Lecture Discovering nutrition - Chapter 11: Life cycle: maternal and infant nutrition

Chapter 11 - Life cycle: maternal and infant nutrition. After studying this chapter you will be able to understand: Pregnancy, lactation, resources for pregnant and lactating women and their children, infancy.

Chapter 11 Life Cycle: Maternal and Infant Nutrition Nutrition Before Conception • • Health Care and Guidance – Screening for risk – Health promotion and education – Intervention as needed Weight – Maintain a healthy weight – Low or high weight increases risk for poor outcome – Not a good time to “diet” Nutrition Before Conception • Vitamins – 400–800 micrograms synthetic folic acid per day reduces risk of fetal neural tube defect – Avoid high doses of vitamin A (retinol) to avoid teratogenic effect Nutrition Before Conception • Substance use – Eliminate prior to pregnancy Physiology of Pregnancy • Stages of Human Fetal Growth – Blastogenic stage: first weeks • Cells differentiate into fetus and placenta – Embryonic stage: weeks to • Development of organ systems – Fetal stage: week to delivery • Growth Physiology of Pregnancy • Maternal Physiological Changes – Growth of maternal tissue • Adipose, breast, and uterine tissues – Increase in maternal blood volume – Slower GI motility Maternal Weight Gain • Recommendations depend on BMI – Normal weight (BMI = 19.8–26 kg/m2) • Gain 25 to 35 pounds – Higher recommended gain for underweight women, teens, and for pregnancies involving multiple fetuses – Lower recommended gain for overweight and obese women Infancy • • • • Growth is the best marker of nutritional status – Evaluated using growth charts Weight gain – Double birth weight by to months – Triple birth weight by 12 months Length gain – Increase length by 50% by 12 months Head circumference Energy and Nutrient Needs During Infancy • Requirements based on composition of breast milk – Energy and Protein • Highest needs of any life stage – Carbohydrate and fat • Fat: major energy source • Carbohydrates as simple sugars – Water • More needed due to immaturity of organs • Human milk or formula satisfies fluid requirements Energy and Nutrient Needs During Infancy • Key Vitamins and Minerals – Vitamin D – Vitamin K – Vitamin B12 – Iron – Fluoride Energy and Nutrient Needs During Infancy • Newborn Breastfeeding – Ideal method of feeding – Feedings should occur every 2-3 hours with total of 8-12 feedings per day Energy and Nutrient Needs During Infancy • Alternative feeding: infant formula – Standard infant formula • Cow’s milk base – Soy-based formula • Soy protein • Used to eliminate feeding problems such as vomiting and diarrhea Energy and Nutrient Needs During Infancy – Special formula • Allergies • Premature babies • Defects in metabolic pathway • Use medium-chain triglycerides as the fat source Energy and Nutrient Needs During Infancy • How much is enough? – Guidelines for feeding infant • Measure amount of formula baby takes • Six or more wet diapers per day • Three or more stools per day • Regain to birth weight within first two weeks Introduction of Solid Foods • • Readiness for solids – Physiological readiness • Digestive enzymes • Ability to maintain hydration – Developmental readiness • Lack of extrusion reflex • Head and body control Feeding schedule – Start Healthy Feeding Guidelines Feeding Problems During Infancy • • • Colic – Crying and distress Early childhood dental caries – Associated with putting baby to bed with a bottle Iron-deficiency anemia Feeding Problems During Infancy • • • Gastroesophageal reflux – Usually disappears within 12–18 months Diarrhea – Requires increased fluids Failure to thrive – Poor growth in absence of disease ... Moderate-protein, low-fat, and high carbohydrate Protein • Extra needed for synthesis of new maternal, placental, and fetal tissues • Additional 25 gm/d over nonpregnancy needs • Energy and Nutrition. .. teens, and for pregnancies involving multiple fetuses – Lower recommended gain for overweight and obese women Energy and Nutrition During Pregnancy • • Energy – Needs increase to support fetus and. .. Multiple nutrition problems for mother • Protein-energy malnutrition • Vitamin and mineral deficiency • Inadequate weight gain Special Situations During Pregnancy • Adolescence – Extra demands for