pregnancy nutrition Flashcards
why does optimum nutrition in pregnancy matter?
optimum fetal growth
optimum fetal well being
optimum maternal health
what are some causes of low birth weight?
preterm birth: - multiple birth - previous preterm - previous TOP - smoking - stress - infection poor fetal growth: - alcohol/smoking - poor nutrition - being under weight before pregnancy - mothers age - genetic abnormality - poverty
what makes up the weight gain in pregnancy?
fetus placenta amniotic fluid extracellular fluìd fat tissue uterus and breast increase blood volume increase
how much more should a pregnant woman eat?
in 1st ad 2nd trimester eat as normal
3rd trimester eat 200kcal more
what can Vit D deficiency cause?
bone fragility, rickets, obstetric complications = pre-eclampsia
why = responsible for enhancing intestinal absorption of calcium and phosphate
therefore give 10mcg per day of cholecalciferol during pregnancy and while breastfeeding
at risk = obese, limited sun exposure, malnutrition
what are healthy start vitamins.vouchers?
one healthy start voucher/week worth £3.10 and a vitamin voucher (folic acid, C, D) to improve the health of low-income pregnancy women o benefits
why is folic acid supplementation given?
to reduce the risk of rural tube defects
as folate acts as cofactor for enzymes involved in DNA and RNA biosynthesis
400mcg for all women
5mg for women with raised BMI >30 or previous NTD
what foods should be avoided in pregnancy?
pate soft cheeses / soft blue cheese uncooked eggs/non-lion code eggs unpasteurised milk rare meats no more than 2 portions of oily fish a week (mercury) vit A suppléments caffeine = 200mg a day 2 instant coffees alcohol
what are the features of fetal alcohol syndrome?
short palpebral fissure flat mid face short nose indistinct philtrium thin upper lip epicentral folds low nasal bridge micrognathia
what can breastfeeding reduce?
for child = acute otitis media, gastroenteritis, severe lower respiratory tract infections, dental malocclusions, obesity, T1/2DM, SIDS, NEC
for mother = breast cancer, ovarian cancer, postnatal depression, another pregnancy too close together
what savings could be made to NHS if more mothers breast fed?
865 fewer cases of breast cancer
£21 million savings
what are the breast feeding rates in the UK like?
65% at birth
40% at 6wks
20% at 6 months
10-15% at 9months
what is the milk produced?
days 1-3 = colostrum
days 3-14 = transitional milk
days 14 onwards = mature milk
what is colostrum?
thicker and more concentrated than breast milk
yellowish or clear
small volume to allow baby to get rid of excess tissue fluid without overloading kidneys
higher concentrations of antibodies, white blood cells and other anti-infective proteins than mature milk
mild laxative effect
rich in growth factors
richer in vit A and K than mature milk
creates acidic envirnoment
what is the volume/fat gradient of breastfeed?
at the start = high volume low fat milk
at end = low volume high fat milk
what immunoglobulins are present in breastmilk?
IgA
what is lactoferrin?
a multifunctional protein of the transferrin family, a globular glycoprotein widely represented in secretory fluids such as milk
what do lysosomes do?
bactericidal and anti-inflammatory action
contributes to the destruction of Ecoli and some salmonella strains
production increases with age of infant
what are risk factors for gesture-enteritis if baby is formula fed?
free iron in gut = bacteria thrive on no lactoferrin no bifidus factor = increase pH conductive to bacterial growth no secretory IgA no white cells no lysosome no epidermal growth factor
what is the prolactin response?
baby suckles -> sensory impulses pass from nipple to brain -> prolactin secreted by anterior pituitary gland goes via bloodstream to the breasts -> lactocytes produce milk
more secreted at night
suppresses ovulation by suppressing GnRH
levels peak after feed to produce milk for next feed
makes mother feel more relaxed and sometime sleepy
what is the prolactin receptor theory?
surges of prolactin prime the receptor sites -> expulsion of placenta opens receptor sites -> unprimed receptor sites shut down reducing potential for milk production
frequent prolactin release maximises long-term milk supply
how can a mother stimulate the prolactin receptor sites?
skin-to-skin
early feeds
expression of breast milk
what is the oxytocin reflex?
baby suckles -> sensory impulses pass from the nipple to the brain -> oxytocin secreted by posterior pituitary gland goes via bloodstream to the breast -> myo-epithelial cells contract and expel milk
helped by sight, sound and smell of baby
becomes conditioned over time
hindered by anxiety/stress
works before/during feed
what is the feedback inhibitor of lactation (FIL)?
a protein that causes the lactocytes to ignore the signals from prolactin when the breast is full
if only little milk is removed/long gap between feeds = milk production will slow down
more frequent sucking/feeds = less effect the FIL will have
why is correct positioning and attachment important?
ensures efficient milk transfer
ensures sufficient milk supply
prevents mothers nipples becoming sore
what can affect breastfeeding resilience ?
support at home how she was fed herself previous experience access to skilled help skills/knowledge social norms peer group/family pressure self esteem/self efficacy
what does NOSH stand for?
nourishing start for health
