Flashcards in Chapter 14: Nutrition During Pregnancy and Lactation Deck (104):
Where does fertilization occur and what does it produce?
Occurs in the oviducts producing a single-celled zygote
How long after fertilization is the cell considered an embryo?
What may happen if birth defects are severe?
A spontaneous abortion or miscarriage
When does the placenta take over the role of nourishing the embryo?
After 5 weeks
Where does the early embryo get its nourishment from?
The breakdown of the uterus
Describe the make-up of the placenta.
The placenta is made up of tissue from both the mother and the fetus. The maternal portion of the placenta develops from the uterine lining. The fetal portion of the placenta develops from the outer layer of pre-embryonic cells.
How does the makeup of the placenta allow for the passage of nutrients and oxygen from mother to child?
Close proximity of fetal blood vessels to maternal blood allows nutrients and oxygen to easily pass from mother to fetus, and allows carbon dioxide and other wastes to pass from fetus to mother for elimination.
Infants who are born on time but have failed to grow normally in the uterus.
Define preterm or premature.
Those born before 37 weeks of gestation.
define low-birth-weight infants
Those who were born too soon or are just small. those weighing less than 2.5 kg (5.5 lbs)
define very-low-birth-weight infants
Those weighing less than 1.5 kg [3.3 lb]
What are low-birth-weight infant and very-low-birth-weight infants at heightened risk for? What do they require as a result of this?
Increased risk for illness and early death.
They require special care and a special diet in order to successfully continue to grow and develop. Survival improves with increasing gestational age and birth weight.
What changes do the hormones produced by the placenta orchestrate? (4 changes)
1. They promote uterine growth
2. They relax muscles and ligaments to accommodate the growing fetus and allow for childbirth
3. They promote breast development
4. They increase fat deposition to provide the energy stores that will be needed during late pregnancy and lactation.
What is the recommended weight-gain for a healthy, adult women during pregnancy?
11.5 −16 kg (25-35 lb)
What percentage of the the total weight-gain during regency can be attributed to the weight of the infant at birth?
What factors in pregnancy account for weight gain? (4)
1. The infant
3. Amniotic Fluid
4. Changes in maternal tissues
What is the recommended maternal weight gain per week in the second and third trimester?
What are the risks associated with being underweight by 10% or more during pregnancy? (2)
1. Infant will be premature
2. Increase the child's risk of developing heart disease or diabetes later in life.
In what ways can excess weight compromise the pregnancy for the mother? (4)
1. high blood pressure
3. difficult delivery, and Caesarean section
4. having a large-for-gestational-age baby
In what ways can excess weight compromise the pregnancy for the infant? (2)
1. increase the risk of neural tube defects
2. increase of fetal death
What is the ideal BMI for women entering into pregnancy?
lower than 25 or if impossible 30.
Why is gradual weight loss for the mother important after the baby is born?
When the mother is breastfeeding it is important that milk production is not compromised.
Is it appropriate for a women to exercise during pregnancy?
healthy women without contraindications can safely engage in aerobic and strength-conditioning exercises with appropriate precautions
What are some benefits of exercise during pregnancy? (6)
1. improved maternal fitness
2. less weight gain during pregnancy
3. easier labour and delivery
4. better posture and reduced back pain
5. reduced risk of developing diabetes during pregnancy (gestational diabetes)
6. reduced blood pressure
When in pregnancy is it considered to be the best time to begin an exercise program?
During the second trimester. the third trimester may limit some activities.
During pregnancy, blood volume expands to nourish the fetus, but this expansion may also cause the accumulation of extracellular fluid in the tissues. It is common in the feet and ankles.
Describe Morning Sickness.
A syndrome of nausea and vomiting that occurs in about 80% of women during pregnancy.
A burning sensation caused by stomach acid leaking up into the esophagus, is another common digestive complaint during pregnancy because the hormones produced to relax the muscles of the uterus also relax the muscles of the gastrointestinal tract. This involuntary relaxation of the gastroesophageal sphincter allows the acidic stomach contents to back up into the esophagus, causing irritation.
The pregnancy-related hormones that cause muscles to relax also decrease intestinal motility and slow transit time.
Are a result of both constipation and physiological changes in blood flow.
List some possible complications/risks during pregnancy.
Describe High Blood Pressure.
A spectrum of conditions involving elevated blood pressure during pregnancy and are a major cause of pregnancy-related maternal deaths.
Describe Gestational Hypertension.
An abnormal rise in blood pressure that occurs after the 20th week of pregnancy. Gestational hypertension may signal the potential for a more serious condition called pre-eclampsia.
is characterized by high blood pressure along with fluid retention and excretion of protein in the urine; it can result in weight gain of several kilograms within a few days. It is dangerous to the fetus because it reduces blood flow to the placenta, and it is dangerous to the mother because it can progress to a condition called eclampsia.
Life threatening seizure occur.
What mineral may play a role in preventing hypertension disorders during pregnancy?
Dietary calcium may play a role in preventing the hypertensive disorders of pregnancy; calcium supplements have been found to reduce the risk of high blood pressure and pre-eclampsia.
Describe Gestational Diabetes Mellitus.
Consistently elevated blood glucose level during pregnancy in a woman without previously diagnosed diabetes.
What treatment is recommended for mothers with Gestational Diabetes Mellitus?
As with other types of diabetes, the treatment of gestational diabetes involves consuming a carefully planned diet, maintaining moderate daily exercise, and in some cases using medications to control blood glucose.
How is the EER calculated for a women during pregnancy?
By totalling the energy needs of nonpregnant women, the increase in energy needs due to pregnancy, and the energy deposited in tissues. During the first trimester, total energy expenditure changes little, so the EER is not increased above nonpregnant levels.
How many kcal should be added to a pregnant women's diet during the second and third trimester?
An additional 350 and 450 kcal/day, respectively, are recommended.
How much does the RDA for protein increase for a women during pregnancy?
An additional 25 g of protein per day above the RDA for nonpregnant women or 1.1 g/kg/day is recommended for the second and third trimesters of pregnancy
How much does the RDA for carbohydrates increase for a women during pregnancy?
45 g during pregnancy to provide sufficient glucose to fuel the fetal and maternal brains. Therefore the RDA for carbohydrate during pregnancy is 175 g/day.
What changes should be made to the fat taken in the diet during pregnancy?
more of the essential fatty acids linoleic and alpha-linolenic acid are recommended because these are incorporated into the placenta and the fetal tissues
What is the importance of DHA (alpha-linolenic acid) in the diet during pregnancy?
It functions in the development of the retina and brain in the fetus and infant.
How much does the water intake increase for a women during pregnancy?
From 2.7 L/day in nonpregnant women to 3 L/day (an extra 250ml)
Why do pregnant women not have to increase their intake of calcium during pregnancy even though it is important to fetal skeleton and teeth formation?
Because calcium absorption increases during pregnancy.21 This increase is believed to be due in part to the rise in estrogen that occurs during pregnancy as well as an increase in the concentration of active vitamin D in the blood.
Does the intake of vitamin D increase during pregnancy?
Why is vitamin C important during pregnancy?
For bone and connective tissue formation because it is needed for the synthesis of collagen, which gives structure to skin, tendons, and the protein matrix of bones.
Why is folate important during pregnancy?
For the synthesis of DNA and thus for cell division. During pregnancy, cells multiply to form the placenta, expand maternal blood, and allow for fetal growth. Adequate folate intake is crucial even before conception because rapid cell division occurs in the first days and weeks of pregnancy.
Neural Tube Defects (2)
Anencephaly: in which the brain and skull do not develop normally—a condition that is fatal at or shortly after birth—
Spina bifida: a condition in which the vertebrae do not close completely, causing part of the spinal cord to be exposed.
List some natural sources of folate.
orange juice, legumes, leafy green vegetables, and organ meats
What are the recommendations for a women who could become pregnant?
That she consume a multivitamin with at least 400 μg/day of synthetic folic acid, in addition to consuming a varied diet rich in natural sources of folate.
Why is vitamin B12 important during pregnancy?
for the regeneration of active forms of folate, so a deficiency of vitamin B12 can also result in megaloblastic anemia.
Why is Zinc important during growth and development?
Because it is involved in the synthesis of DNA, RNA, and proteins.
Why are iron needs higher during pregnancy?
To allow for the synthesis of hemoglobin and other iron-containing proteins in both maternal and fetal tissues.
What is the RDA for someone who is pregnant compared t the regular RDA for iron?
27mg/day rather than 18mg/day.
Where is iron found in the diet?
Red meats, leafy green vegetables, and fortified cereals are good sources of iron.
What supplements recommended during pregnancy? (4)
1. supplements of folic acid are recommended before and during pregnancy
2. iron supplements are recommended during the second and third trimesters.
3. A multivitamin and mineral supplement may also be necessary in those whose food choices are limited, such as vegetarians, or in those whose needs are very high, such as pregnant teenagers.
**A prenatal supplement must be taken in conjunction with, not in place of, a carefully planned diet
An abnormal craving for and ingestion of nonfood substances having little or no nutritional value. Women with pica commonly consume clay, laundry starch, ice and freezer frost, baking soda, cornstarch, and ashes.
What are some risks associated with BMI < 19.8 or gaining too little weight during pregnancy?
Mother: Anemia, premature rupture of the membranes, hemorrhage after delivery
Baby: Low birth weight, preterm birth
What are some risks associated with Prepregnancy BMI > 26 or gaining too much weight during pregnancy?
Mother: Hypertensive disorders of pregnancy, gestational diabetes, difficult delivery, Caesarean section
Baby: Large-for-gestational-age, low Apgar scores (a score used to assess the health of a baby in the first minutes after birth), and neural tube defects
What are some risks associated with Malnutrition during pregnancy?
Mother: Decreased ability to conceive, anemia
Baby: Fetal growth retardation, low birth weight, birth defects, preterm birth, spontaneous abortion, stillbirth, increased risk of chronic disease later in life
What are some risks associated with Phenylketonuria during pregnancy?
Mother: High blood levels of phenylketones
Baby: Mental retardation if low phenylalanine diet is not carefully followed by mother
What are some risks associated with Hypertension during pregnancy?
Mother: Stroke, heart attack, premature separation of the placenta from the uterine wall
Baby: Low birth weight, fetal death
What are some risks associated with diabetes during pregnancy?
Mother: Difficulty adjusting insulin dose, pre-eclampsia, Caesarean section
Baby: Large-for-gestational-age, congenital abnormalities, fetal death
What are some risks associated with frequent pregnancies?
Baby: Low birth weight, preterm birth
What are some risks associated with poor obstetric history or history of poor fetal outcome?
Mother: Recurrence of problem in subsequent pregnancy
Baby: Birth defects/death
What are some risks associated with adolescent mother?
Mother: Malnutrition, hypertensive disorders of pregnancy
Baby: Low birth weight
What are some risks associated with mothers over 35?
Mother: Hypertensive disorders of pregnancy, gestational diabetes
Baby: Down syndrome and other chromosomal abnormalities
What are some risks associated with alcohol consumption during pregnancy?
Mother: Poor nutritional status
Baby: Alcohol-related birth defects, alcohol-related neurodevelopmental disorders, fetal alcohol syndrome
What are some risks associated with cigarette smoking during pregnancy?
Mother: Lung cancer and other lung diseases, miscarriage
Baby: Low birth weight, miscarriage, stillbirth, preterm birth, sudden infant death syndrome, respiratory problems
What are some risks associated with cocaine use during pregnancy?
Mother: Hypertension, miscarriage, premature labour and delivery
Baby: Intrauterine growth retardation, low birth weight, preterm birth, birth defects, sudden infant death syndrome
Immediate Effects of Maternal Malnutrition.
After the first trimester, nutrient deficiencies or excesses are less likely to cause developmental defects (malformations) because most organs and structures have already formed.
Longterm Effects of Maternal Malnutrition.
It has been proposed that problems in maternal nutrition can cause adaptations that change fetal structure, physiology, and metabolism and can affect the child's risk of developing chronic diseases later in life.
What are some risks associated with too much caffeine consumption during pregnancy?
Has been associated with reductions in birth weight and an increased risk of miscarriage.
Why shouldn't people have herbs during pregnancy?
Because there is not a great deal of research on herbal teas and other herbal products, pregnant women should avoid them until they are shown to be safe during pregnancy.
Symptoms of Fetal Alcohol Syndrome.
Facial deformities, growth retardation, and permanent brain damage
Symptoms of Alcohol-related neurodevelopmental disorders.
Functional or mental impairments.
Symptoms of alcohol-related birth defect
Malformations in the skeleton or major organ systems
What is Colustrum?
Colostrum is immature milk. It is rich in protein, including immune factors that help protect the newborn from disease. Within about a week of childbirth, there is a rapid increase in milk secretion, and its composition changes from colostrum to that of mature milk.
What is Prolactin?
A pituitary hormone that stimulates hormone production.
What is the Let-down?
The release of milk from the milk-producing glands and its movement through the ducts and storage sinuses.
What is Oxytocin?
A hormone produced by the pituitary gland that is released in response to the suckling of the infant and causes the let-down of milk.
How is the EER for lactation estimated?
Adding the total energy expenditure of nonlactating women and the energy in milk and then subtracting the energy supplied by maternal fat stores. (330kcal/day)
How much water is required during lactation?
The AI of 3.8 L/day, of which about 3.1 L is from drinking water and other beverages.
What micronutrients are required during lactation?
The recommended intakes of vitamin B6, vitamin B12, other B vitamins, and vitamins A, C, and E are increased above nonlactating levels.
Why do infants need a sufficient water intake?
They lose proportionately more body water in urine and through evaporation.
When do the iron requirements in infants change?
After 6 months, iron stores are depleted but iron needs remain high to provide for hemoglobin synthesis, tissue growth, and iron storage.
Are vitamin D supplements required for infants?
Yes because they do get adequate vitamin D from breast milk.
Why is vitamin K important in an infants diet?
which is essential for normal blood clotting, is another nutrient for which newborns are at risk of deficiency.
Why is fluoride important?
Important in the development of teeth, even before they erupt.
What mothers may be deficient in the B12 requirements?
Someone who is vegan.
Define 'failure to thrive'
Growth that is slower than the predicted pattern.
What are the nutritional advantages of breastfeeding?
Ideal food for babies. Composition changes as they eat and grow.
What are the nutritional advantages of breastfeeding?
Ideal food for babies. Composition changes as they eat and grow.
What are the nutritional disadvantages of formula feeding?
Modelled after human milk, but certain components cannot be duplicated. Composition does not change with time. Must be prepared carefully to supply the correct nutrient mix and ratio of nutrients to fluid.
Breastfeeding vs. Formula feeding. What are the concerns in regard of the amount of milk the child gets?
underfeeding and overfeeding respectively.
Why is breastfeeding more beneficial than formula for the immune system in babies?
Immune factors are transferred from the mother to the infant.
What risks are involved in breastfeeding?
Certain contaminants such as environmental pollutants, medications, illicit drugs, and disease-causing organisms such as HIV can pass from mother to baby.
What are some risks of using formula? (4)
1. more chance of having a food allergy
2. no immune benefits
3. less nutritional value
4. not as sterile
What are some benefits to the mother when breastfeeding?
Promotes uterine contractions, which help the uterus return to prepregnancy size. May promote loss of weight and body fat. May reduce risk of breast cancer.
For how long is breastfeeding, by itself, sufficient?
When is it better to feed the child formula?
If the child is small or weak or when the mother is required to take medications/drugs/ alcohol users that could get into the milk supply.