Transcript Pregnancy and Lactation - Wilkes

Pregnancy and Lactation
 Chapter 10:
Pregnancy and
Lactation
J Pistack MS/Ed
Nutritional Needs During
Pregnancy
 On average, daily caloric intake should increase by
approximately 340- 450 kilocalories per day
 The increase in calories should be from high nutrient
density foods
 Major body organs form 2~3 months after conception
 From implantation to birth 100 mcg–7.5 lbs
Protein and Fat Needs
 Fatty acids have proved essential to fetal retina and
brain development
 Protein essential for building fetal tissues
Vitamin Needs
 Vitamin C is necessary for collagen formation and
tissue building
 Vitamin B12 concentrated and stored in the fetal
liver—provides infant stores to sustain them for the
first several months of life
 Folic acid has been shown to decrease neural tube
defects and is recommended to start before
pregnancy
Fat Soluble Vitamins
 Vitamins A, E, and K is not recommended to
supplement
 Vitamin D—no recommendations yet - it is however
involved with multiple growth and development uses
 Immune system development
 Brain development
 Cellular differentiation
Mineral Needs
 Iron supports the mother’s increased blood volume,
support fetal red blood cells, placenta, umbilical cord
 Calcium-30 grams are donated to a fetus at 350mg
a day in the third trimester
 Iodine, fluoride, zinc – not transferred from mother
– normal intake is required
Water and Weight Gain
 On average woman of normal weight should gain 2
to 4 pounds during the first trimester
 Followed by 1 pound per week for the remainder of
the pregnancy
 Charts to plot weight gain based on pre-pregnancy
BMI can be found here:
www.nal.usda.gov/wicworks/Sharing_Center/NY/pre
natalwt_charts.pdf
Substances to Avoid During
Pregnancy
 Alcohol—fetal alcohol syndrome
 Caffeine
 Limit to < 300 mg/day
 Pregnancy outcomes unaffected by decaffeinated
beverages
 Soft cheeses and ready-to-eat meats
 Listeriosis—often fatal in newborns
Substances to Avoid (continued)
 Certain fish, due to mercury content
 Undercooked meat
 Unwashed produce
 Cat litter—Toxoplasmosis
Common Problems During
Pregnancy
 Morning sickness
 Dry crackers before arising
 Fruits and complex carbohydrates in small, frequent meals
 Avoidance
 of fatty foods
 Cold foods
 Liquids between meals
 High-protein snack at bedtime
 Leg cramps—magnesium supplement may help
 Pica – eating non food items
Common Problems During
Pregnancy (Continued)
 Constipation
 Adequate fluid intake
 Regular exercise
 Up to 30 grams of fiber as food rather than
supplements
 Heartburn
 Avoid spicy or acidic foods
 Eat small, frequent meals
 Sit up for 1 hour after meals
Complications of Pregnancy
 Hyperemesis gravidarum
 Severe nausea and vomiting after 14th week of
pregnancy
 Can be life threatening
 Gestational diabetes
 Any degree of abnormal glucose tolerance beginning
or first recognized in pregnancy
 Screening with glucose tolerance tests usually part of
prenatal care
 Treated aggressively by health care team
Complications of Pregnancy
 Hypertensive disorders of pregnancy
 Chronic hypertension
 Gestational hypertension
 Pre-eclampsia—hypertension + proteinuria

convulsions and coma, rarely coma alone, occurring in a
pregnant or puerperal woman
 Eclampsia—pre-eclampsia + seizures
 Disorders of late pregnancy associated with high blood
pressure, fluid retention, and protein in the urine
 Obstetrics emergency
 May occur postpartum
Nutritional Needs of the
Breastfeeding Mother
 Vitamins
 Chronic maternal deficiencies may affect milk
production
 Vegan mothers—check vitamin B12 status
 Minerals
 Calcium resorbed from bones regardless of intake and
replaced after weaning
 Iodine critical for neurological development must be
obtained dietarily
Breast feeding Benefits
 Through the release of oxytocin uterine muscles
contract and return to their nonpregnant size which
also minimizes postpartum blood loss
 Helps with child spacing
 Breastfeeding is associated with a decreased risk of
breast cancer
Maternal Contraindications to
Breastfeeding
 Certain diseases
 HIV in developed countries
 Active untreated tuberculosis
 Exposure to toxic chemicals
 Use of illegal drugs
 Some medications given to mother
 Antimetabolites
 Therapeutic radiopharmaceuticals