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LIFE CYCLE NUTRITION :PREGNANCY AND LACTATION CH11

STUDY
PLAY
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