Nutrition During Pregnancy 10 24 2012 Initial growth stages Zygote o 0 2 weeks o rapid cell division embryo o 2 8 weeks o organ formation fetus o 8 40 weeks o rapid growth the concept of critical periods and timing critical period recovery is impossible pregnancy outcome gestational length o normal 37 up to 40 weeks o premature less than 37 weeks birth weight o normal 5 6 to 9 9 pounds each organ and tissue type grows with its own characteristic pattern the development of each takes place only at a certain time the if the development of an organ is limited during a critical period o low less than 5 5 pounds greater than 36 weeks low birth weight increases the risk for infant death 12x congenital malformations behavior and learning problems what causes low birth weight Low maternal weight gain during pregnancy Low maternal pre pregnancy weight Maternal lifestyle factors o Alcohol o Smoking o Drugs cocaine heroine etc Recommended weight gain in pregnancy Pre pregnancy weight lb Recommended gain lb o Normal BMI 19 25 9 25 35 o Underweight BMI 18 9 28 40 o Overweight BMI 26 29 9 15 25 o Obese BMI 30 15 Pattern of weight gain 3 5 lbs during first semester 1 lb wk thereafter calorie needs during pregnancy no increase during first trimester o importance of nutrient density 400 kcal day increase in 2nd and 3rd trimester nutrients of particular importance o all women receive supplement of 27 mg day o anemia related to poor birth outcomes o all women receive supplement of 400 mcg day o deficiency leads to neural tube defects iron folate calcium choline o if inadequate intake will be taken from mother s bones other dietary components of interest o essential nutrient o important in fetal development o best source egg yolks DHA EPA o Brain development o May lower risk of pre term labor o Added to baby formulas Other recommendations to pregnant women Exercise guidelines Don t use over the counter prescription medications without consulting your physician Don t smoke while pregnant Caffeine in moderation Artificial sweeteners in moderation Foodborne illness bacteria affects mother and fetus Fetal Alcohol Syndrome Alcohol crosses the placenta freely and is directly toxic Alcohol o Limits oxygen delivery to the fetus o Slows cell division which can cause abnormalities in organs o Affects fetal brain cell division o Interferes with nutrient transport to fetus o Before fertilization alcohol can damage the ovum or sperm leading to abnormalities in the child How much alcohol is too much Moderate alcohol intake leads to low birth weight First month of pregnancy is critical No SAFE intake Exercise guidelines Exercise regularly at least 3 times a week Warm up with 5 to 10 min of light activity 30 min or more of moderate physical activity on most if not all days of the week cool down with 5 to 10 min of slow activity and gentle stretching drink water before during after eat enough to support additional needs of pregnancy plus exercise don t exercise vigorously after long periods of inactivity don t exercise in hot humid weather or when sick with fever don t exercise while lying on your back after 1st trimester or stand rest adequately motionless for prolonged periods don t exercise if you experience pain or discomfort don t participate in activities that may harm the abdomen or involve jerky bouncy movements don t scuba dive Gestational diabetes Diabetes with first occurrence during pregnancy All women tested at 28 weeks sooner if high risk Managed with diet and diabetes medications including insulin Raises risk of Type 2 diabetes later in life Lactation and Infant Feeding 10 24 2012 Ability to Breastfeed Breast milk o Prolactin synthesis of milk o Oxytocin let down of milk o Can pass on virus in HIV positive moms o Certain drugs o Only 5 100 women not able to produce sufficient milk Nutrient needs during lactation Energy o 650 800 kcal to produce milk o energy from diet and fat stores protein vitamins A E C most Bs not folate minerals zinc magnesium selenium not iron water 2 quarts per day very important to keep up milk production other advice for lactation consume plenty of fluids o recommend 4 additional cups per day decrease use or consumption of o cigarettes o alcohol o marijuana o coffee get plenty of rest don t restrict food intake to lose weight rapidly advantages of breastfeeding colostrum o first milk thin yellowish o first few days after birth o immune protection antibodies produced by mother o also factor to stimulate growth of healthy gut bacteria mature milk o nutritionally complete daily Vitamin D supplement o easily digested lactalbumin o high bioavailability of nutrients o protective against infections o decreased risk of food allergies emotional bonding convenience and cost benefit to mother there may be a reduced risk of developing breast cancer over time Feeding Periods Nursing 0 4 months o Liquid only o Immature kidneys stressed by plain cow s milk o Immature gastrointestinal tract o Suckling reflex Transitional 5 12 months o Liquid semi solid foods o Kidneys and GI tract maturing o Mature suck and swallow reflex Modified adult 1 10 years o Increasing variety and texture o GI tract mature o Feeds self When to introduce solids Nutritional needs o After 4 6 months and birth weight doubles o Need additional iron and calories Development o After 4 6 months o Mature suck and swallow reflex o Holds head up o Maturing kidneys and GI tract How to introduce solids Only 1 new food per week o Start with iron fortified cereal o Introduce vegetables before fruit Limit sugar and salt content High water content NO cow s milk in first year NO eggs or honey in first year Avoid choke foods hot dogs peanuts Nutrition for Children and Teens 10 24 2012 feeding a healthy young child at no time in life does the human diet change faster than during the from 12 24 months a child s diet changes from infant foods consisting of mostly formula or breast milk to mostly modified adult o milk remains a central source of calcium protein and other second year foods nutrients changes in eating habits 1 2 years o variable appetites and tastes o taste buds more acute than in adults o learns to feed self o copies others o learns to say no o food jags don t want different types of food to touch each other o food neophobia fear of new foods 2 3 years o can use utensils o develop stronger taste preferences o can make simple choices 4 5 years o peers television major influence marketing o appetite gradually increasing
View Full Document
Unlocking...