Nutrition in Preggers

Question 1

Macronutrients/Calories for pregnant:

– Follow similar macronutrient distribution as nonpregnant women (50-60% CHO, 15-20% protein, 25-30% fat) with

Answer 1

increased calorie level

• Normal body weight = 30 kcal / kg
• >120% IBW = 24 kcal / kg
• <90% IBW = 36 – 40 kcal / kg

Question 2

Prevent anemia; Support fetal growth; Produce additional blood

• Lean beef/pork, whole grains, dark leafy greens
• Vitamin C improves absorption; Calcium can block absorption

Answer 2

Iron

Question 3

Decrease risk of birth defects

• Fortified grains, beans, dark leafy greens

Answer 3

Folic acid

Question 4

Prevent bone loss/Improve fetal bone growth

• Dairy products, fortified OJ, fish with bones

Answer 4

calcium

Question 5

Problems related to overweight or obesity during pregancy

Answer 5

– Gestational diabetes – Macrosomia – Eclampsia

Question 6

weight gain based on BMI

Answer 6

< 18.5 28 – 40 lb

18.5 – 24.9: 25 – 35 lb

25 -29.9 : 15 – 25 lb

> 30: 15 lb

Question 7

Precautiousn w/ pregancy

Answer 7

– Cravings: Pica

– Fish consumption: Limit shark, swordfish, king mackerel, tilefish, albacore tuna due to mercury levels

– Listeriosis: Limit soft cheeses, raw fish (sushi), deli meats, unpasteurized milk, smoked seafood

– Specific disease states: PKU, Renal disease, Diabetes

Question 8

Benefits of breast feeding

Answer 8

– Better for baby’s immune system due to antibodies in milk – Better digested, less gas and constipation – Linked to decreased risk of ovarian & breast cancer – Less expensive – Improves mother/child bonding – Burns calories for mother

Question 9

cals mom burns breast feeding

macro nutrients to increase

risk:

Answer 9

– Mom is burning additional 200-500 kcal/day

– Eat wide variety of foods • Focus on protein sources

• Watch signs from baby for fussiness, rashes – potential food allergy concern

– Higher risk for dehydration – additional fluids are necessary

Question 10

key macronutrients in breastfeeding mom

Answer 10

Micronutrients:

– Continue prenatal vitamin!

– Calcium = 1,000 mg/day

– Folic acid = 500 mcg/day

Question 11

• Premature Infants =____ 2003
• Birth to 24 months =____ growth charts
• 2-20 years old =____ growth charts

Answer 11

Fenton

WHO

CDC

Question 12

Contents of breast milk

Answer 12

• Macronutrient Needs:

– Breastmilk:

• ~40-50% Fat • 40-50% CHO • 10% Pro

Question 13

Single intramuscular prophylactic dose given at birth to infants

Answer 13

– Vitamin K:

Question 14

Breastfed infants - supplement by 6 months of age (can be in the form of food vs supplement

Answer 14

Iron

Question 15

Breastfed infants - start supplement shortly after birth

Answer 15

Vit D

Question 16

Edema that masks muscle wasting

– Caused by lack of adequate protein in diet

Answer 16

Kwashiorkor

Question 17

– Wasted appearance and diminished subcutaneous fat stores

– Caused by overall lack of adequate energy intake

Answer 17

Marsmus

Question 18

Breast milk/Formula feeding: – Breast milk and/or formula should be the sole source of nutrition for the

Answer 18

first 6 months of life

Question 19

• Common in newborns
• Usually resolves with lower volume/more frequent feedings, position changes, and maturation of the infants GI tract
• Painless and not affecting the infant’s growth

Answer 19

– Gastroesophageal reflux (GER):

Question 20

• Reflux accompanied by symptoms and complications (i.e. inadequate growth)

Answer 20

– Gastroesophageal reflux disease (GERD):

Question 21

When do we introduce first foods and how

Answer 21

First Foods: – Introduce around 6 months of age – Choose first foods that help meet micronutrient and energy needs (i.e. Iron-fortified cereals and pureed meats)

Question 22

Rules on juice for infants

Answer 22

• Juice: – Do not introduce before 6 months – Only in an open cup – Limit to ≤4 oz per day

Question 23

rules on milk and water for infants

Answer 23

Milk: Cow’s milk is not recommended until 12 months of age

– Only whole cow’s milk should be offered

• Water: No specific recommendations

Question 24

Expectation for baby shit

Answer 24

– Breastfed infants: 3-4 soft, medium-sized yellow stools per day

– Formula-fed infants: firmer, less-frequent, tancolored stools

Question 25

Red flags for feeding infants

Answer 25

– Consuming too little or too much – Feeding too quickly or too long – Feeding not on a typical schedule – Not advancing to appropriate textures – Having difficulty successfully transitioning to new textures

Question 26

Food needs for toddlers

Answer 26

* Carbohydrate: 50-60% of total intake * Protein: 10-15% of total intake – Populations at risk: dieters, athletes who restrict intake, vegetarians, food allergies * Fat: 25-30% of total intake

Question 27

– Prevents constipation, protects against heart disease

Answer 27

fibers

Question 28

getting adequqate fibers

Answer 28

* Ages 6-12 months→ gradually increase to 5g/day by first birthday * Children older than 2 years of age→ child’s age + 5g/day(age +10g/day found to be safe)

Question 29

• Calcium – adolescence is a critical period to achieve peak bone mass, especially in females – At risk:

Answer 29

low milk intake, high soda intake, low vitamin D

Question 30

benefits of Vit D adolescents

Answer 30

bone health, prevention of cancer, autoimmune and infectious diseases

Question 31

– Deficiency: poorer cognitive performance, delayed psychomotor development – At risk: high milk volume, poor intake of solids, dieting

Answer 31

Iron

Question 32

heme vs non heme iron and what helps iron absorption

Answer 32

– Heme iron sources (meat, fish, poultry) are better absorbed than non-heme sources (vegetables, grains) • Ascorbic acid and heme iron sources help with absorption

Question 33

people that may need vit supplements

Answer 33

• Anorexia, poor appetite, fad diets • Chronic disease (CF, IBD, liver dz) • Deprived, abused, neglected children • Diet restriction to manage obesity • FTT • Food allergies • Omit food groups

Question 34

Rule for feeding toddlers

Answer 34

* Rule of thumb: Offer 1 tablespoon of each food for every year of age for preschool children * Be cautious about choking hazards under age 4 (hot dogs, grapes, nuts, hard candy)

Question 35

Unique issues in 6-12 yo

Answer 35

School-aged children (6-12 years): – Unique issues to this age: • After-school snacks • Fewer family meals • Meals at friend’s houses • Start of skipping breakfast • Preparing their own convenience foods

Question 36

eating issues in adolscents

Answer 36

– Unique issues: • Frequent meal skipping (breakfast, lunch) • Regular snacking • High fast food intake • Potential for disordered eating: – Vegetarianism – Athletes – Eating disorders

Question 37

Restrictive vegetarian diets: – Monitor intake of

Answer 37

vitamin B12, calcium, vitamin D, zinc, long chain omega-3 fatty acids, iron, riboflavin

Question 38

vegan babies can recieve vegan adolescents can receive

Answer 38

Infants: Can be breastfed or receive soy formula • Adolescents: Consider vitamin and/or mineral supplements

Question 39

– Voluntarily-restricted caloric intake resulting in weight loss – Fear of gaining weight – Medical complications include: amenorrhea, bradycardia, abnormal EKG, fatigue, dizziness, hypercholesterolemia – Refeeding is a concern: monitor K, Mg, Phos

Answer 39

anorexia

Question 40

– Binge eating + compensatory behavior to prevent weight gain, – Over concern with body shape and weight, although typically normal weight or overweight – Medical complications include: constipation and laxative dependency, dehydration, electrolyte abnormalities – GI complications from frequent vomiting – esophagitis, reflux, gastritis

Answer 40

bulimia nervosa