Nutrition Across the Life Span (exam 2)

Question 1

what are modifiable factors in low birth weight and preterm infants?

Answer 1

• Underweight prior to pregnancy
  – Low pregnancy weight gain
  – Smoking during pregnancy
  – Certain maternal infections
• Iron deficiency anemia early in pregnancy

Question 2

what are the preventative interventions prior to conception for low birth weight?

Answer 2

• Improve quality of dietary intake
  – Normalize body weight
  – Increase exercise levels
  – Curb tobacco, alcohol, and drug use
  – Reduce stress levels
  – Increase access to high quality medical care

Question 3

what are the phycological changes during pregnancy?

Answer 3

Blood changes:
- Plasma and blood volume increases, hemodilution
* Circulatory system:
– Increased cardiac output
* Respiratory system:
– Increased tidal volume and O2 consumption
* GI system:
– Relaxed GI tract muscle and tone
– Slower GI motility

Question 4

what are the health implications w/ GI changes during pregnancy?

Answer 4

• nausea and vomiting
• constipation
• heartburn

Question 5

what are the consquences nausea and vomiting?

Answer 5

• electrolyte imbalance, dehydration, weight loss

Question 6

what is the management of N/V?

Answer 6

• Separate liquid and solid food intake
  – Small frequent meals
  – Avoid odors and foods that trigger nausea
  – Vitamin B

Question 7

how is heartburn due to pregancy and what are the mangments?

Answer 7

• Result of relaxed GI system secondary to
  progesterone
• management:
  • ingestion of small, frequent meals
    – Avoid lying down after a meal
    – Limit high fat and spicy foods

Question 8

what is the mangement for constipation is how is it related to pregnancy?

Answer 8

• due to relaxed GI system
• increase risk of hemorrhoids
• treatment:
  
  • consume 30 grams fiber/day
    – Laxatives are NOT recommended
    – Bulk forming fiber supplements with water
    * Metamucil

Question 9

what are the kidney, immune system, organ and tissue, basal metabolism physiological changes during pregnancy?

Answer 9

• kidney = increase GFR = more pee
• immune system = suppressed immunity
• organ & tissue = enlargement of heart, thyroid, liver, kidney, uterus, breast, adipose
• increase insulin resistance
• basal metabolism is increased in second half

Question 10

what are the weight gain recommendations based on BMI during pregnancy?

Answer 10

• normal BMI (18.5-24.9): 25 to 35 lbs
  – Underweight BMI (less than 18.5): 28 to 40 lbs
  – Overweight BMI (25-29.9): 15 to 25 lbs
  – Obese BMI (greater than 30): 11-20 lbs

Question 11

what are the nutrient needs during pregnacy?

Answer 11

• protein = 71 g/day
• fat = important for fetal vision & neurological development
• prenatal vitamins
• folate = increase to 600 mcg/day, prevent neural tube defects
• iron = 27 mg/day, iron deficiency anemia can lead to pic

Question 12

what food safety is important for pregant people?

Answer 12

• Avoid raw fish, oysters, soft cheeses, raw or
  undercooked meat, unpasteurized milk
• Mercury – avoid shark, swordfish, king
  mackerel, tile fish– 12 ounces or less of other types appears to be safe
• Potential teratogens: drugs, alcohol, tobacco,
  caffeine (limit to < 200 mg/day)

Question 13

what are the benefits of breast feeding?

Answer 13

• Immunologic protection
  to infant
• Unique formula with
  best profile and
  bioavailability of
  nutrients
  – Reduces risk of food
  allergies
  – Convenience
  – Cost
• Less chance of bacterial contamination– Oral development of infant
  – Chronic disease protection
  – Bonding
  – Decrease breast cancer risk in mom

Question 14

what can breast feed help lower in babies?

Answer 14

• sids
• type 1 & 2 DM
• leukemia
  – asthma
  – overweight/obesity
  – Allergies
  – infections

Question 15

how many kcal per day is needed for breast milk production?

Answer 15

• 500-800 kcal/day for breast milk production– assumes
  ~ 500 kcal contributed by extra food and 250 Kcal mobilized from maternal fat store

Question 16

how much does an infant grow in a year? length and weight size?

Answer 16

• doubles by 6 months
• triples by 1 yr
• height increases by 50% in 1 yr

Question 17

what does feeding from 0 - 6 look like?

Answer 17

– Breast milk exclusively is the #1 advice
– 10-12 times/day feeding occasions first weeks
– Less frequency and longer duration as baby grows, can hold more in stomach, etc
– Formulas if cannot breastfeed
* proper mixing, sanitation important, specialty formula

Question 18

what are key infant needs during infancy?

Answer 18

• vit D, K, iron, fluoride

Question 19

when is it good to introduce solid foods?

Answer 19

• 4 to 6 months
• sit with support, move
  jaws, lips and tongue
  independently for bolus
  formation
• show interest in other
  family’s members food
• caregivers “read”
  baby’s cues: satiety, etc

Question 20

what NOT to feed infants?

Answer 20

• Honey
• Excessive formula or breast milk
• High risk foods for choking– hot dogs, grapes, popcorn, raw carrots, nuts
• Cow’s milk
• Too much juice– Apple, white grape, pear, etc

Question 21

what are the feeding problem during infancy?

Answer 21

• Colic
• Baby bottle tooth decay
• Iron-deficiency anemia
• Gastroesophageal reflux
• Diarrhea
• Failure to thrive