Maternal Nutrition and Breastfeeding

Question 1

Pregnancy Weight

Answer 1

Being underweight or overweight increases risks to the child

Question 2

Weight gain

Answer 2

depends on current weight and height. Underweight mothers should gain more weight. Overweight mothers should gain less weight.

Question 3

Overweight mothers

Answer 3

still need to gain weight. Dieting is inappropriate. Nutrients from mother’s stores are not sufficient. Lack of weight gain may cause birth defects.

Question 4

General guidelines

Answer 4

t should gain 20-35 lbs. ~1 lb/month in the first trimester. 1 lb/week after first trimester.

Question 5

Food cravings

Answer 5

cravings/aversions to certain foods can occur. Does not appear to be related to nutrient needs.

Question 6

Selected vitamins and minerals of interest

Answer 6

Vitamin D and calcium, Iron, Folate/folic acid and vitamen B12, Water, Nutrient supplements/Vitamin A

Question 7

Vitamin D and calcuim

Answer 7

Builds fetal bones and teeth. Calcium is the main component in bone. Vitamin D aids calcium absorption/deposition

Question 8

Insufficient calcium intake

Answer 8

required fetal calcium will be removed from mother’s bones. Calcium is stored in adult bones. Can result in brittle bones of the mother later in life.

Question 9

Vitamin D and calcium from food

Answer 9

Vitamin D fortified milk contains calcium and vitamin D. Skim/fat free milk is the best.

Question 10

Vitamin D from the sun

Answer 10

Skin uses sun energy to create vitamin D. Sunscreen blocks rays to make vitamin D. A few minutes is sufficient for light skin. Darker skin requires more sun. Generally isn’t as effective in the winter.

Question 11

Iron use in red blood cells (RBCs)

Answer 11

Required for RBSs to carry oxygen. Lost during menstruation when not pregnant. Lost during bleeding at birth.

Question 12

Iron need from blood

Answer 12

Blood volume greatly increases in pregnancy. Creates a higher need for iron. Body absorbs more iron to compensate

Question 13

Insufficient iron intake

Answer 13

Iron stores in mother will be transferred to fetus. Iron stores in women are typically low. Can cause pica, and iron deficiency anemia

Question 14

Pica

Answer 14

Craving for food substances. The substances don’t contain iron and can’t help.

Question 15

Anemia

Answer 15

lowered ability of blood to carry oxygen.

Question 16

Iron deficiency anemia

Answer 16

increases risk of low-birthweight and preterm infants. Can cause weakness and shortness of breath in mother.

Question 17

Iron from food

Answer 17

Meat with orange juice. Meat contains iron, and substances that enhance iron absorption. OJ contains vitamin C which aids iron absorption.

Question 18

Foods to avoid when trying to obtain iron

Answer 18

Tea, coffee, milk, legumes. Contain molecules that prevent iron absorption. Can consume during low-iron meals.

Question 19

Folate and vitamin B12

Answer 19

Folate needed for cell division. Aids growth/development of fetus. Needed to increase blood cells of mother. Prevents neural tube defects. Vitamin B12 keeps folate active.

Question 20

Neural tube

Answer 20

hollow tube in early embryo that forms brain and spinal cord. Does not close if folate is low.

Question 21

Anencephaly

Answer 21

absence of most of brain and skull due to neural tube defect. nearly always fatal.

Question 22

Spina bifida

Answer 22

incomplete closure of spinal chord and surrounding bone. causes paralysis.

Question 23

Insufficient folate and vitamin B12

Answer 23

Increases risks of neural tube defects, causes anemia in the mother.

Question 24

Folate from food

Answer 24

Enriched grains. Cereal, pasta, rice. Folic acid supplements are recommended.

Question 25

Vitamin B12 from food

Answer 25

meat, eggs, or dairy products. A vegan should take a vitamin B12 supplement or eat fortified grains.

Question 26

Water

Answer 26

Need increase during pregnancy. Provides material for increasing body fluids. Aids elimination of wastes. Wastes are removed in urine. Growing fetus produces extra wastes. Aids digestion by preventing constipation. It is difficult to drink too much. Pale, yellow urine indicates sufficient intake.

Question 27

Nutrient supplements.

Answer 27

A prenatal vitamin is generally recommended. Should be high in folate, iron, possibly calcium. Should have no more than 100% of any nutrient (especially vitamin A). Don't combine prenatal vitamins. Single vitamin/mineral megadoses should be avoided. Could promote birth defects or cause a pregnancy loss.

Question 28

Excess vitamin A

Answer 28

Causes facial malformations, heart and nervous system defects. Acne medications with vitamin A should be avoided.

Question 29

Breast development in puberty

Answer 29

Estrogen stimulates milk duct growth, increases fatty tissue size

Question 30

Breast development in pregnancy

Answer 30

Estrogen effects continue. Progesterone promotes formation of milk producing tissue.

Question 31

Breastfeeding

Answer 31

promotes prolactin and oxytocin production

Question 32

prolactin

Answer 32

promotes milk production. Prevents return or menstruation, generally for at least 6 months if child is exclusively breast fed. Could prevent it for 1 year or longer.

Question 33

Oxytocin

Answer 33

promotes let down reflex. Brings milk to the front of nipple. Ejects milk.

Question 34

Breastfeeding during first 6 months

Answer 34

Exclusively breast feed. Breast milk provides almost all needed nutrients.

Question 35

Breastfeeding after 6 months

Answer 35

Continue breast feeding. Can incorporate solid foods.

Question 36

Milk supply from breastfeeding

Answer 36

Increases with more nursing. More demand = more supply. First few weeks on demand. Infant nurses every couple hours. Small stomach prevents large meals. Time between feedings gradually increases.

Question 37

Nutrition during Lactation

Answer 37

Modest weight loss (1 lb/wk) is acceptable. Does not affect quality/quantity of breast milk. Significant weight loss can prevent lactation. Don't need to avoid flavorful foods. Child may even enjoy flavorful milk. Eliminate food if it causes a problem. Foods eaten during breastfeeding may be more accepted by child later.