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Chapter 13 Life Cycle Nutrition: Mother and Infant

Chapter 13 Life Cycle Nutrition: Mother and Infant. Nutrition : Concepts & Controversies, 12e Sizer/Whitney. Learning Objectives. Explain why a nutritionally adequate diet is important long before a pregnancy is established.

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Chapter 13 Life Cycle Nutrition: Mother and Infant

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  1. Chapter 13Life Cycle Nutrition: Mother and Infant Nutrition: Concepts & Controversies, 12e Sizer/Whitney

  2. Learning Objectives • Explain why a nutritionally adequate diet is important long before a pregnancy is established. • Identify the special nutritional needs of a pregnant teenager as compared to a pregnant adult. • Evaluate the statement that “no level of alcoholic beverage intake is safe or advisable during pregnancy.”

  3. Learning Objectives • Describe the impacts of gestational diabetes and preeclampsia on the health of a mother and her unborn child. • Discuss the nutrition and health benefits of breastfeeding to both the mother and the child. • Discuss some relationships between childhood obesity and chronic diseases.

  4. Learning Objectives • Develop a healthy eating and activity plan to help an obese child improve his or her short-term and long-term health overall.

  5. Preparing for Pregnancy • Establish eating habits before pregnancy • Fathers-to-be • Mothers-to-be • Pregnancy weight • Appropriate body weight before pregnancy • Obese and underweight women • Low birthweight infant • Infant mortality rate

  6. Infant Mortality Decline Over Time

  7. Preparing for Pregnancy • Healthy placenta and other organs • Placenta • Supply depot and waste-removal system • Two bloods never mix • Metabolically active organ • Umbilical cord • Amniotic sac • Poor maternal nutrition prior to pregnancy could affect her grandchildren and children

  8. The Placenta

  9. The Events of Pregnancy • Fertilized ovum is called a zygote • Implantation • Within two weeks of fertilization • Fetus at eight weeks • Physical changes • Fetal period • Gestation = 40 weeks • Trimesters • Critical periods

  10. Stages of Embryonic and Fetal Development

  11. Increased Need for Nutrients • Energy • Vary with progression of pregnancy • Carbohydrate • Protein • DRI for pregnancy • Supplements • Discretionary calories

  12. Increased Need for Nutrients • Folate • Recommendation increases during pregnancy • Neural tube defects (NTD) • Anencephaly • Spina bifida • Enrichment of grain products • Vitamin B12 • Assists folate with manufacture of new cells

  13. Spina Bifida

  14. Rich Folate Sources

  15. Increased Need for Nutrients • Vitamin D • Rickets • Calcium • Absorption doubles during pregnancy • Recommendations are aimed at preserving maternal bone mass • DRI recommendations

  16. Increased Need for Nutrients • Iron • Iron needs of fetus take priority • Iron supplements • Enhancing absorption • Zinc • Supplementation during pregnancy is not advised • Prenatal supplements

  17. Example of a Prenatal Supplement Label

  18. Food Assistance Programs • Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) • Nutritious foods • Nutrition education • Referrals to health and social services • Benefits of the program • Supplemental Nutrition Assistance Program

  19. Weight and Pregnancy • Weight gain • Women must gain weight during pregnancy • Benefits of appropriate weight gains • Ideal weight-gain pattern • Nearly all lean tissue • Weight loss and pregnancy • Typical woman does not return to prepregnancy weight

  20. Recommended Weight Gains Based on Prepregnancy Weight

  21. Components of Weight Gain During Pregnancy

  22. Pregnancy and Physical Activity • Benefits of physical activity • Consult physician • Types of activities • Recommendations • Prevent dehydration • Prevent high internal temp.

  23. Teen Pregnancy • Special case of intense nutrient needs • Frequent teen deficiencies • Less likely to receive prenatal care • More likely to smoke • Risks associated with teen pregnancy • Infant • Mother

  24. Cravings and Aversions in Pregnancy • Cravings and aversions are common • Do not reflect physiological needs • Pica • Often associated with iron deficiency • “Morning” sickness • Hormones

  25. Some Cautions for the Pregnant Woman • Smoking • Damage to fetal DNA • Developmental defects or diseases • Complications of birth • Risk of SIDS • Medicinal drugs and herbal supplements • No OTC drugs or herbal supplements • Prescriptions only with doctor’s advice

  26. Some Cautions for the Pregnant Woman • Drugs of abuse • Cross the placenta • Complications of use • Environmental contaminants • Lead • Mercury • Fish consumption

  27. Some Cautions for the Pregnant Woman • Foodborne illness • Listeriosis • Foods to avoid • Vitamin-mineral megadoses • Vitamin A • Dieting • Sugar substitutes • Caffeine

  28. Drinking During Pregnancy • Labeling of alcoholic beverages • Alcohol crosses placenta & is toxic • Direct effects in fetus

  29. Fetal Alcohol Syndrome • Drinking alcohol during pregnancy • Fetal Alcohol Spectrum Disorders (FASD) • Fetal Alcohol Syndrome (FAS) • Alcohol-Related Neurodevelopmental Disorder (ARND) • Alcohol-Related Birth Defects (ARBD) • Expert advice

  30. Typical Facial Characteristics of FAS

  31. Troubleshooting - Diabetes • Special challenges for disease management • Problems with poor glycemic control • Continuation of intensified management after pregnancy • Gestational diabetes • Diabetes risk later in life • Increased odds of surgical birth and high infant birthweight

  32. Troubleshooting – Hypertension & Preeclampsia • Hypertension • Chronic vs. gestational hypertension • Risks for mother and fetus • Preeclampsia • High blood pressure and protein in urine • Occurrence • Advancement to eclampsia

  33. Lactation • Preparation before birth • Read books • Consult a certified lactation consultant • Learn about nutritional requirements

  34. Nutrition During Lactation • Energy cost • 500 calories per day above a woman’s need • Fluid need • Prevent dehydration • Variations in breast milk • Quantity vs. quality of milk • Food sensitivities and allergies • Weight loss • Gradual

  35. When Should a Woman Not Breastfeed? • Alcohol and illicit drugs • Alcohol concentration peak within 1 hour • Illicit drug users should not breastfeed • Tobacco and caffeine • Medicines • Danger levels vary – consult physician • Oral contraceptives

  36. When Should a Woman Not Breastfeed? • Environmental contaminants • Maternal illness • Common cold • Hepatitis or tuberculosis • HIV • World Health Organization (WHO)

  37. Feeding the Infant • Nutrient needs • Growth rate • Weight and length • Basal metabolic rate • Energy nutrients • Vitamins • Water

  38. Nutrient Recommendations for an Infant & an Adult Male Compared on the Basis of Body Weight

  39. Why Is Breast Milk So Good for Babies? • AAP and ADA position • Excels as source of nutrients • Vitamin D • Immune factors • Easily digested • Energy-nutrient balance • Lipids

  40. Why Is Breast Milk So Good for Babies? • Vitamins and minerals in breast milk • Vitamin D supplements • Supplements for infants • Vitamin D, iron, fluoride, vitamin K • Immune factors • Colostrum • Benefits of breast milk with infection • Other possible benefits

  41. Formula Feeding • Offers an acceptable alternative to breastfeeding • Nutrient composition • Special formulas • Transition to cow’s milk • 1 year of age • Dietary indicators of readiness for cow’s milk

  42. Percentages of Energy-Yielding Nutrients in Breast Milk, Infant Formula, & Cow’s Milk

  43. Infant’s First Foods • Governing considerations • Nutrient needs • Iron and vitamin C • Physical readiness • Ability to swallow • Need to detect & control allergic reactions • Introduce single-ingredient foods one at a time

  44. Infant’s First Foods • Choices of foods • Variety, balance, moderation • Fat restriction • Foods to omit • Sweets and baby desserts • Sugar alcohols • Canned foods • honey

  45. Looking Ahead • First year of life lays the foundation for future health • Encourage healthy eating habits • Avoid concentrated sweets • Encourage physical activity • Nursing bottle syndrome

  46. Childhood Obesity and Early Chronic Diseases Controversy 13

  47. Childhood Obesity • Increase in childhood obesity rates • Associated health problems • Characteristics of obese children

  48. The Challenge of Childhood Obesity • Physical perils • Blood lipids • Hypertension • Cardiorespiratory fitness • Asthma • Emotional perils • Discrimination • Rejection

  49. The Challenge of Childhood Obesity • Overweight or chubby and healthy • Body mass index (BMI) • Be careful not to set unrealistic expectations • Genetic inheritance • Environmental influence

  50. Development of Type 2 Diabetes • Connection with obesity • Ethnicity and risk • Symptoms of diabetes • Type 1 • Type 2

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