Infant and Maternal Health Quiz

Chapter 17: Life Cycle Nutrition: Pregnancy through Infancy

• Learning Outcomes: This chapter covers the nutritional needs and considerations throughout pregnancy and infancy, including the importance of the placenta, diet and lifestyle factors, nutrient needs in each trimester, breastfeeding, formula feeding, introducing solid foods to infants, and food allergies.

Preconception Period

• Lifestyle choices of both parents before conception influence the baby's health.

Prenatal Development

• Full-term pregnancy lasts 39-40 weeks, divided into three 13-week trimesters.
• Prenatal development is categorized as embryonic (weeks 3-8) and fetal (weeks 9-40).

The Placenta

• The placenta facilitates nutrient, oxygen, and waste exchange between mother and fetus.
• It prevents the passage of harmful substances like alcohol, drugs, and some medications.
• It releases hormones necessary for pregnancy.

Learning Outcomes (Continuing)

• Learning Outcomes (17.1-17.10): The specific learning outcomes outline the key areas of discussion related to each stage of pregnancy, pregnancy-related concerns, breastfeeding and formula feeding, infant nutrition, introducing solid foods, and food allergies.

What Nutrients and Behaviors Are Important for a Healthy Pregnancy?

• Healthy behaviors are essential for both the mother and father to support a healthy pregnancy.

Prospective Fathers' Healthy Habits

• Lifestyle and diet habits affect fertility, sperm production, and sperm health.
• Factors that might decrease sperm production include smoking, alcohol and drug abuse, and obesity.
• Nutrients that promote healthy sperm include zinc and folate. Antioxidants may protect sperm from damage.

Women Should Practice Healthy Habits Before and During Pregnancy

• Maintaining a healthy pre-pregnancy weight is important for a healthy pregnancy outcome.
• Obesity and overweight are linked to infertility, pregnancy complications (e.g., gestational diabetes, hypertension), birth defects, preterm delivery, difficult deliveries, childhood obesity, and cardiovascular disease in children.
• A woman should not try to lose weight during pregnancy.
• Underweight women are at higher risk for preterm delivery, low birth weight infants, and developmental problems in the child.

Women Should Practice Healthy Habits Before and During Pregnancy (continued)

• Adequate folic acid intake before and during pregnancy reduces the risk of neural tube defects in the developing fetus.
• Pregnant women should consume folate or folic acid at 400 mcg daily before conception and 600 mcg during pregnancy.
• Safe fish consumption is recommended (2-3 servings per week); avoiding fish with high methylmercury content.
• Caffeine intake should be limited to less than 200 mg per day.

Women Should Practice Healthy Habits Before and During Pregnancy (continued)

• Avoid smoking, alcohol, and illicit drugs. These habits increase risks for infertility, stunted growth, birth defects, stillbirth, premature birth, and sudden infant death syndrome (SIDS).
• Avoid fetal exposure to tobacco smoke.

Women Should Practice Healthy Habits Before and During Pregnancy (continued)

• Avoid illicit drugs during pregnancy, as they increase the risk of miscarriage, preterm labor, low birthweight, birth defects, drug withdrawal symptoms, and long-term health problems.

Women Should Practice Healthy Habits Before and During Pregnancy (continued)

• Avoid dietary supplements (including botanicals) unless thoroughly vetted by a healthcare professional. Chronic conditions like diabetes, hypertension, and PKU can impact pregnancy outcomes.

First Trimester

• The first trimester brings changes not only to the fetus but also to the mother's body.

First Trimester (continued)

• Key developmental milestones during the first trimester in the fetus include the liver beginning to form red blood cells, the heart beating, and the beginning of limb formation and brain development

Set Goals for Adequate Weight Gain

• The fetus comprises about one-third of the total weight gained during pregnancy; the rest is maternal tissues and fluids.
• Women with a healthy BMI (18.5-24.9) should gain 25-35 pounds; only about 1-4.5 pounds during the first trimester.
• Appropriate weight gain during pregnancy is essential for fetal growth.

Figure 17.5-Components of Weight Gain during Pregnancy

• A breakdown of the total weight gained during pregnancy.
• The chart illustrates the weight distribution among maternal fat stores, uterus and breast, blood volume, fetus, placenta, amniotic fluid, and other fluids.

Table 17.3-Recommended Weight Gain during Pregnancy

• This table outlines recommended weight gain based on pre-pregnancy BMI.

Ensure Adequate Nutrient Intake Throughout Pregnancy

• Increased nutrient needs are not needed in the first trimester, but certain prenatal nutrients are essential after conception.
• Pregnant women have increased needs for certain vitamins and minerals.

Ensure Adequate Nutrient Intake Throughout Pregnancy (continued)

• For example, adequate folate is crucial for the prevention of neural tube defects.
• Appropriate iron intake prevents anemia during pregnancy.

Ensure Adequate Nutrient Intake Throughout Pregnancy (continued)

• Sufficient zinc and copper intake support protein metabolism, DNA synthesis, and cell differentiation, which are essential for fetal development.

Ensure Adequate Nutrient Intake Throughout Pregnancy (continued)

• Calcium is pivotal for fetal bone development.

Ensure Adequate Nutrient Intake Throughout Pregnancy (continued)

• Maintaining adequate vitamin D intake is crucial throughout pregnancy to support calcium absorption as well as healthy fetal skeletal development.

Ensure Adequate Nutrient Intake Throughout Pregnancy (continued)

• Vegetarian or vegan women need to pay close attention to nutrients like omega 3-FFAs and vitamin B12.

Ensure Adequate Nutrient Intake Throughout Pregnancy (continued)

• ALA, and its derivatives EPA and DHA, which support cell membrane development, new tissue formation (including CNS tissues), and brain development.

Ensure Adequate Nutrient Intake Throughout Pregnancy (continued)

• Choline is necessary for cell division and growth, particularly in the brain.

Ensure Adequate Nutrient Intake Throughout Pregnancy (continued)

• Excess intake of certain vitamins and minerals, such as Vitamin A, can be harmful, so mothers should maintain nutrient balance.

Morning Sickness and Cravings

• Morning sickness (nausea) can arise at any point during the day.
• The heightened sense of smell can trigger nausea and vomiting. Focus on alleviating symptoms, such as small, frequent meals that are high in carbohydrates; salty foods; etc.
• Hyperemesis gravidarum is excessive vomiting during pregnancy, which can lead to dehydration, electrolyte imbalances, and weight loss.

Morning Sickness and Cravings (continued)

• Food cravings are common in pregnancy. However, cravings don't necessarily reflect nutritional deficiencies.
• Avoiding specific foods that are unsafe for pregnancy, such as raw or undercooked foods and/or certain shellfish, can prevent potential complications.
• The craving of non-food substances (e.g., dirt, clay) is known as pica and may indicate underlying health issues.

Food Safety Concerns

• The mother's weakened immune system, and the infant's undeveloped immune system, render them vulnerable to foodborne pathogens during pregnancy; proper food safety is crucial.
• Listeriosis, a contamination caused by the bacterium Listeria monocytogenes, can lead to miscarriage, preterm labor, low birth weight, developmental problems, and infant death. To reduce the risk of foodborne illness, avoid raw or undercooked meats, unpasteurized dairy products, and raw sprouts.

Food Safety Concerns(continued)

• Sugar substitutes can be used in moderation, but those with phenylketonuria (PKU) should avoid aspartame.

What Nutrients and Behaviors are Important in the Second and Third Trimester?

• Consistent intake of calories, carbohydrates, and protein is essential.

Second and Third Trimester (continued)

• Additional daily kilocalories are recommended to support an increase in weight, including the weight of a developing fetus.
• The required amounts of carbohydrates and protein are also higher during the latter two trimesters of pregnancy

Be Alert to Potential Complications: Gestational Diabetes

• Gestational diabetes occurs when a pregnant woman has high blood sugar levels.
• Gestational diabetes can cause a large baby (macrosomia), which elevates the risk of newborn jaundice, breathing difficulties, birth defects, and hypoglycemia.

Be Alert to Potential Complications: Gestational Diabetes (continued)

• Common risk factors for gestational diabetes include being overweight, older than 25 years old, having a family history of diabetes, a prior history of higher than typical blood glucose levels, and/or being part of groups with higher risks such as some ethnic groups, and having previously given birth to a large or stillborn baby).

Be Alert to Potential Complications: Hypertension

• Pregnancy-induced hypertension includes three forms.
• Gestational hypertension occurs during pregnancy in women with no prior history of hypertension.
• Preeclampsia is characterized by high blood pressure, edema, and protein in the urine.
• Eclampsia is a severe complication with seizures that occurs with preeclampsia.

Factors that Negatively Affect Pregnancy

• Risks associated with pregnancy, like lifestyle, age, weight, health history, diet, and socio-economic status are important markers to monitor for potential complications.

Lactation-Benefits and Requirements

• Lactation is the production of milk by a woman's body after giving birth.
• Stimuli from infant suckling and hormones like prolactin and oxytocin are essential for milk production and the letdown response.

Lactation- Benefits and Requirements (continued)

• Breastmilk is nutritionally tailored to the specific needs of the infant, and changes in nutritional composition throughout the infant's growth.
• Breastmilk is higher in protein, vitamin A, and minerals, and immune factors after birth

Lactation- Benefits and Requirements (continued)

• Breastfed infants are at reduced risk for infections, allergies, diarrheal disorders, respiratory and ear infections, meningitis, and urinary tract infections.

Breastfeeding Provides Nutritional and Health Benefits for Infants

• Breastmilk changes nutritionally as the infant develops.
• Colostrum, produced right after birth, is rich in protein, vitamin A, minerals, and immune factors.
• Mature milk, produced later, is high in lactose, fat, and B vitamins, while being lower in fat-soluble vitamins and sodium.
• The American Academy of Pediatrics recommends that breastfed infants also receive vitamin D supplements, which are crucial.

Breastfeeding provides physical, emotional, and financial benefits to mothers.

• For mothers, oxytocin assists in uterine contraction and reduced blood loss after childbirth.

• Breastfeeding also can reduce the risk of breast and ovarian cancer in mothers, as well as reduce their risk of hip fractures, improve bone density, and lower risk of type 2 diabetes.

When is Formula a Healthy Alternative to Breastfeeding?

• Formula is an alternative when direct breastfeeding is not possible or advisable.
• Medical conditions such as HIV/AIDS or receiving chemotherapy may make breastfeeding undesirable.
• Galactosemia, (an incapability to metabolize lactose) is a condition that necessitates formula feeding.
• Mothers taking medications need to consult their doctor about safety.

Infants' Nutritional Needs

• Infants need substantial nutritional intake due to their high growth rate.

• The nutritional requirements, and specific amounts of calories, carbohydrates, proteins, and fats are particularly high, and vary by age.

• Vitamin K, Vitamin D, and iron are important nutrients, and infants may need supplements, or fortified foods to meet their nutritional needs.

When are Solid Foods Safe to Introduce to Infants?

• Solid foods should be introduced gradually to infants once certain developmental milestones are met.
• Important milestones include faded tongue-thrust reflexes, head and neck control, and the ability to sit without support.

When are Solid Foods Safe to Introduce to Infants?(continued)

• Solid foods should be gradually introduced.
• To avoid allergies, introduce and monitor infants to each new food individually before adding additional foods.

Some Foods are Not Appropriate for Infants

• Some foods, such as hot dogs, raw carrots, or other foods that might cause choking hazards, should be avoided.
• Avoid giving honey to infants, since it can lead to a rare form of paralysis known as infant botulism.

What Causes Food Allergies?

• A food allergy is an abnormal response by the immune system to a particular food.
• Food allergens are proteins that can't be broken down by cooking, digestion, and enter the body intact, causing adverse reactions.

What Causes Food Allergies? (continued)

• Anaphylaxis is a severe, potentially life-threatening allergic reaction, characterized by inhibited breathing mechanisms.

What Causes Food Allergies? (continued)

• Anaphylactic reactions typically happen in two stages. First, during the sensitization stage, allergens sensitize themselves to the immune system, and the response is amplified during the second stage, the allergic reaction stage. When a person eats the food allergens again, reactions appear.

Common Food Allergies and Outgrowth

• Common food allergens include eggs, cow's milk, peanuts, soy, wheat, tree nuts, and shellfish.

• A substantial portion of children outgrow the most common food allergies, with most instances of egg, milk, wheat, and soy allergies resolving by age 5. Twenty percent of children outgrow peanut allergies over time.