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Nutrition 207 > Pregnancy and Lactation > Flashcards

Pregnancy and Lactation Flashcards

1
Q

What is the zygote?

A

The union of the sperm and the egg

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2
Q

What happens 2-4 days after fertilization?

A

Division and moving through fallopain tubes

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3
Q

What happens 4-5 days after fertilization?

A

Blastocyst reaches uterus

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4
Q

What happens 5-9 days after fertilization?

A

Blastocyst implants in the uterus

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5
Q

Three stages of development after fertilization?

A

Zygote, embryo, fetus

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6
Q

When is the embryo stage?

A

After 5 weeks

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7
Q

When is the fetus stage?

A

At 11 weeks

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8
Q

Placenta can be compared to

A

Villi in the gut, the maternal side of the placental villi is bathed in nutrient-rich maternal blood.
The placental villi absorb the nutrient molecules and release them to the fetus via fetal capillaries

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9
Q

What is “rich chyme”?

A

Nutrient-rich maternal blood

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10
Q

What is the name of the connection between fetus blood and the placenta

A

Umbrical cord

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11
Q

Are placental villi connected to maternal portion of placenta?

A

No, just exchange, no connection

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12
Q

The placenta performs what role for the embryo?

A

Respiratory(lungs),absorptive (GI tract) and excretory system( kidney)

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13
Q

What can cross the placenta?

A

Oxygen, nutrients,drugs ( alcohol,medications) from the mother
Extra waste from the fetus to the mother

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14
Q

What does the fetus have by the end of 8 th week

A

Most of the internal organs, external body structures( central nervous system, heart,digestive system,fingers,toes)

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15
Q

How the weight and the length of the child change from the fetus stage to the moment it was born.+usual length of the new-born

A

The infant is 20 times longer and 50 times heavier .

Usual length is 50 cm

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16
Q

When does the major weight gain happen for the child?

A

second and third trimester

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17
Q

How long usual pregnancy last?

A

38-42 weeks

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18
Q

What is the critical period and its characteristic

A

When each organ grows and develops rapidly. If the development of an organ is limited during a critical period, recovery is impossible

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19
Q

When is the most critical phase for most organs?

A

Embryo stage ( 2-8 weeks)

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20
Q

What are 5 guidelines for a healthy pregnancy?

A
  1. Appropriate weight gain
  2. Good nutrition
  3. Prenatal supplement
  4. Avoidance of harmful substances
  5. Physical activity
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21
Q

Maternal weight gain depends on

A

The starting weight

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22
Q

If BMI of the woman is less than 18.5 how much she should gain in total and in 2nd/3rd trimesters?

A

12.5-18 kg(28-40 pounds) in general

during 2nd and 3rd trimester 0.5 kg/week(1 pound/week)

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23
Q

If BMI of the woman is in normal range zone(18.5-24.9) how much she should gain in total and in 2nd/3rd trimesters?

A

11.5-16 kg in total(25-35 pounds)

during 2nd and 3 rd trimester 0.4 kg/week (1 pound/week)

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24
Q

If BMI of the woman is in overweight zone (25-29.9) how much she should gain in total and in 2nd/3rd trimesters?

A

7-11.5 kg in general (15-25 pounds)

0.3 kg/week( 0.6 pound/week)

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25
Q

If BMI of the woman is obese category (>30) how much she should gain in total and in 2nd/3rd trimesters?

A

5-9 kg(11-20 pounds)

0.2 kg/week(0.5 lbs/week)

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26
Q

How much women do not meet their requirement for the weight gain and what are the consequences ?

A

2/3 women are going beyond

It increases risks of complications during pregnancy and decrease the chance of successive weight loss after the labor

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27
Q

Is the weight of the baby included in the weight gain of the mother?

A

Yes

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28
Q

How much should the normal woman gain each week during pregnancy?

A
  1. 5 pounds (1.5 kg/week) during first trimester

0. 5 kg(1 pound/week) during 2nd and 3rd

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29
Q

How much should the underweight woman gain each week during pregnancy?

A

2.5 kg(5 pounds/week) during 1st trimester

1 pound/ week( 0.5 kg) during second and third

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30
Q

How much should the overweight woman gain each week during pregnancy?

A 
1 kg/week( 2 pounds/week) in the first trimester
330 grams (2/3 pound)/week in 2nd and 3rd
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31
Q

The weight of the mother is closely related to

A

The weight of the child and as a consequence the health out come

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32
Q

3.1-3.6 kg is the_____ for the baby’s weight

A

Appropriate for gestational age

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33
Q

What is the weight of the child who is large for gestational age

A

Bigger than 4.0-4.5 kg

>90 th percentile for age

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34
Q

What is the weight for SGA?

A

Small for gestational age. <2.5 kg

Weight is <10th percentile for age

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35
Q

What is the risk for children who is smaller for their gestational age?

A

At a higher risk of having physical and mental disorders, contracting diseases and die earlier in life

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36
Q

How children can become LGA?

A

Of the mother had uncontrolled weight gain

Diabetic mother-> child has uncontrolled level of glucose coming

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37
Q

What is the percentage of the total weight gain by woman is the weight of the fetus?

A

20-30%

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38
Q

Why women gain 20% of fat during pregnancy?

A

Helpful for delivery and lactation

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39
Q

How much the volume of the blood increases?

A

By 50 %

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40
Q

Should women restrict calories during pregnancy if she wants to lose weight?

A

No, if you want to lose weight, lose it before pregnancy. Restricting calories can exclude some nutrients necessary for the fetus

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41
Q

Factors placing pregnant women at nutritional risk?

A
  1. Pre-existing
  2. Age
  3. Lifestyle/social factors
  4. Conditions of Pregnancy
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42
Q

Explain in detail pre-existing health conditions

A

The specific needs for some nutrient that were before the pregnancy+ the needs for the pregnancy

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43
Q

Explain in detail lifestyle/social factors

A
  • Alcohol/smoking/drug use
  • Poor financial status ( how much money you have to spend on nutritious food)
  • Little family support
  • Low level of education (do you know what are you needs during pregnancy)
  • Too little or too much weight gain during pregnancy
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44
Q

Explain age risks

A

Adolescence have higher nutrient demands than normal woman, so we need to meet the basic requirements+ the requirements of the pregnancy
Low education as well

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45
Q

Explain conditions of pregnancy

A
  • Many previous pregnancies ( the nutrient pools of some nutrients are very low, the baby will take the advantage, the risk for the mother, for example calcium stores will be depleted for bone development ->osteoporosis )
  • Short intervals between the pregnancies
  • History of poor pregnancy outcomes ( gestational diabetes)
  • Pregnant with multiples ( increased needs)
46
Q

How much calories per day should be added during each trimester?

A

1st trimester- 0 kcal/day
2nd trimester-340 kcal/day
3 rd trimester-450 kcal/day

47
Q

What are the increased macronutrient requirements during pregnancy ?

A

Protein(+25 g/day)
Carbohydrates (>175 g/day, but not less than 135 g/day)
Fat ( no change,but focus on EFAs)

48
Q

Do usual women need to increase the protein intake during pregnancy?

A

No, they in the normal diet we have enough

However, vegetarians and vegans should consider

49
Q

How to lower nausea and heart-burn during pregnancy ?

A

Eating smaller portions , but frequently, can help

50
Q

Though all micronutrient needs increase during pregnancy, what are nutrients that increased in particular? Should you take supplements for them?

A

Zinc, Iodine, Iron,Folate
For Fe and Folate supplementation is recommended
For iodine and zinc - not specifically supplementation

51
Q

What are the role of folate and its requirements during pregnancy

A

Key role in synthesis of new cells, prevention of neural tube defects( beginning of the central nervous system)
0.4 mg of folic acids from supplements and ensure intake of folate-rich food

52
Q

What are the roles of vitamin B 12 during pregnancy and requirements

A

Assists folate in the synthesis of new cells.

Supplement for vegans and vegetarians

53
Q

The roles of Fe during pregnancy and requirements

A

Supports enlarged blood volume and provides for placental and fetal needs
Supplementation containing 16-20 mg

54
Q

The roles of Ca and vitamin D and their requirements during pregnancy

A

Maintain integrity of maternal bones, while providing for the skeletal development of the fetus and the production of breast milk
-Ensure intake of calcium-rich food. Supplements conatining 600 IU or 2000 IU vitamin D

55
Q

The requirements for EPA and DHA and their roles

A

Fetal brain development

2 servings of low Hg fish per week

56
Q

What are the roles of zinc and iodine during pregnancy

A

Iodine -fetal brain development

Zinc- Key role in protein synthesis and cell development

57
Q

Why is it important to take enough iron during pregnancy

A

The fetus is building up the stores of iron for the first 4-6 month, because the breast milk is not rich in iron+ the needs of the mom

58
Q

The critical period for CNS?

A

17-30 days

59
Q

What are the recommendations for the food during pregnancy?

A

Eat more nutrient dense foods, because there a re more needs in nutrients than in energy, minimize empty calories

60
Q

Can you be vegetarian and vegan during pregnancy?

A

Yes, just well-planned

61
Q

Prenatal supplements are usually high in

A

Folate, B12, Fe,Ca compare to the normal supplements

62
Q

Supplementation during pregnancy is especially beneficial to

A

Women carrying twins or triplets
Cigarette smokers
Alcohol and drug abuse
However, the supplementation cannot prevent the vast majority of destruction from tobacco, alcohol, drugs

63
Q

Is there a safe amount alcohol during pregnancy?

A

No

64
Q

If you are planning to become pregnant you should

A

Stop drinking, smoking, taking drugs

65
Q

Threatens of alcohol during pregnancy

A
  • Irreversible brain damage
  • Growth retardation
  • Mental retardation
  • Facial abnormalities
  • Vision abnormalities
66
Q

What is FASD

A

Fetal alcohol spectrum disorder-An umbrella diagnostic term describing the range of effects that can occur in an individual who was prenatally exposed to alcohol

67
Q

Some signs of FASD

A

Small head, short nose, flat midface, small eye openings

68
Q

What you should consider with caffeine, sugar and cannabis

A

Caffeine- limit to 2-3 cups a day( less than 300 mg)- not only coffee has caffeine
Sugar- no excess artificial sugar consumption, replace with nutrient-dense food
Cannabis- not sure about the effect, but can be associated with LBW, cognition, academic achievement, etc. Stop to smoke

69
Q

What are pros and cons of fish

A

Pros- omega 3 FA for brain development, protein , vitamin D, zinc
Cons - Hg move across the placenta->damage to fetal nervous system, food safety

70
Q

What common discomforts during pregnancy can be solved with food?

A

Nausea, morning sickness, heartburn,constipation

71
Q

How to avoid nausea during pregnancy?

A
  • On waking, rise slowly.
  • Eat dry toast or crackers.
  • Chew gum or suck hard candies.
  • Eat small, frequent meals.
  • Avoid foods with offensive odours.
72
Q

How to avoid heartburn during pregnancy?

A
  • Relax and eat slowly.
  • Eat small, frequent meals.
  • Avoid spicy or greasy foods.
  • Sit up while eating; elevate the head while sleeping.
  • Wait 3 hours after eating before lying down.
  • Wait 2 hours after eating before exercising.
73
Q

How to avoid constipation?

A
  • Eat foods high in fibre
  • Exercise regularly.
  • Drink at least eight glasses of liquids a day.

• Use laxatives only as prescribed by a physician

74
Q

The positive aspects of exercising during pregnancy

A
  • Better sleep and mood
  • Help to reduce common complaints during pregnancy
  • Promotes strength, muscle tine and endurance-> for labor and recovery
75
Q

What you should do for the exercise during pregnancy?

A

Swimming,aerobics,Scandinavian walk( so the temperature of the body is cool)

  • at least 3 times a week
  • Drink water before, during and after
  • Eat more to meet your energy needs for the exercise
76
Q

What you should not do for the exercise exercise during pregnancy

A

Avoid balance exercise

  • if you feel any pain or discomfort, stop
  • Not very long
  • Not in hot place
  • No exercise that will harm the abdomen
  • Do not exercise when you feel sick
77
Q

What screening should be done to the mother during pregnancy ?

A

Gestational Diabetes
HTN, Preeclampsia( a type of hypertension when there is an extra impact on organs-kidneys)
-Hemoglobin
-Weight gain

78
Q

What is done as screening to the fetus?

A
  • Fetal growth-Ultrasounds

- NTDs-Aminocentesis- check for the defects of the neural tube, not done for everyone, because the risk of miscarriage

79
Q

What are the recommendations for the breastfeeding

A

Breast milk and/or formula only for the first 4 to 6 month of life exclusively and continue for up to 2 years as complementary

80
Q

What are the energy requirements to produce milk and how it influences energy requirements of the mom

A

+500 kcal.day( to non-pregnant EER)- for production of milk
330 kcal/day to add from food
170 kcal to lose weight from the fat storage

81
Q

Why after 6 month of lactation the requirements for extra calories are only 400 kcal?

A

Because from 7-12 month not exclusively breastfeeding

82
Q

How much women who are breastfeeding should drink?

A

3.8 L, food-20%
Water-12 cups
Drink at every meal and at every breastfeeding

83
Q

How many times a day the baby should be breastfed

A

8-12 time

Every 2-3 hours

84
Q

What happens to the micronutrient requirements during lactation?

A

They are even higher than during pregnancy( exception Fe and Folate)
Vitamin supplements depends on intake ( nutrient dense vs poor), vegetarian/vegan
Iron,calcium , vitamin D and B 12- the stores are depleted , a need to refill

85
Q

Nutrition during lactation

A
  • Nutrient-dense foods from all CFG groups
  • Eating a variety of different foods-> change in breast milk-> improved acceptance of solid food after
  • Limit( HG fish, caffeine 300 mg/day,alcohol,illicit drugs-cannabis)
86
Q

What happens to the milk if the mom is not meeting the energy requirements?

A

Less milk, but the quality stays the same, will be kept to the expense of the mother ( calcium will be given to the child)

87
Q

Benefits of breastfeeding

A
  • Immunity of the child, protects against allergies, nutrient-dense food
  • Cost savings
  • May protect against breast cancer, contracts uterus, delays the return of regular menstruation
88
Q

What happens with the weight of the child during the first year of life?

A

Triple their weight, they will never grow with such speed after

89
Q

What is the heart rate of the infant comparing to the adult

A

Infant -120-140

Adults- 70 to 80

90
Q

What is the respiration rate of the infant comparing to the adult

A

Infant-20-40

Adults-15-20

91
Q

What are the energy needs of the infant comparing to the adult

A

Infant- 100 kcal/kg

Adults <40 kcal/kg

92
Q

What is the composition of the breast milk?

A

39% - CHO
55%-fat
6%-protein

93
Q

Why milk is so high in fat

A

Babies ->small stomach-> need a lot calories-> fat is energy-dense+ EFAs for the brain

94
Q

Infants need 10 times more vitamin D , so they need

A

Drops of vitamin D to meet the needs

95
Q

What is the difference between the formula and breast fed infants requirements for vit D

A

Breastfed infants need extra supplementation of vitamin d, but the formula already fortified

96
Q

Breastfed and formula fed infants after 6 month require

A

Iron and fluoride from complementary food

97
Q

What is the name of the milk at 2-3 days and its function

A

Colostrum
Antibodies->Immunity
Good gut bacteria
Help transition of the first poop(muconia)

98
Q

What is the name of the milk at 4-14 days and after 14 days

A

Transition milk

Mature milk

99
Q

Advantages of the formula feeding

A

Vitamin D fortified

Other family members can feed as well

100
Q

Why cow milk is the inappropriate replacement

A
  • Provides low iron low Vitamin C,high in Ca( competition for Fe absorption )
  • Infant’s GI may sensitive to cow milk proteins
  • Stresses om immature kidneys
101
Q

After 12 month of age you can add

A

2/3 of daily energy from cereals, vegetables, fruits and other food
Whole cow’s milk, fortified with vit D and A

102
Q

The rate of breastfeeding initiation and continuity

A

High at the beginning, but only about 25% stay until 6 month

103
Q

Global breastfeeding statisctics

A
  • 3 out of 5 are not breastfeed within the first hour

- Only 23 countries have the rate of >60% for exclusive breastfeeding

104
Q

What should be done to increase breastfeeding rates?

A
  • Education
  • Support for 6 month and complementary beyond
  • Hospitals: early initiation, support, demand
105
Q

What are the procedures for the milk donor

A
  • Only from the consent of the parent
  • Screening on HIV, hepatitis B and C, leukemia
  • Should be pasteurized and kept according to Canadian Food Inspection Agency
106
Q

When you should introduce solid foods to he child?

A

Curiosity
Can swallow
Sit up with support
Good neck and head control

107
Q

What food you should introduce first to the child

A
  • Pureed, mashed,

- Iron fortified foods+ vitamin C to improve absorption

108
Q

Should you decide how much the baby eats

A

No, let them decide on their own

109
Q

When honey can be introduced?

A

After 1 year

110
Q

Infant feeding avoid

A

-Sweets
-Bottle at bedtime
Force feeding
Choking hazards

111
Q

Infant feeding do’s

A

Feed self

  • Try new food
  • Stress-free meals
  • Healthy eating habits

Nutrition 207 (17 decks)

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