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Life Cycle Nutrition: Pregnancy and Lactation

Life Cycle Nutrition: Pregnancy and Lactation. Chapter 15. Nutrition Prior to Pregnancy. 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

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Life Cycle Nutrition: Pregnancy and Lactation

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  1. Life Cycle Nutrition: Pregnancy and Lactation Chapter 15

  2. Nutrition Prior to Pregnancy • 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

  3. Growth and Development During Pregnancy • Placental development • Develops in uterus • Amniotic sac and umbilical cord • Expelled during childbirth • Interweaving of fetal and maternal blood vessels • Metabolically active organ • Requires energy and nutrients • Produces hormones

  4. Growth and Development During Pregnancy • Fetal growth and development • Fertilization of an ovum by a sperm • Zygote • Rapidly divides to become blastocyst • Implantation • Embryo • Eight weeks • Fetus • Full-term

  5. Growth and Development During Pregnancy • Critical periods • Times of intense development • Cellular activities can occur only during these times • Adverse influences on organ and tissue development

  6. Growth and Development During Pregnancy • Neural tube defects • Anacephaly • Brain either missing or fails to develop • Spina bifida • Incomplete closure of spinal cord & its bony encasement • Folate supplementation

  7. Growth and Development During Pregnancy • Chronic diseases • Adverse influences at critical times during fetal development • Malnutrition – type 2 diabetes • Inadequate growth during placental & gestational development – hypertension • Fetal programming • Mother’s nutrition may change gene expression in fetus

  8. Maternal Weight • Birthweight is most reliable indicator of infant’s health • Weight prior to conception • Influences fetal growth • Underweight • Rates of preterm births and infant deaths • Overweight & obesity • Medical complications • Risks for infant

  9. Maternal Weight • Weight gain during pregnancy • Fetal growth and maternal health • Correlates closely with infant birthweight • Predictor of health and development • Recommended weight gains

  10. Recommended Weight Gains

  11. Maternal Weight • Weight gain patterns • 3.5 pounds in first trimester • 1 pound per week thereafter • Large weight gain over short time • Preeclampsia • Components of weight gain • Placenta, uterus, blood, breasts, fluid volume, baby

  12. Maternal Weight • Weight loss after pregnancy • Return to prepregnancy weight • Not typical • Retain a couple of pounds with each pregnancy • Seven or more pounds; BMI increase 1 unit

  13. Exercise During Pregnancy • Can continue exercise throughout pregnancy • Adjust duration and intensity • Benefits • “Low-impact” activities • Fetal development • Excessively high internal body temperature • Dehydration

  14. Energy & Nutrient Needs During Pregnancy • Needs tend to be higher than any other time in life • To meet needs • Make careful selections • Body maximizes absorption • Body minimizes losses

  15. Energy & Nutrient Needs During Pregnancy • Energy • Increase in basal metabolic rate • Second and third trimester • Food energy • 15 to 20% more energy than before pregnancy • Nutrient-dense foods

  16. Energy & Nutrient Needs During Pregnancy • Carbohydrate • Ample carbohydrate is necessary • Protein • RDA – additional 25 grams per day • Supplements are discouraged • Essential fatty acids • Omega-3 and omega-6 fatty acids for brain material

  17. Energy & Nutrient Needs During Pregnancy • Blood production and cell growth • Fetal growth and development • Maternal red blood cell mass • Needs for synthesis of DNA and new cells • Folate • Vitamin B12 • Iron • Zinc

  18. Energy & Nutrient Needs During Pregnancy • Nutrients for bone development • Vitamin D • Deficiency interferes with calcium metabolism • Calcium • Absorption and retention increase • Intake usually falls below recommendations • Other nutrients • Optimal interval between pregnancies

  19. Energy & Nutrient Needs During Pregnancy • Prenatal supplements • Calcium • Folate • Iron • Benefits of use

  20. Vegetarian Diets During Pregnancy & Lactation • Can support healthy pregnancy and lactation • Well planned • Food sources • Vegan diets • Additional supplementation

  21. Common Nutrition-Related Concerns of Pregnancy • Nausea • “Morning sickness” • Hormonal changes • Constipation and hemorrhoids • Heartburn • Food cravings and aversions • Hormone-induced changes • Nonfood cravings

  22. High-Risk Pregnancies • Infant’s birthweight • Low birthweight (LBW) • 5 ½ pounds or less • Risk of complications • Relationship with socioeconomic status • Gestational age

  23. High-Risk Pregnancies • Malnutrition and pregnancy • Fertility • Viable sperm • Sexual interest • Amenorrhea • Early pregnancy • Placenta development • Fetal development • Consequences

  24. High-Risk Pregnancies • Food Assistance Programs • WIC • Nutrition education and nutritious foods • Vulnerable populations who qualify for help • Cost-benefit • Remedial and preventive services

  25. High-Risk Pregnancies • Maternal health • Preexisting diabetes • Risks associated with unmanaged diabetes • Gestational diabetes • Common consequences • Dietary recommendations

  26. High-Risk Pregnancies • Maternal health • Chronic hypertension • Risks • Gestational hypertension • Preeclampsia • Cause is unclear • Risks for mother • Risks for fetus • Eclampsia

  27. High-Risk Pregnancies • Maternal age • Ideal childbearing age • Adolescents • Risk of pregnancy complications • Higher rates of stillbirths, preterm births, and LBW infants • Weight gain recommendations • Need to seek prenatal care

  28. High-Risk Pregnancies • Maternal age • Older women • Complications often reflect chronic conditions • Cesarean section rates increase • Maternal death rates are higher • Risks for fetus

  29. High-Risk Pregnancies • Alcohol consumption • Irreversible mental and physical retardation • Fetal alcohol syndrome (FAS) • Medicinal drugs • No medication use without consulting physician • Herbal supplements • Seek physician advice

  30. High-Risk Pregnancies • Illicit drugs • Many drugs easily cross the placenta • Impair fetal growth and development • Other risks to fetus, infant, and child • Smoking and chewing tobacco • Harmful effects magnified during pregnancy • Risks for mother and infant • SIDS

  31. High-Risk Pregnancies • Environmental contaminants • Lead • Mercury • Foods to avoid • Supplements • Foodborne illness • Increased risk of listeriosis • Risks associated with illness

  32. High-Risk Pregnancies • Vitamin-mineral megadoses • Excessive vitamin A • Fetal malformations • Caffeine • Miscarriage and fetal death • Fetal growth • Weight-loss dieting • Sugar-substitutes

  33. Lactation: A Physiological Process • Hormones promote growth and branching of duct system & milk-producing cells • Prolactin • Milk production • Oxytocin • Cause mammary glands to eject milk into ducts

  34. Breastfeeding: A Learned Behavior • Lactation is an automatic, physiological process • Breastfeeding is a learned behavior • Some decide not to breastfeed • Factors influencing breastfeeding and its success • Partner • Adequate nutrition and rest

  35. Maternal Energy & Nutrient Needs During Lactation • Energy intake and exercise • Almost 500 extra kcalories per day • Exercise is compatible with breastfeeding • Energy nutrients • Recommendations increase for carbohydrates and fibers • Water • Prevent dehydration

  36. Maternal Energy & Nutrient Needs During Lactation • Vitamins and minerals • Inadequacies reduce the quantity, not quality of breast milk • Quality maintained at expense of maternal stores • Prolonged inadequate intakes • Impacts several nutrients • Supplements • Iron

  37. Maternal Energy & Nutrient Needs During Lactation • Food assistance programs • Participants are less likely to breastfeed • WIC incentives to encourage breastfeeding • Particular foods • Flavors • Allergies

  38. Maternal Health • HIV infection and AIDS • Transmission through breastmilk • Medications • Diabetes – type I • Postpartum amenorrhea • Does not protect from pregnancy • Breast health • Breast cancer

  39. Practices Incompatible With Lactation • Alcohol • Easily enters breast milk • Infants eat less when mother consumes alcohol • Medical drugs • Physician consultation • Illicit drugs • Risks

  40. Practices Incompatible With Lactation • Smoking • Reduces milk volume • Sleep less • Passive smoking and SIDS • Environmental contaminants • DDT, PCBs, and dioxin • Caffeine • Iron bioavailability

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