Module 14: Nutrition for Pregnancy, Breastfeeding, and Infant Feeding Flashcards
how long does a full-term pregnancy last
38-42 weeks
why is there a 4 week variation for full-term pregnancy estimations
- beginning of pregnancy marked from date of last menstrual cycle, not the actual conception date
- conception date is difficult to determine
- variation due to uncertainty in exact conception date
define trimester
- 13 week stages in pregnancy
- 3 of them
- mark different phases of fetal development
when is the pre-embryonic period of pergnancy
1-2 weeks
when does the central nervous system develop during pregnancy
3-38 weeks
when does the heart develop during pregnancy
3/4-9 weeks
do major birth defects tend to occur earlier or later in pregnancy
earlier
describe the composition of maternal weight gain during pregnancy
- baby - 7.5 lb
- amniotic fluid - 2 lb
- placenta - 1.5 lb
- uterus - 2 lb
- breasts - 2 lb
- body fluids - 4 lb
- blood - 4 lb
- maternal stores of fat, protein, and other nutrients - 7 lb
is a baby every a parasite to the mother
- no
- mother always gets nutrients first, then baby
what weight is considered low birth-weight
<5.5 lb
what are low birth-weight babies at risk for
- infection
- lung problems
- learning disabilities
- increased mortality
what is the recommended weight gain during pregnancy for a women who is of underweight BMI (<18.5)
28-40 lbs
what is the recommended weight gain during pregnancy for a women who is of normal weight BMI (18.5-24.9)
25-35 lbs
what is the recommended weight gain during pregnancy for a women who is of overweight BMI (25-29.9)
15-25 lbs
what is the recommended weight gain during pregnancy for a women who is of obese BMI (>30)
11-20 lbs
how should increased nutritional needs during pregnancy be met
eating nutrient-dense foods
when do calorie needs increase
after first trimester
are calorie needs increased during the first trimester of pregnancy
no
how many more calories are needed per day after the first trimester of pregnancy
200-300 more calories per day from pre-pregnant calorie requirements
protein requirements during pregnancy
additional 25g per day
why should pregnancy women avoid predatory fish
high in mercury
what is the primary source of energy for pregnant females
carbohydrates
how much carbohydrates should a pregnant woman consume
> 175g per day
what does eating fiber during pregnancy help prevent
- constipation
- hemorrhoids
does recommended total fat intake change during preganancy
no
what fat requirements do change during pregnancy
- increased essential fatty acids
- omega 6 (linoleic) and omega 3 (linolenic)
- polyunsaturated fats in nuts, oils, and whole grains
what type of adipose tissue do babies have increased amounts of
brown adipose tissue
what is the different between white and brown adipose tissue
- white: stores triglycerides, what we think of when we think of body fat
- brown: more mitochondrion, located around organs and along blood pathways to provide warmth
what protein is found in brown adipose tissue
uncoupling protein 1
describe how uncoupling protein 1 found in brown adipose tissue works
- uncouples electron transport chain
- opening along the mitochondrial membrane allowing H+ to flow without producing ATP
- increases metabolism of fatty acids to produce heat
what does inadequate folate/folic acid intake cause during pregnancy
- neural tube defects: spina bifida, anencephaly
- preterm delivery, low birth weight
- slow fetal growth rate
what is increased iron needed for during pregnancy
building red blood cells in the fetus to carry oxygen to cells
what is maternal iron deficiency anemia associated with increased risk of
- premature delivery
- low birth weight
- low iron stores in infant
what is calcium needed for during pregnancy
- development of bones and teeth in the fetus
- maintain strength in the bones of the mother
how much do calcium needs increase during the 3rd trimester; does this mean the RDA for calcium increases
- 30 mg per day more
- RDA does not increase
how does the amount of calcium needed during pregnancy increase but the RDA for calcium doesn’t
- calcium from the body not from the diet
- absorption doubles in intestine
- kidneys increase resorption
- calcium turnover in bone increases
what regulates the amount of calcium absorbed in the body
- vitamin D
- parathyroid hormone
how much do zinc requirements increase during pregnancy
30%
what is zinc needed for during pregnancy
DNA and RNA syntheses
what can inadequate zinc intake during pregnancy lead to
- birth defects
- poor cognitive development after birth
- premature delivery
- prolonged labor
what nutrients should be supplemented through prenatal vitamins
- iron
- folic acid
- calcium
when should folic acid supplementation begin
- 1 month before conception
- before you start trying for a baby
why do fluid needs increase during pregnancy
- support fetal circulation
- amniotic fluid
- increased blood volume
- prevents constipation and hemmrhoids
what is the recommended intake of water for pregnant women
- 1-1.5 mL of water per calorie consumed
- because pregnant women are advised to increase caloric intake by 300 calories, their water intake should increase by about 300mL
what drives most food cravings during pregnancy
hormones
define pica
compulsive eating of nonfood substances (clay, chalk, dirt)
what can pica lead to in pregnant people
- iron deficiency in the mother
- smaller head circumference in the infant
- inadequate weight gain
- intestinal blockages/other GI issues
why does pregnancy cause GI issues
- hormones relax muscles - intended to make labor easier
- can result in relaxation of sphincters causing heartburn
- may also cause constipation and hemorrhoids
describe how heartburn occurs in pregnant people
hormonal changes relax esophageal sphincter
what are recommendations to prevent heartburn
- eat smaller meals
- avoid foods that may cause heartburn
- elevate head while sleeping
- sleep on left side of body
why does eating smaller meals decrease the risk of heartburn
- HCl in the stomach is produced in response to the amount of food eaten
- less food eaten = less acid
what are complications that can occur during pregnancy
- edema
- pregnancy-induced hypertension - pre-eclampsia
- gestational diabetes
define edema
fluid retention that results in swelling of hands, feet, and ankles
what blood pressure is classified as pregnancy-induced hypertension
readings above 140 mmHg (systolic) and 90 mmHg (diastolic)
what can pregnancy-induced hypertension lead to
pre-eclampsia
define pre-eclampsia
- high blood pressure and edema
- protein in the urine
- low calcium status
what can pre-eclampsia lead to
eclampsia
define eclampsia
- manifestation of pre-eclampsia if nothing is done to intervene
- characterized by convulsions or seizures
what causes gestational diabetes
- human placental lactogen hormone
- can encourage insulin resistance
how can gestational diabetes be controlled
- diet
- lifestyle
what are the complications of gestational diabetes for the infant
- macrosomia: high birth weight (over 9 lbs)
- low blood glucose following delivery
what are the complications of gestational diabetes for the mother
increased risk for type 2 diabetes
how does caffeine affect the fetus
- enters through placenta or breast milk
- affects fetal heart rate and breathing
- can increase risk of miscarriage or low birth weight
what are the recommendations for caffeine for pregnant people
- avoid or limit to <300 mg per day
- less than 2 cups of coffee per day
what is the recommended alcohol intake during pregnancy
none
define fetal alcohol syndrome (FAS)
- caused by maternal alcohol consumption
- causes growth retardation, facial abnormalities, and central nervous system dysfunction
what can smoking during pregnancy cause
- miscarriage
- preterm delivery
- small birth weight
- impairs blood flow to the fetus causing decreased nutrients and O2 delivery
why are pregnant people at increased risk of food-borne illness
- weakened maternal immune system
- immature fetal immune system
what two foodborne illnesses are of greatest concern to pregnant people
- listeria
- toxoplasmosis
where is listeria found
- uncooked meats and vegetables
- unpasteurized milk
- ready-to-eat foods (hot dogs, deli meats)
where is toxoplasmosis found
- undercooked meat
- cat litter
what are 5 other pathogens pregnant people should watch out for
- e coli
- c perfringens
- norovirus
- c jejuni
- s aureas
what is the preferred method of feeding for newborns and infants
breastfeeding
when should babies be exclusively breastfed
first 6 months
how long should babies be breasted (both exclusive and complementary)
12 months
should you extend the 12 month breastfeeding period for preterm infants
- yes
- extend by the months early they are
what is the number one way for maternal fat loss and why
- breastfeeding
- mother’s body fat turned into milk fat in breast milk
what are the benefits of breastfeeding for the mother
- weight loss
- build bond with baby
- decreased risk of breast and ovarian cancer
- may save money from buying formula
what are infants less likely to experience if they are breastfed
- allergies and intolerances
- infections: ear, respiratory, meningitis
- vomiting/diarrhea
- sudden infant death syndrome (SIDS)
- possible reduced obesity
why does breastfeeding reduce the risk of allergies
- parts of what the mom eats are transferred to the baby
- exposure to many types of foods lessens chance of food allergies as they get older
why does breastfeeding reduce the risk of infection
breast milk contains antibodies
why is formula potentially dangerous
- more protein than breast milk which can damage immature kidneys
- no antibodies
what volume should infant meals be
2-20 mL
what is the first milk produce after birth
- colostrum
- thin yellowish liquid
what does colostrum do for the baby
- can high amount of protein and antibodies
- serves as laxative to clear meconium (first poop)
why is there no benefit to breastfeeding after 12 months
breast milk becomes diminished in nutrients
when should solid foods start to be introduced
- after 6 months
- in addition to supplemental breastfeeding
how many additional calories from pre-pregnancy requirements should mothers who are exclusively breastfeeding get
640 calories per day for the first 6 months (when exclusively breastfeeding)
describe the breakdown of the 640 additional calories needed when exclusively breastfeeding
- 500 calories from diet
- rest from maternal fat stores
how many additional calories per day should a mother who is breastfeeding in addition to giving solid foods get
400 calories per day
what are the nutritional needs for carbohydrates for breastfeeding mothers
requires additional 80g of carbs from pre-pregnancy requirements
what are the nutritional needs for protein for breastfeeding mothers
additional 15-20g above pre-pregnancy requirements
what are the nutritional needs for fats for breastfeeding mothers
- 30-35% of total calories
- no change from pre-pregnancy requirements
what happens to the iron needs of mothers during lactation
decrease
describe what happens to an infants birth weight during the first year
- double birth weight by 4-6 months
- triple birth weight by 12 months
what are the calorie requirements for infants
40-50 calories per pound of body weight per day
AMDR for fat for infants
50-60%
where do infants get a lot of fat from
breast milk
AMDR for protein for infants
20%
why are infants at an increased risk for dehydration
- lose more water via evaporation (brown adipose tissue producing heat and high surface area compared to size)
- kidneys not completely developed (less recycling of water)
what are the fluid requirements for infants
1/3 cup of fluid per pound of body weight (up to 18 pounds)
why should you not dilute formula with water
- may dilute the sodium in blood (hyponatremia)
- may cause water intoxication (hyponatremia)
- can lead to seizures, coma, and death
should you give an infant cow’s milk, goat’s milk, or soy milk and why
- no
- contains too much protein for the kidneys to handle
what vitamin shot is given to infants right after birth and why
- vitamin K
- GI tract doesn’t have bacteria that make vitamin K
why might infants need additional vitamin D supplements
vitamin D is low in breast milk
when do infants who are exclusively breastfeeding start needing iron supplements and why
- 4-6 months
- iron content in breast milk starts decreasing
at what age may infants need fluoride supplements
over 6 months
why might a baby need vitamin B12 supplements
if mother is vegan
what two nutrients are reasons why solid foods are not needed until 6 months of age and why
- iron and zinc
- healthy infants born with iron and zinc stores
- levels of iron and zinc decrease in breast milk after 3 months
- infant stores used up by 6 months
define complementary foods
solids and liquids that join breastfeeding in normal progression toward adult eating patterns
why should you not introduce solid foods before 6 months
- enzyme for digestion of starches is not produced in sufficient amounts until 6 months
- may increase risk of type 1 diabetes because of stress put on pancreas
- fruits and vegetables can increase risk of anemia
- choking if not finely prepared
- increase risk of obesity later in life
- extrusion reflex
what is often the first food introduced to infants and why
- iron-fortified cereals such as rice cereal
- least allergenic
describe the extrusion reflex and it’s significance in timing of starting solid foods
- extrusion reflex is when a baby instinctively sticks tongue out when things are brought to their mouth
- usually gone by 6 months of age
what are physical signs an infant is ready for solid foods
- loss of extrusion reflex
- capable of sitting on their own
- become intrigued with sight of spoon or fork
- capable of bringing item to their mouth
- able to chew and swallow
what are recommendations regarding order of solid food introductions based on
preventing allergies
why should you introduce one type of solid food at a time
- so you can watch for allergies
- of allergic reaction occurs, you will know what caused it
what is the typical sequence of solid food introduction
- iron-fortified cereals
- fruits and vegetables
- meats
define bottle-mouht syndrome
- caused by infants going to bed with a bottle of milk or juice
- carbs in the drink are fermented by oral bacteria causing dental decay
