Nutrition in Pregnancy, Lactation, Infancy & Childhood Flashcards
The fertilized egg is called a….
Zygote
After implantation, from 2-8 weeks the egg is referred to as a…
Embryo
After 8 weeks until 40 weeks, embryo referred to as…
Fetus
Fertilization occurs…
12 to 24 hours after ovulation
About 6 days after fertilization…
The zygote begins to implant into the uterine lining
Implantation is complete by…
14 days after fertilization
How are nutrients delivered to the fetus?
- via the placenta, a highly vascularized tissue
- also removes waste and secretes hormones
- blood of fetus and mother do not mix
Should women gain weight during pregnancy?
- total recommended weight gain differs depending on pre-pregnancy weight
- recommendations minimize chances of delivering a small or large for GA baby
- underweight women advised to gain more weight, vice versa for overweight women
What are the recommendations for weight gain during pregnancy?
Underweight: 28-40 lb
Normal: 25- 35 lb
Overweight: 15-25 lb
Obese: 11-20 lb
What are the effects of GDM on offspring health?
- increased perinatal mortality
- increased lifelong risks for obesity, metabolic, CV, and malignant diseases
- increased risk of autism, especially if mother was also obese
Recommendations for overweight women during pregnancy?
- advise to lose weight before pregnancy if possible
- screen for GDM and treat if positive
Lack of sleep in pregnancy is correlated to…
Gestational diabetes
What is the distribution of weight during pregnancy?
- mostly maternal fat and fetus
- also gain weight from amniotic fluid, placenta, uterus, maternal blood, breast tissue, and ECF
What problem exists in Canada for weight gain during pregnancy?
- many women are gaining more than recommended
- 55% of overweight women are gaining more than they should
What nutrient needs are increased during pregnancy and lactation?
- almost all nutrient needs increase
- folate, zinc, iron especially important
- during lactation, vitamins A, C, E, B’s increase due to loss in milk
- small amount of extra calories required in pregnancy and lactation
How many more calories are required during pregnancy?
- none in first trimester
- 350 second trimester
- 450 third trimester
Why is iron so important during pregnancy?
- infant needs to store iron for first 6 months before they begin eating
What are the recommendations for exercise during pregnancy?
- participate in aerobic and strength exercises
- goal should be to maintain goof fitness level
- choose activities that minimize loss of balance and fetal trauma
- no adverse outcomes increased from PA
- pelvic floor exercise immediate postpartum
- moderate exercise during lactation
What factors increase pregnancy risk?
- low pre-pregnant BMI or gaining too little weight
- high pre-pregnant BMI or gaining too much weight
- malnutrition
- phenylketonuria
- hypertension
- diabetes
- frequent pregnancies
- poor obstetric hx or poor fetal outcome
- adolescence or older age
- alcohol consumption
- smoking
- cocaine use
Pregnant teens have…
Increased micronutrient needs; refer to dietician
Why is folate important before and during pregnancy?
- cells divide rapidly very early in pregnancy, therefore there is a need for good folate status beforehand
- folate deficiency linked with neural tube defects, it can result in anencephaly or spina bifida
- lower incidence of NTDs now that government mandates fortification of pasta, white flour and cornmeal
What are teratogens?
- substances of chemical or biological origin that can cause birth defects
- different organ systems are particularly susceptible at various times
- smoking and some medications
What is thalidomide?
- drug used in 50s to treat morning sickness
- caused abnormal limb development in infant
What are critical development periods during pregnancy?
- damage from teratogens most likely to be greatest in the embryonic period
- CNS, heart, extremities, eyes, ears, teeth, genitalia most susceptible in the embryonic period
- damage less likely to occur in fetal period (after 8 weeks)
How does the CPNP reach mothers at risk?
- provide education, referral, support through drop-in sessions, craft or cooking circles, home visits, one-on-one support
Why may nutritional needs during lactation exceed those during pregnancy?
- faster growth, and greater need for water
What nutrients does breast milk contain?
- includes most nutrients needed for infant as long as mom is well-nourished
- supplementation indicated for vitamins D and K (no bacteria)
- fluoride may need to be supplemented (except in formula fed babies where water is fluoridated)
- supplement B12 in infants of vegans
What nutritional needs exist during infancy?
- require higher percentage of fat than do adults
- also need about double the protein per kg
- water is vital; most common cause of infant death in developing world in dehydration due to diarrhea
- breast milk high in fat and protein
What 3 underlying cellular processes cause growth?
- hyperplasia; increase in cell number
- hypertrophy; increase in cell size
- accretion; increase in intracellular substances
How long should babies be fed only breast milk?
- during the first 6 months of life
- formula and solid food should not be introduced until after 6 months of age
When can babies feed themselves?
- 12 to 18 months; can drink from a cup, feed self, eat ground or chopped table food
When should food be pureed?
- 6 to 12 months
What solid foods should be introduced to infants?
- iron rich food such as egg yolks, meat, clams, shrimp, broccoli, fortified cereal, etc.
- earlier peanut introduction reduces risk of an allergy
- high fat foods
What foods should not be fed to infants?
- cow milk not until 9 months to 1 year
- honey not until 1 year because botulinum spores
- choking hazards like baby carrots, hot dogs, grapes, nuts, raisins
- limit fruit juice
- goat milk; too high in protein
What is nursing bottle syndrome?
- dental caries and decay from allowing child to fall asleep with full bottle in mouth
- causes tooth decay
Healthy eating is developed…
Young!
How to prevent childhood obesity?
- remember 5-3-2-1-0
- 5 fruits and veg
- 3 meals with family
- 2 hours or less of screen time
- 1 hour of activity
- 0 sugary drinks
What are the physical activity recommendations for children?
- 60 minutes a day
