Life Cycle Nutrition: Life Cycle Nutrition: Pregnancy and LactationPregnancy and Lactation
Chapter 15
Nutrition Prior to Nutrition Prior to PregnancyPregnancy
• Nutrition may affect fertility• Preparation before pregnancy
– Achieve and maintain healthy body weight– Choose an adequate and balanced diet– Be physically active– Receive regular medical care– Manage chronic conditions– Avoid harmful influences
Growth and Development Growth and Development During PregnancyDuring Pregnancy
• Placental development– Develops in uterus
• Amniotic sac and umbilical cord
– Expelled during childbirth– Interweaving of fetal and maternal blood vessels– Metabolically active organ
• Requires energy and nutrients• Produces hormones
Growth and Development Growth and Development During PregnancyDuring Pregnancy
• Fetal growth and development– Fertilization of an ovum by a sperm– Zygote
• Rapidly divides to become blastocyst • Implantation
– Embryo• Eight weeks
– Fetus• Full-term
Growth and Development Growth and Development During PregnancyDuring Pregnancy
• Critical periods– Times of intense development
• Cellular activities can occur only during these times
– Adverse influences on organ and tissue development
Growth and Development Growth and Development During PregnancyDuring Pregnancy
• Neural tube defects – Anacephaly
• Brain either missing or fails to develop
– Spina bifida• Incomplete closure of spinal cord & its bony
encasement
– Folate supplementation
Growth and Development Growth and Development During PregnancyDuring Pregnancy
Chronic diseases Adverse influences at critical times during
fetal development Malnutrition – type 2 diabetes Inadequate growth during placental & gestational
development – hypertension
Fetal programming Mother’s nutrition may change gene
expression in fetus
Maternal WeightMaternal Weight Birthweight is most reliable indicator of
infant’s health Weight prior to conception
Influences fetal growth Underweight
Rates of preterm births and infant deaths Overweight & obesity
Medical complications Risks for infant
Maternal WeightMaternal Weight• Weight gain during pregnancy
– Fetal growth and maternal health– Correlates closely with infant birthweight
• Predictor of health and development
– Recommended weight gains
Recommended Weight Recommended Weight GainsGains
Maternal WeightMaternal Weight• Weight gain patterns
– 3.5 pounds in first trimester– 1 pound per week thereafter– Large weight gain over short time
• Preeclampsia
• Components of weight gain– Placenta, uterus, blood, breasts, fluid volume,
baby
Maternal WeightMaternal Weight• Weight loss after pregnancy
– Return to prepregnancy weight• Not typical
– Retain a couple of pounds with each pregnancy– Seven or more pounds; BMI increase 1 unit
Exercise During PregnancyExercise During Pregnancy Can continue exercise throughout
pregnancy Adjust duration and intensity
Benefits “Low-impact” activities Fetal development
Excessively high internal body temperature Dehydration
Energy & Nutrient Needs Energy & Nutrient Needs During PregnancyDuring Pregnancy
• Needs tend to be higher than any other time in life
• To meet needs– Make careful selections– Body maximizes absorption– Body minimizes losses
Energy & Nutrient Needs Energy & Nutrient Needs During PregnancyDuring Pregnancy
• Energy– Increase in basal metabolic rate
• Second and third trimester
– Food energy• 15 to 20% more energy than before pregnancy• Nutrient-dense foods
Energy & Nutrient Needs Energy & Nutrient Needs During PregnancyDuring Pregnancy
Carbohydrate Ample carbohydrate is necessary
Protein RDA – additional 25 grams per day
Supplements are discouraged
Essential fatty acids Omega-3 and omega-6 fatty acids for brain
material
Energy & Nutrient Needs Energy & Nutrient Needs During PregnancyDuring Pregnancy
• Blood production and cell growth– Fetal growth and development– Maternal red blood cell mass– Needs for synthesis of DNA and new cells
• Folate• Vitamin B12
• Iron• Zinc
Energy & Nutrient Needs Energy & Nutrient Needs During PregnancyDuring Pregnancy
• Nutrients for bone development– Vitamin D
• Deficiency interferes with calcium metabolism
– Calcium• Absorption and retention increase• Intake usually falls below recommendations
– Other nutrients• Optimal interval between pregnancies
Energy & Nutrient Needs Energy & Nutrient Needs During PregnancyDuring Pregnancy
• Prenatal supplements– Calcium– Folate– Iron
• Benefits of use
Vegetarian Diets During Vegetarian Diets During Pregnancy & LactationPregnancy & Lactation
• Can support healthy pregnancy and lactation– Well planned– Food sources
• Vegan diets – Additional supplementation
Common Nutrition-Related Common Nutrition-Related Concerns of PregnancyConcerns of Pregnancy
Nausea “Morning sickness” Hormonal changes
Constipation and hemorrhoids Heartburn Food cravings and aversions
Hormone-induced changes Nonfood cravings
High-Risk PregnanciesHigh-Risk Pregnancies Infant’s birthweight
Low birthweight (LBW) 5 ½ pounds or less Risk of complications Relationship with socioeconomic status
Gestational age
High-Risk PregnanciesHigh-Risk Pregnancies• Malnutrition and pregnancy
– Fertility• Viable sperm• Sexual interest• Amenorrhea
– Early pregnancy• Placenta development
– Fetal development• Consequences
High-Risk PregnanciesHigh-Risk Pregnancies• Food Assistance Programs
– WIC• Nutrition education and nutritious foods• Vulnerable populations who qualify for help• Cost-benefit• Remedial and preventive services
High-Risk PregnanciesHigh-Risk Pregnancies• Maternal health
– Preexisting diabetes• Risks associated with unmanaged diabetes
– Gestational diabetes• Common consequences• Dietary recommendations
High-Risk PregnanciesHigh-Risk Pregnancies• Maternal health
– Chronic hypertension• Risks
– Gestational hypertension– Preeclampsia
• Cause is unclear• Risks for mother• Risks for fetus
– Eclampsia
High-Risk PregnanciesHigh-Risk Pregnancies• Maternal age
– Ideal childbearing age– Adolescents
• Risk of pregnancy complications• Higher rates of stillbirths, preterm births, and LBW
infants• Weight gain recommendations• Need to seek prenatal care
High-Risk PregnanciesHigh-Risk Pregnancies• Maternal age
– Older women• Complications often reflect chronic conditions• Cesarean section rates increase • Maternal death rates are higher• Risks for fetus
High-Risk PregnanciesHigh-Risk Pregnancies• Alcohol consumption
– Irreversible mental and physical retardation• Fetal alcohol syndrome (FAS)
• Medicinal drugs– No medication use without consulting physician
• Herbal supplements– Seek physician advice
High-Risk PregnanciesHigh-Risk Pregnancies• Illicit drugs
– Many drugs easily cross the placenta• Impair fetal growth and development
– Other risks to fetus, infant, and child• Smoking and chewing tobacco
– Harmful effects magnified during pregnancy– Risks for mother and infant
• SIDS
High-Risk PregnanciesHigh-Risk Pregnancies• Environmental contaminants
– Lead– Mercury
• Foods to avoid• Supplements
• Foodborne illness– Increased risk of listeriosis– Risks associated with illness
High-Risk PregnanciesHigh-Risk Pregnancies• Vitamin-mineral megadoses
– Excessive vitamin A• Fetal malformations
• Caffeine– Miscarriage and fetal death– Fetal growth
• Weight-loss dieting• Sugar-substitutes
Lactation: A Physiological Lactation: A Physiological ProcessProcess
• Hormones promote growth and branching of duct system & milk-producing cells– Prolactin
• Milk production
– Oxytocin• Cause mammary glands to eject milk into ducts
Breastfeeding: A Learned Breastfeeding: A Learned BehaviorBehavior
• Lactation is an automatic, physiological process
• Breastfeeding is a learned behavior– Some decide not to breastfeed
• Factors influencing breastfeeding and its success– Partner– Adequate nutrition and rest
Maternal Energy & Nutrient Maternal Energy & Nutrient Needs During LactationNeeds During Lactation
• Energy intake and exercise– Almost 500 extra kcalories per day– Exercise is compatible with breastfeeding
• Energy nutrients– Recommendations increase for carbohydrates and
fibers• Water
– Prevent dehydration
Maternal Energy & Nutrient Maternal Energy & Nutrient Needs During LactationNeeds During Lactation
• Vitamins and minerals– Inadequacies reduce the quantity, not quality of
breast milk• Quality maintained at expense of maternal stores
– Prolonged inadequate intakes• Impacts several nutrients
• Supplements – Iron
Maternal Energy & Nutrient Maternal Energy & Nutrient Needs During LactationNeeds During Lactation
• Food assistance programs– Participants are less likely to breastfeed – WIC incentives to encourage breastfeeding
• Particular foods– Flavors– Allergies
Maternal HealthMaternal Health HIV infection and AIDS
Transmission through breastmilk Medications
Diabetes – type I Postpartum amenorrhea
Does not protect from pregnancy Breast health
Breast cancer
Practices Incompatible With Practices Incompatible With LactationLactation
• Alcohol– Easily enters breast milk– Infants eat less when mother consumes alcohol
• Medical drugs– Physician consultation
• Illicit drugs– Risks
Practices Incompatible With Practices Incompatible With LactationLactation
• Smoking– Reduces milk volume– Sleep less– Passive smoking and SIDS
• Environmental contaminants– DDT, PCBs, and dioxin
• Caffeine– Iron bioavailability
