Pregnancy, lactation & weaning Flashcards
Does energy requirement change during pregnancy?
Not until 3rd trimester where it increases by 191 kcals
What are main points to remember with nutrition and pregnancy?
- Don’t eat for two
- Maintain general healthy eating
- Eat regularly, don’t go too long without eating
- Small meals and snacks
- Being at a high weight can lead to complications
- Supplement if deficient in anything
- Speak to GP if there are any concerns
Why is there no increment in iron RNI during pregnancy?
No menstruation so extra iron that was lost through blood loss can the ben used to help organ expansion
What can a folate deficiency cause during pregnancy?
Neural tube defects such as spinal bifida
What is the RNI for folate for a pregnant woman?
300ug/day throughout whole of pregnancy
400ug/day preconception
Who is most at risk of spinal bifida?
- Those who have it
- Partners who have it
- Previous baby having it
- Family history of NTD
- Diabetes and anti-epileptic medication
- Folate deficient
What is Healthy Start?
- An organisation that provides vouchers to spend on fresh fruit, vegetables, milk and formula
- Each week worth £4.25
- 2 vouchers per week when baby is born
- Provide free vitamin supplement (Vitamin C, D and folic acid)
- Provides Vitamin D drops for breastfed babies
What foods should be avoided during pregnancy?
Andy why?
- Soft cheese with white rinds e.g. brie, camembert
- Soft blue cheese e.g. roquefort
- Pate - all
All can cause listeria - Rare meat
- Uncooked cured meats
- Unwashed fruit and veg
All contain toxoplasmoids - Raw/ partially cooked eggs without a red lion logo
- Homemade mayonnaise/ mouse
To prevent salmonella - Shark, marlin, swordfish and raw shellfish
- Only 2 portions of oily fish per week
Contain high levels of mercury and pollutants which the foetus is susceptible to - Alcohol
Can cause foetal alcohol syndrome
What is Alcohol Foetal Syndrome?
What does it cause?
When a mother drinks alcohol during pregnancy it can lead to Alcohol Foetal Syndrome of the baby. The symptoms include - Restricted growth - Facial abnormalities - Learning and behavioural difficulties
What is the advice with caffeine during pregnancy?
- Maximum 200mg/day
- High intake linked with low birth weight and miscarriage
What should be avoided during breastfeeding?
- Caffeine
- Alcohol
- 2 portions of oily fish per week
What are the benefits of breastfeeding?
- Immunity and providing antibodies to the baby
- Less have gastroenteritis
- Few infections
- Better microbiota - encourage good bacteria to grow in gut
- Disease prevention later on in life
- Bonding and relationship building between mum and child
- Convenience
- Complete nutrition for the baby
- Affordable - no equipment needed unless expressing
- Disease prevention for mother - breast and ovarian cancer risk reduced
At what age should weaning start?
6 months
What is the earliest you can introduce solids during weaning?
4 months
What are the requirements for weaning?
- Baby need to be able to sit up and hold their head steady
- They need to be able to coordinate putting food into their mouth
- Need to be able to swallow food
What should be avoided for babies under 6 months
- Foods with allergens e.g. wheat, cow’s milk, eggs, honey, nuts, gluten, shellfish
What foods babies under 6 months have?
Watery, pureed foods such as porridge and pureed veg
What should a child on 6 months eat?
- Finger foods
- Iron containing foods due to lack of iron in milk
- Variety of textures and tastes
- Can have foods containing cows milk
What should a baby of 8-9 months eat?
- 3 meals a day
- All food soft, chopped or mashed
- Finger foods
- All food groups
- No added sugar or salt
What should a child 12+ months eat?
- 3 meals a day
- Family foods
- Snacks may be needed due to small stomach size
- No added sugar or salt
When can a child drink full fat cows milk?
12 months
When can a child drink skimmed milk?
From 2 years old, unless not growing properly then wait until age 5
Are plant based milks okay for infants?
Should not be used, as they are not nutrient rich enough
When should breastfeeding end?
There is no end date and can be continued throughout weaning
Why can’t a baby have solids before 4 months?
- Not ready orally - cannot swallow or breakdown food
- Gut not fully developed enough
What is the energy increment for breastfeeding mothers?
+335kcal for first 6 months
What is the protein increment for breastfeeding mothers?
+ 11g/day
What is the vitamin A increment for breastfeeding mothers?
600ug/d + 350ug/d
What is the calcium increment during breastfeeding?
700mg/d + 550mg/d
What diets may need attention during pregnancy and breastfeeding?
- Vegans and vegetarians
- Teenagers - have own growth requirement to meet
Why is Listeria dangerous?
What are the symptoms?
- Can cause miscarriage or still birth
- Can cause blindness, deafness and other malformations in baby
- Vomiting, diarrhoea and high temperature are some symptoms in mother
- Can grow at fridge temperature
Why should cat litter not be handled during pregnancy?
Contains toxoplasmoids
What should be consideration should be taken about retinol?
- Harmful to foetus at high levels
- Avoid liver, pate, haggis, fish oil and retinol supplements
- Avoid homeopathic remedies
What cheeses are unsafe during pregnancy?
- Unpasteurised cheese
- Soft cheese with white rinds e.g camembert, brie
- Soft blue cheese e.g. gorgonzola, roquefort
Can sushi be eaten during pregnancy?
Only if frozen as it can contain parasitic worms
Are peanut okay to eat during pregnancy?
- Used to be avoided but now only if mother is allergic
- Some evidence suggests it’s better to expose it
When should follow on milks be introduced?
When the infant is a fussy eater or not getting enough nutrition
What contribute to the energy requirements of a pregnant individual?
- Body weight
- Body composition
- Physical activity levels
- Whether its a single baby, twins or triplets
What is the Vitamin D RNI for both pregnant and lactating women?
- 10ug/day
