Life Cycle Nutrition: Pregnancy, Lactation, & Infancy Chapter 14.
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Transcript of Life Cycle Nutrition: Pregnancy, Lactation, & Infancy Chapter 14.
Life Cycle Nutrition: Life Cycle Nutrition: Pregnancy, Lactation, Pregnancy, Lactation, & Infancy& Infancy
Chapter 14
PregnancyPregnancy
Nutrition may affect fertility Preparation before pregnancy
Achieve and maintain healthy body weight Choose an adequate and balanced diet Be physically active Receive regular medical care Manage chronic conditions Avoid harmful influences
Stages of Embryonic and Stages of Embryonic and Fetal DevelopmentFetal Development
The Placenta and The Placenta and Associated StructuresAssociated Structures
Growth and Development Growth and Development During PregnancyDuring Pregnancy
Critical periods Times of intense development Many happen in the first several weeks!
Mother’s nutritional status crucial beginning at moment of conception
About 1/2 of pregnancies are unplanned Adverse influences on organ and tissue
development Alcohol, tobacco, and other substance use Imbalances of key nutrients
Critical Periods of Critical Periods of DevelopmentDevelopment
Folate StatusFolate Status Low: neural tube defects
AnacephalyBrain either missing or fails to develop
Spina bifida Incomplete closure of spinal cord & its
bony encasement
400 micrograms/day of folic acid recommended, plus food sources
Neural tube develops in first 6 weeks
Neural Tube Neural Tube DevelopmentDevelopment
Spina BifidaSpina Bifida
Other Key NutrientsOther Key Nutrients Pre-formed vitamin A
– Too much is teratogenic– UL: 3,000 mcg (10,000 IU)/day– Accutane and Retin-A: potent teratogens– Beta-carotene is safe!
Iron– Good status is important prior to conception– If low, mother can experience anemia during pregnancy
Omega-3 fatty acids: DHA/EPA– Crucial for neurological development– Sources: seafood, grass-fed beef, omega-3 eggs– Watch out for mercury
• Limit: albacore tuna• Avoid: tilefish, shark, swordfish, king mackerel
Maternal WeightMaternal Weight Weight and health prior to conception
Influences fetal growth and pregnancy outcomes Underweight
Increased rates of preterm births (before 37 weeks), low birth weight, and infant deaths
Increases child’s risk for heart disease or diabetes
Overweight & obesity Medical complications: HTN, gestational diabetes,
preeclampsia, prolonged labor, difficulty breastfeeding
Risks for infant
Recommended Weight Recommended Weight GainsGains
Components of Weight Components of Weight GainGain
Maternal WeightMaternal Weight Weight loss after pregnancy: takes time!
Some lost in childbirth (~10 pounds) Weeks after delivery: fluid volume returns to
normal (about another 5 pounds) Return to pre-pregnancy weight not typical during this
time Many retain a couple of pounds with each pregnancy
(as body fat)
Retention of seven or more pounds Diabetes and hypertension Chronic diseases later in life
Breastfeeding helps significantly
Exercise During Exercise During PregnancyPregnancy
Can continue exercise throughout pregnancy Adjust duration and intensity
Benefits: Prevention/management of gestational DM Easier labor Fewer discomforts during pregnancy Reduced stress Maintaining fitness can help with post-pregnancy
weight loss
“Low-impact” activities Avoid excessively high internal body temperature
Energy & Nutrient Energy & Nutrient Needs: Pregnancy and Needs: Pregnancy and LactationLactation Needs tend to be higher than any other time in life Increased BMR Depositing and maintenance of new fetal and
maternal tissues Energy: 15 to 20% more energy than before
pregnancy Even greater increase in micronutrient needs
Choose nutrient-dense foods Differences between pregnancy and lactation
requirements Many needs even greater in lactation
MacronutrientsMacronutrients Carbohydrate
Ample carbohydrate is necessary; fuels fetal brain during pregnancy
175 g or more/day (no less than 135 g/d) Protein
RDA – additional 25 grams per day (or adjust to 1.1 g/kg)Supplements are discouraged
Essential fatty acids Omega-3 and omega-6 fatty acids for brain
material
Micronutrients Blood production, cell and
tissue growth in mother and fetus Needs for synthesis of
DNA and new cells Folate Vitamin B12
Vitamin B6
Iron Zinc
Bone and connective tissue Calcium Vitamin D Vitamin C
Increased energy utilization B vitamins
Some recommendations remain the same; others increase
Prenatal vitamin usually recommended Does not take the place
of a nutrient-rich diet! Does not meet all needs
Water
Water needs increase – Blood volume– Production of other fluids– Fluids for fetus
6-9 liters of water accumulated during pregnancy!
Increase intake from 2.7 liters to 3 liters/day
Needs During LactationNeeds During Lactation Energy needs and exercise
Uses almost 500 extra kcalories per day Need 330-400 from food, the rest from fat stores Minimum: 1800 kcal/day to meet all needs
Exercise is compatible with breastfeeding Energy nutrients
Recommendations increase above pregnancy recommendations for carbohydrates and fibers
Micronutrients: relative to pregnancy, several increased recommendations for vitamins and minerals, some decreased
Water 1 additional liter of water per day to prevent dehydration
Bottle Feeding & Formula Weak/small infants may have difficulty suckling
– Bottles provide more forceful flow Drugs and communicable diseases
– Avoiding risk to infant health outweighs benefits of breast milk
Infant formula– Not milk or milk substitutes!!!– Most based on cow’s milk, some soy or elemental– Most fortified with iron– Some fortified with EFA--more expensive
Baby bottle tooth decay– Usually due to allowing baby to take bottle to bed
Nutritional Needs of Infancy Growth more rapid than any other time of life Kcal needs per kg of body weight are high
~100 kcal/kg/day vs. 30 in adults Macronutrient proportions differ from adult
needs– Small stomach– More fat needed to increase energy density– Type of fat also important to support nervous
system development• DHA (n-3) and AA (n-6)• Both contained in breast milk• Addition of these is not required in formula in US
Macronutrient Distribution: Infant vs. Adult
Assessing
Infant Growth