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Test 1 Lactation Flashcards

1
Q

Infertility vs subfertility

A

Infertility: inability to conceive within 12 months of trying

Subfertility: women who have had 2-3 losses or ovulate infrequently or men with sperm abnormalities

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2
Q

Most important micronutrients in the preconception state?

A

Zinc
Folate
Iron
Vitamin A

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3
Q

Lifestyle for increasing fertility

A

Adequate weight
Don’t smoke
Limit alcohol

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4
Q

Female diet for increasing fertility

A 
Vitamin D
Multivitamin with Folic acid
Iron
Protein
More PUFAs
Less caffeine
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5
Q

Male diet for increasing fertility

A 
Vitamin D, C
Calcium
Zinc
Low GI index foods
Less caffeine, animal protein and soy
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6
Q

Most important nutrients for fetal brain development

A 
Iron
Zinc
Iodine
PUFA
Vitamin A
B12
Folate
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7
Q

Physiological changes in blood during pregnancy

A
  • Increased volume
  • Water soluble components decrease
  • blood lipids increase
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8
Q

Physiological changes in circulatory system during pregnancy

A
  • Increase HR/CO
  • low BP first half, high BP second
  • low mg/ca intake associate with higher BP
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9
Q

Physiological changes in GI during pregnancy

A

Heartburn
Nausea/vomiting
Increased transit time (constipation)

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10
Q

Physiological changes in kidneys during pregnancy

A
  • GFR increases 50%

- increased Na retention

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11
Q

Physiological changes in metabolism during pregnancy

A

-fetus prefers glucose energy (carb intake)
-increased protein synthesis
Decreased nitrogen excretion
-fat storage in first half, mobilization in second half
-increased Ca absorption and mobilization from bone
-increased metabolism (fasts 12+ longer increase many keytones)

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12
Q

Causes of IUGR (intrauterine growth restrictions)

A 
1. Small placenta: less SA for absorption
Infection
HTN
Preeclampsia
Malnutrition
Small maternal size
Young mother
Substance abuse
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13
Q

What increases risk of miscarriage

A
  1. Underweight mother
  2. Oxidative stress
  3. Vitamin E and D deficiency in 1st trimester
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14
Q

What nutrient decreases risk of preterm delivery**?

A

Folic acid

Supplementation is required at least a year before getting pregnant to have affect

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15
Q

Energy requirements during each trimester

A

1st: no change
2nd (13-26wks) : +340 cal/d
3rd (27-42wk): +452 cal/day

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16
Q

Carb requirement during pregnancy

A

175 g/d

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17
Q

Fiber requirement during pregnancy

A

28 g/d

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18
Q

Most important nutrients DURING pregnancy

A 
Folate
B6,12
Vitamin K
Iron
Ca
Iodine
Zn
Cu
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19
Q

What is choline needed for during pregnancy

A

Signaling and nerve transmission

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20
Q

What vitamins in supplement form if taken during pregnancy increase risk of preterm labor and decrease birth weight

A

Vitamin C and E

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21
Q

What vitamin is teratogenic at high doses during pregnancy

22
Q

What are vitamin D and K good for during pregnancy

A

Bone health

23
Q

Severe deficeiency of Iodine during pregnancy can cause what

A

Impaired fetal neurodevelopment

24
Q

Deficiency in iron during pregnancy increases risk of what?

A

Postpartum depression

25
RDA of what nutrient doubles during pregnancy
Iron
26
What is epigenetics
Stable changes to a gene structure without changing DNA sequence. Changes how genes are expressed
27
What vitamins may have influence on gene expression (epigentics) because they are capable of methylation
B12 and folate
28
What is fetal programming?
Maternal under or overnutrion can program infant to be predisposed to: ``` Heart disease Stroke Diabetes Obesity Hypertension ```
29
Maternal stress and fetal cortisol relationship
11B-HSD2 produced by placenta and inactivated cortisol. Increased maternal stress causes decreased expression of 11B-HSD2 and causes increased fetal cortisol
30
What maternal dietary factors may increase fetal stress and cortisol concentrations
Calorie restriction Low protein High fat and sugar Low Mg, choline, folate Silence 11B-HSD2 (Hydroxysteroid dehydrogenase)
31
What dietary factors cause healthy epigenetic alterations?
Polyunsaturated fats Fruits/veggies (polyphenols) Folate/Vit B12 Selenium
32
What is one of the main dietary compounds that influence epeigenetic gene expression
Glucose Affects methylation patterns
33
Epigenetic diet
``` Vitamin C, A, B12 Folate Polyphenols Copper Sulforaphane Omega-3s Zinc ```
34
How much weight should a woman gain during pregnancy
Normal weight: 25-35lbs Twins: 35-45 Overweight: 15-25
35
What are some side effects of pregnancy and fix?
Constipation Heartburn: smaller meals, less caffine, stay upright, carbonated beverages Nausea/vomiting: carb containing meals, ginger, smelling lemons Hypertension: Ca/Mg/K Leg cramps/edema: Mg, stretch, increase fluids
36
What foods should be limited in pregnancy?
- unpasteurized food (soft cheeses) - no salads from store - reheat meat (no cold deli meat) - shark, swordfish, tilefish, mackerel - albacore/tuna: 6oz/wk
37
What supplements should pregnant females take
Folic acid | Iron
38
What nutrients take longest to normalize after pregnancy
2-4 months: Iron | 6+ months: folate
39
What does WHO consider the minimum time between weaning 1 in fact and conception of the next?
18-24 months Risk decreases with folic acid supplementation
40
How many extra calories are required during lactation
0-6months: 330 cal/day | 6+ months: 400 cal/day
41
How many carbs are required during lactation
210g/day
42
What are most important nutrients during lactation
``` Vitamin D B12 Iron Iodine Zinc ```
43
Stages of lactation
Colostrum: 0-5days Transition milk: 5-14 days Mature milk: 2+ weeks
44
Colostrum
``` -0-5 days Many antibodies Fat-soluble vitamins Electrolytes High in protein ```
45
Transition milk
5-14 days Protein drops Lactose/fat increase
46
Mature milk
2+ weeks 40% of energy as lactose 55:45 casein:whey
47
Foremilk contents
First milk secreted High in water, cards and water-soluble vitamins Low fat
48
Hindmilk contents
High-fat milk
49
What are galactagogues
Milk production stimulants
50
Examples of galactagogues (milk production stimulants)
- Oats, barley, beans, almonds - Dark leafy veggies - fenugreek milk thistle - alfalfa - caraway Meds: motilium, reglan
51
What foods may prevent postpartum depression
``` Omega3 Folate Riboflavin: cows milk/grains B6,12: meats Vitamin D Calcium Iron Selenium: Brazil nuts/anything from ground ```
52
What is used to measure postpartum depression
Edinburgh postpartum depression scale EPDS

Clinical Nutrition (5 decks)

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