Maternal Nutrition

Question 1

Folic Acid

Answer 1

Necessary for cell division and DNA synthesis
Prevents Neural Tube Defects
CDC recommends 400 mcg for all women of child-bearing age
NIH recommends 600 mcg in pregnancy
Synthetic supplement is better absorbed

Question 2

weight gain in pregnancy CDC recommendation

Answer 2

15 pounds of their ideal weight prior to pregnancy

Question 3

Rule of Thumb #1

Answer 3

1 lb/mo during 1st trimester

1 lb/wk during 2nd and 3rd trimesters

Question 4

Rule of Thumb #2

Answer 4

10 lb by 20 weeks

Then 1 lb/week until birth

Question 5

Prenatal Nutrition (RDA)

Answer 5

During the 2nd and 3rd trimesters about 300 kcal more than pre-pregnancy requirement

Question 6

Prenatal Nutrition - protein

Answer 6

60 g (20% increase over than pre-pregnancy requirement)

Question 7

Prenatal Nutrition - iron

Answer 7

30 mg (2X increase over than pre-pregnancy requirement)

Question 8

Prenatal Nutrition - calcium

Answer 8

1,000 mg in adult women

1,300 mg in teens

Question 9

Prenatal Nutrition - low nutritional risk

Answer 9

can meet needs through diet alone

exceptions are folic acid and iron

Question 10

Prenatal Nutrition - high nutritional risk

Answer 10

vegans - vitamin B12 source

Vitamin D insufficiency (diet or sunlight) need supplement

Question 11

Nutritional Risk in Pregnancy

Answer 11

Adolescents - only think of themselves
Poverty
Closely spaced pregnancies
Previous poor fetal outcome 
Multi-fetal pregnancy
Poor diet habits, resist change
Use of tobacco, alcohol, or drugs
Low Hgb or HCT

Question 12

Listeriosis

Answer 12

• causes: miscarriage, preterm birth, stillbirth, neonatal infection
• avoid: unpasteurized, raw, or undercooked foods, pâté, soft cheeses, leftovers, hot dogs, and deli meats (unless heated to steaming)

Question 13

Toxoplasmosis

Answer 13

causes: mental retardation, blindness, and epilepsy
avoid: raw meat and cat feces

Question 14

Alcohol

Answer 14

• teratogenic
• damage is caused by fetal cell dehydration
• causes: mental retardation, learning disabilities, and fetal alcohol syndrome
• no known safe amount, AVOID ENTIRE PREGNANCY

Question 15

Caffeine

Answer 15

• limit intake to 300 mg/day

- linked to miscarriages and low birth weight

Question 16

Non-nutritive sweets safe in pregnancy?

Answer 16

YES

Question 17

Fish and Shellfish

Answer 17

contain mercury
limit intake 12 oz/wk
avoid top of food chain marine foods

Question 18

Pica and Food Cravings

Answer 18

• influenced by cultural background
• most common among African American women, rural women, and women with a family history of pica
• regular and heavy consumption of low-nutrient products may displace more nutritious foods from diet
• more likely to be anemia

Question 19

Exercise during pregnancy

Answer 19

• Improves muscle tone, potentially shortening course of labor
• Promotes a sense of well-being
• Ensure liberal amounts of fluids and balanced calorie intake/expenditure
• Avoid abdominal trauma
• Important component of good nutrition
• Do not start any strenuous activities while being pregnant

Question 20

Diet Assessment

Answer 20

• Appetite, meal intervals, vitamins
• Any modifications with pregnancy?
• Preferred foods, dietary history
• Non-food substances, unusual habits
• Religious, cultural, ethnic influences
• Alcohol, caffeine, tobacco, herbs
• Knowledge of nutrition, pregnancy requirements

Question 21

Nutrition During Lactation -

Answer 21

• IOM recommends not consuming < 1,800 kcal/day
• about 200 kcal/day over pregnancy requirement
• 500 kcal/day over pre-pregnancy requirement

Question 22

Nutrition During Lactation - guideline components based on

Answer 22

• rough-amount of maternal fat stores
• amount of milk
• infant demands
• maternal efficiency at converting fat and food to milk
• infant’s age/supplementation

Question 23

Nutrition During Lactation - caloric demands

Answer 23

peak about 6 months of lactation in exclusively breastfeeding women b/c after that infants usually eat supplemental foods

Question 24

Nutrition During Lactation - protein

Answer 24

60 g

Question 25

Nutrition During Lactation - iron

Answer 25

15 mg/day unless to replaced iron lost during pregnancy, through either the blood loss and/or transfer to the fetus

Question 26

Nutrition During Lactation - components in breast milk that is not affected by diet

Answer 26

Calcium, Phosphorus, Magnesium, Sodium, Potassium, and Zinc

Question 27

Nutrition During Lactation - minerals

Answer 27

deficient are calcium, zinc, and magnesium and will taken from maternal stores

Question 28

Nutrition During Lactation - vitamin content of breast milk

Answer 28

- depends on maternal dietary intake and stores of fat-soluble vitamins - deficient in the maternal diet are B6, Thiamine, and folic acid

Question 29

Nutrition During Lactation - weight loss

Answer 29

- breastfeeding mothers who eat to appetite lose about 1-2 lbs/mo in the first 4-6 mo - moderate exercise has little effect on breast feeding