nutrition chapter 10
what vitamin deficiencies have shown to result in neurological insult to infant?
B12
what vitamin is stored in the fetal liver during pregnancy and provides the infant with stores to sustain them for the fist several months of life?
B12
what are food handling rules that pregnant women should follow?
-avoid soft cheese -cook leftover food or ready to eat foods until steaming hot -don't eat refrigerated meat spreads without cooking -don't consume unpasteurized milk -refrigerate food within 2 hours and use leftovers within 3-4 days
to prevent infection of toxoplasmosis pregnant women should do what?
-cook meat, poultry and seafood thoroughly -clean raw food items -peel or meticouslsy wash raw foods and vegetables -keep cats indoors and feed only cooked or prepared cat food -avoid changing cat liter
altered physiology or pathology states that contrindations to breastfeeding are limited to what?
-galactosemia -mothers who are positive for human T cell lymphotrophic virus type 1 or 2 -untreated brucellosis -untreated tuberculosis -active herpes simples lesions on breast -developed varicella 5 days before or 2 days after delivery -infected with H1N1 influenza
the use of calcium supplements of at least _____ milligrams reduces the risk of hypertension, preeclampsia, maternal death and low birth weight
1000 milligrams
a pregnant women RDA for vitamin C is ___% higher then that of a non pregnant women and is necessary for collagen formation and tissue building
13
because the entire embryo and fetus major body organs form within __-__ months of conception nutrition during that time is especially critical to the health of the child
2-3 months
approximately __ grams of calcium is transferred to the fetus and __% of maternal bone mass is mobilized during pregnancy and lactation and the loss is reversed after cessation or lactation
30 grams 5%
the mother plasma volume increases by ____-___% by the 34th week of gestation and red cell mass increases by about __%
45-50% 33%
studies have shown that preconptional consumption of adequate folic acid of 4mg daily can prevent how much neural tube defects?
50-70%
the goal of healthy people 2020 is increase breastfeeding rates to __% of mothers who ever breastfeed __% those who breastfeed until infant is 6 months old __% breastfeed until infant is 1 year old
82% 61% 34%
what are risk factors for gestational diabetes?
Family history of diabetes Obesity Maternal age older than 25 Previous delivery of infant that was large or stillborn
it is best to counsel the breastfeeding mother to discontinue breastfeeding if the mother:
Has been infected with H1N1 influenza
diagnosis of toxoplasma include testing what immunoglobulins?
IgG and IgM
during pregnancy the placenta transfers limited amounts of vitamin ___ to the fetus
K
many women only have what when they are pregnant and believe it cures annoyances of pregnancy and ensures a beautiful baby but health concerns include inadequate neutron, iron deficiency anemia, constipation and lead poisoning?
Pica
while pregnant women are urged to limit caffeine and eliminate what?
alcohol, soft cheeses and ready to eat meats, certain amounts of fish and undercooked meats and unwashed produce
the mothers blood volume increases in anticipation for blood loss at delivery, breasts develop in preparation for lacation and uterus enlarges and contains a sac with what?
amniotic fluid
pregnant women have slower caffeine metabolism rates than nonpregant women and caffeine can be detected in what four places of the fetus meaning it transfers through the placenta?
amniotic fluid, umbilical cord, urine and plamsa
why should the mother alternate breasts when breastfeeding?
because the infant will take 80-90% milk from each breast in the first 4 minutes and altering will stimulate further milk production and faster rate in the one that is emptied
mobilization of calcium from the mothers bones also frees sequestered lead which can be transferred through what?
breast milk
over the long term what has been associated with a decreased risk of breast cancer and ovarian cancer later in life?
breastfeeding
what is always at the correct temperature and is less expensive than formula?
breastmilk
deficiency of what may result in skeletal and neurologic disorders in the infant and increased risk of maternal osteoporosis?
calcium
what plays an important role in the development of the fetus and maintaining good health of the mother and absorption increases during pregnancy?
calcium
increasing water intake and participation in moderate amounts of activity can decrease what?
constipation
decreased gastrointestinal muscle tone and increased water absorption from the intestines and the growing uterus pressing on the intestine causes what?
constipation (effects 33% pregnant women)
myplate recommendation are for the mother to enter what to individualize an eating plan while following my-plate recommendations?
daily food plan for moms
what require temporary cessation of breastfeeding until the drug has left the mother system?
diagnostic radioactive compounds
alcohol (water soluble and passes effortlessly into breastmilk) and caffeine (no more than 3 cups a day) may also affect the infant but are not though of as what?
drugs
increased _________ is needed to sustain the mother and for the development of the fetus and placenta
energy
what accumulate in the fetal brain rapidly during the third trimester of gestation during first postpartum month and can be supplied directly from omega 6 fatty acids and omega 3 fatty ?
fatty acids
effects of methyl mercury can include what?
fetal abnormalities, microcephaly and severe mental and physical retardation
what was introduced to encompass several diagnostic categories covering the wider range of alcohol effects in infants and children?
fetal alcohol spectrum disorder
what was first recognized in 1973 and diagnosed between ages 4-14 which characteristics of smooth philtrum, thin upper lip and short palpebral fissures (facial features), prenatal and postnatal growth defects and central nervous system abnormalities like head circumference?
fetal alcohol syndrome
during the seventh to the ninth months (third trimester) much of the energy supports what?
fetus and the placenta (extra 452 kilocalories per day)
what crosses the placenta so that the concentration in fetal circulation is 1/4 that or the mother and is found in bone and teeth (form during 10th and 12th week)?
fluoride
which of the following decreases neural tube defects?
folic acid
on average women should gain 2-4 pounds during the ________ ______________ and 1 pound per weeks for the remainder of the pregnancy
frist trimester
what is defined as hyperglycemia in the second or third trimester in a women who had not had diabetes and affects 5-9% pregnancies?
gestational diabetes
fourth through sixth month (second trimester) much of the energy supports what?
growth of uterus and maternal tissue (extra 340 kilocaliroes per day)
pregnant teenagers need nutrients to provide for their own growth as well as what?
growth the fetus
best thing for an expectant mother to do is go into the pregnancy with good nutrition stores and consume well balanced diet while pregnant, avoiding what?
harmful substances like alcohol and drugs
my plate recommendations except for iron should suffice for who?
healthy people
what is a burning sensation beneath the breastbone that can be cause by normal changes due to the cardiac sphincters upward pressure on the diaphragm from enlarging uterus and reflux of gastric content?
heartburn
healthy people 2020 recommends women's who are capable of becoming pregnant chose food high in ________ _______ and take iron supplements as needed
heme iron
what two places should focus on rooming in, early and frequent breast feeding, support and avoidance of artificial nipples, pacifiers and formulas?
hospitals and birthing centers
severe nausea and vomiting persisting after the 14th week of pregnancy called what that is reported higher multiple pregnancies and other conditions associated with increased pregnancy hormone levels which hospitalizations are very few?
hyperemesis gravidarum
what major vitamin deficiencies have resulted from hyperemesis gravidarum?
hyponatremia, vitmins B6, B12, thiamine
what are some contraindications to breastfeeding?
illegal drug use certain medications illness in mother exposure to toxic chemicals galactosemia (due to metabolic defect in infant)
from ________________ to birth the fertilized ovum develops into an infant who weights 3.4 kilograms
implantation
women who experience nausea and vominting consume significantly less meat and more carbohydrates when?
in the frist trimester
breastfeeding mothers are sometimes counseled to do what two things when there is lack of provider knowledge regarding medication safely?
interrupt breastfeeding or wean infant
what is essential to the control of metabolism, RDAs increase by 46% in pregnant women and deficiency can result in cretinism in the newborn?
iodine
even a moderate ________ deficiency anemia is associated with twice the risk of maternal death and can have adverse effects like per birth delivery, low birth weight, central nervous system damage to fetus
iron
the body adjust to limited or abundant _____ sources and absorption is enhances in the second and their trimester
iron
what supports the mothers increased blood volume, red blood cells in the fetus, placenta and umbilical cord
iron
what is a vitamin A metabolite used to treat severe acne and is hazardous to the fetus with 335% risk for malformations if exposed beyond first 15 days of conception?
isotretinion
what had been found to be an effective form of birth control and birth spacing when following amenorrhea, fully or nearly fully breastfeeding and less than 6 months postpartum?
lactational amenorrhea
what is the hallmark result of diabetes in pregnant women?
large newborns
pregnant women often complain of what which can be from neuromuscular irritability due to low serum calcium and can be linked to magnesium deficiency also?
leg cramps
staying well hydrated, maintaining adequate intakes of potassium, sodium, calcium and magnesium and stretching the muscle before exercise can help to avoid what?
leg cramps
what is a bacterial food borne illness caused by listeria monocytogenes and for the mother symptoms are mild and flue like but bacteria can be passed via placenta resulting in spontaneous abortion, premature delivery, stillbirth, neonatal meningitis and septicemia?
listeriosis
what have demonstrated crucial importance in fetal growth and development of the fetal retina and brian?
long chain polyunsaturated fatty acids
what glands can extract ,osteoporosis nutrients from the circulation so that breastmilk may contain adequate levels of nutrients?
mammary gland
studies have demonstrated declines in neural tube defects including spinal bifida, anencephaly and encephalocele in counties that have implemented what?
mandatory fortification of gains with folic acid
fish and shellfish can be a major source of what that is a widespread environmental neurotoxin that can be harmful to fetal Brian development?
methylmercury
persistent maternal vitamin deficiencies may result in inadequate concentrations in what?
milk
some of the energy for the _______ come from the mothers dietary intake, some from fat stores accumulated during pregnancy
milk
gaining ________ weight then recommended is associated with hypertension, preeclampsia, gestational diabetes and cesarean delivery, gaining ________ then recommended is associated with fetal growth retardation, low birth weight and increased perinatal mortality
more less
the average lactating women produces 26 ounces of milk daily and epltying the breast stimulates what?
more mil production
the primary source of calcium in human milk is calcium reabsorbed from where in a process that is not prevented by increased calcium intake from food or supplements?
mothers bones
hormonal changes, some which produce relaxed gastrointestinal muscle tone cause what which 80% of pregnant women will develop?
nausea and vomiting
RDA of folic acid for women of childbearing age is from synthetic folic acid or form fortified foods or supplements what prevent 72% of what in infants?
neural tube defects (NTDs)
is the etiology and pathology of hyperemesis gravidarum known?
no
during breast-feeding the sucking of the infant stimulates the release of ___________ from the posterior pituitary gland in the brain and what causes uterine muscles to contract and helps return the uterus to its nonpregat size and reducing blood loss
oxytocin
who are encouraged to provide information on benefits and methods of breastfeeding so that the mother can make an informed choice?
pediatricians
protein intake can become a hazard to the fetus when the mother has what an is eating inappropriately and the treatment for this is to keep phenylalanine levels within normal limits (120-360 mol/L)?
phenylketonuria
adoptive mothers have successfully breast-feed there infants by using what to establish milk supply?
physical stimulation and breast pumps
what is compulsive ingestion of nonfood items like dirt, clay, laundry starch, baking soda or ice and physiologic causes can be from deficiency of zinc, iron, calcium, thiamine or vitamin C?
pica
during the first month of gestation the mother must be well nourished so that the ________ that forms will be healthy
placenta
pregnant women who drink alcohol is endangering her baby because alcohol really crosses the ____________ and the fetus cant detoxify it and the amniotic fluid accumulates alcohol in its metabolites and prolongs fetal exposure
placenta
what has functions that include transporting gas, nutrients and waste products, provides a barrier to the transfer for some substances like maternal red blood cells and bacteria?
placenta
what supplementation should be considered in the care of hyperemesis and this treatment is needed for the women and fetus and other treatments include?
prophylactic thiamine supplements pyridoxine, ginger, rehydration, enteral and parental nutritional support, antiemetics, corticosteroid therapy
what is required to build fetal and maternal tissue?
protein
transmission of toxic chemicals to the infant through breastmilk has what?
raised concern but some are also not concerned
after birth and weaning if a child the mother needs time to __________ nutrient stores (pregnancies less than 18 moths apart can lead to low birth weight)
rebuild
an excess of retinol or retinoic has been related to birth defects where 10000 UI per day or treatment with isotretionin during he first trimester increases the risk of what syndrome?
retinoid acid syndrome (characteristics- small or no ears, abnormal or missing ear canal, brain malformation and heart defects)
what are fish to avoid for pregnant women and ones who may become pregnant?
shark, swordfish, king mackerel, tilefish
overselling of benefits and ease of breastfeeding has resulted in what so the choice of the mother should be respected and the infant should be monitored?
starvation deaths of infants
Dichlorodiphenyltrichloroethane and polychlorinated bipheyels have been shown to be what and have congenital defects?
teratogenic
in most cases nausea and vomiting subsides after what?
the first trimester
vitamins A deficiency is a greater problem in developing countries then what?
toxicity
an infection with toxoplasma gondii a harmful parasite causes an estimated 400-40000 cases of congenital what which produce mental retardation, blindness and epilepsy
toxoplasmosis
what is a rare self limiting syndrome typically characterized by hip pain in the third trimester of pregnancy accompanied by radiologic osteopenia?
transient osteoporosis
what is the breastfeeding position where the infant is facing the breast squarely and grasps the entire areola?
tummy to tummy
vitamin B12 is only slightly increased for pregnant and lactating women and serum levels in newborns are ________ the maternal levels
twice
what can also result in adverse effects for the mother including gestational diabetes, bacterial vaginosis and preeclampsia?
vitamin D
what has multiple functions in the growth and development of the fetus and maternal deficiency can result in impaired fetal skeletal formation, low bone mass, low birth rate, small for gestational age and intrauterine girth retardation?
vitamin D
what is not mobilized in the mothers tissue and the mother needs a regular intake and deficiency can have negative effects of endocrine system leading to growth failure?
zinc