NUTR 2351-Chapter 17 Lecture-S24 PDF

Nutrition: From Science to You Fourth Edition Chapter 17 Life Cycle Nutrition: Pregnancy through Infancy Slides in this prese...

Nutrition: From Science to You Fourth Edition Chapter 17 Life Cycle Nutrition: Pregnancy through Infancy Slides in this presentation contain hyperlinks. JAWS users should be able to get a list of links by using INSERT+F7 Instructor: April J. Stull, Ph.D, RDN, FAND Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Learning Outcomes 17.1 Identify the stages of pregnancy and importance of the placenta. 17.2 Discuss the key diet and lifestyle factors associated with a successful pregnancy. 17.3 Identify key nutrient needs, health behaviors, and nutrition-related concerns during the first trimester of pregnancy. 17.4 Identify key nutrient needs and potential complications during the second and third trimesters of pregnancy. 17.5 Discuss factors that may negatively affect a pregnancy 17.6 Describe the benefits and dietary requirements of breastfeeding. 17.7 Explain why infant formula is a healthy alternative to breast milk. 17.8 Discuss the nutritional needs of infants. 17.9 Explain when and how solid foods should be introduced to infants. 17.10 Explain how a food allergen causes a potentially life-threatening reaction. Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Learning Outcomes 17.1 Identify the stages of pregnancy and importance of the placenta. 17.2 Discuss the key diet and lifestyle factors associated with a successful pregnancy. 17.3 Identify key nutrient needs, health behaviors, and nutrition-related concerns during the first trimester of pregnancy. 17.4 Identify key nutrient needs and potential complications during the second and third trimesters of pregnancy. 17.5 Discuss factors that may negatively affect a pregnancy 17.6 Describe the benefits and dietary requirements of breastfeeding. 17.7 Explain why infant formula is a healthy alternative to breast milk. 17.8 Discuss the nutritional needs of infants. 17.9 Explain when and how solid foods should be introduced to infants. 17.10 Explain how a food allergen causes a potentially life-threatening reaction. Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Preconception Period The lifestyle choices a mother and father make before conception help to give the baby a better chance for good health at birth and beyond Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  What are the Critical Periods of Prenatal Development? During pregnancy, the diet must support the health of a woman and her growing baby Full-term pregnancy lasts 39 to 40 weeks from conception to birth – Divided into three 13-week trimesters Prenatal development is divided into two periods – Embryonic ▪ At the beginning of week 3, it is referred to as an embryo – Fetal ▪ Eight weeks after conception, it is called a fetus Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  The Placenta Plays a Key Role Allows nutrients, oxygen, and waste products to be exchanged through the umbilical cord between a mother and fetus Prevents passage of red blood cells, bacteria, and many large proteins from mother to fetus Alcohol, illicit drugs, common prescriptions and over-the-counter medications, and other potentially harmful substances can cross the placenta Releases hormones required to support the physiological changes of pregnancy Maternal and fetal blood do not mix, but the placenta allows the embryo to use the mother’s organ systems Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved Figure 17.2-The Placenta Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Learning Outcomes 17.1 Identify the stages of pregnancy and importance of the placenta. 17.2 Discuss the key diet and lifestyle factors associated with a successful pregnancy. 17.3 Identify key nutrient needs, health behaviors, and nutrition-related concerns during the first trimester of pregnancy. 17.4 Identify key nutrient needs and potential complications during the second and third trimesters of pregnancy. 17.5 Discuss factors that may negatively affect a pregnancy 17.6 Describe the benefits and dietary requirements of breastfeeding. 17.7 Explain why infant formula is a healthy alternative to breast milk. 17.8 Discuss the nutritional needs of infants. 17.9 Explain when and how solid foods should be introduced to infants. 17.10 Explain how a food allergen causes a potentially life-threatening reaction. Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  What Nutrients and Behaviors are Important for a Healthy Pregnancy? Both the mother and the father need to practice healthy behaviors to support a healthy pregnancy. Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Prospective Fathers Should Practice Healthy Habits A man's lifestyle and diet habits can affect fertility – Factors that may decrease sperm production and function ▪ Smoking, alcohol and drug abuse, and obesity – Nutrients that promote healthy sperm production ▪ Zinc and folate: linked to production of healthy sperm ▪ Antioxidants (vitamins C and E, and carotenoids): may protect sperm from free radical damage Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved Women Should Practice Healthy Habits Before and During Pregnancy Attain a healthy weight before conception Obesity and overweight are associated with – Infertility – Pregnancy complications (gestational diabetes and hypertension; induced labor and C-section) – Birth defects, preterm delivery, and difficult deliveries – Children are more likely to develop childhood obesity and develop diabetes and cardiovascular disease later in life A woman should never try to lose weight during pregnancy Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved Women Should Practice Healthy Habits Before and During Pregnancy Underweight women are at risk of delivering preterm, low birth weight ,or small for gestational age babies – Babies at higher risk for developmental disabilities, vision and hearing loss, dying within the first year of life Definitions – Low birthweight-a baby weighing less than 5.5 pounds at birth – Small for gestational age (SGA)-babies who weigh less than the 10th percentile of weight for gestational age Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved Women Should Practice Healthy Habits Before and During Pregnancy Consume adequate folic acid – Reduces risk of neural tube defects – Needed for new cell synthesis and help a fetus grow and develop properly in utero – Recommendation ▪ 400µg daily at least 1 month prior to conception (preferably earlier) ▪ 600µg during pregnancy Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Women Should Practice Healthy Habits Before and During Pregnancy Eat safe fish – 2 to 3 servings of fish a week – Avoid fish that have high levels of methylmercury ▪ Can harm the developing nervous system of the fetus Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Women Should Practice Healthy Habits Before and During Pregnancy Consume moderate amounts of caffeine – Caffeine is passed on to the baby – Limit caffeine intake: < 200 mg per day before and during pregnancy ▪ 1 to 2 cups per day Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Women Should Practice Healthy Habits Before and During Pregnancy Avoid cigarettes, alcohol, and illicit drugs Smoking increases the risk of: – Infertility – Stunted growth, intellectual development, birth defects, stillbirth, premature birth, and sudden infant death syndrome (SIDS) The carbon monoxide and nicotine in cigarettes place a baby at risk for decreased oxygen exposure; even second-hand smoke can harm an unborn baby Women who smoke are more likely to weigh less and gain less weight during pregnancy Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Women Should Practice Healthy Habits Before and During Pregnancy Drinking alcohol during pregnancy can lead to: – Fetal alcohol spectrum disorders (FASDs); fetal alcohol syndrome (FAS) ▪ pregnant women are advised to abstain completely from alcohol – Even low levels of alcohol exposure while in the womb can lead to learning and behavioral disabilities in childhood. Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Women Should Practice Healthy Habits Before and During Pregnancy Illicit drugs used during pregnancy can increase the risk of: – miscarriage, preterm labor, low birth weight baby, birth defects, drug withdrawal symptoms (excessive crying, trembling, seizures), and long-term health problems in the baby (heart defects, behavioral and learning problems) Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Women Should Practice Healthy Habits Before and During Pregnancy Avoid dietary supplements, including botanicals – Plants or plant parts, that are believed to have medicinal effects – Not enough research has been done to determine their safety Manage chronic conditions – Diabetes, hypertension, and PKU, can affect the outcome of a pregnancy – Medications may be contraindicated during pregnancy – Prepregnancy counseling Copyright © 2019, 2016, is essential 2014 Pearson Education, Inc. All Rights Reserved  Learning Outcomes 17.1 Identify the stages of pregnancy and importance of the placenta. 17.2 Discuss the key diet and lifestyle factors associated with a successful pregnancy. 17.3 Identify key nutrient needs, health behaviors, and nutrition-related concerns during the first trimester of pregnancy. 17.4 Identify key nutrient needs and potential complications during the second and third trimesters of pregnancy. 17.5 Discuss factors that may negatively affect a pregnancy 17.6 Describe the benefits and dietary requirements of breastfeeding. 17.7 Explain why infant formula is a healthy alternative to breast milk. 17.8 Discuss the nutritional needs of infants. 17.9 Explain when and how solid foods should be introduced to infants. 17.10 Explain how a food allergen causes a potentially life-threatening reaction. Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  First Trimester The first trimester brings changes not only in the fetus but also in the mother’s body – In a fetus: ▪ liver begins to form red blood cells ▪ heart begins to beat ▪ limbs take shape ▪ brain grows rapidly Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved Set Goals for Adequate Weight Gain – The fetus comprises about one-third of the total weight gained, and the rest is maternal tissues and fluids Women at a healthy weight (BMI between 18.5 and 24.9) should gain 25 to 35 pounds – Only about 1-4.5 pounds in the first trimester Appropriate weight gain should provide adequate growth of the fetus Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved Figure 17.5-Components of Weight Gain during Pregnancy Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Table 17.3-Recommended Weight Gain during Pregnancy Prepregnancy Body Recommended Weight Mass Index (BMI) Gain (in Pounds) < 18.5 28–40 18.5–24.9 25–35 25–29.9 15–25 > 30.0 11–20 Source: Institute of Medicine. 2009. Weight Gain during Pregnancy: Reexamining the Guidelines. Copyright 2009 by the National Academy of Sciences, Courtesy of the National Academies Press, Washington, DC. Reprinted with permission. Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Ensure Adequate Nutrient Intake Throughout Pregnancy An increased amount of kcals is NOT needed in the first trimester, but certain nutrients should be increased after conception Pregnant women have a fifty percent increase in needs for certain vitamin and minerals Dietary considerations ▪ Folate or Folic acid – Need 600 micrograms daily – Take a supplement and/or fortified foods in addition to consuming folate-rich foods Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Ensure Adequate Nutrient Intake Throughout Pregnancy Dietary considerations (continued) ▪ Iron – Needed to make additional red blood cells – Prevents iron-deficiency anemia – Essential for fetal growth and development – Needed for the growth of the placenta – A dietary supplement is needed to meet iron needs Should avoid consuming milk products (Ca), high-fiber foods (Phytate), and coffee and tea (Polyphenolic compounds) with the iron supplement Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Ensure Adequate Nutrient Intake Throughout Pregnancy Dietary considerations (continued) – Zinc and copper ▪ Increased need due to inhibited absorption by iron ▪ Zinc needed in protein metabolism and in the synthesis of DNA so that cells can replicate and differentiate ▪ Copper (part of enzyme-cofactor) needed in the production of energy, the synthesis of connective tissues, and the transport and use of iron Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Ensure Adequate Nutrient Intake Throughout Pregnancy Dietary considerations (continued) – Calcium ▪ Calcium needs do not increase during pregnancy; however, many women fail to get adequate calcium before pregnancy ▪ Calcium absorption increases during pregnancy to offset the fetus’s need for calcium; still, the mother needs to preserve bone mass and prevent future osteoporosis ▪ Needed to support fetal bone growth Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Ensure Adequate Nutrient Intake Throughout Pregnancy Dietary considerations (continued) – Vitamin D ▪ Vitamin D needs do not increase during pregnancy; however, many women fail to get adequate vitamin D ▪ Insufficient vitamin D during pregnancy can lead to poor absorption and use of calcium – Impairs fetal bone formation – Linked to hypertension, preterm birth, low birthweight, and gestational diabetes Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Ensure Adequate Nutrient Intake Throughout Pregnancy Dietary considerations (continued) – Other nutrients ▪ Vegetarian or vegan women need to be careful about meeting needs for alpha-linolenic acid (omega 3-FFA) and vitamin B12 ▪ ALA and its derivatives EPA and DHA are needed in the development of cell membranes and are important in the formation of new tissues, particularly those of the central nervous system ▪ Choline is important during pregnancy and when nursing for the growth of healthy cells to divide and grow, especially the brain Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved Docosahexaenoic acid (DHA)  Ensure Adequate Nutrient Intake Throughout Pregnancy Limitation of some nutrients is important to fetal health – Excess vitamin A can be toxic and lead to birth defects Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved Figure 17.7-Nutrient Needs During Pregnancy Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Morning Sickness And Cravings Are Common "Morning sickness" or nausea – Can occur at any time of the day – The heightened sense of smell can trigger nausea and vomiting – Focus on alleviating the symptoms ▪ Small, frequent meals high in carbohydrates ▪ Salty foods with sour and tart beverages ▪ Vitamin B6 may reduce nausea and vomiting ▪ Ginger may reduce nausea and vomiting – Hyperemesis gravidarum ▪ Excessive vomiting during pregnancy that can lead to dehydration, electrolyte imbalances, and weight loss. ▪ Usually have to be hospitalized Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Morning Sickness And Cravings Are Common Random food cravings and aversions – No scientific evidence supports the belief that foods craved is an indicator that mother is missing nutrients – Cravings for chocolate, citrus fruits, pickles, chips, and ice cream are particularly common – Pica is the craving of nonfood substances; this practice can harm the mother and baby ▪ Laundry starch, burnt matches, cornstarch, clay, dirt, paint chips, and baking soda ▪ May be associated with low blood levels of iron (mixed results) ▪ Can lead to ingestion of toxic compounds Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Food Safety Is A Concern The weakened immune system of the mother, and the baby’s undeveloped immune system, make pregnancy a time of heightened susceptibility to foodborne pathogens The bacterium Listeria monocytogenes may cause miscarriage, premature labor, low birth weight, developmental problems, and possibly infant death Pregnant women should avoid: – Raw or undercooked meats – Unpasteurized milk, cheese, and juices – Raw sprouts Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Food Safety Is A Concern Sugar substitutes – Sugar substitutes may be used in moderation along with a balanced, nutrient-rich meal plan – Aspartame (Equal), sucralose (Splenda), acesulfame- K (Sunett), and saccharin (Sweet 'N Low) have been deemed safe to consume – Women with phenylketonuria (PKU) should avoid aspartame Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Learning Outcomes 17.1 Identify the stages of pregnancy and importance of the placenta. 17.2 Discuss the key diet and lifestyle factors associated with a successful pregnancy. 17.3 Identify key nutrient needs, health behaviors, and nutrition-related concerns during the first trimester of pregnancy. 17.4 Identify key nutrient needs and potential complications during the second and third trimesters of pregnancy. 17.5 Discuss factors that may negatively affect a pregnancy 17.6 Describe the benefits and dietary requirements of breastfeeding. 17.7 Explain why infant formula is a healthy alternative to breast milk. 17.8 Discuss the nutritional needs of infants. 17.9 Explain when and how solid foods should be introduced to infants. 17.10 Explain how a food allergen causes a potentially life-threatening reaction. Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  What Nutrients and Behaviors are Important in the Second and Third Trimester? Consume adequate kilocalories, carbohydrate, and protein. Second-An additional 340 kilocalories daily Third-An additional 450 kilocalories daily Gain between one-half and 1 pound weekly Minimum of 175 grams carbohydrate per day Protein needs increase 35 percent to about 71 grams daily Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Be Alert to Potential Complications: Gestational Diabetes Gestational diabetes occurs when a woman develops high blood glucose levels during her pregnancy – Typically onsets after the 20th week – May result in macrosomia ▪ Large baby – Newborn ▪ Increased risk for jaundice, breathing problems, birth defects ▪ Increased risk for hypoglycemia after birth Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Jaundice Condition that causes the skin, whites of the eyes, and mucous membranes to turn yellow due to excess levels of bilirubin in the blood – Bilirubin is a yellowish pigment found in bile Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Be Alert to Potential Complications: Gestational Diabetes – Risk factors ▪ Being overweight ▪ Being over 25 years old ▪ Having a family history of diabetes ▪ History of higher-than-normal blood glucose levels ▪ Being Hispanic, African-American, Native American, or Pacific Islander ▪ Previously gave birth to a very large baby (>9 lbs) or a stillborn baby ▪ Having had gestational diabetes in the past Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Be Alert to Potential Complications: Hypertension Pregnancy-induced hypertension includes three categories. – Gestational hypertension: Occurs early in pregnancy in women with no history of hypertension – Preeclampsia: Characterized by hypertension, severe edema, and protein losses in the urine; deprives fetus of oxygen- and nutrient-rich blood from the placenta – Eclampsia: Can cause seizures and is a major cause of death of women during pregnancy The only cure for preeclampsia and eclampsia is to deliver the baby Bedrest, medications, and hospitalization are used to treat preeclampsia until the baby can be born safely Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Learning Outcomes 17.1 Identify the stages of pregnancy and importance of the placenta. 17.2 Discuss the key diet and lifestyle factors associated with a successful pregnancy. 17.3 Identify key nutrient needs, health behaviors, and nutrition-related concerns during the first trimester of pregnancy. 17.4 Identify key nutrient needs and potential complications during the second and third trimesters of pregnancy. 17.5 Discuss factors that may negatively affect a pregnancy 17.6 Describe the benefits and dietary requirements of breastfeeding. 17.7 Explain why infant formula is a healthy alternative to breast milk. 17.8 Discuss the nutritional needs of infants. 17.9 Explain when and how solid foods should be introduced to infants. 17.10 Explain how a food allergen causes a potentially life-threatening reaction. Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Table 17.5 Factors That May Negatively Affect a Pregnancy Factor Conditions Associated with Increased Risk Lifestyle Smoking, alcohol, and abuse of illicit drugs Use of over-the-counter medications or dietary supplements without consulting with a health care provider Use of certain prescription medications Sedentary lifestyle Age Under age 20 Over age 35 Weight Pre-pregnancy: underweight, obese During pregnancy: insufficient or excessive weight gain Health history Chronic diseases, including diabetes and hypertension Past history of a pregnancy affected by a birth defect, such as a neural tube defect Gestational diabetes, pregnancy-induced hypertension Diet Environmental contaminants (methylmercury, pica) Insufficient or excessive kilocalorie intake Nutrient deficiencies (folic acid, iron, calcium, vitamins D and B 12) Excessive caffeine intake Foodborne illness Socioeconomic Poverty status Limited food supply Copyright Low educational © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved level  Learning Outcomes 17.1 Identify the stages of pregnancy and importance of the placenta. 17.2 Discuss the key diet and lifestyle factors associated with a successful pregnancy. 17.3 Identify key nutrient needs, health behaviors, and nutrition-related concerns during the first trimester of pregnancy. 17.4 Identify key nutrient needs and potential complications during the second and third trimesters of pregnancy. 17.5 Discuss factors that may negatively affect a pregnancy 17.6 Describe the benefits and dietary requirements of breastfeeding. 17.7 Explain why infant formula is a healthy alternative to breast milk. 17.8 Discuss the nutritional needs of infants. 17.9 Explain when and how solid foods should be introduced to infants. 17.10 Explain how a food allergen causes a potentially life-threatening reaction. Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  What are the Benefits and Nutrient Needs of Breast-Feeding? Lactation is the production of milk in a woman's body after birth – The infant suckling at the mother's breast stimulates milk production – Prolactin: Stimulates milk production – Oxytocin: Releases milk for infant to receive through the nipple "letdown response" Breastfeeding – Mother provides food that is uniquely tailored to meet her infant's nutritional needs in an easily digestible form Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved Figure 17.9-The Letdown Response Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved Breast-Feeding Provides Nutritional and Health Benefits for Infants The nutritional composition of breast milk changes as the infant grows. Right after birth – Colostrum, a yellowish fluid that is lower in fat but higher in protein, vitamin A, minerals, and immune factors Four to seven days after birth – Breast milk is high in lactose, fat, and B vitamins and lower in fat-soluble vitamins, sodium, and other minerals Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved Breast-Feeding Provides Nutritional and Health Benefits for Infants Breast milk does not provide infants with an adequate intake of vitamin D The American Academy of Pediatrics recommends supplementing breast-fed babies with vitamin D – Minimum of 400 IU vitamin D per day – Give in the form of drops Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved Breast-Feeding Provides Nutritional and Health Benefits for Infants Protects against infections, allergies, and chronic disease – Decreases: ▪ Risk and severity of diarrhea and other intestinal disorders ▪ Respiratory and ear infections ▪ Meningitis ▪ Urinary tract infections – Lactoferrin protein protects against bacteria, viruses, fungi, and inflammation by binding with iron and making it unavailable to bacteria that need to flourish – Provides antioxidants, hormones, enzymes, and growth factors Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved Breast-Feeding Provides Nutritional and Health Benefits for Infants Reduced childhood obesity risk – Breast-feeding beyond six months may reduce risk for childhood obesity. Brain development – Breast milk contains docosahexanoic acid (DHA) and arachidonic acid (AA) ▪ Needed for vision and central nervous system ▪ Breast-fed infants may have greater cognitive function Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved Breast-Feeding Provides Physical, Emotional, and Financial Benefits for Mothers Physical benefits – Oxytocin helps return the uterus to its prepregnancy size and shape – Reduces blood loss in the mother after delivery – May help mothers return to their prepregnancy weight and manage their postpregnancy weight – May reduce risk for breast and ovarian cancer – May reduce risk for hip fractures later in life, increase bone density, and reduce risk for type 2 diabetes Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved Breast-Feeding Provides Physical, Emotional, and Financial Benefits for Mothers Expense and convenience – Can spend $1,200 to $1,500 on infant formula in the first year alone – Formula-fed infants have higher health care costs – Environmental costs ▪ Uses fewer resources than formula-feeding – Breast milk is always sterile and at the right temperature – Less cleanup Stress reduction and bonding – Promotes a unique bonding experience; reduces stress; helps baby feel safe, secure, and emotionally attached Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Breast-Feeding is Recommended by Experts American Academy of Pediatrics and Academy of Nutrition and Dietetics recommendations – Exclusive breast-feeding for the first six months and then use a combination of appropriate foods during at least the first year Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Breast-Feeding Mothers Have Special Nutrient and Lifestyle Needs Fluid and nutrient requirements – Thirteen cups of fluid per day to meet increased fluid needs Additional 500 kcals per day during first six months – Not all need to come from foods; approximately 170 kilocalories are mobilized daily form fat that was stored during pregnancy; 330 kcals from food Additional 400 kcals per day during second six months A well-balanced diet should meet nutrient needs during lactation. Lactating women who are vegans need adequate amounts of vitamin B12 from dietary supplements and fortified foods Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Breast-Feeding Mothers Have Special Nutrient and Lifestyle Needs Lifestyle habits – Substances in the mother's body are transmitted through breast milk ▪ Avoid alcohol, drugs, tobacco, and smoking ▪ Limit caffeine consumption and fish containing methylmercury ▪ Breast milk reflects foods the mother eats and may cause problems for the baby Children in families with a family history of food allergies may benefit from breastfeeding Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Taste of Human Milk Flavor of foods in mother’s diet influences taste of breast milk – Human milk is slightly sweet and carries the flavors of compounds ingested by the mother (mint, garlic, vanilla, and alcohol) – Infants seem more interested in mother’s milk if flavor is new – Exposure to a variety of flavors may contribute to infant’s interest and acceptance of new flavors in solid foods Copyright © 20172016 © Cengage Learning Cengage Learning. All Rights Reserved.  Breastfeeding at Work Many women feel uncomfortable about breastfeeding or pumping breast milk outside the home Worksite support is not only healthy for the infant and mother, but may be good for the job – Breastfed infants are sick less – Employees who breastfed are usually happier, miss fewer workdays, and more productive Women returning to work while lactating need worksite resources to accommodate their breastfeeding Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Learning Outcomes 17.1 Identify the stages of pregnancy and importance of the placenta. 17.2 Discuss the key diet and lifestyle factors associated with a successful pregnancy. 17.3 Identify key nutrient needs, health behaviors, and nutrition-related concerns during the first trimester of pregnancy. 17.4 Identify key nutrient needs and potential complications during the second and third trimesters of pregnancy. 17.5 Discuss factors that may negatively affect a pregnancy 17.6 Describe the benefits and dietary requirements of breastfeeding. 17.7 Explain why infant formula is a healthy alternative to breast milk. 17.8 Discuss the nutritional needs of infants. 17.9 Explain when and how solid foods should be introduced to infants. 17.10 Explain how a food allergen causes a potentially life-threatening reaction. Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  When is Formula a Healthy Alternative to Breast Milk? Some women may not be able to breastfeed – Women with HIV or AIDS, human T–lymphotrophic virus, or active tuberculosis; receiving chemotherapy and/or radiation; or using illegal drugs should not breastfeed – Infants with galactosemia cannot metabolize lactose and should not be breastfed – Women taking prescribed medications should check with their doctor or pharmacist to ensure they are safe Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  When is Formula a Healthy Alternative to Breast Milk? Formula can be a healthy alternative to breast- feeding – Developed to be as similar as possible to breast milk – Standard formula is made from cow's milk (has been altered) – Soy protein-based formulas and hypoallergenic formulas – Unmodified cow's milk is too high in protein, sodium, and potassium, and too low in fat and linoleic acid for infants – Avoid letting infants sleep with a bottle containing sugary liquids ▪ Leads to nursing bottle tooth decay (early-childhood caries) ▪ Increases risk Copyright for© ear 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved infections  Learning Outcomes 17.1 Identify the stages of pregnancy and importance of the placenta. 17.2 Discuss the key diet and lifestyle factors associated with a successful pregnancy. 17.3 Identify key nutrient needs, health behaviors, and nutrition-related concerns during the first trimester of pregnancy. 17.4 Identify key nutrient needs and potential complications during the second and third trimesters of pregnancy. 17.5 Discuss factors that may negatively affect a pregnancy 17.6 Describe the benefits and dietary requirements of breastfeeding. 17.7 Explain why infant formula is a healthy alternative to breast milk. 17.8 Discuss the nutritional needs of infants. 17.9 Explain when and how solid foods should be introduced to infants. 17.10 Explain how a food allergen causes a potentially life-threatening reaction. Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved What are an Infant’s Nutrient Needs and Why are They So High? Infants grow at an accelerated rate – Birth weight doubles by six months of age and triples it by 12 months – Length doubles by one year of age – Significant intellectual and social development occurs during infancy – Adequate nutrition is needed to meet physical, social, and intellectual milestones – Failure to thrive (FTT) occurs when a child is delayed in physical growth or size or does not gain enough weight – Growth charts are used to track physical development Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved Figure 12.2-Foods and Milestones for Baby’s First Year Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved What are an Infant’s Nutrient Needs and Why are They So High? Infants have specific kilocalorie, iron, and other nutrient needs. – Energy needs ▪ 108 kcal /kg for the first six months of life ilo or ies ilo r am – Carbohydrate needs ▪ 60 grams per day for the first six months ▪ 95 grams per day at 7 to 12 months – Protein needs ▪ 9 grams per day during the first six months ▪ 11 grams per day at 7 to 12 months – Fat needs ▪ Do not limit fat intake Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  What are an Infant’s Nutrient Needs and Why are They So High? Infants have specific kilocalorie, iron, and other nutrient needs (continued) – Require vitamin K, vitamin D, and iron supplements ▪ Receive vitamin K injection at birth ▪ 400 IU vitamin D drops beginning at two months ▪ Iron-fortified foods such as infant cereal should be introduced at around six months of age ▪ Vitamin B12 should be supplemented if exclusively breast- fed by a strictly vegan mother ▪ Fluid needs are met with breast milk or formula ▪ Limit extra fluids and give 100 percent juice in moderation; don’t give until at least 6-9 months of age and should be limited to 4-6 ounces per day Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Learning Outcomes 17.1 Identify the stages of pregnancy and importance of the placenta. 17.2 Discuss the key diet and lifestyle factors associated with a successful pregnancy. 17.3 Identify key nutrient needs, health behaviors, and nutrition-related concerns during the first trimester of pregnancy. 17.4 Identify key nutrient needs and potential complications during the second and third trimesters of pregnancy. 17.5 Discuss factors that may negatively affect a pregnancy 17.6 Describe the benefits and dietary requirements of breastfeeding. 17.7 Explain why infant formula is a healthy alternative to breast milk. 17.8 Discuss the nutritional needs of infants. 17.9 Explain when and how solid foods should be introduced to infants. 17.10 Explain how a food allergen causes a potentially life-threatening reaction. Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  When are Solid Foods Safe to Introduce to Infants? Solid foods are introduced once certain milestones are met – When body systems are physiologically ready to process solid foods – Infant should be physically ready to eat; this is specific to each child ▪ Tongue-thrust reflux should have faded – Forceful protrusion of the tongue in response to an oral stimulus, such as a spoon ▪ Infant has head and neck control ▪ Infant can sit without support and can turn his or her head – The milestones typically occur around four to six months of age Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  When are Solid Foods Safe to Introduce to Infants? Solid foods should be introduced gradually Parents should watch for signs of allergies after a new food is introduced Introduce one food at a time (order does not matter) – Single-grain cereals, then multigrain cereals – Pureed vegetables – Fruits – Meats Avoid whole cow's milk until after one year of age Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved Some Foods are Not Appropriate for Infants Limit choking hazards: Foods that are difficult to chew – Hot dog rounds – Raw carrots Avoid serving food in large pieces Avoid honey—it can lead to infant botulism – A rare but serious paralytic illness caused by a toxin secreted by the bacterium Clostridium botulinum Avoid added seasonings (salt, sugar) and added fats (butter, margarine) Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  Learning Outcomes 17.1 Identify the stages of pregnancy and importance of the placenta. 17.2 Discuss the key diet and lifestyle factors associated with a successful pregnancy. 17.3 Identify key nutrient needs, health behaviors, and nutrition-related concerns during the first trimester of pregnancy. 17.4 Identify key nutrient needs and potential complications during the second and third trimesters of pregnancy. 17.5 Discuss factors that may negatively affect a pregnancy 17.6 Describe the benefits and dietary requirements of breastfeeding. 17.7 Explain why infant formula is a healthy alternative to breast milk. 17.8 Discuss the nutritional needs of infants. 17.9 Explain when and how solid foods should be introduced to infants. 17.10 Explain how a food allergen causes a potentially life-threatening reaction. Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  What Causes Food Allergies? Food allergy: An abnormal reaction by the immune system to a particular food Food allergens: Proteins that are not broken down by cooking or digestion and enter the body intact, causing an adverse reaction by the immune system Anaphylaxis-severe, life-threatening allergic reaction; inhibits the ability to breathe Reaction occurs in two stages. – Sensitization stage: Allergens sensitize themselves to the immune system – Allergic reaction stage: Occurs when a person eats the food allergens again and reactions appear Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  A Taste Could Be Dangerous: Food Allergies Reactions appear quickly – Difficulty breathing may develop within minutes – After the food reaches the stomach and begins to be digested, vomiting and/or diarrhea may result – When they enter the blood, the food allergens can cause a drop in blood pressure Epinephrine can help combat symptoms Food intolerance-adverse reaction to a food that does not involve an immune response (ex, lactose intolerance) Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved Figure 17.13-Reactions to Allergens Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved  A Taste Could Be Dangerous: Food Allergies Common allergens – Eggs, cow’s milk, peanuts, soy, wheat, tree nuts (such as walnuts), fish, and shellfish Children do outgrow food allergies – 80 to 90 percent of egg, milk, wheat, and soy allergies disappear by five years – Twenty percent of children outgrow peanut allergy Copyright © 2019, 2016, 2014 Pearson Education, Inc. All Rights Reserved