Module 7: Nutritional Aspects of Pregnancy Breast Feeding & The Growing Years

  1. describe factors that predict a successful pregnancy outcome
    A favorable pregnancy outcome is a full-term gestation period (longer than 37 weeks) that results in a live, healthy infant weighing more than 5.5 lbs and permits the mother to return to her prepregnancy health status.
  2. specify the optimal weight gain during pregnancy for adult women
    • A healthy goal for total weight gain for a woman of normal BMI averages about 25-30lbs.
    • For women with a low BMI (<18.5), the goal increased to 28-40lbs. 
    • The goal decreases to 15-25lbs for overweight women (BMI 25-29.9) and
    • 11 to 20 lbs for an obese woman (BMI>30).
  3. Identify four key nutrients for which intake should be significantly increased during pregnancy?
    • Essential Fatty Acids – many women need to increase the amount of omega-3 fats, may improve gestation duration and infant birth weight, length and head circumference.
    • Folate– when folate intake is insufficient, fewer red blood cells are synthesized, causing folate related anemia. Insufficient folate intake also may cause premature birth, low birth weight, fetal growth retardation, spontaneous abortion, poor placenta development and other pregnancy complications.
    • Folate deficiencies in early stage of pregnancy also can cause neural tube defects. 
    • Zinc – severe zinc deficiency may cause birth defects, fetal growth retardation, premature birth and spontaneous abortion. Pregnant women may experience prolonged labor, bleeding, infections and serious complications, such as pregnancy induced hypertension and preeclampsia. Protein intake recommendation for pregnant women are more than 50% above that of nonpregnant women.
  4. What steps can lactating women take to ensure they consume an adequate amount of nutrients?
    • Calcium intake is important because women who breastfeed their babies for 6 months or more lose significant amount of calcium from their bones.
    • Water is the main component of human milk. Inadequate water intake can alter milk composition, decrease the amount of milk produced, & lead to maternal dehydration. Breastfeeding woman should drink 32 oz, in addition to the 72 oz recommended for nonpregnant women.  More, if feeding more than one baby. 
    • Calorie needs can be met by eating the same number of servings from each food group as recommended for a pregnant woman in the last 2 trimesters. The average breastfeeding woman uses about 800 calories/day during the first 6 months of lactation to produce 750ml of milk daily.  Approximately 400-500 calories should come from her diet, with the remainder supplied by the fat stored during pregnancy
  5. What vitamin and mineral supplements are recommended for infants, children, and teens?
    • With the exception of a vitamin K supplement for newborns, an iron supplement for breastfed infants, a vitamin B-12 supplement for breastfed infants/vegan mothers, a vitamin D supplement for some infants, and a fluoride supplement for infants, children & teens with a unfluoridated water supply, routine nutrition supplementation is not needed by healthy children and teens.
    • However, supplements may be recommended for children and teens who are poor eaters, vegans, pregnant, or programs to manage obesity, and/or deprived, neglected or abused.
    • The American Academy of Pediatrics suggest that these children and teens may benefit from a children’s multivitamin and mineral supplement not exceeding 100% of the RDA or Adequate intakes.
  6. describe the calorie and nutrient needs of infants
    • Newborn need about 50 calories/lb each day to support their rapid growth and high basal metabolic rate. After2-3 months of age, calorie needs drop to about 40 calories/lb daily and remain at about this level until age3 or so. 
    • Fat is an important part of infant’s diets. It provides constituents such as cholesterol and essential fatty acids.  It addition, because it contains many calories in a small volume, fat can meet infants’ high calorie demands without overfilling their small stomachs.  Total fat should account for about 40-55% of a baby’s calorie intake. 
    • Daily protein needs in infancy are roughly 1.5g/kg of body weight daily to support their rapid rate of tissue synthesis.
    • Water is of special importance for babies because they have a large body surface area per pound of weight, turn over body water quickly, produce a large quantity of waste, and have inefficient kidneys. A young baby’s need for water is usually met by human milk or formula.  However, giving infants too much water can lead to water intoxication.
    • Newborns frequently have low stores of fluoride, vitamin K and vitamin D.
  7. describe the calorie and nutrient needs of children
    • The slower growth of childhood in comparison with infancy translates into a gradual reduction in calorie need/lb decrease to 32 by age 5 and drop to about half that amount by age 15.
    • Fat –it is wise to reduce fat intake gradually between ages 2-5 until children are getting an average of 30-35% of their calories from fat. As fat intake declines, children should replace fat calories with nutrient-rich foods, such as fruit, vegetables, lean meats and low fat dairy products. 
    • Many children consume too little calcium, zinc, folate and vitamins A & C.
  8. describe the calorie and nutrient needs of adolescents
    • The total quantities of nutrients and calories needed are greater during adolscense than at any other time, except pregnancy & lactation.
    • Adolescent males need more of many nutrients than females because males are larger, develop more muscle mass and bone density and have a longer, more intense growth period.
    • Total calorie needs rise steadily and peak for females at about age 15-16 and for males around age 18.
    • Many teens consume too little calcium, zinc, folate and vitamins A & C.
  9. describe the benefits of breastfeeding
    • The protein in human milk are easier for the infant to digest and less stressful to the immature kidneys than cow milk.
    • The proteins in human milk are not likely to cause allergic reactions in infants.
    • Human milk protein – lactoferrin, increases the rate of iron absorption by the infant. As a result, more iron is absorbed from human milk than infant formula or milk from other animals, even though human milk contains less iron than these foods. 
    • Factors in the human milk promote the maturation of the immune system and intestinal tract.
    • Reduces risk of food allergies and intolerances, as well as some other allergies.
    • Provide immune factor proteins (antibodies) and other compounds (lactobacillus bifidus) that reduce the risk of infections and diarrhea while the immune system is till immature.
    • Reduces risk of childhood asthma, leukemia, obesity, diabetes, chronic intestinal diseases, misaligned teeth, ear infections, and respiratory infections.
    • May enhance visual acuity, nervous system development, and learning ability by providing the fatty acid docohexaenoic acid.
    • Establishes the habit of eating in moderation, thus decreasing the possibility of obesity later in life by about 20%.
    • Contributes to normal development of jaws and teeth for better speech development.
    • Is bacteriologically safe.
    • Is always fresh and ready.
  10. explain the rationale -- from the standpoints of both nutrition and physical development -- for the delay in feeding infants solid foods until 4-6 months of age
    • If solid food takes the place of human milk or formula, reduced nutrient intake (especially calcium) may occur.
    • The strain that solid food puts on a young infant’s organs, introducing food too early nay lead to feeding problems and food dislikes.
    • An infant’s intestinal tract is immature and cannot readily digest starch before 3 months.
    • Because infants can easily absorb whole proteins until 4-5 months of age, exposing them to many different proteins before age 6 months may predispose a child to future allergies and other health problems. 
    • Infants show signs that they are ready for solid foods: they are able to sit up with support, the extrusion reflex weakens and they can make a chewing motion.
  11. discuss the factors that affect the food intake of children and adolescents
    • Children – Children tend to have erratic appetites. Pressuring a child to eat more or less than desired tells the child not to rush his/her hunger & satiety signals – this can lead to a lifetime battle with weight problems.  Offering children 6 or so small meals succeeds better than limiting them to 3 meals daily. 
    • Nutrition lesson for children of all ages involve expanding familiarity with new foods & helping them develop a willingness to accept new foods.
    • Many preschool children go through periods of unpredictable and unusual eating behavior, such as going on food jags, refusing to eat, and being a picky eater. The best way to handle most of these behaviors is to not overreact, offer a variety of healthy foods, and let the child exert some autonomy over the specific types of food and amounts eaten. 
    • Teens – the struggle to establish independence and individual identity gain peer acceptance, and cope with their heightened concern about physical appearance affects teens’ food choices. Other factors that affect their food choices are perceived and desired body image, participation in athletics and substance use.
  12. Prenatal
    If prenatal care is inadequate, delayed or absent, untreated maternal nutritional deficiencies can deprive a developing fetus of needed nutrients.  In addition, untreated chronic diseases, such a hypertension or diabetes, in crease the risk of fetal damage.  Without prenatal care, a woman is 3 times more likely to deliver a low-birth weight baby.  Although the ideal time to start prenatal care is before conception, about 20% of women in the US receive no prenatal care throughout the first trimester
  13. Gestation
    period of intrauterine development of offspring, from conception to birth.  In humans, gestation last for about 40 weeks after the woman’s last menstrual period.
  14. Favorable pregnancy outcome
    Researchers often define a favorable pregnancy outcome as a full-term gestation period (longer than 37 weeks) that results in a live, healthy infant weighing more than 5.5 lbs and permits the mother to return to her prepregnancy health status
  15. Failure to thrive
    Inadequate gains in weight & height in infancy, often due to an inadequate food intake.
  16. Solid foods
    experts currently agree that most babies are not ready for solid food until they are 6 months old. Infants show signs that they are ready for solid foods: they are able to sit up with support, the extrusion reflex weakens and they can make a chewing motion.
  17. Extrusion reflex
    Normal response present in first few months of life that causes the tongue to thrust outward when touched or depressed.  It helps a baby express milk from a nipple, but is also causes an infant to push objects placed on the tip of the tongue, such as a spoon or food, out of the mouth; also called tongue-thrusting.
  18. Outline current weight-gain recommendations for pregnancy. What is the basis for these recommendations?
    • A healthy goal for total weight gain for a woman of normal BMI averages about 25-30lbs.
    • For women with a low BMI (<18.5), the goal increased to 28-40lbs. 
    • The goal decreases to 15-25lbs for overweight women (BMI 25-29.9) and 11 to 20 lbs for an obese woman (BMI>30).
    • The recommendations promote optimal fetal growth while minimizing the risks of complications at delivery, postpartum maternal weight retention and the infant’s chance of developing chronic disease later in life.
  19. How do iron deficiency anemia and physiological anemia differ?
    Iron deficiency anemia – decreased oxygen carrying capacity of the blood. This can be caused by many factors, such as iron deficiency or blood loss. 

    Physiological anemia – normal increase in blood volume in pregnancy that dilutes the concentration of red blood cells, resulting in anemia; also called hemodilution
  20. Nutrient supplements during pregnancy are recommended for which groups of women?
    • A multivitamin and mineral supplement is recommended for women who have a history of frequent dieting; are teenagers or vegans; have a low income; are underweight; smoke or abuse alcohol or illegal drugs; are carrying multiple fetuses; are/or are eating a diet restricted in variety.
    • Health professionals believe a pregnant woman should take nutrient supplements only when there is evidence that her usual diet is likely to limit maternal or fetal iron during the last 2 trimesters.
    • Supplements for specific nutrients may be recommended in circumstances where these nutrients are inadequate.
  21. Why is the need for water of critical importance during infancy?
    • Water is of special importance for babies because they have a large body surface area per pound of weight, turn over body water quickly, produce a large quantity of waste, and have inefficient kidneys.
    • A young baby’s need for water is usually met by human milk or formula. 
    • Giving infants too much water can lead to water intoxication.
  22. How might an infant signal he or she has had enough to eat?
    • Removes mouth from nipple.
    • Falls asleep
    • Relief of body tension.
    • Tosses head back or turns away.
    • Covers mouth with hand Spits out food.
    • Protests (fusses or cries)
  23. What physical ability signs indicate babies are developmentally ready for solid foods?
    • Able to sit up with support
    • Extrusion reflex weakens
    • Can make a chewing motion.
  24. Which two nutrients are of particular concern in planning diets for teenagers? Why does each deserve to be singled out?
    • Iron – teens are vulnerable to iron deficiency anemia because their need increases about 40% (males) and 90% (females) during this life stage. Much of the increase results from expanding lean body mass, which directly incorporates substantial quantities of iron.  In addition, with the onset of menstrual periods, adolescent females need additional iron to replace the blood lost.
    • Calcium – bones are growing longer and denser.  The majority of bone formation occurs between the ages of 9-18.  Less than optimal calcium intakes may lead to decreased bone density and a greater risk of osteoporosis later in life.
  25. Which of the following is true of a favorable pregnancy outcome?  




    D.  all of the above
  26. Iron needs rise significantly during pregnancy because ________.
    The fetus is building iron stores & the number of red blood cells increases in the mother.
  27. A woman who begins pregnancy at a healthy weight should gain _______.
    25 to 35 lbs
  28. If development does not occur during a critical period, the embryo can make up for this development later when more nutrients are available. 

    a.  true
    b.  false
    b.  false
  29. When adolescence ends, females have ________.
    twice as much body fat as males and 2/3 as much lean body mass as males.
  30. The percentile growth curve a child follows depends mostly on _________.
    dietary intake and genetic endowment
  31. Children are likely experiencing growth stunting if their __________.
    Statue for age falls below the 5th percentile.
  32. To help children accept new foods, caregivers should _________.
    involve the child in preparing the food.
Author
mjperez1
ID
316811
Card Set
Module 7: Nutritional Aspects of Pregnancy Breast Feeding & The Growing Years
Description
Chp. 16 & 17
Updated