Nutrition Across the LIfe Cycle: Pregnancy and Infancy Flashcards
- LIst risk factors for low birth weight
defined as less than 5.6lbs, and put the child at life long risk for chronic diseases, risk factors include: underweight before pregnancy low pregnancy weight gain iron deficiency anemia in early pregnancy certain maternal infections smoking during pregnancy alcohol and drug use during pregnancy poorly controlled chronic disease in mom
- Describe factors to consider when making weight gain recommendations during pregnancy.
the mothers BMI pre-pregnancy
the number of fetuses the mom has to support
- List disadvantages of material weight gain that is less than or greater than the recommended range.
LBW can put baby at risk for chronic disease : metabolic syndrome, high blood pressure, DM, CVD while large birth weight can lead to complications on delivery, ie. more likely to deliver by Cesarian
- Describe examples of nutrition-related congenital anomalies, with emphasis on folate deficiency.
folic acid and neural tube defects (found in green leafy veggies, legumes and citrus foods) leading to anencephaly or spin bifida
fetal alcohol spectrum disorder causing mental retardation and LBW
- Compare energy, protein and fluid requirements in pregnancy and lactation
no increase in the first trimester
+300 kcal/day for 2nd and 3rd trimester
+500 kcal/day for first 6 mo of lactation;
multifetal pregnancies increase to +500-600 kcal/day
+25g protein /day during pregnancy and lactation
fluid requirements don’t change much during pregnancy but increase by 3-4 liters during lactation
- Discuss recommendations for vitamin and mineral supplementation in pregnancy
vitamin and mineral needs other than folic acid and iron are not necessary if women eat healthily but recommended regardless for high risk pregnancies
iron supplement pre-conception and esp in last two trimesters 30mg.day to support growth in blood volume
calcium if mother is regularly deficient
folic acid before and throughout pregnancy (400mcg/day)
- Describe recommendations for consumption of alcohol, caffeine and fish and avoiding literiousis during pregnancy.
no alcohol
limit caffeine to 300mg/day (2 cafe coffees)
3 or less servings of artificial sweeteners
care with herbal supplements
low intake (6 oz/week tuna; 12oz/week others) of large fish ie. tuna, catfish, shrimp or salmon, specific guidelines per state
liter monocytogenes: avoid soft cheses, anything not pasteurized, rehear deli meats and sausages, observe all expiration dates
- List the risk factors for gestational diabetes
hx of GDM, first degree relative with diabetes
overweight or excessive pregnancy weight gain
maternal age and race
previous pregnancy complications, large baby, still born baby, fetal demise etc.
maternal hypertension, POS, excess amniotic fluid
treatment for HIV
all should be screened for diabetes at the first prenatal visit
- Describe the treatment of gestational diabetes.
increasing insulin sensitivity with diet, exercise and controlled weight gain, in some cases insulin to control blood sugar levels.
- Describe patterns of growth in weight, length, and head circumference during the first year of life.
BW usually doubles at 5 mo and triples at 12 mo. and quadruples at 36 mo
length increases 50% at 12 months and doubles at 48mo
head circumference increases by about ⅓ in the first year
- Outline the recommendations for protein, calcium, iron, fluoride and vitamin D in the diet of infants.
no additional water first 6mo supplement protein after 6mo adequate Ca iron supplementation at 4-6mo fluoride after 6mo w/o fluoridinated water vitamin D supplement through 1st year vitamin K prophylaxis at birth
- Compare and contrast the use of breast milk and formula for infant nutrition.
exclusive breastfeeding 4-6mo, and continued breastfeeding for 12mo (sterile, includes IgA and growth factor, less expensive and promote infant maternal bonding)
contraindications include galactosemia, material HIV/AIDs, TB, herpetic lesions, syphilis, breast abscess and certain meds
infant formulas as close as possible to breast milk, careful preparation re: germs– important to be aware of appropriate dilutions
- Outline the rationale and recommended procedures and progression for introduction of complementary foods in the infant diet.
iron stores deplete, so fortified cereals or meat at 4-6mo, followed by veggies and fruits at 5-8 mo, introduced one at time to watch for allergies, introduced with a spoon (to help develop feeding skills) best to move solids that dissolve and cubes of soft foods that are easy to chew
- List foods that should not be included in the infant’s diet during the first year.
.honey and corn syrup because may contain clostridium botulinum spores
foods like fish, wheat, egg white and PB due to allergies
nuts, popcorn, hot dogs, grapes, raw veggies, gum, candy pretzels due to choking hazard
- Outline recommendations and concerns about the use of cow’s milk or goat’s milk during the first year.
infants fed whole cow’s milk receive less iron, linoleum acid and vit, higher casein and calcium in cows milk inhibits abs. of iron
goats milk is unsuitable for infant feeding for the same reasons, it can also lead to megaloblastic anemia due to low folate content
