Pregnancy, lactation, and infant nutrition

Question 1

healthy lifestyle prior to pregnancy

Answer 1

• healthy pre pregnancy weight
• adequate and balanced diet
• physical activity included
• avoid cigs/toxic substances
• prenatal supplements (folic acid and iron)

Question 2

what should you be cautious of nutrient wise before pregnancy?

Answer 2

• preformed vitamin A
• iron
• zinc
• selenium
• B6
• Vitamin D and C

Question 3

full term gestation

Answer 3

38-42 weeks

Question 4

pre-term

Answer 4

birth prior to 37 weeks gestation

Question 5

low birth weight (LBW)

Answer 5

less than 5.5 lbs

Question 6

small for gestational age

Answer 6

infants that weigh less than expected for gestational age

Question 7

when does gestation begin?

Answer 7

when sperm and egg unite

Question 8

zygote

Answer 8

conception to two weeks

Question 9

embryo

Answer 9

2-8 weeks

Question 10

fetus

Answer 10

9 weeks to birth

Question 11

when is the period of very rapid development?

Answer 11

fetus

Question 12

critical period

Answer 12

finite windows of opportunity for development of a tissue or organ

Question 13

how does the zygote nourish itself?

Answer 13

• absorbing secretions from glands in the uterus

Question 14

placenta

Answer 14

• forms in the uterus as zygote develops into an embryo

- living organ

Question 15

functions of placenta

Answer 15

• synthesizes fatty acids, cholesterol, and glycogen for the fetus
• produces hormones that direct maternal nutrients to fetus, control fetal metabolism, and promote changes in the mother’s body that support pregnancy

Question 16

umbilical cord

Answer 16

• connection between placenta and fetus

Question 17

factors predicting a successful pregnancy

Answer 17

• nutritious diets (fetal growth promoted)

- likelihood of full-term development

Question 18

Most important maternal calorie and nutrients

Answer 18

• calories (growth retardation)
• protein (reduced head circumference)
• vitamin C (premature birth)
• folate (spontaneous abortion, neural tube effects)
• vitamin A (premature birth)
• vitamin D (low birth weight)
• calcium (decreased bone density)
• iron (low birth weight)

Question 19

energy requirements first trimester

Answer 19

0 kcal

Question 20

energy requirements second trimester

Answer 20

340 kcal

Question 21

energy requirements third trimester

Answer 21

452 kcal

Question 22

nutrients of concern

Answer 22

protein, essential fatty acids, zinc, folate. B12, iron

Question 23

increase in maternal RBC and fetal stores leads to?

Answer 23

increase in fluid volume, DNA synthesis, and brain development

Question 24

vitamin d and calcium

Answer 24

bone development (calcium needs do not increase)

Question 25

which nutrients of concern increase?

Answer 25

folate (400 to 600), B12 (2.4 to 2.6), vitamin C (75 to 85), iron (18 to 27), iodine (150 to 220)

Question 26

weight gain during pregnancy

Answer 26

``` obese (11-20 lbs) normal (25-35 lbs) underweight (28-40 lbs) overweight (15-25 lbs) obese should gain the least amount of weight ```

Question 27

what complicates pregnancy outcomes?

Answer 27

- young maternal age - maternal eating patterns (restriction, vegetarian/vegan, eating disorders) - maternal health (number of pregnancies, time between pregnancies, prenatal care, eclampsia, and gestational diabetes)

Question 28

preeclampsia

Answer 28

- high blood pressure - protein in urine - headaches - blurred vision - changes in blood clotting - edema - HELLP syndrome

Question 29

Eclampsia

Answer 29

- maternal convulsions - coma - death of mother and fetus

Question 30

gestational diabetes

Answer 30

- more common in families with a history of the betes - low blood glucose levels of infant at birth - increased risk of obesity later - T2DM later in life for both maternal and offspring development

Question 31

sociocultural factors

Answer 31

- limited income - limited education - lack of social support

Question 32

physiological concerns

Answer 32

- heartburn - constipation - nausea and vomiting - edema

Question 33

avoid these during pregnancy and lactation

Answer 33

-contaminants (PCB's, mercury in large fish) -pathogens -caffeine -food additives NO DRUGS/ALC CAUTION W/ HERBALS NO SMOKING

Question 34

FAS

Answer 34

- small head circumference - reduced eye opening - low nasal bridge - short nose - thin upper lip - no midline groove

Question 35

breastfeeding

Answer 35

feed baby from breast

Question 36

lactation

Answer 36

physiological process of females that occurs postpartum when the mother's breast secretes milk

Question 37

let down reflex

Answer 37

1. suckling stimulates nerves in nipple (hypothalamus) 2. posterior pituitary (oxytocin) 3. anterior pituitary (prolactin)

Question 38

oxytocin

Answer 38

release milk from storage

Question 39

prolactin

Answer 39

stimulates milk production

Question 40

colostrum

Answer 40

- immature milk - rich in protein, minerals, vit A - less lactose/fewer kcals - provides infant with defense system

Question 41

transitional milk

Answer 41

- few days post delivery to 1 week | - contains more fat, lactose, water-soluble vitamins, and kcal than colostrum

Question 42

mature milk

Answer 42

- replaces transitional milk - thin and watery - 20 kcal/ounce - nutritionally complete for the infant with the exception of vit D and iron

Question 43

calorie need for lactation

Answer 43

500 kcal above prepreg requirements (300 from food sources, rest comes from fat stores)

Question 44

fluid requirement for lactation

Answer 44

main component of milk so increased fluid is needed (32 additional ounces daily)

Question 45

what needs decrease during lactation?

Answer 45

iron

Question 46

factors affecting lactation

Answer 46

- maternal weight and age - eating patterns - maternal and infant health - sociocultural factors - maternal lifestyle choices - maternal food supply

Question 47

when do infants double their birth weight?

Answer 47

by 4-6 months

Question 48

when do infants triple their birth weight?

Answer 48

1 year of age

Question 49

infancy peak growth

Answer 49

-length increases by 50% in a year

Question 50

at risk of development problems

Answer 50

birth-2 years | - head circumference is less than 5th percentile or 95th percentile

Question 51

stunted growth

Answer 51

Birth to 2 years length for age <5th percentile • 2 to 20 years BMI for age <5th percentile

Question 52

underweight

Answer 52

Birth to 2 years weight for length <5th percentile • 2 to 20 years BMI for age <5th percentile

Question 53

overweight

Answer 53

Birth to 2 years weight for length > 95th percentile • 2 to 20 years BMI for age ≥ 85th and <95th percentile

Question 54

obese

Answer 54

2 to 20 years: BMI for age ≥ 95th percentile or BMI ≥ 30 (whichever is smaller

Question 55

protein nutrient needs infant

Answer 55

1.5 g/kg/day

Question 56

protein children and adolescents

Answer 56

1.1 g/kg/day (20-40% than adult needs on a pound by pound basis)

Question 57

fat infant

Answer 57

40-55% of kcal (EFA needs met) | children over 2 have same recommendations as adults

Question 58

carb infants

Answer 58

primarily lactose for infants (aim for starch)

Question 59

fiber

Answer 59

remains important | - 1 year of age (AI is 14 g/1000 kcal)

Question 60

water babies

Answer 60

babies need is greater than adults (can be met by formula or breastmilk) -limit to 4 ounces/day to prevent water intoxication

Question 61

nutrients of concern

Answer 61

- iron - K - calcium (bone health) - fluoride (fluoridated water) - zinc (impairs growth if there is a low intake) - folate (impairs growth if there is a low intake) - vitamin D (rickets) - vitamin K (inability to clot due to risk of deficiency/deficiency in general)

Question 62

what does human milk have that formula lacks?

Answer 62

- antibodies - hormones - immune factors - growth factors - enzymes