Nutrition Across the Lifespan (Nutrition Ch 7) Flashcards
Major stages of the lifespan that have specific nutritional needs:
1) pregnancy and lactation
2) infancy
3) childhood
4) adolescence
5) adulthood and older adulthood
Pregnancy and Lactation
overview
- early fetal development occurs before a woman may realize she’s pregnant–women should be well nourished and in normal weight range prior to conception
- daily increase of 340 calories during 2nd trimester
- daily increase of 452 calories during 3rd trimester
Recommended weight gain during pregnancy
-varies depending on BMI and weight prior to pregnancy
-during 1st trimester: 1-4 lb.
-2nd and 3rd trimester: 2-4 lb/month
-trimesters 2 and 3:
normal weight = 1 lb/wk = 25-35 lbs
underweight = just more than 1 lb/wk = 28-40 lbs
overweight = 0.66 lb/wk = 15-25 lbs
Lactating women and daily caloric intake
- additional 330 calories during 1st 6 months
- additional 400 calories during 2nd 6 months
Pregnancy and Lactation
major nutrient requirements
- protein: 20% of daily intake–1.1 g/kg/day
- fat: 30% of daily intake
- carbohydrates: 50%
Pregnancy and Lactation
additional dietary recommendations
- folic acid: 600 mcg/day during pregnancy; 500 mcg/day during lactation
- fluid: 2,000-3,000 mL/day
Dietary complications during pregnancy
1) nausea and constipation
- nausea = eat dry crackers or toast; avoid alcohol, caffeine, fats, spices; avoid drinking fluids w/ meals
- constipation = increase fluid consumption and include extra fiber in diet (fruits, vegetables, whole grains)
2) maternal phenylketonuria (PKU)–maternal genetic disease where high levels of phenylalanine pose danger to fetus
Infancy
overview
- birth weight doubles by 4-6 mths and triples by 1 year
- appropriate weight gain averages 0.15-0.21 kg (5-7 oz) per week during 1st 5-6 mths
- grows approx 2.5 cm (1 in) per month in height 1st 6 months, and approx 1.25 cm (0.5 in) per month the last 6 months
- AAP recommends exclusive breastfeeding for 1st 6 mths, followed by breastfeeding w/ intro of complimentary foods until at least 12 mths
- semisolid foods should not be introduced before 4 months to coincide w/ development of head control, ability to sit, and back-and-forth motion of the tongue
- iron-fortified cereal is first solid food introduced as gestational iron stores begin to deplete around 4 months
- cow’s milk should not be introduced until after 1 year because protein and mineral content stress immature kidney
Advantages of breastfeeding
1) incidence of otitis media, type 1 and 2 diabetes, obesity, leukemia, lymphoma, and GI and respiratory disorders are reduced (due to transfer of antibodies from mother to infant)
2) carbs, proteins, and fats in breast milk are predigested for ready absorption
3) high in omega-3 fatty acids
4) iron, zinc, and magnesium found in breast milk are highly absorbable
5) calcium absorption is enhanced as the calcium-to-phosphorus ratio is 2:1
6) risk of allergies is reduced
7) maternal-infant bonding is promoted
Breastfeeding teaching points
1) newborn is offered breast immediately after birth and frequently thereafter (8-12 feedings in a 24-hr period)
2) instruct mother to demand-feed infant and assess for hunger cues (rooting, suckling on hands and fingers, and rapid eye movement). Crying is a late sign of hunger
3) newborn should nurse 15-20 min/breast (avoid educating clients regarding expectation of duration of feeds and to pay attention to cues)
4) do not offer newborn any supplements unless indicated by provider
5) mother’s milk supply is equal to demand of the infant
6) frequent feedings (every 2 hr) and manual expression of milk to initiate flow may be needed
7) if it has been 4 hour and infant has not breastfed, mother should awaken infant for feeding
8) expressed milk can be refrigerated in sterile bottles or storage bags and labeled w/ date and time milk was expressed. Can remain in fridge for 10 days or frozen for 6 months.
9) thaw milk in fridge. It can be stored for 24 hr after thawing. NEVER defrost or heat in microwave-destroys milk’s antibodies and may burn infant’s oral mucosa
10) DO NOT refreeze thawed milk
11) unused breast milk must be discarded
12) avoid consuming freshwater fish or alcohol, and limit caffeine
Formula feeding
1) no artificial pacifier or bottle should be used until after 2 wks when breastfeeding is well established
2) iron-fortified formula is recommended for @ least first 6 months or until infant consumes adequate solid food. After 6 months, formula w/o added iron may be indicated
3) precisely follow manufacturer’s directions
4) DO NOT use liquid formula if it has been left at room temperature for 2 hr or longer. DO NOT reuse partially emptied bottles of formula.
5) formula may be fed chilled, warmed, or at room temp. always give at approximately same temp.
6) hold infant during feedings with head slightly elevated to facilitate passage of formula into stomach. Tilt bottle to maintain formula in the nipple and prevent swallowing of air.
7) do not prop bottle or put infant to bed with bottle–promotes tooth decay.
8) infant should not drink more than 32 oz of formula per 24 hr unless directed by provider
Weaning
- developmentally, infant ready to wean from breast or bottled to a cup between 5-8 months
- if breastfeeding is stopped before 5-6 months, a bottle should be provided for infant’s sucking needs
- best to substitute cup for one feeding period at a time over 5-7 days
- infant may not be ready to wean from bottle or breast until 12-14 months
Introducing solid food
1) solid food should not be introduced before 4-6 months (risk of allergies and stress on immature kidneys)
2) indicators for readiness: voluntary control of head and trunk, hunger less than 4 hr after vigorous nursing or intake of 8 oz of formula, and interest of the infant
3) iron-fortified rice cereal should be offered first. Wheat cereals should not be introduced until after 1st year.
4) introduce new foods one at a time over a 4-5 day period to observe for signs of allergy or intolerance.
5) vegetables and fruits started between 6-8 months–after both introduced, meats can be added to diet.
6) delay introduction of milk, eggs, wheat, and citrus fruits that may lead to allergic reactions in susceptible infants
7) infant may be ready for 3 meals a day w/ 3 snacks by 8 months
8) open jars of infant food may be stored in fridge for up to 24 hr
9) by 9 months, infant should be able to eat table foods that are cooked, chopped, and seasoned
10) do not feed infant honey because of risk of botulism
11) do not give peanuts or peanut butter due to risk of severe allergic reaction
12) appropriate finger foods = bananas, toast strips, graham crackers, cheese cubes, noodles, and peeled chunks of apples, pears, peaches
Colic
- characterized by persistent crying lasting 3 hr or longer per day
- usually resolves by 3 months
Lactose intolerance
- inability to digest significant amounts of lactose (predominant sugar of milk) and is due to inadequate lactase (enzyme that digests lactose into glucose and galactose)
- abdominal distention, flatus, occasional diarrhea
