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Chapter 12

Chapter 12. Maternal and Fetal Nutrition Debbie Hogan RN. Maternal and Fetal Nutrition. Good nutrition before and during pregnancy an important preventive measure Low-birth-weight (LBW) infants Preterm infants Neonatal death rates for moderate LBW are five times higher than babies >2500 g

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Chapter 12

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  1. Chapter 12 Maternal and Fetal Nutrition Debbie Hogan RN

  2. Maternal and Fetal Nutrition • Good nutrition before and during pregnancy an important preventive measure • Low-birth-weight (LBW) infants • Preterm infants • Neonatal death rates for moderate LBW are five times higher than babies >2500 g • The risk for VLBW is 100 times higher

  3. Nutrient Needs Before Conception • First trimester crucial for embryonic and fetal organ development • Healthful diet before conception ensures that adequate nutrients are available for developing fetus • Folic acid intake important in periconceptual period • Neural tube defects are more common in infants of women with poor folic acid intake

  4. Fig. 12-1. Factors that influence the outcome of pregnancy.

  5. Nutrient Needs During Pregnancy • Energy needs • Weight gain • Body mass index (BMI) = weight/height2 • Pattern for weight gain • Hazards of restricting adequate weight gain • Protein • Fluids

  6. Nutrient Needs During Pregnancy—cont’d • Minerals and vitamins • Iron • Calcium • Other minerals and electrolytes • Magnesium • Sodium • Potassium • Zinc • Fluoride

  7. Nutrient Needs During Pregnancy—cont’d • Minerals and vitamins • Fat-soluble vitamins • Vitamins A, D, E, and K • Water-soluble vitamins • Folate or folic acid • Pyridoxine • Vitamin C • Multivitamin-multimineral supplements

  8. Nutrient Needs During Pregnancy—cont’d • Other nutrition issues during pregnancy • Pica and food cravings • Adolescent pregnancy needs • Improve nutritional health of pregnant adolescents by focusing on knowledge and planning of meals • Nutrition interventions and educational programs effective with adolescents • Understanding factors that create barriers to change in adolescent population • Promote access to prenatal care

  9. Nutrient Needs During Pregnancy—cont’d • Physical activity during pregnancy • Moderate exercise yields many benefits, including improving muscle tone, shortening course of labor, and sense of well-being • Liberal amounts of fluid should be consumed before, during, and after exercise • Calorie intake sufficient to meet increased needs of pregnancy and exercise

  10. Nutrient Needs During Lactation • Nutrition needs during lactation similar to those during pregnancy • Needs for energy (calories), protein, calcium, iodine, zinc, the B vitamins, and vitamin C greater than nonpregnant needs

  11. Nutrient Needs During Lactation—cont’d • Energy intake increase of 500 kcal more than woman’s nonpregnant intake recommended • Smoking, alcohol intake, and excessive caffeine intake should be avoided during lactation

  12. Nursing Care Management • Assessment • Diet history • Obstetric and gynecologic effects on nutrition • Medical history • Usual maternal diet • Physical examination • Laboratory testing

  13. Nursing Care Management—cont’d • Plan of care and implementation • Adequate dietary intake • Pregnancy • Postpartum • Daily food guide and menu planning • Medical nutrition therapy • Counseling about iron supplementation

  14. Nursing Care Management—cont’d • Plan of care and implementation • Adequate dietary intake • Coping with nutrition-related discomforts of pregnancy • Nausea and vomiting • Constipation • Pyrosis (heartburn) • Cultural influences • Vegetarian diets

  15. Nutrition & Adolescent Pregnancy • Adolescent attempting to meet needs of her growing body • Now needs nutrients for fetus • Weight restriction/mask the pregnancy • Insufficient dietary intake=SGA

  16. Key Points • Woman’s nutritional status before, during, and after pregnancy contributes to her well-being and that of her infant • Physiologic changes during pregnancy influence need for additional nutrients and efficiency with which the body uses them • Total maternal weight gain and pattern of weight gain are important determinants of outcome of pregnancy

  17. Key Points—cont’d • Appropriateness of mother’s prepregnancy weight for height (BMI) is major determinant of recommended weight gain during pregnancy • Nutritional risk factors include adolescent pregnancy; bizarre or faddish food habits; abuse of nicotine, alcohol, or drugs; low weight for height; and frequent pregnancies

  18. Key Points—cont’d • Iron supplementation is recommended routinely during pregnancy • Other supplements recommended when nutritional risk factors present • Nurse and woman influenced by cultural and personal values and beliefs during nutrition counseling

  19. Key Points—cont’d • Pregnancy complications that may be nutrition related include: • Anemia • Gestational hypertension • Gestational diabetes • Intrauterine growth restriction • Dietary adaptations can be effective interventions for some common discomforts of pregnancy, including nausea and vomiting, constipation, and heartburn

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