Nutrition throughout the lifecycle: Maternal, foetal and infant health Flashcards
Why is nutrition during pregnancy and lactation important?
- Mother’s and infants are one of the most nutritionally vulnerable groups
- All women need to eat a healthy balanced diet and gain weight to sustain a healthy preganany and childbirth
- A fetus’s weight doubles in the first 6 weeks
- Infant doubles in weight from birth to 4-5 months
- Barker hypothesis - poor nutrition in utero may increase risk of chronic disease later in life.
- Fetus has limited ability to compensate for limited supplies.
- Growth depends on a supply of nutrients via placenta and then breatmilk
- Marginal nutrients are more important in developmental peroid than steady state (adulthood)
What is the Barker Hypothesis?
It is an hypothesis concerning how early nutrition can affect health outcomes in adult life. It proposes that there is a correlation between in-uterine growth retardation, low birth weight and premature birth and developing hypertension, CHD and Type 2 diabetes in adult life.
What is Barker’s hypothesis proposed mechanism?
- Peroids of rapid post-natal growth (high E intake, Western dietary pattern)
- Transgenerational epigenetic inheritance (peroid of nutritional deprivation)
What is the drawback of Barker hypothesis?
A overview of nutritional needs during pregnancy
Are you eating for two during preganany?
- Nutrients for two
- 10% extra energy
- Nutrient rich diet recommended
Preganant wo have an healthy weight should gain
Between 11.5- 16 kg
Prégnant women who are underweight should gain
Prégnant women for are obese should gain
between 7pm 11.5 kg
Summary of macronutrient needs during preganany
Energy needs:
First trimester: no change
Second trimester: increases 340kcal/day
Third trimester: increases 452 kcal/day
Protein needs: increases from 46g/day to 71 g/day
Iron needs in preganany
increased need for iron in diet:
- increased blood volume
- develpoing fetus draws enough iron to last 0-6 months
- iron loss reduced but overall need for iron much greater
- RDI=27 mg
Calcium in pregnancy:
Foetus retains about 25-30g calcium (predom. 3rd trimester).
‒ RDI = 1000 mg same for non-pregnant as calcium absorption increased in pregnancy
‒ Dietary calcium does not appear to influence maternal bone mass inpregnancy
‒ Support concept of maternal adaptive mechanism
Vitamin A needs in preganany
Why should pregnant women be wary about some types of fish?
mercury in fish: pregnant women and women planning pregnancy should avoid fish with high levels of mercury such as billfish, gemfish, southern blue fin tuna
-should safely eat 2-3 meals of fish each week though, but choose the type of fish carefully.
Why are vitamin supplements in preganancy controversial?
not usually recommended but may be needed for:
- vegetarians
- teenagers who have inadequate food intake
- substance abusers
- obese women who are restricting their energy intake to prevent large weight gains
What was the impact of mandatory folate fortification in Australia?
- NTDs fell by 14%
- NTDs fell by 74% for Indigenous Australians
- NTDs fell by 55% among teenagers giving birth
What was the impact of mandatory iodine fortification?
Iodine intakes by children increased by 29%
-Iodine intake in women of childbearing age increased by 52%
Why is the nutritional status of the father important?
Age of father is associated with reduced sperm quality:
- May lead to structural defect
- increased DNA fragmentation
- more gene mutations
- more children carrying heritable genetic defects
What are the advantages of breastfeeding for the infant?
- Breast milk design for optimal growth of infant
- Supply determined by demand – rare to be overfed
- Breast milk adjusted to needs of infant
- Iron in breast milk more easily absorbed
• Formula fed babies may be more likely
to develop obesity later in life
What is the prevalence of breastfeeding in Australia
- 90% of women commence breastfeeding
- 50% by 6 months
- Almost 39% exclusively breastfeed to 4 months
What is the Australian National Breastfeeding strategy?
‐ Aims to support all mothers, fathers/partners and babies in Australia by providing support for mothers to breastfeed their infants.
‐ Provides framework for integrated, coordinated approach to other local policies and
programs
‐ The strategy is evidence based
‐ DoH will establish and advisory committee to oversee implementation of strategy
What are the types of first foods?
- cooked potato
- mashed smooth foods
- grilled chicken or meat
- banana
What is the parents role in feeding a toddler
Toddlers can explore and enjoy food
Parents role is to continue offering a wide selection of food from the five food groups – their choice is whether to eat or not.
Rejecting new foods is normal – acceptance is more likely as become familiar with food through repeated opportunities to taste them
Sweet foods should be limited
What are the factors affecting children’s growth?
How is a child’s growth monitored?
NHMRC recommends children’s growth should be monitored at regular intervals
Each state and territory in Australia has health monitoring schedules for infants and young children when growth measures are taken and plotted on the relevant charts.
These schedules are for otherwise healthy children and allow for early detection of altered growth should it occur.
Children with ongoing health concerns may need to have their growth monitored more frequently.
Growth monitoring is especially important during infancy for:
- Detecting slow or excessive growth
- Checking the impact of illness and response to treatment
- Screening for high risk individuals
Childhood obesity facts
Usually formally diagnosed if body weight is >120% of expected weight for age
- Other, similar reference points used
- BMI>age see-specific reference standards (85th and 95th percentile)
Major health issue in many developed countries, increasing incidence in Australia (-25% Australian children o/weight or obese)
Micronutrients: iron deficiency
- Most common nutritional deficiency of early childhood
- Full-term infants have sufficient stores for the first 6 months
- Iron intake needs to be sufficient in order to support growth
Dental caries and diet facts
Affects all ages and socioeconomic backgrounds
- Bacteria in mouth cause plaque formation
