Post on 28-Dec-2015
Maternal and Child Nursing NUR 362
Lecture 4
Why is nutrition so important?Why is nutrition so important?
Meet increased nutrient demandsMeet increased nutrient demands
Provide needed energyProvide needed energy
Prevent or minimize common pregnancy-Prevent or minimize common pregnancy-related problemsrelated problems
Reduce risk of birth defectsReduce risk of birth defects
Supply needed nutrients for baby’s growthSupply needed nutrients for baby’s growth
Ensure healthy birth weightEnsure healthy birth weight
Maintain a healthy weightMaintain a healthy weight
Key Components of a Healthy Key Components of a Healthy PregnancyPregnancy
Appropriate weight gainAppropriate weight gain
Consumption of a variety of foodsConsumption of a variety of foods
Vitamin and mineral supplementationVitamin and mineral supplementation
Avoidance of alcohol, tobacco and Avoidance of alcohol, tobacco and other harmful substancesother harmful substances
Safe food handlingSafe food handling
Recommended Weight GainRecommended Weight Gain
UnderweightUnderweight 28-40 lbs28-40 lbs
Normal weightNormal weight 25-35 lbs25-35 lbs
OverweightOverweight 15-25 lbs15-25 lbs
ObeseObese ~~ 15 lbs 15 lbs
TwinsTwins 35-45 lbs35-45 lbs
TripletsTriplets 50 lbs50 lbs
1 pound = about 0.45 kilograms
Normal Pregnancy Weight Normal Pregnancy Weight GainGain
BreastBreast 1-1.5 lbs1-1.5 lbs
BloodBlood 3-4.5 lbs3-4.5 lbs
Extra waterExtra water 4-6 lbs4-6 lbs
UterusUterus 2.5-3.0 lbs2.5-3.0 lbs
Placenta/amniotic Placenta/amniotic fluidfluid 3.5-5.5 lbs3.5-5.5 lbs
BabyBaby 7-8 lbs7-8 lbs
Fat storesFat stores 4-6.5 lbs4-6.5 lbs
TotalTotal 25-35 lbs25-35 lbs
Risks of Low Weight GainRisks of Low Weight Gain
Low weight gain in second or third Low weight gain in second or third trimester increases risk of trimester increases risk of intrauterine growth retardationintrauterine growth retardation
Low weight gain in third trimester Low weight gain in third trimester increases risk of preterm deliveryincreases risk of preterm delivery
Guidelines for teenagersGuidelines for teenagers
Higher weight gains and greater Higher weight gains and greater postpartum weight retention is postpartum weight retention is common if mother is still growingcommon if mother is still growing
Maternal growth in multiparous Maternal growth in multiparous teenagers is associated with lower teenagers is associated with lower birth weightsbirth weights
Proper nutritionProper nutrition
Major NutrientsMajor Nutrients
CarbohydratesCarbohydrates
ProteinProtein
FatFat
VitaminsVitamins
MineralsMinerals
WaterWater
Special Interest Special Interest NutrientsNutrients
Vitamin BVitamin B1212
Generally adequate amounts are obtained Generally adequate amounts are obtained through animal productsthrough animal products
Fish, eggs, milk, meats, etc. Fish, eggs, milk, meats, etc.
Vegans that do not have any animal products in Vegans that do not have any animal products in their diet need supplementationtheir diet need supplementation
Works with folic acid in cell growth and is Works with folic acid in cell growth and is essential to the normal development of the infantessential to the normal development of the infant
Folic AcidFolic Acid
A supplement taken 1-3 months prior to conception A supplement taken 1-3 months prior to conception and during first 6 weeks gestation reduces the risk of and during first 6 weeks gestation reduces the risk of neural tube defects, cleft palate/lipneural tube defects, cleft palate/lip
400 micrograms per day of synthetic folic acid 400 micrograms per day of synthetic folic acid needed per day (pregnant women and those of needed per day (pregnant women and those of childbearing age)childbearing age)
Needed for rapidly dividing cells, protein metabolism, Needed for rapidly dividing cells, protein metabolism, and formation of red blood cellsand formation of red blood cells
IronIron
Needed for the formation of red blood cellsNeeded for the formation of red blood cells
15 milligrams a day for woman during 15 milligrams a day for woman during childbearing years recommendedchildbearing years recommended
Iron supplement (30 mg/d) recommended for Iron supplement (30 mg/d) recommended for pregnant womenpregnant women
CalciumCalcium
Calcium absorption doubles early in Calcium absorption doubles early in pregnancypregnancyIs used in the formation of fetal bonesIs used in the formation of fetal bonesWill be absorbed from maternal bones if Will be absorbed from maternal bones if not enough calcium in dietnot enough calcium in dietCalcium absorption increases with Calcium absorption increases with Vitamin DVitamin DCalcium and vitamin D supplements Calcium and vitamin D supplements sometimes neededsometimes neededRecommended amounts of calcium during Recommended amounts of calcium during Pregnancy 1200-1500 mg per dayPregnancy 1200-1500 mg per day
Multivitamin and Mineral Multivitamin and Mineral SupplementsSupplements
Recommended for:Recommended for:
Women who smokeWomen who smoke
Women with iron deficiency anemia or poor Women with iron deficiency anemia or poor quality dietsquality diets
Women who eat animal products rarely or not Women who eat animal products rarely or not at all (such as vegans)at all (such as vegans)
Vitamin B 12 supplement important for vegansVitamin B 12 supplement important for vegans
Foods to AvoidFoods to Avoid
Fish containing high levels of mercury Fish containing high levels of mercury
Undercooked fishUndercooked fish
Partially cooked eggsPartially cooked eggs
undercooked meat and poultryundercooked meat and poultry
Things to Avoid During Things to Avoid During PregnancyPregnancy
CigarettesCigarettes
Over-The-Counter Medications or Over-The-Counter Medications or Herbal SupplementsHerbal Supplements
Consult health care providerConsult health care provider
CaffeineCaffeine
Consult health care providerConsult health care provider
Smoking during PregnancySmoking during PregnancyLimits oxygen supplied to the fetusLimits oxygen supplied to the fetus
Reduces birth weight of the infantReduces birth weight of the infant
Increases the risk of pre-term deliveryIncreases the risk of pre-term delivery
Increases the risk of perinatal mortalityIncreases the risk of perinatal mortality
Passive exposure to tobacco smoke may also reduce infant Passive exposure to tobacco smoke may also reduce infant growthgrowth
Associated with mental retardation and nicotine addiction Associated with mental retardation and nicotine addiction in the fetusin the fetus
Common Pregnancy Common Pregnancy ProblemsProblems
Nausea and VomitingNausea and VomitingAvoid strong odorsAvoid strong odors
Eat before getting out of bed Eat before getting out of bed
Avoid an empty stomachAvoid an empty stomach
Eat easy-to-digest foodsEat easy-to-digest foods
Eat slowlyEat slowly
Snack before bedSnack before bed
ConstipationConstipation
Hormonal changes slow down the Hormonal changes slow down the intestineintestine
Drink 8-12 glasses of water everydayDrink 8-12 glasses of water everyday
Eat high-fiber foodsEat high-fiber foods
Be as physically active as possibleBe as physically active as possible
Do not use laxatives unless Do not use laxatives unless prescribed by health care providerprescribed by health care provider
HeartburnHeartburnEat small meals frequentlyEat small meals frequently
Cut down on caffeinated and carbonated Cut down on caffeinated and carbonated beveragesbeverages
Eat slowly in a relaxed environmentEat slowly in a relaxed environment
Do not lie down after eatingDo not lie down after eating
Prop head of bed upProp head of bed up
Wear loose-fitting comfortable clothesWear loose-fitting comfortable clothes
Avoid gaining too much weightAvoid gaining too much weight
Talk to doctor before taking antacids Talk to doctor before taking antacids
SwellingSwelling
As blood supply increases, legs, feet, As blood supply increases, legs, feet, and arms may swelland arms may swell
Drink plenty of fluids, especially waterDrink plenty of fluids, especially water
Avoid diuretics, unless prescribed by Avoid diuretics, unless prescribed by health care providerhealth care provider
Elevate your feet whenever possibleElevate your feet whenever possible
Wear loose-fitting shoes and clothesWear loose-fitting shoes and clothes
Pica (nonfood cravings)Pica (nonfood cravings)
Some pregnant women develop cravings for Some pregnant women develop cravings for nonfood substances like clay, dirt, or icenonfood substances like clay, dirt, or ice
This does not reflect a physiological need for This does not reflect a physiological need for a particular nutrienta particular nutrient
Pica is especially common in African Pica is especially common in African American womenAmerican women
Pica may lead to iron-deficiency anemia, Pica may lead to iron-deficiency anemia, malnutrition and lead exposure (brain damage)malnutrition and lead exposure (brain damage)
Respiratory distressRespiratory distress
In many women respiratory distress In many women respiratory distress occurs because of the growing uterus occurs because of the growing uterus as the pregnancy advances. as the pregnancy advances.
Fatigue and insomniaFatigue and insomnia
Fatigue is very common in early pregnancy and Fatigue is very common in early pregnancy and reaches a peak at the end of the first trimester. reaches a peak at the end of the first trimester.
Rest, lifestyle adjustment and reassurance are Rest, lifestyle adjustment and reassurance are usually all that is required. usually all that is required.
Fatigue also occurs in late pregnancy, when Fatigue also occurs in late pregnancy, when anemia should be excluded. anemia should be excluded.
Insomnia is also very common and due to a Insomnia is also very common and due to a combination of anxiety, hormonal changes and combination of anxiety, hormonal changes and physical discomfort. physical discomfort.
Varicose veinsVaricose veins
Feet and ankles can also become Feet and ankles can also become swollen. swollen.
Treatment is by elevation of legs when Treatment is by elevation of legs when sitting, support, encourage walking sitting, support, encourage walking and avoid standing still. and avoid standing still.
BackacheBackache
Many women develop backache during Many women develop backache during pregnancy and it often first develops during pregnancy and it often first develops during the 5th to 7th months of pregnancy. the 5th to 7th months of pregnancy.
Encourage light exercise and simple Encourage light exercise and simple analgesia, and consider physiotherapy analgesia, and consider physiotherapy referral. referral.
Exercising in water, massage therapy and Exercising in water, massage therapy and group or individual back care classes have group or individual back care classes have been shown to be effective interventions. been shown to be effective interventions.