Pregnancy

Question 1

What can too much weight gain during pregnancy be linked to?

Answer 1

• Gestational diabetes

- High blood pressure

Question 2

What are the energy requirements during pregnancy?

Answer 2

• Additional 191kcal during 3rd trimester

Question 3

What is the protein recommendation during pregnancy?

Answer 3

• additional 6g/d

Question 4

Why is there no increment for iron during pregnancy?

Answer 4

• no menstruation so the extra iron can be used to cover the development of the placenta and extra organs for the baby.

Question 5

What is the recommendation for vitamin d during pregnancy?

Answer 5

• 10 microgram/d supplement

Question 6

What is the RNI for folate for pregnancy?

Answer 6

400ug/day preconception up to first 12 weeks.

normal RI = 200ug/day

Question 7

What are Neural Tube Defects?

Answer 7

Neural Tube defects are a group of conditions where the neural tube, the surrounding bit of the spinal cord, doesn’t close properly and can cause spine or brain defects. Most common is spina bifida - can cause paralysis of the legs and incontinence but severity varies.

Question 8

Higher does of 5mg/day are advised for some people at risk of neural tube defects. Who is at risk?

Answer 8

• Themselves or biological father have NTD
• Themselves or father have family history of NTD
• Previous pregnancy affected by NTD
• Diabetes
• Anti-epilepsy medication

Question 9

What is Healthy Start?

Answer 9

NHS scheme for women and children in the UK which starts when women are 10 weeks pregnant until child is 4 that helps women who are on low incomes and receiving benefits. They are edible to get weekly vouchers worth £4.25 for fruit, vegetables, milk or formula.
- Healthy start women’s vitamin tablets contain Vitamin C, vitamin D3 and folic acid.

Question 10

What foods should be avoided during pregnancy?

Answer 10

Listeria can cause deafness, blindness and stillbirth in baby and can be contracted from uncooked:

• soft cheese with white rind e.g. brie
• pate

Salmonella:

• uncooked eggs unless have a Red Lion logo
• mayonnaise/mousse unless made with Red Lion stamped eggs
• care with food hygiene and raw meat, especially poultry

Toxoplasmosis

• Avoid rare meat
• Wash all fruit and vegetables if eaten raw
• Avoid cat litter

Retinol can be harmful to foetus at high levels:

• Liver
• Fish oil
• Retinol supplements

Fish: Because of the pollutants that are now in the food chain, especially mercury which can damage the developing nervous system of the foetus. More pollutants the higher up the food chain they are. Can also be high levels of PCBs which come from plastics and again build up in the food chain.

• Shark, swordfish
• Tuna
• two portions of oily fish per week

Caffeine: high intakes linked to low birth weight and miscarriage
- 200mg/day

Alcohol

Question 11

Why should you not drink alcohol during pregnancy?

Answer 11

Foetal Alcohol syndrome:

• Restricted growth
• Facial abnormalities
• Learning and behaviour difficulties

Question 12

What problems can occur during pregnancy and what food related solutions?

Answer 12

• Nausea and vomiting - Eat little and often. Dry foods, ginger, avoid cooking smells where possible
• Heart burn - avoid acidic foods, dairy can help neutralise it
• Constipation - ensure plenty of fibre and fluid

Question 13

What are the extra energy requirements for breastfeeding?

Answer 13

335kcal/day for first 6 months

Question 14

What are the extra protein requirements for breastfeeding?

Answer 14

11g/day

Question 15

What vitamins and minerals need increasing during breastfeeding?

Answer 15

• Calcium: 550mg/day
• Vitamin A - 350mg/day
• Vitamin C - 30mg/day
• Vitamin D - to absorb calcium
• Fluid increase as losing so much to breastmilk.

Question 16

What are the advantages of breastfeeding?

Answer 16

• Immunity - reduced risk of gastroenteritis and ear and chest infections
• Better microflora - breast milk encourages good bacteria to grow
• Disease prevention - reduced chances of obesity, diabetes
• Mother and baby bonding
• Affordable
• Disease prevention for mother - breast and ovarian cancer risk reduction

Question 17

When should weaning start?

Answer 17

At 6 months

Question 18

What foods are not suitable before 6 months?

Answer 18

• Any allergens e.g. cows milk, gluten, eggs.
• Honey has a toxin in
• Not too sweet as can develop a sweet tooth
• Salt - kidneys not designed to handle salt

Question 19

Why should you include iron rich foods during weaning?

Answer 19

As there is not much iron in breast milk

Question 20

What should baby eat from 6 months?

Answer 20

• first foods
• pureed foods
• introduce foods individually to check baby doesn’t have allergies
• can have diary but shouldn’t be main milk until 1 year.

Question 21

What should baby eat from 8-9months?

Answer 21

• gradual move to 3 meals a day. may need snacks in between as small stomach
• soft, chopped, mashed and finger foods
• move to include all main food groups but not added sugar or salt

Question 22

What should baby eat from 12 months?

Answer 22

• 3 meals a day - family foods
• no added sugar or salt
• full-fat milk - up until 12 months the main drinks will be breast milk of formula milk or water.

Question 23

How should the eatwell guide be adapted for children younger than 5?

Answer 23

• more energy dense foods so more protein and dairy foods than fruit and vegetables as they cannot handle eating too much volume. May need more oils and spreads to get sufficient calories
• Don’t want any high sugar and salt foods
• Stick to milk and water for drinks - no going back once introduced apple juice.