Chapter 17: Life Cycle Nutrition-Pregnancy Through Nutrition

Embryo is what week time period?

3-8 weeks

Full-term pregnancy lasts __-__ weeks from __________ to birth.

39-40 weeks; conception

During the third trimester, a women should add an additional ___ kcal to her diet.

450kcal/day

What is the recommended weight gain if prepregnancy BMI is 18.5-24.9?

25-35lbs

What is the recommended weight gain if prepregnancy BMI is <18.5?

28-40lbs

Prenatal development is divided into how many periods and what are those periods called?

2; Embryonic and fetal (should technically be 3- zygote, embryo, and fetus)

What are the carbohydrate needs for an infant in the first 6 months of life?

60 g/day

How much folate should women have throughout pregnancy?

600ug; take a supplement or consume folate-rich foods.

Fetus is what week time period?

9-birth

What are the protein needs for an infant in the first 6 months of life?

9.1 g/day

What are the carbohydrate needs for an infant in the first 7-12 months of life?

95g/day

If famine occurs early in pregnancy, it is associated with...

A high cumulative incidence of heart disease and diabetes.

Infants should receive what kind of injection at birth?

A vitamin K injection at birth because they have a sterile gut, so they can't really produce vitamin K from their gut that lacks a microbiome.

Teratogens

Alcohol, drugs, radiation, viruses, bacteria, etc. that are harmful to the development of the embryo/fetus.

Sensitization stage

Allergens sensitizes or introduces themselves to the immune system; no reaction. In response, the immune system creates an army of antibodies that enter the blood. The antibodies attach to mast cells found in connective tissues, setting the stage for a potential future allergic reaction.

If iron deficiency occurs early in pregnancy, it is associated with...

poor cognitive development.

Every dollar spent on ________ ___ _____________ ___ ___-______ _____ saves between $_.__ and $_.__ in health care costs within the the first 60 days after birth.

prenatal WIC participation for low-income women; $1.77-$3.13

Cow's milk should be avoided until...

1 year of age.

What is the pathway of the letdown response?

1. Sucking stimulates nerve that sends signal to mother's hypothalamus. 2. Hypothalamus stimulates the release of prolactin and oxytocin. 3. Prolactin triggers milk production and oxytocin triggers the letdown response

What are the energy needs for an infant in the first 6 months of life?

108 kcal/kg of body weight

What is the recommended weight gain if prepregnancy BMI is >30?

11-20lbs

What are the protein needs for an infant in the first 7-12 months of life?

11g/day

What are the fluid and nutrient needs for breastfeeding women?

13 cups of plain water/day; additional 500kcals/day during the first 6 months (not all need to come from foods); Additional ____ months; lactating women who are vegans need adequate amounts of vitamin B12 and zinc.

The full term pregnancy is divided into three __-____ trimesters.

13-week

What is the recommended weight gain if prepregnancy BMI is 25-29.9?

15-29 lbs

Solid foods be introduced gradually and parents should watch for signs of what?

Allergies after a new food is introduced, so make sure you introduce your main allergen foods one by one.

Food allergy

An abnormal reaction by the immune system to a particular food.

What is the average weight gain for healthy women?

An average of 27.5lbs during pregnancy; the _____ weight, gained, and the rest is maternal tissues; this is the approximate amount of weight that is needed to support the growth of the baby.

What are foods to avoid for infants?

Avoid serving food in large pieces, hot dog rounds, raw carrots, avoid honey until 1 year, avoid peanut butter until 1 year, avoid peanuts until 3 years, avoid added seasonings (salt, sugar) and added fats (butter, margarine)

Solid foods should be introduced around when?

Around 4-6 months of age after the infant has met certain milestones: the body is physiologically capable of consuming solid foods, infant's tongue-thrust reflex should have faded, infant has head and neck control, infant can sit without support and can turn his or her head.

When should iron-fortified foods such as infant cereal be introduced?

Around 6 months.

What are risk factors for gestational diabetes?

Being overweight, being over 25 years old, history of higher-than-normal blood glucose levels, being Hispanic, African-American, Native American, or Pacific Islander, previously gave birth to a very large baby or a stillborn baby, and having had gestational diabetes in the past.

Mast cells

Cells in connective tissue to which antibodies attach, setting the stage for potential future allergic reactions.

Fetal Alcohol Spectrum Disorders (FASDs)

Characteristics caused by alcohol during pregnancy.

What mineral enhances the absorption of iron?

Copper, so that is why you have be careful with how much you're consuming because although it increases iron absorption, that iron decreases zinc absorption.

Critical periods

Developmental stages during which cells and tissue rapidly grow and differentiate to form body structures; occurs in the second and third trimesters; times when developing organism is most vulnerable to teratogens.

What are the fat needs for an infant?

Do not limit fat intake.

What should a woman in her third trimester do to reduce heartburn?

Eat frequent, small meals, avoid spicy or highly seasoned foods, avoid lying down immediately after meals.

What are common allergens in children?

Eggs, cow's milk, peanuts, strawberries, chocolate, and fish.

What can help combat symptoms of a food allergy?

Epinephrine

The American Academy of Pediatrics and Academy of Nutrition and Dietetics recommends what about breastfeeding?

Exclusive breast-feeding for the first 6 months and then use a combination of appropriate foods and breastfeeding during the remainder of the first year of life, and breastfeed for longer, if desired.

The nutritional composition of breast milk does not change as the infant grows (true/false)?

False, it does change as the infant grows.

Mothers should not avoid botanicals (true/false)?

False, they should avoid it because there is not enough research done on it.

Zygote is what week time period?

First two weeks.

Colostrum

Fluid that is expressed from the mother's breast after birth and before the development of breast milk; breast milk contains a carotenoid-rich, yellowish fluid that is lower in fat but higher in protein, vitamin A, minerals, and immune factors.

Throughout pregnancy what nutrients needs are increased and by what percent increased?

Folate, zinc, iron, and calcium needs increase by 50%.

Pregnancy-induced hypertension includes what three categories?

Gestational hypertension, preeclampsia, and eclampsia

What should you do about exercise in the second trimester?

Get enough exercise, (low?) or more moderate exercise on most days; low-impact activities; avoid significant increases in body core temperature; avoid activity in the supine position.

What concerns may older mothers (>35years?) have?

Higher risk for complications: difficulty conceiving, gestational diabetes and pregnancy-induced hypertension, more likely to have a baby with Down Syndrome or other developmental disabilities.

What can cause slow movement of food through the GI tract during the third trimester and what can be done to alleviate it?

Hormonal changes; exercise and consume fiber-rich foods and drink plenty of fluids.

Gestational hypertension

Hypertension occurring during pregnancy in a woman without prior history of high blood pressure; occurs early in pregnancy in women with no history of hypertension.

When should vitamin B12 be supplemented to an infant?

If the infant is exclusively breast-fed by a strictly vegan mother.

Smoking increases the risk of...

Infertility, a low birth weight baby, stunted growth or intellectual development, and sudden infant death syndrome (SIDS).

What are the supplemental foods offered by the WIC?

Iron-fortified infant formula and cereal an iron-fortified adult cereal, vitamin C-rich fruit or vegetable juice, and eggs, milk, cheese, peanut butter, dried beans/peas, tuna fish, and carrots.

Why is iron needed throughout pregnancy?

It is needed to make additional red blood cells, prevents anemia, essential for fetal growth and development, and needed for growth of the placenta.

What is unmodified cow's milk not used for infants?

It is too high in protein, sodium, and potassium, and too low in fat and linoleic acid for infants.

What are the benefits of breast-feeding from a protective standpoint?

It protects against infections, allergies (not allowing the baby to consume too much protein from cow milk or other non-breast milk foods before 6 months), and chronic disease. Decreases risk and severity of diarrhea and other intestinal disorders, respiratory and ear infections, meningitis, and UTIs. Protects against bacteria, viruses, fungi, and inflammation. Provides antioxidants, hormones, enzymes, and growth factors. Breast-feeding beyond six months may reduce risk for childhood obesity. Breast milk provided docosahexanoic acid (DHA) and arachidonic acid (AA), which are needed for vision and CNS and may contribute to a greater cognitive function.

Overall, what are the factors that may negatively affect a pregnancy?

Lifestyle (smoking, alcohol, drugs, botanicals, and certain herbal teas), age (<20 or >35), weight (Prepregnancy: underweight/obese or During pregnancy: insufficient or excessive weight gain), Health (chronic diseases, past history of pregnancy issues, and pregnancy related conditions), Diet (teratogens, nutrient deficiencies/excesses, and foodborne illnesses), and Socioeconomic status (Poverty, limited food supply, and low educational level).

What is the criteria for WIC?

Low-income pregnant women, low-income postpartum women, and children up to age 5 who are at nutritional risk.

What nutrients and behaviors are important for a healthy pregnancy on the dad's part?

Men should practice healthy habits. They should avoid smoking alcohol and drug abuse, and obesity to avoid affecting fertility, sperm production, and sperm function. They should also consume zinc, folate, and antioxidants for production of healthy sperm and to protect them from free radical damage.

Standard formula is made from what?

Modified cow's milk.

What are the monetary benefits of breast-feeding for the mother?

Mom's who breastfeed can save between $1200-$1500 in expenditures on infant formula in the first year alone (however, these savings do not include the costs of clean water, energy, or time that goes into sterilizing, preparing, heating, and cleaning bottles, nor healthcare savings. Formula-fed infants have higher health care costs, fewer natural resources are used, breast milk is always sterile and at the right temperature, less cleanup, stress reduction and bonding, and helps baby feel safe, secure, and emotionally attached.

Breast-feeding

Mother provides food that is uniquely tailored to meet her infant's nutritional needs in an easily digestible form.

Calcium and vitamin D are needed for what during pregnancy?

Needed to support fetal bone growth and prevents low bone mass in the mother.

Why does zinc need to be increased during pregnancy?

Needs to be increased because of the increased iron intake, which decreases bioavailability of Zn.

Milestones

Objectives or significant events that occur during development.

Failure to Thrive (FTT)

Occurs when a child is delayed in physical growth or size or does not gain enough weight.

Allergic reaction stage

Occurs when a person consumes the food allergen again. The food comes in contact with the mast cells carrying the antibody for the particular allergen; occurs when a person eats the food allergens for the second and subsequent times.

Gestational diabetes

Occurs when a woman develops high blood glucose levels during her pregnancy; Typically onsets (?); may result in macrosomia; increased risk for jaundice, breathing problems, birth defects, increased risk for hypoglycemia after birth.

During pregnancy for vegetarians, they need what nutrients more?

Omega 3-fatty acids, choline, and vitamin B12.

How many pounds should you gain in the first trimester?

Only about two pounds in the first trimester.

Introduce new food when?

Only once a week; such as single-grain cereal, then multigrain cereals, pureed vegetables, fruits, and meats.

What are the physical benefits of breast-feeding for mothers?

Oxytocin helps return the uterus to its prepregnancy size and shape, reduces blood loss in the mother after delivery, may help mothers return to their prepregnancy weight and manage their postpregnancy weight, may reduce risk for cancer of the breast and ovaries as well as postpartum depression. May reduce risk for hip fractures later in life, increase bone density, and reduce risk for type 2 diabetes.

Metabolic or fetal programming

Process by which the prenatal environment interacts with genetic and other factors to produce permanent change; able to alter how genes are expressed during critical periods of development.

What are the two hormones that nerve signals sent from the nipple to the hypothalamus in the mother's brain prompt the pituitary gland to release?

Prolactin and oxytocin

Food allergens

Proteins that are not broken down by cooking or digestion and enter the body intact, causing an adverse reaction by the immune system.

Pregnant women should should avoid what foods to prevent foodborne illness?

Raw or undercooked meats, fish, or poultry, unpasteurized milk, cheese, juices, and raw sprouts.

Letdown response

Release of milk from the mother's breast to feed a nursing baby.

What is a good first food?

Rice cereal

Eclampsia

Seizures or coma in a women with preeclampsia; results from untreated preeclampsia; can cause seizures and is a major cause of death of women during pregnancy.

Reactions to foods occur in what two stages?

Sensitization and allergic reaction stage.

Preeclampsia

Serious medical condition developed late in pregnancy in which hypertension, severe edema, and protein loss occur.

What should mom's do to alleviate the symptoms of morning sickness?

She should have small, frequent meals high in carbohydrates, salty foods with sour and tart beverages, vitamin B6 may reduce nausea and vomiting, and ginger may reduce nausea and vomiting.

What are common allergens in adults?

Shellfish, peanuts, tree nuts, fish, wheat, soy, and eggs.

Chronic conditions (such as diabetes, hypertension, PKU, or sexually transmitted diseases should or should not be controlled before conception?

Should be controlled before conception because they can increase maternal and fetal complications; medications can be contraindicated during pregnancy, so prepregnancy counseling is essential.

Placenta

Temporary organ that transports nutrients and wastes to and away from the developing embryo; prevents passage of RBCs, bacteria, and many large proteins from mother to fetus; releases hormones required to support the physiological changes of pregnancy.

What physiological changes occur in the mother in the first trimester?

Tender breasts, heightened sense of taste or smell, random food cravings and aversions (no scientific evidence supports the belief that food craved is an indicator that mother is missing nutrients).

small for gestational age (SGA)

Term for babies who weight less than the 10th percentile of weight for gestational age.

What is a food assistance program for low-income mothers?

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); designed to ensure that pregnant women and mothers of young children have access to nutrition information and nutritious foods.

Pica

The craving of nonfood substances; this practice can harm the mother and baby; laundry starch, burnt matches, cornstarch, clay, dirt, paint chips, and baking soda; associated with low blood levels of iron (which is contradictory to the whole "there is not scientific evidence to support cravings are related to nutrient deficiencies," but whatever...)

Why is heartburn common in women during the third trimester?

The growing baby exerts pressure on the mother's intestines and stomach.

What stimulates milk production?

The infant suckling at the mother's breast and Prolactin

Oxytocin triggers what response?

The letdown response.

What nutrients and behaviors are important for a healthy pregnancy on the mom's part?

The mom should attain a healthy weight before conception to prevent obesity and overweightness from causing infertility, pregnancy complications (diabetes and hypertension; induced labor and C-section), birth defects, preterm delivery and difficult deliveries; also children are more likely to develop childhood obesity and develop diabetes and hypertension later in life. On the other hand, women should avoid being underweight to prevent risk of delivering a LBW or small for gestational age babies (SGA), which puts the babies at higher risk for developmental disabilities, lung disease, dying within the whom; they should eat 400ug of B9; eat safe fish to eat less methylmercury (limit albacore tuna to no more than 6oz weekly and NO shark, swordfish, mackerel, or tilefish); consume moderate amounts of caffeine (limit caffeine intake <150mg/day); avoid); avoid smoking/drugs.

Lactation

The production of milk in woman's body after birth.

How are fluid needs met for an infant?

They are met with breast milk or formula; thus, it is important to limit extra fluids and give 100% juice in moderation.

What happens when the food allergens enter the bloodstream?

They can cause a drop in blood pressure.

What are concerns for teenage mothers?

They face nutritional challenges: they are still growing, so their nutrient needs are even higher, diet more likely to be unbalanced (typical bad eating), tend to be low in iron, folic acid, calcium, and potentially kcals, and inadequate diet (can lead to LBW or SGA babies and compromised growth and health of the teenaged mom.

What are the recommendations about sugar substitutes?

They may be used in moderation along with a balanced, nutrient-rich meal plan; aspartame, sucralose, acesulfame-K, and saccharin have been deemed safe to consume.

What are concerns for low-income mothers?

They may need food assistance.

What behaviors are important in the second trimester?

To consume adequate kcals, carbohydrate, and protein; there should be an additional 250-500 kcal daily; eat a minimum of 175g carbs/day; protein needs increase 35% to about 71g/day

What is the only cure for preeclampsia and eclampsia?

To deliver the baby.

A prenatal vitamin supplement is needed to meet iron needs (true/false)?

True, I guess you can't get enough extra from your diet.

There are Breast Milk Banks for those who are unable to breast-feed (true/false)?

True, but what does that mean for your infants nutritional need considering breast milk composition changes overtime as the baby grows?

Children in families with a strong family history of ______ may benefit from breastfeeding.

Type 2 diabetes?

Morning sickness (nausea) is characterized by what?

Typical of the first trimester, can occur at any time of the day, the heightened sense of smell can trigger nausea and vomiting, emotional stress or traveling can aggravate the problem.

What vitamins should you avoid overconsumption of during pregnancy?

Vitamin A and D.

What happens when a food allergen reaches the stomach and begins to be digested?

Vomiting and/or diarrhea may result.

When should women not breastfeed?

When women have HIV or AIDS, human T-cell leukemia, or active TB, who are receiving chemotherapy and/or radiation, or who use illegal should not breastfeed. Also women who have infants that are lactose intolerant cannot metabolize lactose and should not be breastfed. Women with certain medications.

Reactions appear quickly after contact, but difficulty breathing develops when?

Within minutes.

Do children grow out of food allergies?

Yes. 80-90% of egg, milk, wheat, and soy allergies disappear by 5 years and 20% of children outgrow peanut allergy.

What should you avoid letting your infant do to prevent nursing bottle tooth decay and increased risk for ear infections?

You should avoid letting them sleep with their bottles.

What are food and milestones and age associated with those milestones for a baby's first year?

birth 0-3 months (suckles; breast milk or iron-fortified formula), 3-6 months (controls head movement; iron-fortified infant cereal), 6-9 months (sits with support, chews, grasps; pureed or strained meat or beans, plain yogurt, pureed or strained vegetables and fruit, fruit juiced mixed with same amount of water), 9-12 months (feeds self; mashed or chopped food from family meal).

Length of infants _______ by _ year of age.

doubles; 1

Birth weight _______ by _ months of age and _______ it by __ months.

doubles;6; triples; 12

Four to seven days after birth breast milk is high in... and lower in

lactose, fat, and B vitamins; fat-soluble vitamins, sodium, and other minerals.

At 6-7 months breast milk has...

less protein.

At 6-7 months, The American Academy of Pediatrics recommends supplementing breast-fed babies with... and how much of it/day... and by what means?

vitamin D; Minimum of 400 IU/day; in the form of drops; later, the PPT mentions to begin this at 2 months.