Module 14: Nutrition for Pregnancy, Breastfeeding, and Infant Feeding Flashcards
1
Q
how long does a full-term pregnancy last
A
38-42 weeks
2
Q
why is there a 4 week variation for full-term pregnancy estimations
A
- 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
3
Q
define trimester
A
- 13 week stages in pregnancy
- 3 of them
- mark different phases of fetal development
4
Q
when is the pre-embryonic period of pergnancy
A
1-2 weeks
5
Q
when does the central nervous system develop during pregnancy
A
3-38 weeks
6
Q
when does the heart develop during pregnancy
A
3/4-9 weeks
7
Q
do major birth defects tend to occur earlier or later in pregnancy
A
earlier
8
Q
describe the composition of maternal weight gain during pregnancy
A
- 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
9
Q
is a baby every a parasite to the mother
A
- no
- mother always gets nutrients first, then baby
10
Q
what weight is considered low birth-weight
A
<5.5 lb
11
Q
what are low birth-weight babies at risk for
A
- infection
- lung problems
- learning disabilities
- increased mortality
12
Q
what is the recommended weight gain during pregnancy for a women who is of underweight BMI (<18.5)
A
28-40 lbs
13
Q
what is the recommended weight gain during pregnancy for a women who is of normal weight BMI (18.5-24.9)
A
25-35 lbs
14
Q
what is the recommended weight gain during pregnancy for a women who is of overweight BMI (25-29.9)
A
15-25 lbs
15
Q
what is the recommended weight gain during pregnancy for a women who is of obese BMI (>30)
A
11-20 lbs
16
Q
how should increased nutritional needs during pregnancy be met
A
eating nutrient-dense foods
17
Q
when do calorie needs increase
A
after first trimester
18
Q
are calorie needs increased during the first trimester of pregnancy
A
no
19
Q
how many more calories are needed per day after the first trimester of pregnancy
A
200-300 more calories per day from pre-pregnant calorie requirements
20
Q
protein requirements during pregnancy
A
additional 25g per day
21
Q
why should pregnancy women avoid predatory fish
A
high in mercury
22
Q
what is the primary source of energy for pregnant females
A
carbohydrates
23
Q
how much carbohydrates should a pregnant woman consume
A
> 175g per day
24
Q
what does eating fiber during pregnancy help prevent
A
- constipation
- hemorrhoids
25
does recommended total fat intake change during preganancy
no
26
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
27
what type of adipose tissue do babies have increased amounts of
brown adipose tissue
28
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
29
what protein is found in brown adipose tissue
uncoupling protein 1
30
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
31
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
32
what is increased iron needed for during pregnancy
building red blood cells in the fetus to carry oxygen to cells
33
what is maternal iron deficiency anemia associated with increased risk of
- premature delivery
- low birth weight
- low iron stores in infant
34
what is calcium needed for during pregnancy
- development of bones and teeth in the fetus
- maintain strength in the bones of the mother
35
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
36
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
37
what regulates the amount of calcium absorbed in the body
- vitamin D
- parathyroid hormone
38
how much do zinc requirements increase during pregnancy
30%
39
what is zinc needed for during pregnancy
DNA and RNA syntheses
40
what can inadequate zinc intake during pregnancy lead to
- birth defects
- poor cognitive development after birth
- premature delivery
- prolonged labor
41
what nutrients should be supplemented through prenatal vitamins
- iron
- folic acid
- calcium
42
when should folic acid supplementation begin
- 1 month before conception
- before you start trying for a baby
43
why do fluid needs increase during pregnancy
- support fetal circulation
- amniotic fluid
- increased blood volume
- prevents constipation and hemmrhoids
44
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
45
what drives most food cravings during pregnancy
hormones
46
define pica
compulsive eating of nonfood substances (clay, chalk, dirt)
47
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
48
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
49
describe how heartburn occurs in pregnant people
hormonal changes relax esophageal sphincter
50
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
51
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
52
what are complications that can occur during pregnancy
- edema
- pregnancy-induced hypertension - pre-eclampsia
- gestational diabetes
53
define edema
fluid retention that results in swelling of hands, feet, and ankles
54
what blood pressure is classified as pregnancy-induced hypertension
readings above 140 mmHg (systolic) and 90 mmHg (diastolic)
55
what can pregnancy-induced hypertension lead to
pre-eclampsia
56
define pre-eclampsia
- high blood pressure and edema
- protein in the urine
- low calcium status
57
what can pre-eclampsia lead to
eclampsia
58
define eclampsia
- manifestation of pre-eclampsia if nothing is done to intervene
- characterized by convulsions or seizures
59
what causes gestational diabetes
- human placental lactogen hormone
- can encourage insulin resistance
60
how can gestational diabetes be controlled
- diet
- lifestyle
61
what are the complications of gestational diabetes for the infant
- macrosomia: high birth weight (over 9 lbs)
- low blood glucose following delivery
62
what are the complications of gestational diabetes for the mother
increased risk for type 2 diabetes
63
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
64
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
65
what is the recommended alcohol intake during pregnancy
none
66
define fetal alcohol syndrome (FAS)
- caused by maternal alcohol consumption
- causes growth retardation, facial abnormalities, and central nervous system dysfunction
67
what can smoking during pregnancy cause
- miscarriage
- preterm delivery
- small birth weight
- impairs blood flow to the fetus causing decreased nutrients and O2 delivery
68
why are pregnant people at increased risk of food-borne illness
- weakened maternal immune system
- immature fetal immune system
69
what two foodborne illnesses are of greatest concern to pregnant people
- listeria
- toxoplasmosis
70
where is listeria found
- uncooked meats and vegetables
- unpasteurized milk
- ready-to-eat foods (hot dogs, deli meats)
71
where is toxoplasmosis found
- undercooked meat
- cat litter
72
what are 5 other pathogens pregnant people should watch out for
- e coli
- c perfringens
- norovirus
- c jejuni
- s aureas
73
what is the preferred method of feeding for newborns and infants
breastfeeding
74
when should babies be exclusively breastfed
first 6 months
75
how long should babies be breasted (both exclusive and complementary)
12 months
76
should you extend the 12 month breastfeeding period for preterm infants
- yes
- extend by the months early they are
77
what is the number one way for maternal fat loss and why
- breastfeeding
- mother's body fat turned into milk fat in breast milk
78
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
79
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
80
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
81
why does breastfeeding reduce the risk of infection
breast milk contains antibodies
82
why is formula potentially dangerous
- more protein than breast milk which can damage immature kidneys
- no antibodies
83
what volume should infant meals be
2-20 mL
84
what is the first milk produce after birth
- colostrum
- thin yellowish liquid
85
what does colostrum do for the baby
- can high amount of protein and antibodies
- serves as laxative to clear meconium (first poop)
86
why is there no benefit to breastfeeding after 12 months
breast milk becomes diminished in nutrients
87
when should solid foods start to be introduced
- after 6 months
- in addition to supplemental breastfeeding
88
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)
89
describe the breakdown of the 640 additional calories needed when exclusively breastfeeding
- 500 calories from diet
- rest from maternal fat stores
90
how many additional calories per day should a mother who is breastfeeding in addition to giving solid foods get
400 calories per day
91
what are the nutritional needs for carbohydrates for breastfeeding mothers
requires additional 80g of carbs from pre-pregnancy requirements
92
what are the nutritional needs for protein for breastfeeding mothers
additional 15-20g above pre-pregnancy requirements
93
what are the nutritional needs for fats for breastfeeding mothers
- 30-35% of total calories
- no change from pre-pregnancy requirements
94
what happens to the iron needs of mothers during lactation
decrease
95
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
96
what are the calorie requirements for infants
40-50 calories per pound of body weight per day
97
AMDR for fat for infants
50-60%
98
where do infants get a lot of fat from
breast milk
99
AMDR for protein for infants
20%
100
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)
101
what are the fluid requirements for infants
1/3 cup of fluid per pound of body weight (up to 18 pounds)
102
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
103
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
104
what vitamin shot is given to infants right after birth and why
- vitamin K
- GI tract doesn't have bacteria that make vitamin K
105
why might infants need additional vitamin D supplements
vitamin D is low in breast milk
106
when do infants who are exclusively breastfeeding start needing iron supplements and why
- 4-6 months
- iron content in breast milk starts decreasing
107
at what age may infants need fluoride supplements
over 6 months
108
why might a baby need vitamin B12 supplements
if mother is vegan
109
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
110
define complementary foods
solids and liquids that join breastfeeding in normal progression toward adult eating patterns
111
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
112
what is often the first food introduced to infants and why
- iron-fortified cereals such as rice cereal
- least allergenic
113
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
114
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
115
what are recommendations regarding order of solid food introductions based on
preventing allergies
116
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
117
what is the typical sequence of solid food introduction
- iron-fortified cereals
- fruits and vegetables
- meats
118
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
