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chapter 13 life cycle nutrition

Preparing for Pregnancy. A mother's nutritional status before and during pregnancy can affect a child's health for the rest of its life.Mothers should establish good eating habits prior to becoming pregnant. Nutrient stores are especially important for early development

Mercy
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chapter 13 life cycle nutrition

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    1. Chapter 13 LIFE CYCLE NUTRITION Mother and Infant

    3. Preparing for Pregnancy Dads should also focus on good nutrition and avoid alcohol.

    4. Preparing for Pregnancy Prepregnancy weight Mother too thin-low birth weight babies with a variety of health problems: Low IQ, other brain impairments & learning difficulties Short stature Babies under 5 ˝ lbs. are 40X more likely to die in the 1st year.

    5. Preparing for Pregnancy Prepregnancy weight Mother too fat: gestational diabetes, hypertension & infections in the mother. Babies are large (even when premature) and may have: Heart defects Neural tube defects*

    6. Preparing for Pregnancy Implantation of zygote and development of the placenta depends on good nutritional status – prior to conception. Placenta is the connection between the baby’s and the mother’s blood, fig 13.2. Provides nutrients, hormones & antibodies to the fetus. Removes waste products from the fetus.

    7. FIGURE 13-2: THE PLACENTA. The placenta is composed of spongy tissue in which fetal blood and maternal blood flow side by side, each in its own vessels. The maternal blood transfers oxygen and nutrients to the fetus’s blood and picks up fetal wastes to be excreted by the mother. Thus, the placenta performs the nutritive, respiratory, and excretory functions that the fetus’s digestive system, lungs, and kidneys will provide after birth. FIGURE 13-2: THE PLACENTA. The placenta is composed of spongy tissue in which fetal blood and maternal blood flow side by side, each in its own vessels. The maternal blood transfers oxygen and nutrients to the fetus’s blood and picks up fetal wastes to be excreted by the mother. Thus, the placenta performs the nutritive, respiratory, and excretory functions that the fetus’s digestive system, lungs, and kidneys will provide after birth.

    8. Preparing for Pregnancy Placenta also secretes hormones and enzymes that support pregnancy and prepare the mother’s breasts for lactation.

    9. Events of Pregnancy 1st 2 weeks, fig 13.3: Fertilized egg divides repeatedly and implants in the uterine wall. Placenta begins to develop and embryonic tissues form. Problems: failure to implant, neural tube defects.

    10. FIGURE 13-3: STAGES OF EMBRYONIC AND FETAL DEVELOPMENT. FIGURE 13-3: STAGES OF EMBRYONIC AND FETAL DEVELOPMENT.

    11. Events of Pregnancy 2-8 weeks: Continued development of the placenta. At 8 weeks the embryo has complete nervous and digestive systems, a beating heart, defined fingers and toes, and beginnings of facial features. Calcification of the skeleton begins.

    12. FIGURE 13-3: STAGES OF EMBRYONIC AND FETAL DEVELOPMENT. FIGURE 13-3: STAGES OF EMBRYONIC AND FETAL DEVELOPMENT.

    13. Events of Pregnancy 8 weeks – term: rapid growth and development of organ systems in fetus. Mother’s uterus expands and supporting muscles strengthen, breasts prepare for lactation, blood volume increases by ˝.

    14. FIGURE 13-3: STAGES OF EMBRYONIC AND FETAL DEVELOPMENT. FIGURE 13-3: STAGES OF EMBRYONIC AND FETAL DEVELOPMENT.

    15. FIGURE 13-3: STAGES OF EMBRYONIC AND FETAL DEVELOPMENT. FIGURE 13-3: STAGES OF EMBRYONIC AND FETAL DEVELOPMENT.

    16. Events of Pregnancy Critical periods Times during which tissues and organs differentiate and mature. If proper “building” blocks (proteins, carbohydrates, lipids) are not present the tissue/organ does not develop properly and cannot catch up.

    17. Events of Pregnancy Good nutrition is vital for the mother’s and the developing child’s health throughout pregnancy. Nutritional risk factors, table 13.1: Teen mother Frequent pregnancies, close together Poor nutrition, smoking Underweight or overweight Multiple births Gain insufficient or excessive weight during pregnancy.

    18. Nutritional Needs Food energy, fig 13.4. Balanced meals are especially important. 1st trimester – none 2nd trimester - extra 340 calories per day 3rd trimester- extra 450 calories per day Protein: increase by 25 g/day??. Vegans need to be especially vigilant.

    19. Nutritional Needs Carbohydrates: extra 175 g/day needed to spare protein. Fiber needed to prevent constipation. Lipids: omega 3 and omega 6 vital for nervous system development. BUT - Minimal fish intake is recommended because of the mercury, etc.

    20. Nutritional Needs Vitamins: especially folate and B12. Deficiencies result in neural tube defects: anencephaly, spina bifida.

    21. Nutritional Needs Minerals: Calcium, phosphorus & magnesium are needed for growth of bones and teeth. Iron is necessary for RBCs, supplement of 30 mg/day. Zinc is required for protein synthesis and cell development.

    22. FIGURE 13-4: COMPARISON OF NUTRIENT RECOMMENDATIONS FOR NONPREGNANT, PREGNANT, AND LACTATING WOMEN. aEnergy allowance during pregnancy is for 2nd trimester; energy allowance during the 3rd trimester is slightly higher; no additional allowance is provided during the 1st trimester. Energy allowance during lactation is for the first 6 months; energy allowance during the second 6 months is slightly higher. FIGURE 13-4: COMPARISON OF NUTRIENT RECOMMENDATIONS FOR NONPREGNANT, PREGNANT, AND LACTATING WOMEN. aEnergy allowance during pregnancy is for 2nd trimester; energy allowance during the 3rd trimester is slightly higher; no additional allowance is provided during the 1st trimester. Energy allowance during lactation is for the first 6 months; energy allowance during the second 6 months is slightly higher.

    23. Nutritional Needs Supplements: avoid with the exception of iron and a multi-vitamin as prescribed by your doctor. Food Assistance - WIC

    24. Weight Gain Depends on prior weight status, table 13.4 Normal weight: 25-35 pounds Underweight: 28-40 pounds Overweight: 15-25 pounds Obese: 15 pounds minimum Pregnancy is not a time to diet or overeat. Teen mothers need to gain more because they are still growing.

    25. FIGURE 13-7: COMPONENTS OF WEIGHT GAIN DURING PREGNANCY. FIGURE 13-7: COMPONENTS OF WEIGHT GAIN DURING PREGNANCY.

    26. Physical Activity? Yes with precautions, fig 13.8. Low impact, safe exercise. Consult your physician!

    27. Cravings and Morning Sickness Cravings usually do not indicate need but different smell and taste sensitivities. Morning sickness and other discomforts are due to hormonal changes. Table 13.5: tips for relieving discomforts.

    28. What to Avoid Cigarette smoking (incl. second-hand): Decreases vitamin C absorption Produces toxins - nicotine and cyanide Causes vasoconstriction Is associated with low birth weights, SIDS. Medicinal drugs and herbal supplements: NO, incl. aspirin and ibuprofen; consult your physician.

    29. What to Avoid Illegal drugs: no brainer. Environmental contaminants: mercury and lead (some large ocean fish). Mega vitamins/minerals: no, especially vitamin A. Prenatal vitamins – YES. Dieting: NO Sugar substitutes and caffeine – avoid or limit.

    30. What to Avoid ALCOHOL: NO, NO, NO; abnormalities seen with intakes as low as 1-2 drinks/day. Decreased oxygen and nutrient delivery to fetus. Slows cell division and damages DNA. During the 1st month it is detrimental to brain development. Often associated with malnutrition in the mother. Before fertilization can damage egg and *SPERM.

    31. Alcohol and Babies FAS, ARND, ARBD Irreversible brain damage. Growth retardation. Mental retardation, mild to severe. Behavior abnormalities. Facial abnormalities, fig 13.10. Vision abnormalities. Stop before you become pregnant, dads included.

    32. FIGURE 13-10: TYPICAL FACIAL CHARACTERISTICS OF FAS. The severe facial abnormalities shown here are just outward signs of severe mental impairments and internal organ damage. These defects, though hidden, may create major health problems later. FIGURE 13-10: TYPICAL FACIAL CHARACTERISTICS OF FAS. The severe facial abnormalities shown here are just outward signs of severe mental impairments and internal organ damage. These defects, though hidden, may create major health problems later.

    33. Pregnancy Problems Gestational diabetes - after 24 weeks. Usually resolves after birth of baby, but 1/3 develop Type 2 diabetes. Risk is increased in overweight/obese women.

    34. Pregnancy Problems Preeclampsia/eclampsia: Dangerous increases in blood pressure, protein in urine and edema of face & hands in addition to feet & ankles. Convulsions and death. Leading cause of maternal death. Increased in African American women. No clear relationship to dietary intake but is increased in areas where nutrition is compromised. Inadequate calcium intake may play a role.

    35. Lactation Cost to mother is ~500 calories/day above normal needs. Recommended – extra 330 calories/day; the remainder coming from stored fat. Fig 13.4: nutritional requirements are higher than those for pregnancy in most categories.

    36. Lactation Volume of milk produced adjusts to baby’s demand. Recommended fluid intake – 13 cups per day. Nutrient deficiencies usually result in lower quantity not quality of milk. Avoid excess intake of fat soluble vitamins (esp. vit A) and foods that disagree with the baby.

    37. Lactation NO to alcohol, nicotine, and other drugs (except as prescribed by a doctor), limit caffeine. Most infections, treated properly, are not transmitted via breast milk. Exception - HIV.

    38. Feeding the Infant Rapid growth during the 1st year requires an ample supply of nutrients, more than twice that of adults, per pound body weight, fig 13.12. Iodine, vitamins A,D, & C are needed in especially high quantities.

    39. FIGURE 13-12: NUTRIENT RECOMMENDATIONS FOR A FIVE-MONTH-OLD INFANT AND AN ADULT MALE COMPARED ON THE BASIS OF BODY WEIGHT. Infants may be relatively small and inactive, but they use large amounts of energy and nutrients in proportion to their body size to keep all their metabolic processes going. FIGURE 13-12: NUTRIENT RECOMMENDATIONS FOR A FIVE-MONTH-OLD INFANT AND AN ADULT MALE COMPARED ON THE BASIS OF BODY WEIGHT. Infants may be relatively small and inactive, but they use large amounts of energy and nutrients in proportion to their body size to keep all their metabolic processes going.

    40. Feeding the Infant The baby adjusts energy intake to growth rate and physical activity. Do not force infants to eat. **Vitamin K Water – breast milk and formulas contain plenty. No need for other fluids except during episodes of vomiting and diarrhea.

    41. Feeding the Infant Breast milk – 6 benefits: Easily digested Nutrient rich and adjusts to baby’s needs (if mother practices good nutrition). Exception – vitamin D and iron. Immune factors: colostrum provides antibodies and WBCs.

    42. Feeding the Infant Breast milk cont’d Promotes growth of beneficial bacteria in intestines Hormones promote development of digestive tract Supplements are not necessary except perhaps vitamin D, iron (after 4-6 months and fluoride (after 6 months).

    43. Feeding the Infant Breast fed babies May have increased intelligence Are less likely to become obese Breast feeding also benefits the mother, table 13.7

    44. Feeding the Infant Formulas Derived from cow’s milk that is diluted and fortified. Plain cow’s milk is not recommended for babies under 1yr; low-fat milk only after 2yrs. No human antibodies

    45. Feeding the Infant Formulas cont’d Soy based formulas for premature infants, infants with allergies and for vegan families. Advantages: allows for monitoring of intake and developing relationships with other family members.

    46. Feeding the Infant Solid foods: after 4-6 months, depending on baby’s development. Fortified cereals; rice first, wheat last. 4-6 months: pureed vegetables and fruits introduced one at a time to check for allergies. Ability to chew properly does not develop until 2nd year.

    47. Feeding the Infant Fluids: Increased need with the introduction of solid food. Best - water, 2nd - unsweetened fruit juices offered in a cup not a bottle. Common Allergies: wheat, egg whites, soy, peanuts, cow’s milk, citrus fruits.

    48. Feeding the Infant 1st year Model and teach good eating habits Do not use food as a reward or to stop crying; do not withdraw food as punishment. Do not use a bottle as a pacifier – dental problems, p.512. Do not underfeed or overfeed

    49. Nursing bottle syndrome, an extreme example. The upper teeth have decayed all the way to the gum line. Nursing bottle syndrome, an extreme example. The upper teeth have decayed all the way to the gum line.

    50. Controversy – Childhood Obesity Genetic and environmental (incl. poor nutrition). Type 2 diabetes: obesity, increased blood lipids, CVD. Obesity: risk increased if parents are obese, high birth weight ?, formula fed ?, physical inactivity. Other – OYO, pp 514-518

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