Maternal Nutrition and Breastfeeding Flashcards
Pregnancy Weight
Being underweight or overweight increases risks to the child
Weight gain
depends on current weight and height. Underweight mothers should gain more weight. Overweight mothers should gain less weight.
Overweight mothers
still need to gain weight. Dieting is inappropriate. Nutrients from mother’s stores are not sufficient. Lack of weight gain may cause birth defects.
General guidelines
t should gain 20-35 lbs. ~1 lb/month in the first trimester. 1 lb/week after first trimester.
Food cravings
cravings/aversions to certain foods can occur. Does not appear to be related to nutrient needs.
Selected vitamins and minerals of interest
Vitamin D and calcium, Iron, Folate/folic acid and vitamen B12, Water, Nutrient supplements/Vitamin A
Vitamin D and calcuim
Builds fetal bones and teeth. Calcium is the main component in bone. Vitamin D aids calcium absorption/deposition
Insufficient calcium intake
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.
Vitamin D and calcium from food
Vitamin D fortified milk contains calcium and vitamin D. Skim/fat free milk is the best.
Vitamin D from the sun
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.
Iron use in red blood cells (RBCs)
Required for RBSs to carry oxygen. Lost during menstruation when not pregnant. Lost during bleeding at birth.
Iron need from blood
Blood volume greatly increases in pregnancy. Creates a higher need for iron. Body absorbs more iron to compensate
Insufficient iron intake
Iron stores in mother will be transferred to fetus. Iron stores in women are typically low. Can cause pica, and iron deficiency anemia
Pica
Craving for food substances. The substances don’t contain iron and can’t help.
Anemia
lowered ability of blood to carry oxygen.
Iron deficiency anemia
increases risk of low-birthweight and preterm infants. Can cause weakness and shortness of breath in mother.
Iron from food
Meat with orange juice. Meat contains iron, and substances that enhance iron absorption. OJ contains vitamin C which aids iron absorption.
Foods to avoid when trying to obtain iron
Tea, coffee, milk, legumes. Contain molecules that prevent iron absorption. Can consume during low-iron meals.
Folate and vitamin B12
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.
Neural tube
hollow tube in early embryo that forms brain and spinal cord. Does not close if folate is low.
Anencephaly
absence of most of brain and skull due to neural tube defect. nearly always fatal.
Spina bifida
incomplete closure of spinal chord and surrounding bone. causes paralysis.
Insufficient folate and vitamin B12
Increases risks of neural tube defects, causes anemia in the mother.
Folate from food
Enriched grains. Cereal, pasta, rice. Folic acid supplements are recommended.
Vitamin B12 from food
meat, eggs, or dairy products. A vegan should take a vitamin B12 supplement or eat fortified grains.
Water
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.
Nutrient supplements.
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.
Excess vitamin A
Causes facial malformations, heart and nervous system defects. Acne medications with vitamin A should be avoided.
Breast development in puberty
Estrogen stimulates milk duct growth, increases fatty tissue size
Breast development in pregnancy
Estrogen effects continue. Progesterone promotes formation of milk producing tissue.
Breastfeeding
promotes prolactin and oxytocin production
prolactin
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.
Oxytocin
promotes let down reflex. Brings milk to the front of nipple. Ejects milk.
Breastfeeding during first 6 months
Exclusively breast feed. Breast milk provides almost all needed nutrients.
Breastfeeding after 6 months
Continue breast feeding. Can incorporate solid foods.
Milk supply from breastfeeding
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.
Nutrition during Lactation
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.
