Pre-pregnancy-infancy: Nutritional principles Flashcards
(8) Health habits that contribute to pregnancy.
- Man’s fertility
- Achieve & maintain healthy body weight
- Adequate & balanced diet
- Be physically active
- Receive regular medical care
- Manage chronic conditions
- Avoid harmful influences; alcohol, drugs, environment (lead)
- Ensure adequate folate consumption: required for cell division
A primary supplement recommended for women wanting to get pregnant. Purpose?
Folate; 1 month prior to pregnancy, 3 months after pregnancy.
Cell division; required to adequate development for foetus.
Exercise DOs during pregnancy
- begin gradually
- most days of the week
- warm up 5-10mins with light activity
- 30mins moderate activity
- coll down 5-10mins slow activity/stretching
- stay hydrated
- eat enough to support pregnancy + exercise
- rest adequately
Exercise DONTs during pregnancy.
- vigorous exercise after long period of inactivity
- exercise in hot/humid weather
- exercise when sick with fever
- exercise while lying on back after 1st trimester
- stand motionless for prolonged periods
- exercise if experiencing pain, discomfort, fatigue
- participate in activities that may harm the abdomen
- participate in jerky, bouncy movements
- scuba dive
How Maternal Weight affects infants weight
Underweight
- lower birth weight babies
- higher rates of preterm (<38 weeks) & infant death
Overweight
- born post term (>42 weeks), >4kg
- more difficult labour
- higher risk of neural tube defects, heart defects & other abnormalities
Identify normal weight gain amounts in specific elements of pregnancy
foetus - 3.5kg
breast increase - 0.5kg
blood increase - 2kg
placenta - 0.5kg
amniotic fluid - 1kg
uterus increase - 1kg
maternal fat stores - 1.5-4.5kg
Total Avg. - 10-13kg
Identify healthy, underweight, overweight & obese weight gain amounts in pregnancy
healthy: 11.5-16kg
underweight: >13kg
overweight: 7-11.5kg
obese: 5-9kg
What is low birth weight (LBW) and what does it increase risks of?
<2.5kg
- developmental & learning disorders
- long-term adverse health outcomes: higher risk of high blood pressure & blood cholesterol in later life
- miscarriage, neonatal death, malformations
What factors affect low birth weight?
- low pre-pregnant weight
- poor nutrition pre-conception
- low maternal weight gain
- poor gestational nutrition
- inherited conditions & perinatal insults
- smoking status
Identify maternal structures critical to nutrition & safety of the foetus. Why are they critical?
umbilical cord, amniotic sac, placenta:
- size influence by maternal weight - determines amount of nutrition & birth weight of infant
- lower BW have lighter placentas - higher incidence of LBW & prematurity
- outcome improved with extra weight gain
Four factors that affect birth outcome
- Intrauterine Growth Retardation (IUR), CHD, stroke, diabetes, increased BP
- prematures delivery: depends on growth rates post birth
- Over nutrition in utero: Diabetes, CVD
- intergenerational factors
How does optimal birth weight and length impact pregnancy?
reduces morbidity & mortality initially and in the long term
Identify the stages of Foetal growth in terms of development and nutritional needs.
0-2wks
- ovum divides & embeds in uterine wall
- folate prevents NTD & possible role of omega-3 FAs - DHA
2-6wks
- organs & tissues differentiate & develop
- nutrition extremely important: (DHA for neurological development)
- permanent effects on development (alcohol)
7-40wks
- rapid growth
- foetus concentrates nutrients to help through 1st 6 months (iron)
- energy & nutrient requirements increase; obtained from diet & body stores
What are the energy needs during pregnancy?
- physical activity decrease
2nd trimester: approx 1400kJ extra/day
3rd trimester: approx 19000kj extra/day (tub yoghurt + 2 slice bread)
What are the protein needs during the 2nd & 3rd trimester?
Increase of 12-14g/day, but usually already adequate
Regular intake - 46g/day
pregnant - 58-60g/day
NNS 83-127g/day
What are the mineral requirements during pregnancy?
- slight increases for many
- calcium: +300mg 14-18yrs // otherwise none as you absorb more in pregnancy
- iron: +9-12mg (absorption increases - 7% 12wks > 66% 36wks)
- Zinc: +3mg
- Iodine: +70ug
What are the vitamin requirements during pregnancy?
- general requirements increase but usually enough consumed
- vitamin B12 for strict vegans
- increased folate
- vitamin A - issues with toxicity
What is the recommended dietary intake for Protein, Calcium, Iron, Folate for women 14-50yrs?
Protein 45-46g
Calcium 1000-1300mg
Iron 15-18mg
Folate 400ug
What is the recommended dietary intake for Protein, Calcium, Iron, Folate for pregnant girls 14-18yrs?
Protein 58g
Calcium 1300mg
Iron 27mg
Folate 600ug
What is the recommended dietary intake for Protein, Calcium, Iron, Folate for pregnant women 19-50yrs?
Protein - 60g
Calcium - 1000mg
Iron - 27mg
Folate 600ug
Define the importance of Iron to pregnancy
Extra 800mg needed (15mg/day)
- increase in maternal blood supply
- active bone marrow (500mg)
- term foetus & placenta (300mg)
What does iron supplementation depend on?
- iron status before pregnancy
- intake & absorption during (haemoglobin & ferritin;serum levels)
- anemia: 60-120mg of ferrious iron/day until normal levels then 30mg/day
- 15-20% iron in food absorbed - affected by factors (not in tea, milk, coffee)
- vitamin C increases absorption
Calcium requirements during pregnancy, impact of low intake & inhibitors to absorption.
- extra after 12wks (foetal skeleton)
- 30g stored in skeleton; remainder stored for lactation
Low intake: - causes leaching from maternal skeleton (increased risk of osteomalacia)
- affects neonatal bone density
Absorption inhibited by: - oxalates, caffeine
Why is Folate/ folic acid required during pregnancy, effects of deficiency, how supplementation helps
- demands double
- maternal erythropoiesis
- foetal & placental growth
Deficiency - causes reduction in DNA synthesis & miotic activity in individual cells
= anencephaly/spina bifida
Supplementation - reduces risk of neural tube defects
