Ch. 18 Nutrition During Pregnancy and Breastfeeding SB

Cow's milk should never be used in infant feeding until the infant is at least ______ months old

12 Human milk is different in composition from cow's milk. Unless altered (i.e., to make infant formula), cow's milk should never be used in infant feeding until the infant is at least 12 months old. Unaltered cow's milk is too high in minerals and protein and does not contain enough carbohydrate to meet an infant's nutritional needs. In addition, the major protein in cow's milk is harder for an infant to digest than the major proteins in human milk. The proteins in cow's milk may also spur allergies in some infants.

The recommendation to limit caffeine intake to less than 200 milligrams per day is equivalent to about

2 cups of coffee

The ideal age for pregnancy is between ______ and ______ years of age.

20 and 35 The age of the mother is another factor that determines pregnancy outcome. The ideal age for pregnancy is between 20 and 35 years of age.

What is the time period for a normal pregnancy?

38-42 weeks

human milk oligosaccharides

Small, indigestible carbohydrates made in the human breast from lactose and other simple sugars.

High blood glucose that occurs for the first time during pregnancy is called

gestational diabetes

What are some components of colostrum?

growth factors Immune system cells Antibodies (not vit K and other clotting factors)

True or false: A woman should address any ongoing health concerns prior to conception.

true Addressing ongoing health concerns prior to conception allows a woman to plan how to control the health problems during the pregnancy.

True or false: The weight status of a woman at the beginning of a pregnancy may influence the infant's health status.

true If a woman begins pregnancy substantially above or below her personal healthy weight, then the infant's likelihood to experience health problems is increased.

Adequate intake of ______ at least 8 weeks before conception and during pregnancy improves pregnancy outcomes.

vitamins and minerals In particular, meeting folate needs (400 micrograms of synthetic folic acid per day) helps to prevent birth defects such as neural tube defects (see Section 18.8) and decrease the risk of preterm delivery. Low intakes of calcium and iron or excessive intakes of vitamin A also are causes for concern during pregnancy. Page 622 Although it is difficult to predict the degree to which poor nutrition will affect each pregnancy, a daily eating pattern containing only 1000 kcal has been shown to greatly restrict fetal growth and development. Increased maternal and infant death rates seen in famine-stricken areas of Africa provide further evidence.

Healthy prepregnancy weight and ________ ________ during pregnancy are two excellent predictors of pregnancy outcome.

weight gain

who is at most risk for hypertension during pregnancy?

women with diabetes overweight or obese women women under age 17 and over 35

Which statements are true about colostrum?

Colostrum is the first fluid released from the breast at the end of pregnancy. Colostrum is a thick, yellowish fluid. release of colostrum indicates that the breast is ready to produce milk; milk stores are high in the breast

Which factors differentiate cow's milk from human milk?

Cow's milk does not contain enough carbohydrate to meet the infant's need. Certain proteins in cow's milk may spur allergies in the infant. Cow's milk is too high in minerals and protein in comparison to human milk.

Folate is important for fertility because of its role in

DNA synthesis As you learned in Section 13.3, folate is involved in DNA synthesis and the metabolism of homocysteine. For no other cells is proper DNA synthesis so important as for the egg and sperm, which transmit genetic information from one generation to the next. Foods such as leafy green vegetables, strawberries, and orange juice are sources of natural folate. The synthetic form, folic acid, can be found in fortified foods (e.g., ready-to-eat breakfast cereals) and dietary supplements.

True or false: Human milk production requires an additional 500 kcal per day.

FALSE Human milk production requires an additional 800 kcal/day. The Estimated Energy Requirement during breastfeeding is 400-500 additional calories/day to allow for gradual loss of body fat.

True or false: Pregnant women should not engage in physical activity because it may induce preterm labor or cause miscarriage.

FALSE Both the baby and the mother benefit from regular physical activity during pregnancy.

Effects of Teenage Pregnancy on Mother and Child

FOR MOM: Depression and other mental health problems Use of illicit drugs and alcohol Poverty and reliance on public assistance Graduation rates from high school and college Single parenthood FOR CHILD: Birth weight Premature birth Infant mortality Hospital admissions during childhood Academic performance Nutritional status Rates of imprisonment during adulthood

What are some common physiological changes that occur during pregnancy?

Fluid retention due to placental hormones Hormones relax muscles of uterus and GI tract During pregnancy, fetal needs for oxygen and nutrients as well as excretion of waste products increase the burden on the mother's lungs, heart, and kidneys. Although a mother's organ systems work efficiently, some discomfort may accompany the changes her body undergoes to accommodate the fetus.

What are some common physiological changes that occur during pregnancy?

Fluid retention due to placental hormones Hormones relax muscles of uterus and GI tract insulin efficiency is decreased (potential for gestational diabetes) sense of smell is often increased blood volume is increased significantly

______ is a B vitamin that is important for DNA synthesis and homocysteine metabolism.

Folate

Compared to a mother who is 25 years old, a mother who is 15 years old has ______ likelihood for birth complications.

INCREASED Outside that age range—at either extreme—complications are more likely to arise. The rates of teen pregnancy have declined since 1990; still, approximately 250,000 babies are born to teen mothers in the United States each year—the highest rate of any industrialized country. Teen pregnancy increases risk for negative outcomes for both mother and child (Table 18-1) and costs taxpayers an estimated $9.4 billion each year Teens who are pregnant frequently exhibit a variety of risk factors that can complicate pregnancy and pose risk to the fetus.12 For instance, teenagers are more likely than adult women to be underweight at the start of pregnancy and to gain too little weight during pregnancy. In addition, their bodies may lack the physical maturity needed to carry a fetus safely. Even with prenatal care, 10% of children born to teenage mothers are of low birth weight and 14.5% are preterm.

__________ is the period of milk secretion following pregnancy.

lactation, breastfeeding, nursing, or breast feeding During the second trimester, the mother's breast weight typically increases by approximately 30% due to the development of milk-producing cells and the deposition of 2 to 4 pounds of fat for lactation. This stored fat serves as a reservoir for the extra energy that will be needed to produce breast milk.

Physiological anemia during pregnancy is also referred to as

hemodilution physiological anemia: The normal decrease in red blood cell concentration in the blood due to increased blood volume during pregnancy; also called hemodilution. To supply fetal needs, the mother's blood volume expands to approximately 150% of normal. The number of red blood cells, however, increases by only 20% to 30%, and this occurs more gradually. As a result, a woman has a lower ratio of red blood cells to total blood volume in her system during pregnancy. This hemodilution is known as physiological anemia. It is a normal response to pregnancy, rather than the result of inadequate nutrient intake. *hemorrhage=refers to blood loss *hematocrit=refers to the proportion of whole blood that is made up of red blood cells. It is one way to assess red blood cell health. *Amenorrhea refers to absence of menstrual periods.

Who is at most risk for hypertension during pregnancy?

overweight or obese women (women with high BMI) women under age 17 and over 35 women with diabetes

_____ energy balance occurs when the calories consumed exceeds the amount of calories required to support metabolism and physical activity.

positive *Negative energy balance describes a situation in which energy intake is lower than energy expenditure. Positive energy balance describes a situation in which the amount of calories consumed exceeds the amount of calories required to support basic body processes and physical activity. Sustained over time, positive energy balance leads to gains in both lean mass and adipose tissue. Negative energy balance occurs when calorie intake falls short of calorie needs. Prolonged negative energy balance leads to loss of both lean and adipose tissue. At either extreme, prolonged energy imbalance can impair fertility.

After birth, the mother produces more ___________ hormone so that she can produce milk for breastfeeding

prolactin

edema becomes a concern if it is accompanied by

protein in the urine hypertension if these all occur, it indicates preeclampsia

Pregnant and breastfeeding mothers should consume _____ because the omega-3 fatty acids present in fish are secreted into breast milk and are important for the development of the infant's nervous system.

8 to 12 ounces of low-mercury fish per week 1 gram of omega-3 fatty acids from a fish oil supplement per day And, as mentioned for pregnancy, during breastfeeding, women should consume 8 to 12 ounces of low-mercury fish per week (or 1 gram per day of omega-3 fatty acids from a fish oil supplement) because the omega-3 fatty acids present in fish are secreted into breast milk and are likely to be important for development of the infant's nervous system. Milk production requires approximately 800 kcal every day.

How many calories are required for production of milk?

800 kcal/day

DEFINE PCOS (polycystic ovary syndrome)

A condition of hormonal imbalance (e.g., elevated testosterone and insulin) in a woman that can lead to infertility, weight gain in the abdominal region, excessive growth of body hair, and acne.

Which statement is true about birth defects and death?

Birth defects are the presumed cause of many spontaneous abortions and are linked to 20% of infant deaths before one year. Birth defects impact 1 in every 33 babies born in the United States.62 In some cases, they are so severe that a baby cannot survive or thrive. Defects in embryonic or fetal development are the presumed cause of many spontaneous abortions and are at the root of about 20% of infant deaths before 1 year of age. However, many babies with birth defects can go on to live healthy and productive lives.

Which statement is true about birth defects rates in the United States?

Birth defects impact 1 in 33 babies born in the U.S.

Choose the risk factors that put a woman at greater risk for gestational hypertension.

Diabetes African-American race Woman's first pregnancy Women under 17 and over 35 are at higher risk. The populations most at risk for these disorders are women under age 17 or over age 35, women who are overweight or obese, and those who have had multiple-birth pregnancies. A family history of gestational hypertension in the mother's or father's side of the family, diabetes, African-American race, and a first pregnancy also raise risk.

Which statement is true regarding a woman's awareness of pregnancy?

Even if a pregnancy is planned, a woman may not know that she is pregnant during the first few weeks of pregnancy. "Surprise, we're pregnant!" Considering the fact that only about half of all pregnancies are planned, a positive pregnancy test can be shocking news. Even when planned, women often do not suspect they are pregnant during the first few weeks after conception

Which factor contributes to the increased occurrence of heartburn during pregnancy?

Hormones from the placenta relax GI tract muscles. Hormones (such as progesterone) produced by the placenta relax smooth muscles in the uterus and the gastrointestinal tract. This often causes heartburn as stomach acid refluxes into the esophagus (review Section 3.10). When this occurs, the woman should avoid lying down for at least three hours after eating, choose meals that are lower in fat so that foods pass more quickly from the stomach into the small intestine, and avoid spicy foods, which can worsen symptoms. The hormone-induced relaxation of muscles in the GI tract may also lead to constipation. This is especially likely to develop late in pregnancy, when the fetus competes with the GI tract for space in the abdominal cavity.

True or false: Although vitamin needs increase during pregnancy, mineral needs remain the same.

false Most notably, iron, zinc, and iodine needs increase during pregnancy.

Which of the following statements are true about prolactin?

Infant suckling stimulates the release of prolactin from the pituitary gland. Prolactin hormone stimulates milk production. Prolactin hormone is secreted by the mother's pituitary gland and stimulates the synthesis of milk in her breast.

What are some substances a woman should avoid/eliminate both in preparation and during pregnancy?

NSAIDs Alcohol Tobacco Common cold medications *All of the currently approved artificial sweeteners in the U.S. have been deemed safe for use, even during pregnancy. The only exception would be for women with phenylketonuria (PKU, a rare genetic condition) to avoid aspartame

Why is it important for a breastfeeding woman to consume an adequate amount of omega-3 fatty acids?

Omega-3 fatty acids are secreted into breast milk and are important for development of the infant's nervous system.

Which factors contribute to edema during pregnancy?

Placental hormones Increased blood volume Placental hormones cause various body tissues to retain fluid during pregnancy. Blood volume also greatly expands during pregnancy. The extra fluid normally causes some swelling (edema), especially in the extremities. There is no reason to restrict salt severely or use diuretics to limit mild edema. However, the edema may limit physical activity late in pregnancy and occasionally requires a woman to elevate her feet or wear compression stockings to control the symptoms. Overall, edema is only a mild nuisance unless it is accompanied by hypertension and the appearance of extra protein in the urine (which together can all be suggestive of preeclampsia!-not good!)

Which of the following dietary components must be increased to support pregnancy?

Protein Carbohydrates Essential fatty acids (sodium requirements do not increase during pregnancy) The RDA for carbohydrate increases to 175 grams daily, primarily to prevent ketosis lipid needs=Recommendations are slightly increased during pregnancy to 13 grams per day of linoleic acid and 1.4 grams per day of alpha-linolenic acid. The RDA for protein increases to 1.1 grams per kilogram per day, which equates to an additional 25 grams per day during pregnancy Relative macronutrient and water requirements for pregnancy and breastfeeding. Note that there is no RDA or AI for total fat; needs are based on 20% to 35% of overall energy intake.

The most critical time period for potential problems to occur during pregnancy is during the _______ trimester

first *most spontaneous abortions happen at this time

When is the most critical time period for potential problems to occur during pregnancy?

first trimester

Which of the following is a normal reaction to pregnancy?

fluid retention due to placental hormones increased maternal heart rate increased blood volume

during pregnancy, the RDA or AI increases for which of the following vitamins?

Vitamin B-12, Vit B-6, Folate (NOT Vit K, bcuz the Ai for Vit K during pregnancy is the same as the AI for nonpregnant women) Vitamin needs increase from prepregnancy RDAs/AIs by up to 30% for most of the B vitamins, by 45% for vitamin B-6, and by 50% for folate (Fig. 18-6). Vitamin A needs only increase by 10%, so a specific focus on this vitamin is not needed.21 Recall from Section 8.1 that excess amounts of vitamin A are harmful to the developing fetus.

The best time for a woman to address any ongoing health concerns is

before becoming pregnant Adequate prenatal care helps to promote success in pregnancy. Ideally, women should receive examinations and counseling before becoming pregnant and should continue regular prenatal care throughout pregnancy. In addition, untreated health conditions, such as anemia, AIDS, hypertension, diabetes, or depression, must be carefully addressed to minimize complications during pregnancy. Treating ongoing infections will also decrease risks of fetal damage. Without prenatal care, a woman is three times more likely to deliver an LBW baby—one who will be 40 times more likely to die during the first 4 weeks of life than a normal-birth-weight infant.

"Morning sickness" is probably due to changes in the pregnant woman's

hormone levels

It is normal for breast size to ______ during pregnancy, particularly during the second trimester.

increase

To ensure that infants are receiving adequate nutrition from breastfeeding,

infant weight gain should be monitored

To ensure that infants are receiving adequate nutrition from breastfeeding,

infant weight gain should be monitored.

Certain hormones increase a pregnant woman's sense of smell contributing to

morning sickness

Adequate folate intake at least 8 weeks prior to conception helps prevent

neural tube defects premature birth

True or false: Regardless of whether or not pregnancies are planned, women often do not suspect they are pregnant during the first few weeks after conception.

true : Not all women experience the same symptoms of pregnancy and many do not experience any symptoms during the first few weeks after conception.

True or false: Cow's milk should not be introduced into the infant's diet until after the first year of life.

true Because the protein and mineral content of cow's milk is too high and the carbohydrate content is too low, it is important to exclusively feed human milk or infant formula during this critical first year of growth and development.

True or false: Pregnant women are at greater risk of experiencing heartburn than nonpregnant women.

true Reason: Hormones produced by the placenta relax muscles in the uterus and GI tract and may allow gastric acid to reflux into the esophagus.

True or false: Protein, carbohydrate, and micronutrient needs are increased to support pregnancy.

true The RDAs for protein and carbohydrate increase during pregnancy as do most of the B vitamins, especially folate, and the minerals iodine, zinc, and iron.

During pregnancy, the RDA or AI increases for which of the following vitamins?

vitamin B-12 vitamin B-6 folate

Compared to the needs of nonpregnant women, the RDA for ______ is increased during pregnancy.

zinc iron iodine *Calcium needs do not increase, however, they may deserve special attention because many women are deficient prior to becoming pregnant. Mineral needs generally increase during pregnancy, especially the requirements for iodine, iron, and zinc (Fig. 18-7).9,41 Calcium needs do not increase but still may deserve special attention because many women find it difficult to meet their calcium needs.

When is gestational diabetes most likely to begin during a pregnancy?

20-28 weeks Hormones synthesized by the placenta decrease the efficiency of insulin. This leads to a mild increase in blood glucose, which is normal and helps supply calories to the fetus. If the rise in blood glucose becomes excessive, this leads to gestational diabetes, often beginning between weeks 20 and 28, particularly in women who have a family history of diabetes or who are obese. Other risk factors include maternal age over 35 and gestational diabetes in a prior pregnancy.

Caffeine intake during pregnancy should be limited to less than

200 mg per day Most authorities recommend that pregnant women limit caffeine intake to 200 milligrams per day (equivalent to about 2 cups of coffee).

The main purpose of the increase in carbohydrates during pregnancy is primarily to prevent

ketosis

What is a safe level of alcohol intake for women during pregnancy?

0 drinks per day There is no known safe level of alcohol intake during pregnancy. The safest course of action is to avoid alcohol during pregnancy

What is the recommendation for alpha-linolenic acid (the essential omega-3 fatty acid) during pregnancy?

1.4 grams/day Recommendations are slightly increased during pregnancy to 13 grams per day of linoleic acid and 1.4 grams per day of alpha-linolenic acid. These needs can be met by consuming 2 to 4 tablespoons per day of plant oils. However, usual intakes of omega-3 fatty acids among women—pregnant or not—fall short of recommendations.32 Consumption of two to three servings (8 to 12 ounces) per week of fish is recommended for meeting needs for essential fatty acids.3 13 grams/day=recommendation for linoleic acid during pregnancy 1.1 grams/day=recommendation for alpha-linolenic acid for nonpregnant adult women 12 grams/day=recommendation for linoleic acid for nonpregnant adult women

Recommendations for omega-6 fatty acid intake during pregnancy are increased to

13 omega-6 fatty acid=linoleic

On average, how much do vitamin requirements increase during pregnancy?

30% Folate needs increase by 50% during pregnancy - this is the greatest increase for all vitamins. Vitamin needs increase from prepregnancy RDAs/AIs by up to 30% for most of the B vitamins, by 45% for vitamin B-6, and by 50% for folate (Fig. 18-6). Vitamin A needs only increase by 10%, so a specific focus on this vitamin is not needed.

A gestation period of at least _________ is one criterion for a successful pregnancy.

37 weeks For the mother, a successful pregnancy is one in which her physical and emotional health is protected so that she can return to her prepregnancy health status. For the infant, two widely accepted criteria are: (1) a gestation period longer than 37 weeks and (2) a birth weight greater than 5.5 pounds (2.5 kilograms). Sufficient lung development, likely to have occurred by 37 weeks of gestation, is critical to the survival of a newborn. The longer the gestation (up to 42 weeks), the greater the ultimate birth weight and maturation state, leading to fewer medical problems and better quality of life for the infant.

The normal duration period of pregnancy is __________ to ____________ weeks.

38 to 42 The length of a normal pregnancy is 38 to 42 weeks, measured from the first day of the woman's last menstrual period

What is physiological anemia?

An increase in blood volume that dilutes red blood cell concentration To supply fetal needs, the mother's blood volume expands to approximately 150% of normal. The number of red blood cells, however, increases by only 20% to 30%, and this occurs more gradually. As a result, a woman has a lower ratio of red blood cells to total blood volume in her system during pregnancy. This hemodilution is known as physiological anemia. It is a normal response to pregnancy, rather than the result of inadequate nutrient intake.

risks for older women getting pregnant

Advanced maternal age also poses special risks for pregnancy.13 The likelihood of LBW and preterm delivery increases modestly, but progressively, with maternal age beyond 35 years. Given close monitoring, however, a woman older than 35 years has an excellent chance of giving birth to a healthy infant.

weight loss after pregnancy

After giving birth, women are often eager to shed the excess "baby fat." Breastfeeding, however, is no time for crash diets. A gradual weight loss of 1 to 4 pounds per month by the nursing mother is appropriate. At significantly greater rates of weight loss—when calories are restricted to less than about 1500 kcal per day—milk output decreases. A reasonable approach for a breastfeeding mother is to follow a dietary plan that supplies at least 1800 kcal per day; has moderate fat content; and includes a variety of dairy products, fruits, vegetables, and whole grains.

Which of the following infants is likely to be born with a low birth weight?

An infant born 14 months after his older sibling *A mother who smokes during her pregnancy has increased risk of giving birth to a low-birth-weight infant. *Exposure to chronically high levels of glucose in utero leads to fetal macrosomia. *A prepregnancy BMI in the normal range (18.5 - 24.9) is associated with optimal birth outcomes.

Which statement is true about breast size during pregnancy?

Breast size during pregnancy is not an indication of successful breastfeeding. Breast size generally increases during pregnancy and is no indication of success in breastfeeding. Most women notice a dramatic increase in the size and weight of their breasts by the third or fourth day of breastfeeding. If these changes do not occur, a woman needs to seek advice from her primary care provider or a lactation consultant. Breastfed infants must be followed closely by caregivers over the first few days of life to ensure that feeding and weight gain are proceeding normally. Monitoring is especially important with a mother's first child because the mother will be inexperienced with the technique of breastfeeding. The infant is at risk of undernutrition and dehydration if feeding does not proceed smoothly.

negative energy balance

Calorie intake falls short of calorie needs leading to a loss of lean and adipose tissue.

Which statements are true about colostrum?

Colostrum is the first fluid released from the breast at the end of pregnancy. Colostrum is a thick, yellowish fluid. release of colostrum indicates that the breast is getting ready to feed your baby At the end of pregnancy, the first fluid made by the human breast is colostrum. This thick, yellowish fluid may leak from the breast during late pregnancy and is produced in earnest for a few days after birth. Colostrum differs from mature human milk in that it contains a higher concentration of antibodies, immune system cells, and growth factors, some of which pass intact through the infant's immature GI tract into the bloodstream. The first few months of life are the only time when we can readily absorb whole proteins, such as these immune factors, across the GI tract. These immune factors and cells protect the infant from some GI tract diseases and other infectious disorders, compensating for the infant's immature immune system during the first few months of life. These protective qualities of colostrum are an important reason for mothers to nurse their infants if even for just the first few weeks after birth. rich in immune factors and protein.

What are some nutritional problems experienced by infants that are born before 37 weeks' gestation?

Insufficient fat Insufficient iron and calcium stores Poor ability to suck and swallow (NOT DEC METABOLIC RATE) The third trimester is a crucial time for fetal growth. The fetus will double in length and increase its weight by three to four times. The third trimester is the time when many nutrients are transferred from the mother to the fetus. An infant born after only about 26 weeks of gestation has a good chance of surviving if cared for in a nursery for high-risk newborns. However, the infant will have low stores of minerals (e.g., iron and calcium), fat, and fat-soluble vitamins that normally accumulate during the last month of gestation. This and other medical problems, such as a poor ability to suck and swallow, complicate nutritional care for preterm infants.

Siblings born in close succession are more likely to be born with a ______ birth weight than those farther apart in age.

LOWER *Infants who were conceived less than 6 months after an older sibling's birth are at increased risk for low birth weight. The interval between the birth of one child and subsequent conception may affect the outcome of the latter pregnancy. Infants conceived less than 12 months after a previous birth have increased risks for preterm birth, LBW, SGA, birth defects, and developmental problems compared to those conceived at least 18 months following the birth of their older siblings. These poor outcomes are probably related to insufficient time to rebuild nutrient stores depleted by the previous pregnancy. Similarly, multiple births (i.e., twins) increase the risk for preterm birth, LBW, and other medical complications for the mother and the offspring. The American College of Obstetricians and Gynecologists recommends that women should wait until 18 months after giving birth before getting pregnant again.

let-down reflex; lactation

Let-down reflex. Suckling sets into motion the sequence of events that lead to milk let-down, the flow of milk into ducts of the breast. Both milk production and let-down are regulated by hormones produced by the pituitary gland. Lactation is regulated by two hormones: prolactin and oxytocin. Prolactin is the hormone that stimulates milk production in the lobules of the breast. As milk is produced between feedings, it is stored in the lobules.

What are some substances a woman should avoid/eliminate both in preparation and during pregnancy?

NSAIDs Tobacco Common cold medications Alcohol

teratogens list

Smoking is linked to preterm birth and appears to increase the risk of birth defects, sudden infant death, childhood cancer, and disabilities. Illicit drug use is particularly harmful during pregnancy. Many chemicals in recreational drugs cross the placenta and affect the fetus, whose detoxification systems (e.g., liver and kidneys) are immature. Marijuana, the most common recreational drug used during the reproductive years, can result in reduced blood flow to the uterus and placenta, leading to poor fetal growth. Risks of low birth weight and preterm birth are increased for infants whose mothers used marijuana during pregnancy. Use of psychoactive drugs, such as opioids, cocaine, and methamphetamines, restricts fetal growth and brain development, leading to lifelong physical and mental disabilities. Page 621 Even prescribed and common over-the-counter medications could have harmful effects on the developing fetus. Problem drugs include aspirin (especially when used chronically or heavily), hormone ointments, nose drops and related "cold" medications, rectal suppositories, weight-control pills, antidepressants, and medications prescribed for preexisting illnesses. Some herbal therapies also have the potential to damage the fetus. Lower doses and/or safer alternatives should be substituted when a woman is planning to or has become pregnant.15 In addition to these toxic chemicals, health hazards in the mother's environment, including job-related hazards and exposure to X-rays, should be minimized.

True or false: Infection with Listeria monocytogenes is of particular concern for pregnant women because it can cause fetal death.

TRUE During gestation, the fetus is protected from many maternal infections, but Listeria monocytogenes is one foodborne pathogen that can cross the placental barrier, infect the fetus, and lead to fetal death. Infection with this microorganism typically causes mild flu-like symptoms, such as fever, headache, and vomiting, about 7 to 30 days after exposure. However, pregnant women and their offspring may suffer more severe symptoms, including fetal death. Unpasteurized milk, soft cheeses made from raw milk (e.g., Brie, Camembert, feta, and blue cheeses), and some raw vegetables (e.g., cabbage and sprouts) can be sources of Listeria organisms, so it is especially important that pregnant women (and other people at high risk for infection) avoid these products. Experts advise consuming only pasteurized milk products and cooking meat, poultry, and seafood thoroughly to kill Listeria and other foodborne organisms.

What is the RDA for carbohydrates during pregnancy?

The RDA for carbohydrates increases to 175 grams per day during pregnancy, primarily to prevent ketosis

positive energy balance

The amount of calories consumed exceeds the amount of calories required to support basic body processes and physical activity.

Which of the following are considered to be important indicators of a successful pregnancy?

The mother's physical and emotional health are protected. Infant birth weight is greater than 5.5 pounds. Gestation period is/should be longer than 37 weeks

What is one of the best predictors of pregnancy outcome?

appropriate weight gain during pregnancy Healthy prepregnancy weight and appropriate weight gain during pregnancy are excellent predictors of pregnancy outcome.24,25 The mother's dietary pattern should allow for approximately 2 to 4 pounds (0.9 to 1.8 kilograms) of weight gain during the first trimester and then a subsequent weight gain of 0.8 to 1 pound (0.4 to 0.5 kilogram) weekly during the second and third trimesters (Fig. 18-4). A healthy goal for total weight gain for a woman of normal weight (based on prepregnancy BMI; Table 18-2) averages about 25 to 35 pounds (11.5 to 16 kilograms). Women of normal prepregnancy BMI carrying twins should aim to gain within the range of 37 to 54 pounds, whereas women who are overweight or obese and carrying twins should gain less (31 to 50 pounds or 25 to 42 pounds, respectively).

Lactation is the technical term for

breastfeeding

What first action should a pregnant woman take if she is interested in beginning a regular physical activity program during pregnancy?

consult a physician

When it comes to carbohydrate choices, women with PCOS should

consume fewer sugar-sweetened beverages. choose whole grains instead of refined grains. *Both sucrose and high fructose corn syrup are simple sugars that should be limited in the diets of women with PCOS. *Whole fruits and vegetables are preferable to fruit juice because they provide more fiber and less sugar. Many dietary and lifestyle changes have been studied to see how they can alter the course of PCOS. To date, evidence most clearly indicates that weight loss is important to improve metabolic and fertility issues among overweight women with PCOS. If an overweight woman with PCOS loses just 5% to 10% of her body weight, her chances of conception improve.3 Daily physical activity, known to improve insulin sensitivity, is a key component of any weight-management strategy In addition to managing body weight, the quality and quantity of carbohydrates may make a difference in controlling PCOS and improving fertility. Some experts recommend reducing carbohydrate intake to the lower end of the range recommended by the Food and Nutrition Board (about 45% of total kcal) and choosing low glycemic-index carbohydrates

What are some problems that can occur at the beginning of breastfeeding which explain why careful monitoring of breastfeeding in the first week is necessary?

dehydration inadequate weight gain blood clots *neural tube defects, such as spina bifida, occur during the first trimester Although it is the most natural way to feed a newborn child, the technique does not always come naturally. Gathering information on breastfeeding, what obstacles to anticipate, and how to respond to such obstacles will help new mothers and their babies to succeed with breastfeeding. It also helps to have an experienced friend, family member, or a professional lactation consultant to call for advice when questions arise. In most cases, problems encountered in breastfeeding are due to a lack of knowledge or support. Anatomical problems in breasts, such as inverted nipples, can be corrected during pregnancy.

The foodborne illness that poses the greatest risk during pregnancy is caused by

listeria monocytogenes One type of foodborne illness that poses particular danger for pregnant women is caused by the bacterium Listeria monocytogenes *Norovirus could cause foodborne illness in pregnant women, but infection with L. monocytogenes can lead to miscarriage. *Salmonella could cause foodborne illness in pregnant women, but infection with L. monocytogenes can lead to miscarriage. *S. aureus could cause foodborne illness in pregnant women, but infection with L. monocytogenes can lead to miscarriage.

To improve fertility among women with PCOS, research most clearly supports the benefits of

loss of excess body weight

To improve fertility among women with PCOS, research most clearly supports the benefits of

loss of excess body weight *NOT a low glycemic index diet; While there is some evidence to support a low-glycemic index diet, the strongest evidence points to loss of excess body weight to improve fertility among women with PCOS. *NOT a low-carb diet; Claims that following a low-carbohydrate diet is useful for women with PCOS are not well supported by evidence. The strongest evidence points to loss of excess body weight to improve fertility among women with PCOS.

A preterm infant is likely to have

low iron and calcium levels

Compared to cow's milk, human milk contains ______ essential fatty acids.

more

Infants born to mothers with a prepregnancy BMI of 25 or higher are ______ to experience health problems compared to infants born to mothers of BMI in the range of 18.5 - 24.9.

more likely

Certain hormones increase a pregnant woman's sense of smell contributing to

morning sickness About 70% to 85% of women experience nausea during the early stages of pregnancy. Nausea and vomiting of pregnancy are probably related to changes in GI motility induced by pregnancy-related hormones. Although commonly called "morning sickness," pregnancy-related nausea may occur at any time and persist all day. It is often the first signal to a woman that she is pregnant.