Chapter 11 Diet During Pregnancy And Lactation PDF

Chapter 11 Diet during Pregnancy and Lactation  Objectives  Identify nutritional needs during pregnancy and lactation.  Describe the nutritional needs of pregnant adolescents.  Modify the normal diet to meet the needs...

Chapter 11 Diet during Pregnancy and Lactation  Objectives  Identify nutritional needs during pregnancy and lactation.  Describe the nutritional needs of pregnant adolescents.  Modify the normal diet to meet the needs of pregnant and lactating women. 11-2 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Weight Gain during Pregnancy  Average weight gain is 25–35 pounds for normal-weight women.  Underweight women should gain 28–40 pounds.  First trimester: 2–4 pound weight gain  Second and third trimester: 1 pound/week  No one should lose weight during pregnancy. 11-3 (continues) Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. (continued) Weight Gain during Pregnancy  No additional calories are usually required during the first trimester.  An additional 300 calories needed during the second and third trimesters.  Folic acid supplementation prior to conception decreases risk of brain and spinal cord defects. 11-4 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Nutritional Needs during Pregnancy  The protein requirement is increased by 20% for the pregnant woman over age 25 (25% for pregnant adolescent).  No need to increase vitamin A; excess vitamin A can cause birth defects.  Vitamin D requirement is 10 g.  Vitamin E requirement is 5 g.  Vitamin K requirement is 75–90 g depending upon age. 11-5 (continues) Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 11-6 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. (continued) Nutritional Needs during Pregnancy  Requirements for all the water-soluble vitamins are increased.  Requirements for vitamins B and C are increased.  Requirements for calcium, iron, zinc, iodine, and selenium are all increased.  Iron supplements are commonly prescribed. 11-7 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Fulfillment of Nutritional Needs during Pregnancy  Base diet on MyPyramid.  Drink additional fat-free milk or appropriate substitute.  Prenatal vitamins and iron supplement may be prescribed.  Over-the-counter nutrient supplements may be harmful to the fetus. 11-8 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Concerns during Pregnancy  Nausea  Pregnancy-induced  Constipation hypertension  Heartburn  Pica  Excessive weight  Anemia gain  Alcohol, caffeine, drugs, and tobacco 11-9 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Nausea  “Morning sickness” occurs most commonly in first trimester.  Suggestions  Eat dry crackers or dry toast before rising  Eat small, frequent meals  Avoid food with offensive odors  Avoid liquids at mealtime 11-10 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Hyperemesis Gravidarum.  Occurs when the nausea becomes so severe that it is life-threatening  May require hospitalization and parenteral nutrition 11-11 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Constipation  Caused by relaxed gastrointestinal tract due to progesterone  Eat a high-fiber diet.  Participate in daily exercise.  Drink eight glasses of water per day. 11-12 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Heartburn  Caused by pressure on the stomach by the growing fetus and relaxation of the cardiac sphincter.  Eat small, frequent meals.  Avoid spicy or greasy foods.  Avoid liquids with meals.  Wait at least 1 hour after eating to lie down and 2 hours before exercising. 11-13 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Excessive Weight Gain  Re-evaluate diet and eliminate foods that do not fit within MyPyramid.  Drink fat-free milk.  Eat clean, crisp, raw vegetables as a snack.  Eat fruits and custards made with fat-free milk as desserts.  Broil, bake, or boil instead of frying. 11-14 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Pregnancy-Induced Hypertension  Formerly called pre-eclampsia or toxemia  Characterized by high blood pressure, presence of protein in the urine, and edema in third trimester  May progress into the eclamptic stage with convulsions, coma, and possible death of the mother and infant 11-15 (continues) Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. (continued) Pregnancy-Induced Hypertension  Higher incidence during first pregnancy, multifetal pregnancies, morbidly obese mothers, or those with inadequate diets, especially protein deficient 11-16 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Pica  Pica is the craving for nonfood substances such as starch, clay (soil), or ice.  Ingestion of soil should be discouraged due to possible contamination and nutrient deficiencies.  Multiple nutritional deficiencies can result from pica. 11-17 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Anemia  Anemia is a condition caused by an insufficiency of red blood cells, hemoglobin, or blood volume.  Causes weakness, fatigue, poor appetite, and pallor 11-18 (continues) Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. (continued) Anemia  Iron-deficiency anemia is the most common form.  Folate deficiency may lead to megaloblastic anemia and is prevented by folate supplement. 11-19 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Alcohol, Caffeine, Drugs, and Tobacco  Fetal alcohol syndrome (FAS) is characterized by a growth deficiency, central nervous system dysfunction, microcephaly (small head), and other physical characteristics.  Fetal alcohol effect (FAE) causes fewer physical defects, but many behavioral and psychosocial problems. 11-20 (continues) Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. (continued) Alcohol, Caffeine, Drugs, and Tobacco  Abstinence of alcohol is recommended.  Caffeine has been shown to cause birth defects in rats, but no data exist for humans. Limit caffeine intake to < 300 mg/day.  Illegal drugs can cause the infant to be born addicted. 11-21 (continues) Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. (continued) Alcohol, Caffeine, Drugs, and Tobacco  Drugs derived from vitamin A can cause fetal malformations and spontaneous abortions.  Tobacco smoking is associated with low birth weights, sudden infant death syndrome (SIDS), fetal death, spontaneous abortions, and complications at birth. 11-22 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Diet for the Pregnant Woman with Diabetes  The nutrient requirements of the pregnant woman with diabetes are the same as for the nondiabetic pregnant woman.  The dietitian should plan the diet depending on the type and number of insulin injections required.  Gestational diabetes occurs during pregnancy and disappears after the infant is born. 11-23 (continues) Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. (continued) Diet for the Pregnant Woman with Diabetes  Routine screening for gestational diabetes is part of prenatal care.  Insulin is used during pregnancy to control any type of diabetes.  Oral hypoglycemic agents have not been used during pregnancy.  Artificial sweeteners have been found to be safe during pregnancy. 11-24 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Pregnancy during Adolescence  The nutritional, physical, psychological, social, and economic demands on pregnant adolescents are tremendous.  Nutrition must meet the needs of her growing body and the needs of the fetus.  High risk for pregnancy-induced hypertension and premature delivery 11-25 (continues) Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. (continued) Pregnancy during Adolescence  Inadequate nutrition of the mother is related to both mental and physical birth defects.  Much counseling and emotional support is needed. 11-26 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Lactation  The production and secretion of breast milk for the purpose of nourishing an infant  Recommended that no supplemental feedings be given until feeding routine is established.  Human milk is formulated to meet the nutrient needs of infants for the first 6 months of life. 11-27 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Benefits of Breastfeeding for the Infant  Breast milk has the perfect composition for a baby’s needs.  No babies are allergic to their mother’s milk.  Human milk contains at least 100 ingredients not found in formula. 11-28 (continues) Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. (continued) Benefits of Breastfeeding for the Infant  Lower incidence of ear infections, diarrhea, allergies, and hospital admissions  Breastfed babies receive antibodies from breast milk.  Promotes good jaw development  Decreases risk of obesity later in life  Facilitates bonding 11-29 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Benefits of Breastfeeding for the Mother  Helps lose the weight gained during pregnancy  Stimulates uterus to contract back to its original size  Breastfeeding is economical.  Provides opportunity for resting  Milk is always at the right temperature and is readily available. 11-30 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Nutrient Requirements during Lactation  The Food and Nutrition Board suggests an increase of 500 calories a day.  Most nutrient requirements are increased, especially protein.  Nutrition should be based on MyPyramid.  Fluid intake should replace fluids used for milk production. 11-31 (continues) Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. (continued) Nutrient Requirements during Lactation  Most chemicals can pass into the mother’s milk.  Check with obstetrician before using any medication or nutrient supplement.  Caffeine may make an infant irritable. 11-32 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Considerations for the Health Care Professional  Articles in newspapers and magazines may be inaccurate.  Re-education may be necessary.  Teaching pregnant teenagers presents the biggest challenge. 11-33 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  Conclusion  A pregnant woman is most likely to remain healthy and bear a healthy infant if she follows a well-balanced diet.  Anemia and PIH are two conditions that can be caused by inadequate nutrition.  Caloric and most nutrient requirements increase for pregnant and lactating women. 11-34 Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.