LIFE CYCLE NUTRITION :PREGNANCY AND LACTATION CH11

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PLACENTA

is not just a passive conduit for nutrients. it can selectively extract nutrients of the appropriate form
ex: long-chain essential fatty acids and alpha tocopherol (vit E) suited to the needs of the fetus

POOR OUTCOMES OF PREGNANCY

spontaneous abortion (miscarriage), premature delivery, a low birth weight (LBW) infant, a small for gestational-age (SGA) infant, and mental and physical abnormalities in newborn

BEST ACTIONS A EXPECTING MOTHER CAN TAKE

enter pregnancy with good nutrient stores and to consume a well-balanced diet while pregnant. also avoid harmful substances such as alcohol and contraindicated drugs, including over-the-counter and prescription preparations

ENERGY NEEDS IN PREGNANCY

increased energy is needed to sustain the mother and for the development of the fetus and the placenta
to meet this increased metabolic workload and to spare protein for tissue building, a pregnant woman needs an additional energy intake

BLOOD GLUCOSE AND PREGNANCY

maintaining levels is vital in pregnancy because the glucose is the fetus's preferred fuel and because the fetus's blood glocuse level is always lower than mothers

PROTEIN NEEDS

is required to build fetal tissue. the mother also needs adequate protein for growth of her tissues

WHAT THINGS SHOULD CAUSE A HEALTH-CARE WORKER TO FURTHER INVESTIGATE

when a woman cites a history of troubled pregnancies, congenital abnormalities, a mentallpy retarded infant, spontaneous abortion, or stillbirth

VITAMIN NEEDS IN PREGNANCY

pregnant women have an increased need for some vitamins. they must avoid taking excessive amounts of others because of potential hazard to the fetus

FOLIC ACID IN PREGNANCY

A CDC guideline recommens that a woman who has previously borne a child with a neural tube defect take 4 milligrams of folic acid per day from 1 month before conception through the first trimester

VITAMIN A IN PREGNANCY

used to treat acne could post risk to the fetus of a teenager who unintentionally because pregnant. the risk of a major congenital abnormality in a child exposed to isotretinoin a vitamin A metabolite. in utero during the first trimester appears to be increased about 25 times

WOMEN OF CHILDBEARING YEARS AND ISOTRETINOIN

should adhere to strict contracepticve protocols, including simulataneous use of two methods

MINERAL NEEDS

minerals become part of the structure of the body whereas vitamins do not. both the mother and the fetus require minerals to build new tissues

IRON AND PREGNANCY

during pregnancy, the mothers blood volume increases about 35% and her volume of red blood cells increases by 21%-26%. additional iro n is need for the redblood cells in the fetus, placenta, and umbilical cord.

IRON DEFICIENCY ANEMIA

during the first 2 trimesters of pregnancy is associated with twice the risk of preterm delivery and 3x's the risk for producig a LBW infant

LBW

low birth weight

SGA

small gestational age

CALCIUM IN PREGNANCY

is the chief mineral in the adult body, with the bones serving as a storage deposit. intestinal absorption of calcium increases during pregnancy.

AI FOR CALCIUM AND PREGNANT AND LACTATING WOMEN

women ages 19 yrs of age and older is 1000mg

PHOSPHORUS AND MAGNESIUM IN PREGNANCY

involved in skeletal formation and in great demand during pregnancy

IODINE IN PREGNANCY

as part of the thyroid hormones, iodine is essential to the control of metabolism. during the 2nd half of pregnancy resting energy expenditure increases as much as 23%

FLUORIDE IN PREGNANCY

the fetus begins to develop teeth at the tenth to twelfth week of pregnancy

ZINC IN PREGNANCY

is not mobilized from the mothers tissues. to provide for the fetus, the mother needs constant intake

ZINC DEFICIENCY IN PREGNANCY

has been associated with abnormally long labors and delivery of small and malformed infants

WATER AND WEIGHT GAIN IN PREGNANCY

current recommendation is based on a BMI that incorporates the woman's height and weight before pregnancy

MEAL PATTERNS

they can meet their basic needs and the needs of the fetus by consuming one additional cup of milk, an additional 1/2 oz of meat, and a additional 1/2 cup of fruit/vegetable rich in vitamin C

PREGNANT TEENS AND DIET

need nutrients to provide for their own growth as well as that of the fetus. they should have additional milk, meat, vegetables, grains and oils over and above the intake

TEENAGE MOTHERS RISK/COMPLICATIONS

preeclampsia and premature delivery for .

FOOD ASSISTANCE

supplemental food assistance is available for families in the Food Stamp Program and for women and children in the supplemental feeding program for Women, Infants and Children (WIC) the later program serves about 7.6 million people annually

FETAL ALCOHOL SYNDROME (FAS)

first recognized in 1973. the major cause of mental retardation in the western world. because alcohol readily crosses the placenta but the fetus has inadequate enzymes to detoxify it. fetus is most vulnerable during the first trimester when basic structural development occurs. often the woman doesnt know she is pregnant till late in 1st trimester

CAFFEINE IN PREGNANCY

caffeine has been associates with spontaneous abortion.

LISTERIOSIS

a bacterial infection that is particulary virulent for fetuses, with case-fatality rate of 30% in newborns and almost 50% if the onset occurs in the first 4 days of life

OUTBREAKS OF LISTERIOSIS

have been associated with raw or contaminated milk, soft cheeses, contaminated vegetables and ready-to-eat meats. the reservoir of the organism is soil, water, mud, and silage

FOOD HANDLING FOR PREGNANT AND IMMUNOCOMPROMISED INDIVIDUALS

-avoid soft cheese
-cook leftover foods or ready-to-eat foods
-although the risk for listeriosis assocated with foods from deli counters is low, pregnant women and immunocompromised individuals may avoid these foods altogether or thoroughly reaheat cold cuts before eating

TOXOPLASMA GONDII

a protozoan spread by undercooked meat, unwashed fruits and vegetables, contaminated soil, and cat feces.

PRECAUTIONS TO AVOID TOXOPLASMA GONDII

-cook meat, poultry and seafood thoroughly
-clean items that those raw foods have come in contact with
-peel or meticulously wash raw fruits and vegetables before eating
-keep cats indoors feed them only cooked/prepared food
-avoid changing cat litter, if not possible mask and wear gloves

TOBACCO

pregnant woman who smoke 1+ packs of cigarettes/day deliver infants weighing about 1/2 pound less than those delivered by nonsmoking

COMPLICATIONS TO TABACCO USE IN PREGNANCY

double the risk of stillbirth, and infant mortality was increased by 80% in women who had smoked during pregnancy compared with children of non smokers

COCAINE IN PREGNANCY

crosses the placenta and can be detected in the infants intestinal waste for up to 8 wks

PROBLEMS & COMPLICATIONS PREGNANCY AFFECTING NUTRITION

morning sickness and leg cramps are usually annoying but only occasionally require medical intervention. other conditions such as hypertensive disorders of pregnancy and gestational diabetes are more complicated and hazardous and require medical treatment

FOUR MOST COMMON PROBLEMS OF PREGNANCY

morning sickness, leg cramps, constipation, and heartburn.

PICA

is a regional practice that is mainly influenced by culture. the compulsive ingestion of nonfood items usually dirt, clay, laundry starch, or ice

MORNING SICKNESS

eating dry crackers before getting out of bed is the classic preventative. other suggestions (1) avoid fatty foods in favor of fruits and complex carbs (2) consume cold foods rather than hot (3) drink liquids between rather than with meals (4) eat a high-protein snack at bedtime

LEG CRAMPS

one possible cause may be neuromuscular irratability due to low serum calcium, but the evidence that supplemental calcium reduces cramping is weak

CONSTIPATION

the growing uterus presses on the intestines, causing constipation. adequate fluid intake, regular exercise, and a high fiber diet should relieve this condition

HEARTBURN

a burning sensation beneath the breastbone is called heartburn. hormonal changes cause relaxation of the cardiac sphincter, located between the esophagus and the stomach.

CONTROL OF HEARTBURN

avoid spicy or acidic foods and taking small frequent meals

HYPEREMESIS GRAVIDARUM

severe nausea and vomiting persisting after the 14th week of pregnancy

HYPERTENSIVE DISORDERS

this group of disorders includes chronic hypertension, gestational hypertension, preeclampsia, and eclampsia

HYPERTENSION

defined as blood pressure >140mmHg systolic or greater than >90mmHg diastolic

GESTATIONAL DIABETES

considered to be a form of type 2 diabetes. it appears to develop in women with a predisposition to insulin resistance and type 2 diabetes that becomes apparent due to physiological changes of pregnancy

NUTRITIONAL NEEDS FOR BREAST-FEEDING MOTHER

the recommended meal plan for breast feeding women is the same as for pregnant women, with the stipulation of 120mg vitamin C or 1.5 cups of foods rich in vitamin C daily.

ENERGY FOR BREASTFEEDING MOTHER

requires an additional 500 kilocalories/day from food. although 750 kilocalories are required, the remainder should be derived from fat stores

BENEFITS OF BREASTFEEDING TO THE MOTHER

it helps the uterus return to its nonpregnant state more quickly. its convenient and low cost, and may protect against breast cancer later

OXYTOCIN

hormone released by the posterior pituitary gland in the brain. causes uterine muscles to contract

TECHNIQUES OF BREASTFEEDING

the infant should face the breasts squarely. if the breast is very large, the mother must take care to prevent it from blocking the infant's nose lest it impede infants breathing.

MATERNAL CONTRAINDICATIONS TO BREAST-FEEDING

mothers exposure to toxic chemicals, the mothers use of illegal drugs and certain medications and certain illnesses

GALACTOSEMIA

a contraindiction due to a metabolic defect in the infant

EXPOSURE TO CHEMICALS IN PREGNANCY

chemicals such as DDT amd PCB have been shown to be teratogenic

TERATOGENIC

causing congenital defects

SUBSTANCES THAT ARE OFTEN NOT THOUGHT OF DURING PREGNANCY

alcohol and caffeine

ALTERED PHYSIOLOGY/PATHOLOGY IN BREAST-FEEDING

include active untreated TB and AIDs. acute and chronic diseases in the mother also may preclude breast-feeding

HIV AND BREAST-FEEDING

HIV infected women should be counseled not to breast-feed

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