excess retinol form of vitamin A Fish liver oils containing more than 700mcg/day Liver and liver products e.g. pate, faggots

99
Q

how do you avoid and take care around caffeine?

A

Foods labelled high caffeine content

Have no more than 200mg caffeine daily. No more than two mugs of instant coffee (one mug of filter coffee) or three cups of tea a day. Or choose decaffeinated. Other foods containing caffeine include cola, high energy drinks and chocolate.

100
Q

Do I need to be eating for two?

A

No. The amount you need to eat will depend on your Body Mass Index (BMI) at the start of your pregnancy (use this BMI calculator to find out your BMI). If you are of healthy BMI, an average adult needs around 1900kcal per day prior to pregnancy, your energy needs will increase by 200 kcal only in the third trimester.

101
Q

How do I know that I am meeting my nutritional needs?

A

By concentrating on a healthy varied diet and staying active your body should naturally gain sufficient weight for your baby to be born at optimum birth weight. This is important for them to continue to grow and develop well.

102
Q

Should I take additional nutritional supplements?

A

Yes. There are two vitamin supplements needed during pregnancy: folic acid and vitamin D.

Those who follow a vegetarian/plant-based diet may need to take additional supplementation of iodine, omega-3 fatty acids and vitamin B 12

103
Q

what is vitamin D?

A

Vitamin D: Vitamin D helps to absorb calcium and is important for bone health; too little could cause rickets in your baby. Take a supplement of ten micrograms (mcg) of vitamin D every day throughout your pregnancy and when breastfeeding. Higher doses (25mcg) of vitamin D are likely needed for groups at increased risk (with increased skin pigmentation, reduced exposure to sunlight, or those who are socially excluded or living with obesity), but further evidence is needed to support this.

104
Q

what is iodine?

A

If you are planning pregnancy, are pregnant or lactating have a higher requirement of iodine which can effectively be met with food sources such as fish, milk and dairy products. If you are vegan or have a compromised nutritional intake, it is recommended to take a supplement of 150 mcg daily. Those with pre-existing thyroid conditions need to discuss iodine requirements with their GP or maternal dietitian.

105
Q

what is omega 3?

A
  • Adequate consumption of omega-3 fatty acids is vitally important during pregnancy as they are critical building blocks of fetal brain and retina.
  • Omega-3 fatty acids may also play a role in determining the length of gestation and in preventing perinatal depression.
  • The most biologically active omega-3 fatty acids are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)
  • 200 mg
    1- 2 servings oily fish per week or a supplement
106
Q

what is a multivitamin?

A

If you are taking a prenatal multivitamin, ensure that you only take the recommended dose as high levels of certain vitamins and minerals can be toxic to you and your baby. Do not take vitamin supplements that have vitamin A (retinol) in when you are pregnant as high levels can cause harm to your baby.

107
Q

do you take iron supplements just because you are pregnant?

A

Routine iron supplementation for all women in pregnancy is not recommended in the UK . An individual approach is preferable, based on results of blood count screening tests as well as identification of women at increased risk

108
Q

if you have a BMI of less than 18.5 at the start of pregnancy what the is guided weight gain during pregnancy?

A

12.5-18kg

0.5kg/week (1.0 lbs/week)

109
Q

if you have a BMI of 18.5 - 24.9 at the start of pregnancy what the is guided weight gain during pregnancy?

A

11.5-16kg

0.4kg/week (1.0lbs/week)

110
Q

if you have a BMI of 25 - 29.9 at the start of pregnancy what the is guided weight gain during pregnancy?

A

7-11.5kg

0.3kg/week (0.6kg/week)

111
Q

if you have a BMI of 30 and over at the start of pregnancy what the is guided weight gain during pregnancy?

A

5-9kg

0.2kg/week (0.5kg/week)

112
Q

what are the effects of pregnancy on the pelvis and pelvic floor?

A
  • Changes in hormones, ligamentous laxity (hypermobile joints that are very flexible and have a wider range of motion than most people.)
  • Changes in muscle power, abdominal being stretched
  • More pressure of pelvic floor and centre gravity change due to weight gain.
  • Can change the movement round the pelvis resulting pelvic girdle pain.
    Higher risk of pelvic girdle pain if had previous lower back pain.
113
Q

what can physiotherapy do for pelvic girdle pain?

A
  • Advice - activity modification (one legged activities are the issue)
  • Manual therapy
  • Advise/supply supports - tubigrip
    Individualised exercise programmes
114
Q

what can physiotherapy do for pelvic floor dysfunction?

A
  • Assess - assessing contraction of pelvic muscle when the woman coughs.
  • Exercises
  • Advice
115
Q

what does the exercise during pregnancy involve?

A
  • General Exercise - 150 mins moderate intensity exercise per week.
    Pelvic Floor Exercise - Strengthening Relaxation
116
Q

what can you do to look after you perineum?

A
  • Perineal massage
    Epino and aniball - inflate in within the vagina to stretch it and then practice expelling the ballon from 37 weeks of pregnancy.
117
Q

when to start pelvic floor exercise?

A

vaginal delivery as soon as they feel comfortable to, C-section or catheterised as soon as catheter is out.

118
Q

how does exercise work in the first 6 weeks?

A

Exercise in the first six weeks - gentle exercise, any heaviness or discomfort, stop.

119
Q

when do you ask for help with you pelvic floor?

A
  • Heaviness
  • Discomfort
  • Leaking (urine, gas, poo)
  • Painful sex
  • ?? 6 week check
    GP/Physio
120
Q

how does c-section recovery work?

A
  • Progressive gentle exercise
  • Abdominal exercise
  • Pelvic floor exercise
  • Scar massage
  • When to ask for help…
121
Q

what is sexual health?

A

About well-being and not merely the absence of disease

involves respect, safety and freedom from discrimination and violence

depends on the fulfilment of certain human rights.

relevant throughout the individual’s lifespan, not only to those in the reproductive years, but also to both the young and the elderly.

expressed through diverse sexualities and forms of sexual expression.

critically influenced by gender norms, roles, expectations and power dynamics.

122
Q

what is scotland public health areas of work?

A
  • Teenage pregnancy
  • Termination of pregnancy
  • High risk groups
  • Sexually transmitted infections
  • Long acting reversible contraception
    Sexual wellbeing
123
Q

on average people report to having sex how many times a month?

A

3

124
Q

1 in ? men and women in a relationship do not share the same level of interest in sex as their partner?

A

1 in 4

125
Q

1 in ? women experience sexual difficulties, 1 in ? is distressed or worried about sex life?

A
  • 1 in 2 women experience sexual difficulties, 1 in 10 is distressed or worried about sex life
126
Q

what are the most common STI?

A

HPV was the most common STI, followed by chlamydia, HIV and gonorrhoea

127
Q

what percentage of pregnancies were planned?

A

Only 50% of pregnancies (either given birth, miscarried or had and abortion) were planned. Most unplanned pregnancies were in women aged 20- 34.

128
Q

what does sexuality in the antenatal period involve?

A

Progressive decrease in frequency of intercourse
Preference for positions with more control over the degree of vaginal penetration
Lessening of clitoral sensitivity, responsiveness, ability to orgasm

129
Q

what does sexuality in the postnatal period involve?

A

Reduced frequency of any sexual behaviour compared to pre-pregnancy Resumption of sexual intercourse between 5 to 8 weeks postpartum
More dyspareunia, less desire and arousal, shorter and “softer” orgasms

130
Q

what is the human microbiome?

A
  • Bacteria, fungi, viruses, protists and archaea that live on and in us.
  • The community of these microbes is referred to as the Human Microbiome-100 trillion microbes call our body home
  • We are 90% microbial, 10% mammalian
131
Q

where do microbes live?

A
  • 1000 species in our gut
  • 400 species in the vagina
  • 700 species on our skin
  • A person’s microbiome is unique
132
Q

What do microbes do?

A

Microbes are critical for human health - they play an essential role in health and wellbeing.

  • They aid DIGESTION
  • They help METABOLISM
  • The interact with the NERVOUS SYSTEM and produce neuro chemicals
  • They interact with our HORMONES
  • They have ANTI INFECTIVE properties
    THEY ARE INTEGRAL TO OUR IMMUNE SYSTEM
133
Q

How do microbes impact on the brain?

A

Microbes can affect the neurotransmitters sending signals to the brain, and produce chemical and hormones can impact on depression, behaviour and inflammatory diseases such as Alzheimer’s disease

134
Q

how does the heritage of the microbiome work?

A

The microbiome is passed from mother to baby and therefore we inherit the microbes from our mothers, grandmothers, great grandmothers and so on….

135
Q

what are the main colonising events with microbes?

A
  • During birth as the baby descends through the vagina
  • Whilst in skin to skin
    During breastfeeding, as the microbes are transferred through breastmilk
136
Q

What influences the health of our microbiome at the beginning of life?

A
  1. The mode of birth- Mode of birth can have long term consequences on the health of the microbiome. Babies born by C-Section have a different microbiome from babies born vaginally- much less diversity of microbes
    1. Babies born to mothers who had antibiotics during labour also have changes in their gut microbiome.
    2. Skin to skin contact- babies placed in skin to skin straight after birth and frequently during the new-born period
      Breastfeeding- breastmilk has high levels of healthy bacteria and HMOs (go into baby’s gut and feed the microbes that are in the baby’s gut enabling the microbes to flourish and grow.
137
Q

What are the lifelong impacts of an impaired microbiome?

Increase in. Risk of…. ?

A
  • Childhood allergies
  • Asthma
  • Obesity
  • Type 2 diabetes
  • Bowel disease such as IBS and Chrons disease
  • Liver diseases
  • Several types of cancer
  • Mental health illness
138
Q

How do we promote a healthy microbiome through life?

A
  • Increase fibre intake- aim for 40g a day
  • Eat many different types of fruit and veg- seasonally
  • Eat and cook veg with high levels of prebiotics such as onion, garlic, leeks, artichokes
  • Eat food high in polyphenols such as nuts, seeds, berries, olive oil, brassica and green tea- antioxidants fuel for microbes
    Avoid snacking- having intervals between meals gives microbes a rest
139
Q

How do we promote a healthy microbiome through life?

A
  • Fermented foods can act as probiotics adding healthy microbes into the body- sources such as keffir, kimchi, sauerrkraut are recommended for a healthy microbiome
  • Avoid high sugar, artificial sweeteners and processed food as these reduce gut diversity
  • Living with pets (especially dogs) increases microbial diversity and a health microbiome
  • Avoid antibiotics whenever possible and also medicines whenever possible- antibiotics kill off good bacteria as well as harmful ones. Even common medicines like paracetamol can have an effect
  • Daily use of disinfectants such as surface cleaners has a detrimental effect on the diversity of microbes
    Unhealthy lifestyle such as smoking, substance use, lifestyle also impacts
140
Q

What does the microbiome mean for us as midwives?

A
  • Ensure that we are aware of how the heath of pregnant women and their infants is influenced by the health of the microbiome- keep up to date with research
  • Ensure that women are aware of how to optimise their microbiome and that of their baby- have informed conversations about the microbiome when talking about birth choice, skin to skin, breastfeeding
    Support healthy nutrition, exercise, support with substance cessation programmes through pregnancy and into the postnatal period
141
Q

How are genes modulated through epigenetics?

A
  1. DNA methylation-acts on Cytosine one of the nucleobases that form DNA and RNAswitching on and off genes
    1. Histone modification
      Micro RNA
142
Q

Environment changes how the genes are expressed?

A
  • Mode of birth
  • The levels of stress we are exposed to
  • The pollutants and toxins around us
  • The nutrition that we consume out down epigenetic tags that can influence our health and the health of our offspring. For up to 5 generations! Relevance nutrition in pregnancy and nutrition in infancy. Breastmilk is highly correlated with positive epigenetic changes
  • Early years of life have the most epigenetic influence
143
Q

What are the health benefits of breastfeeding?

A
  • Gastroenteritis (infection)
  • Respiratory infections
  • Allergies
  • Obesity
  • Type 1 and 2 diabetes
  • Ear infections
  • Urinary tract infection
  • NEC ( necrotizing enterocolitis) (infection of the lining of the gut)
  • Dental caries
  • SIDS
    Impaired cognitive and emotional function
144
Q
  • What are the constituents in breastmilk that
A
  • Vitamins and minerals
  • Fats
  • Carbohydrates
  • Protein
  • Water
  • Growth factors
  • Lymphocytes
  • Stem cells
  • Immunoglobulins
  • Leukocytes
  • Lactoferrin
  • Oligosaccharides
  • Milk lipids
  • Enzymes
  • IL-7
    Cytokines
145
Q

What does the research say on breastmilk and reduction in obesity?

A
  • Longer term breastfeeding is associated with a 26% reduction in the risk of overweight or obesity.
  • This is data collected from 113 trials from across the world.- this type of research is called a Meta Analysis and is based on the highest quality of evidence
  • The longer the baby breastfeeds for the greater the reduction in risk of obesity
  • Direct feeding at the breast is associated with maximum benefit, though feeding breastmilk via bottle still offers some protection
146
Q

How does breastfeeding reduce risk of obesity?

A
  • When a baby breastfeeds- microbes such as Bifidobacterium passed through breastmilk help to optimise metabolism, influencing adiposity and potentially regulating satiation
  • Human Milk Oligosaccharides (HMOs) are abundant in breastmilk. These complex sugars are metabolised by the microbiota, supporting bacterial proliferation and function, thus further enhancing the health of the microbiome
  • Epigenetic changes as a result of breastfeeding changes the gene expression affecting the hormone Leptin that controls our feeling of satiation (being full)
  • Breastmilk also contains hormones and fatty acids that are thought to impact on metabolism and susceptibility to weight gain through life.
147
Q

Why is formula milk associated with higher levels of overweight and obesity?

A
  • Parent led feeding rather than responsive feeding- unable to self - regulate and receiving higher volumes and excessive calories
  • Higher protein and sugar content
  • Lacks the biodynamic properties
    Lack of regulation in the marketing of formula means that parents are exposed to aggressive marketing of follow on milks and high sugar baby foods,
148
Q

How can midwives support optimal microbiome and epigenetics?

A
  • Support maternal and infant mental health and bonding and attachment through pregnancy, birth and into the postnatal period- we will talk more about this in upcoming session
  • Support an empowering birth experience reducing the risk of birth trauma
  • Ensure that women know about the importance of mode of birth and breastfeeding from a microbiome and epigenetic point of view
  • Support healthy nutrition, exercise, support with substance cessation programmes through pregnancy and into the postnatal period
    Support women who want to, to breastfeed
149
Q

ramadan,

do pregnant women have to fast?

A

Islamic law gives permission for pregnant and breastfeeding women to opt out of fasting if she fears that it will harm her health or the health of her baby.

Missed days of fasting can be made up later, or if this is not possible, a ‘fidyah’ can be paid by providing food for someone in poverty for every missed day of fasting.

Fasting should be discussed with your midwife or GP so that you can have a health check, find any potential complications you may be at risk of when fasting and get their advice on whether fasting is likely to harm you or your baby’s health.

150
Q

Is fasting during pregnancy safe?

A

There is some evidence to suggest that pregnant women who fast during Ramadan may have smaller placentas and/or babies with slightly lower birth weights, compared to women who do not fast. Fasting may also increase the risk of becoming dehydrated, especially if Ramadan falls during the summer, and this may affect the way your kidneys function and the amount of fluid surrounding your baby. However, other studies have not found any differences between babies who are born to mothers who have fasted and those who have not fasted during Ramadan. The impact of fasting during pregnancy may depend on the overall health of the mother, the stage of pregnancy and the time of year Ramadan occurs.

151
Q

If I decide to fast, is there anything I can do to make it more manageable for me and my baby?

A

If you are fasting, dehydration is something to watch out for, especially if Ramadan falls during long hot summer days. Feeling thirsty or having dark-coloured urine can be early signs of dehydration. Other symptoms may include dizziness, headaches, tiredness, dry mouth and passing small amounts of urine infrequently (less than three or four times a day). If you feel dizzy, faint, weak, confused or tired during fasting, even after resting, then you should break your fast with a sweet drink, to replace lost sugar and fluids, and a salty snack, to replace lost salt, or an oral rehydration solution, and contact your doctor

Make sure you are still taking your supplements (such as folic acid and vitamin D)

152
Q

which nutrients need careful consideration in a vegetarian and vegan diet?

A
  • Protein
  • Omega-3 fats
  • Iron
  • Calcium
  • Vitamin B12
  • Riboflavin (vitamin B2)
  • Selenium
    Iodine
153
Q

what is protein?

A

Protein is made up of amino acids, which are the building blocks of your body’s cells – and of your baby’s. Essential amino acids are those that the body cannot make itself and so are needed from the diet.

154
Q

what are the other vegetarian sources of protein?

A

soya is a particularly good source of protein for vegetarians and vegans

  • eggs
  • dairy products, such as milk, yogurt and cheese
  • some dairy alternatives, such as soya-based drinks and yogurts (choose versions fortified with calcium and other nutrients)
  • beans and other pulses, such as chickpeas, kidney beans, soya beans and lentils
  • some nuts and nut butters, such as peanuts, almonds and cashews (where possible, choose the no added salt or sugar varieties)
  • tofu
  • mycoprotein-based products
  • Some grains (such as quinoa) can also contribute to your protein intake.
155
Q

what is an omega-3 supplement that is vegan friendly?

A

Algae-based omega-3 supplements are available that provide a vegan-friendly source but check that any supplements you are taking do not contain vitamin A and are suitable for pregnancy. There are also a limited range of foods and drinks fortified with long-chain DHA.

156
Q

what is omega-3 fats?

A

Long-chain omega-3 fats, in particular DHA (docosahexaenoic acid), are important for the normal development of your baby’s brain and eyes. Oily fish, such as salmon, mackerel and trout are rich sources of DHA. If you do not eat fish, you can get short-chain omega-3 fats, such as α-linolenic acid (ALA), from other foods (see list below). The omega-3 fats these foods contain are not the long-chain versions found in oily fish. The body can convert a small proportion of these short-chain fats into long-chain omega-3s, but this process is not thought to be very efficient.

157
Q

what foods contain short-chain omega-3 fats (ALA)?

A
  • some seeds (such as flax and chia seeds)
  • walnuts and walnut oil
  • vegetable oils (such as flaxseed, rapeseed and soyabean oil)
    soya beans
158
Q

why is iron important in pregnancy?

A

Iron is important for the normal growth and development of your baby. A lack of iron can make you feel tired too. Anaemia due to iron deficiency can often occur during pregnancy, and your doctor or midwife can diagnose this through a simple blood test.

159
Q

what foods can you get iron from?

A
  • pulses (such as beans, peas and lentils)
  • green leafy vegetables (such as watercress)
  • wholemeal, seeded and wheatgerm bread
  • quinoa
  • iron-fortified breakfast cereals (check the label)
  • dried apricots and figs
  • sesame and pumpkin seeds
160
Q

why is calcium important in pregnancy?

A

Calcium is important for the growth of your baby’s bones, as well as helping to maintain your own bone health. Calcium is also important when breastfeeding, and requirements for calcium increase during this time. Dairy foods, such as milk and yogurt, are a good source of calcium. Try to select lower fat and lower sugar versions where possible, as these are likely to contain at least the same amount of calcium but without the extra calories. Cheese is also a great source of calcium, but many can be high in fat and salt, so eat in moderation and choose reduced-fat

161
Q

what vegan friendly foods can you try to get calcium?

A
  • bread (breads made using flour which does not contain the wholegrain, such as white and some brown breads in the UK, have to be fortified with calcium by law)
  • some green leafy vegetables, such as kale, rocket and watercress
  • calcium-fortified breakfast cereals
  • calcium-fortified dairy alternatives (such as soya, oat, rice or almond-based dairy alternative drinks and yogurts)
    calcium-set tofu
162
Q

why is vitamin B12 important in pregnancy?

A

Vitamin B12 is important for the normal growth and development of your baby and helps the body to release the energy from the food you eat. Typically, vitamin B12 is only found naturally in foods from animal sources (meat, dairy products and eggs). So vegetarians who consume dairy products and eggs can get enough vitamin B12 from their diet; however vegans may not get enough of this vitamin, due to the lack of reliable sources. Studies have shown low intake and blood concentrations of vitamin B12 in vegans and vegetarians.

163
Q

B12 for vegan and vegetarian?

A

If you are vegetarian and eat eggs and dairy foods regularly, you should be getting enough vitamin B12. However, the only reliable source of B12 for a vegan are fortified foods. Products other than eggs and dairy foods which contain vitamin B12 include:

  • vitamin B12-fortified yeast extract (savoury spread)
  • vitamin B12-fortified dairy-free alternatives (such as soya, oat and almond dairy-free alternative drinks or vegan spreads)
  • vitamin B12-fortified breakfast cereals
164
Q

what is riboflavin?

A

Like vitamin B12, riboflavin (also known as vitamin B2) is important for the normal growth and development of your baby and helps the body release energy from the food you eat. Riboflavin is also found in animal products (meat, dairy products and eggs), but unlike vitamin B12 it is also found in some plant-based foods. If you are vegetarian and eat eggs and dairy foods regularly (milk is a good source of riboflavin), you should be getting enough.

165
Q

what food contain B2 for vegans?

A

If you are vegan, products other than eggs and dairy foods which contain riboflavin include:

  • mushrooms
  • some nuts and seeds (such as almonds)
  • yeast extract (savoury spread) (especially fortified varieties)
  • riboflavin-fortified dairy alternatives (such as soya, oat and almond-based drinks)
  • riboflavin-fortified breakfast cereals
166
Q

what is selenium?

A

Selenium is needed for the normal function of the immune system, and to help protect your body’s cells from damage due to oxidative stress

167
Q

what are good sources of selenium?

A

Meat and fish are good sources of selenium, and eggs are also a good source.

168
Q

what are the vegan and vegetarian food selenium?

A

Although the actual levels of selenium vary depending on the soil in which plant foods are grown, these include:

  • some nuts and seeds, especially Brazil nuts, but also cashew nuts and sunflower seeds
  • some breakfast cereals, such as puffed wheat cereal, shredded wheat and cornflakes
  • some breads, such as seeded and wheatgerm bread
169
Q

why is iodine important in pregnancy?

A

Iodine is particularly important for your baby’s brain development and your requirements increase during pregnancy

170
Q

what dietary group is a risk of iodine deficiency?

A

Vegetarians, and particularly vegans, are at risk of iodine deficiency as they do not eat foods that are a source of iodine (such as fish and dairy products).

171
Q

what foods are sources of iodine?

A

sources of iodine include fish, eggs, milk and milk products,

172
Q

what vegan iodine sources include?

A
  • Although seaweed is a concentrated source of iodine, it can provide excessive amounts, particularly brown seaweed (like kelp), and therefore eating it more than once a week is not recommended, especially during pregnancy or breastfeeding.
    Iodine supplements are available.
173
Q

what supplements should you take during pregnancy?

A

folic acid and vitamin d

174
Q

what dose of folic acid should you take in pregnancy and when and why?

A
  • Folic acid: It is recommended that you take a daily folic acid supplement containing 400µg (micrograms) from before you become pregnant until up to 12 weeks of pregnancy. If you did not start taking folic acid before you conceived, you should start as soon as you find out that you are pregnant.
175
Q

what dose of vitamin D should you take in pregnancy and when and why?

A

Vitamin D: Pregnant and breastfeeding women should take a daily supplement containing 10μg (micrograms) of vitamin D during the autumn and winter months to help protect their bone and muscle health, as this advice applies to all adults in the UK

176
Q

what should you look out for with multivitamins?

A

If you decide to take a multivitamin and mineral supplement, select one which is specifically for pregnancy or which does not contain vitamin A, as high levels of vitamin A during pregnancy can harm your baby.

177
Q

what do the healthy start vitamins contain?

A

Healthy Start vitamins for pregnant women (containing folic acid and vitamins C and D) are also available.

NU2101 (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions