Ch.13 Nutrition

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2nd trimester:The fetus's organs continue to grow and mature in their ability to function. As the fetus moves around, its mother becomes increasingly aware of its presence within her body.

morning sickness

A common sign of pregnancy is _____, nausea that is sometimes accompanied by vomiting.

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A fetus generally needs to spend at least 37 weeks developing within the uterus to be physiologically mature enough to survive after birth without the need for special care. A fetus's weight depends on the supply of nutrients that it receives through the placenta. If the placenta fails to grow properly, the developing fetus is likely to be born too soon and be lighter than average at birth.

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A lactating mother, however, has to observe her baby for cues indicating the child is full. When a breastfeeding baby is no longer interested in nursing and stops, its mother has to assume the infant is satisfied with the feeding. A well-nourished breastfed infant will gain weight normally and generally have six or more wet diapers as well as one or two soft bowel movements per day. Parents or caregivers who are concerned about their infants' food intake or nutritional status should consult their physician immediately.

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A pregnant woman's requirements for folate and iron are 50% higher than those of a nonpregnant woman. It is important for women to enter pregnancy with adequate folate status, because embryos need the vitamin to support rapid cell division.

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A question commonly asked is whether the breastfed infant needs additional water, especially in hot weather. Human milk provides adequate water intake for healthy infants who are exclusively breastfed

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A reflex is a physical response that is automatic and not under conscious control. When let-down occurs, the infant removes the milk by continued sucking. Shortly before the flow of milk begins, the lactating woman often feels a tingling sensation in her nipples, a signal that let-down is occurring.

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A very preterm infant who is born after about 26 weeks of pregnancy may survive if cared for in a hospital nursery for high-risk newborns; However, the tiny infant's body will not have stores of fat and certain minerals that normally accumulate during the last month of pregnancy. Additionally, very preterm babies are likely to have conditions that complicate their medical care and food intake, such as breathing difficulties and weak sucking and swallowing abilities.

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According to estimates, 3 to 8% of pregnant women in the United States develop type 2 diabetes during pregnancy (gestational diabetes). When a woman has gestational diabetes, her fetus receives too much glucose and converts the excess into fat.

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According to experts with the American College of Obstetricians and Gynecologists (ACOG), women who were underweight prior to pregnancy should gain 28 to 40 pounds; women whose prepregnancy weights were within the healthy range can expect to gain 25 to 35 pounds.Women who were overweight before they became pregnant should gain 15 to 25 pounds, and obese women should gain at least 15 pounds during pregnancy.

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Additionally, an infant's length increases by 50% during its first year of life. Thus, if a baby girl weighs 7 pounds and is 20 inches long at birth, you would expect her to weigh 21 pounds and be 30 inches long by her first birthday

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Additionally, the health care provider can advise the pregnant woman to make appropriate lifestyle choices, such as avoiding the use of tobacco, alcohol, and illegal substances. Women who receive adequate prenatal care are more likely to have good pregnancy outcomes, including babies who have healthy birth weights, than women who do not receive such care

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Additionally, women who breastfeed their babies have lower risks of breast cancer (before menopause) and ovarian cancer than women who do not breastfeed. Some of these benefits depend on whether a woman breastfeeds exclusively, that is, provides no other foods, and the number of months the mother nurses her infant. American infants who are breastfed have a lower infant mortality rate than American babies who are not.

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After an infant reaches 6 months of age, breastfeeding should continue, but the infant can also be offered some appropriate solid foods. Breastfeeding may be combined with infant foods until the child's first birthday. However, there is no reason why children cannot be breastfed for longer periods. Throughout the world, many mothers continue to nurse their babies well past the babies' first birthdays, but in the United States, this practice is uncommon.

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After giving birth, the women who developed diabetes during pregnancy generally experience a decline in their blood glucose levels to normal values. However, women who have experienced gestational diabetes have higher risk of developing type 2 diabetes later in life.

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Although breast milk is highly nutritious, it is not a complete food for all infants. Human milk may contain inadequate amounts of vitamins D and B-12, and the minerals iron and fluoride. The American Academy of Pediatrics (AAP) recommends all breastfed infants be given a supplement that supplies 400 IU of vitamin D per day until they are consuming that amount of the vitamin from food or infant formula.

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An estimated 50% of pregnancies are unplanned in the United States. Therefore, all sexually active women of childbearing age should be aware of their likelihood of becoming pregnant. Dietary practices before and after pregnancy play a major role in a healthy infant

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An interesting feature of human milk is that its fat content changes during each feeding, which usually lasts about 20 minutes. In the beginning of the session, the mother's milk is low in fat, but as her infant continues to suckle, the fat content of her milk gradually increases.The higher fat content of the "hind milk" may make the baby feel satisfied and, as a result, discontinue feeding

physiological anemia

As a result, pregnant woman develops _______, a condition characterized by a lower concentration of red blood cells in the bloodstream. This form of anemia is a normal response to pregnancy, rather than the result of inadequate nutrient intake

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As the pregnant woman's blood volume expands, her need for iron increases because her body must make more hemoglobin for the extra red blood cells.

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As the second trimester begins, the fetus is still very tiny, about 2½ to 3 inches in length, and weighs only about an ounce. However, the fetus is beginning to look more like a human infant—it has fully formed arms, hands, fingers, legs, feet, and toes.

Birth weight

Birth weight is a major factor that determines whether a baby is healthy and survives his or her first year of life.

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By the beginning of the third trimester, the fetus is approximately 12 inches long and weighs about 1½ to 2 pounds.During this trimester, the fetus will nearly double in length and multiply its weight by three to four times. Thus, the fetus usually weighs about 6 to 8 pounds and is 19 to 21 inches long by the time it is full-term and ready to be born.

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By the third trimester, however, most pregnant women are easily fatigued again, possibly because carrying a rapidly growing fetus is physically demanding

Lactobacillus bifidus

Colostrum also contains a substance that encourages the growth of a type of bacteria, _________ (L. bifidus), in the infant's GI tract. Such biologically active substances help an infant's body fight infections and hasten the maturation of the baby's immune system. Thus, breastfed infants, especially those who are exclusively breastfed, have lower risks of allergies and gastrointestinal, respiratory, and ear infections than formula-fed infants.

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Compared to breastfed infants, formula-fed babies have a greater risk of food allergies.When a woman has a personal or family history of food allergies, she may be able to prevent her children from developing such allergies if she breastfeeds her babies exclusively for 6 months. Infants rarely develop allergic reactions to food proteins that enter breast milk from the mother's bloodstream.

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Compared to older children, an infant needs more energy and nutrients per pound of weight to support its rapid growth. If an infant lacks adequate energy and nutrients, the baby's growth may slow or even stop.

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Cravings are common during this stage of life. However, ask pregnant women to identify the foods they crave, and you are likely to get a variety of responses. The causes of cravings are unknown, but they may be responses to the hormonal changes associated with pregnancy or to the emotional state of the mother-to-be. In other instances, specific food cravings may simply reflect the pregnant woman's family traditions. Unless food cravings contribute to excess weight gain, they are generally harmless.

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Dietitians and pediatricians generally recommend that new mothers breastfeed their infants exclusively during their babies' first 6 months of life. It is not necessary to supplement young infants' diets with other fluids, such as water, infant formula, and juices, or with solid foods, such as baby food

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During pregnancy, a woman's body undergoes major physiological changes, such as increased blood volume, breast size, and levels of several hormones.These adaptations enable her body to nourish and maintain the developing embryo/fetus, as well as produce milk for her infant after its birth. However, some of the physical changes cause discomfort for the pregnant woman.

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During pregnancy, certain hormones produced by the placenta relax muscles of the digestive tract.As a result, intestinal movements slow down and digested material takes longer to pass through the tract, increasing the likelihood of constipation

prolactin

During pregnancy, hormones signal the breasts to increase in size in preparation for lactation.The mother's pituitary gland in the brain produces ______, a hormone that stimulates the development of milk-producing tissue in the breasts.

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During pregnancy, the mother-to-be should follow a diet that meets her own nutritional needs as well as those of her developing offspring. Depending on the trimester, an expectant woman's requirements for energy (calories), protein, and many other nutrients are greater than her needs prior to pregnancy.

uterus

During the first 2 weeks after conception, the fertilized egg (ovum) divides repeatedly, forming a mass of cells that enters the woman's ______, the female reproductive organ that protects the developing organism.

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During the second trimester, the expectant mother should consume approximately 340 more kilocalories per day than her prepregnancy EER. Throughout the third trimester, she should add about 450 kcal per day to her prepregnancy EER

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Early in pregnancy, 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 change occurs more gradually.

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Embarrassment, emotional stress and tension, pain, and fatigue can easily block the let-down reflex. For example, if a lactating mother is tense or upset, let-down does not occur, and her infant will not be able to obtain milk when it suckles. When this happens, the hungry infant becomes frustrated and angry, and the mother may respond by becoming even more tense and upset, setting up a vicious cycle. At this point, new mothers often give up breastfeeding, reporting that they tried to suckle their babies but were unable to "produce" milk.

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Even when their diets include good sources of iron such as red meats and enriched cereals, pregnant women often need a supplemental source of iron. Thus most physicians recommend special prenatal multiple vitamin/mineral supplements that contain iron for their pregnant patients.

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Experts with the AAP recommend that caregivers provide an iron-fortified infant formula for babies who are not breastfed. Also need a source of fluoride, but caregivers should check with their infants' physicians before providing a supplement containing the mineral

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Exposing the infant to some sun can also help meet part of the child's vitamin D needs. If a lactating woman is a total vegetarian and she does not consume a source of vitamin B-12, she should consult her physician concerning the need for vitamin B-12 supplementation. When breastfed infants are about 6 months old, they should also be consuming some iron-containing solid foods, because the amount of iron in their mother's milk may no longer meet their needs.

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Exposure to alcohol and tobacco is harmful to the embryo/fetus. Women who drink alcohol during pregnancy are at risk of having a child with a fetal alcohol spectrum disorder such as FAS. Scientists do not know if there is a "safe" amount of alcohol that pregnant women can consume; therefore, women of childbearing age who are sexually active or pregnant should avoid alcoholic beverages.

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Fish and shellfish (e.g., clams, shrimp, and crabs) are excellent sources of many minerals, omega-3 fatty acids, and high-quality protein. However, most fish and shellfish contain very small amounts of methylmercury, a compound that contains the toxic mineral mercury.

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For an expectant mother, the rate of the weight gain is important, as well as the amount of weight gained. Most pregnant women add up to 4 pounds of weight during the first trimester.Throughout the rest of their pregnancies, women typically gain at a faster rate, 3 to 4 pounds each month. Note how the rate reaches a steady pace of about 1 pound/week during the second and third trimesters.

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For example, the mother's let-down reflex may be triggered just by thinking about nursing her infant or hearing it cry.When a new mother breastfeeds her newborn immediately after delivery, oxytocin signals her uterus to contract, reducing the risk of excessive uterine bleeding.

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For most healthy adults, ingesting amounts of methylmercury that are generally in fish and shellfish is not thought to be harmful. Certain kinds of fish and shellfish, however, contain higher levels of methylmercury than others. When a pregnant woman eats these foods, the methylmercury in them can eventually reach the developing fetus and damage its nervous system.

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Furthermore, a fluoride supplement may be necessary for breastfed babies. Before giving any dietary supplements to their baby, parents or caregivers should discuss their infant's nutritional needs with the child's physician. in the United States, newborns are given an injection of vitamin K to protect them against excessive bleeding.

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Furthermore, breastfed babies are less likely to develop childhood asthma, leukemia, obesity, sudden infant death syndrome (SIDS), and type 1 diabetes than infants who are not breastfed

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Furthermore, expectant mothers who gain excessive amounts of weight are more likely to give birth to high-birth-weight (HBW) babies. HBW newborns generally weigh more than 8.8 pounds. When compared to newborns with healthy weights, HBW infants have higher risk of being injured during the birth process and of having birth defects. Furthermore, HBW infants are more likely to develop obesity, diabetes, and hypertension at some point in their lives. In 2006, about 8% of babies born in the United States were HBW

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Gestational diabetes can be detected during routine prenatal care. Diet and exercise are usually necessary to treat the condition, but in some cases, insulin injections are required.

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Heartburn is another common complaint of pregnant women. As the fetus grows, the uterus pushes upward in the mother's abdominal cavity and applies pressure on her stomach

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High levels of certain hormones can cause various tissues to retain fluid during pregnancy.Although the extra fluid causes some minor swelling (edema), especially in the hands and feet, the condition is normal.

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However, A pregnant woman's breasts do not form milk, because high levels of progesterone, a hormone that helps maintain pregnancy, inhibit milk production. After birth, the level of progesterone drops rapidly, essentially removing the "brakes" from the breasts' ability to produce milk.

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Human milk is a rich source of lipids, including cholesterol, and fatty acids such as linoleic acid, arachidonic acid (AA), and docosahexaenoic acid (DHA). An infant's nervous system, especially the brain and eyes, depends on AA and DHA for proper development. Furthermore, the fat in breast milk helps supply the energy needed to maintain the infant's overall growth.

colostrum

Human milk is uniquely formulated to meet the nutrient needs of a newborn baby. During the first couple of days after giving birth, the new mother's breasts produce ______, a yellowish fluid that does not look like milk.

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Hypertension is a common complication of pregnancy. In the United States,6 to 8% of pregnant women develop high blood pressure.19 Pregnant women who have high risk of PIH are those who are under 20 or over 40 years of age, are overweight or obese, have a history of diabetes or hypertension, and are carrying more than one fetus. Major signs of preeclampsia include sudden weight gain, elevated blood pressure, edema, and protein in urine.

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If a woman is physically active during her pregnancy, she may need to increase her kilocalorie intake by even more than these levels. Why? As the pregnant woman gains weight, her muscles require more energy to move her body. The average expectant mother, however, reduces her physical activity level during the third trimester, conserving energy.

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If the nausea and vomiting contribute to weight loss of more than 2 pounds, the pregnant woman should contact her physician for treatment. Morning sickness that persists beyond the fourth month of pregnancy should also be brought to the attention of a physician.During pregnancy, excessive vomiting is harmful because it can lead to dehydration and nutritional deficiencies.

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If they are unaware that colostrum is secreted by breasts soon after birth, women may think something is wrong with their ability to produce milk. However, colostrum is a very important first food for babies, because the fluid contains antibodies and immune system cells that can be absorbed by the infant's immature digestive tract.

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In 2006, 21% of women in the United States gained more than 40 pounds during pregnancy. Women who gain excess weight during pregnancy are likely to retain the extra pounds long after their babies are born

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In 2009, about 2% of births were very preterm, that is, the infants were born before 32 weeks of gestation.Very preterm infants are more likely to have serious health problems or die soon after birth than babies delivered after 32 weeks of pregnancy

casein

In addition, infants have more difficulty digesting ____, the major protein in cow's milk, than the major proteins in human milk. Cow's milk can also contribute to intestinal bleeding and iron deficiency.Thus, whole cow's milk should not be fed to infants until they are 1 year of age. Furthermore, fat-reduced and fat-free cow's milk are too low in energy to be given to most children until they are 2 years of age

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In most cases, mild edema does not require treatment such as restricting salt intake or taking diuretics. Edema, however, can be a sign of trouble if hypertension and the appearance of extra protein in the urine accompany the swelling.

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In the first trimester, a pregnant woman's daily energy requirement (Estimated Energy Requirement or EER) is essentially the same as a nonpregnant woman's, because the embryo/fetus is quite small. However, the fetus grows rapidly during the second and third trimesters, and the pregnant woman requires more energy and nutrients to support its growth as well as her own body's needs.

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Infant formulas, however, have uniform composition; that is, they do not change their fat content during a feeding session. Thus, the mother or infant caregiver is more likely to control the amount of formula the baby consumes, possibly leading to overfeeding. Nevertheless, the overall energy content of human milk is about the same as that of infant formulas (about 20 kcal per ounce).

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It is important to understand that much of the weight a woman gains during a healthy pregnancy is not body fat.By the end of a full-term pregnancy, the average fetus weighs about 7½ pounds, and the placenta and amniotic fluid that surrounds the fetus account for about 3½ pounds. The remaining weight is comprised of tissues and fluids the mother's body gains during pregnancy (maternal weight gain).

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Lactating women need to be aware of the connection between their emotional state and failure to let down. To smooth the path to successful lactation, it helps if new mothers are in a comfortable, relaxed environment when they breastfeed their babies. When lactation and breastfeeding are well established, the let-down response often occurs without the need for suckling.

preterm

Low birth weight is often associated with premature or preterm births. In 2009, approximately 12.2% of births in the United States were ______; that is, they occurred before the 37th week of pregnancy. Preterm birth and LBW are one of the leading causes of death among American infants who are less than 28 days of age

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Milk production requires approximately 800 kcal every day. However, the lactating woman's daily energy needs can be met by adding only about 300 to 400 kcal to her prepregnancy EER.

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Most American women have normal pregnancies and deliver healthy infants, but some women experience serious health problems such as PIH. At present, the only effective treatment for PIH is delivering the fetus, but infants born before the 24th week of pregnancy are unlikely to survive. If the fetus is older than 24 weeks, its mother may be hospitalized for treatment. This practice helps physicians monitor the mother's condition and enables the fetus to mature until it has a better chance of surviving after a premature birth.

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Nearly all healthy women are physically capable of breastfeeding their infants. In 2008, about 75% of American women started breastfeeding their babies soon after birth. Within 2 days of birth, almost 25% of the breastfed babies were also consuming formula. By the time the infants were 6 months old, 43% continued to be breastfed. By their first birthday, only about 24% of the babies were still being nourished with their mother's milk.

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Nearly all pregnant women experience weight gain. In fact, gaining an appropriate amount of weight is crucial during pregnancy. How much weight a woman should gain depends on her prepregnancy weight.

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Nevertheless, a pregnant woman does not need to double her usual food intake just because she is "eating for two." Table 13.1 compares Recommended Dietary Allowances (RDA) for energy and selected nutrients that apply to healthy 25-year-old nonpregnant and pregnant women.

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No special foods are necessary to sustain milk production. However, a lactating woman should drink fluids every time her infant suckles to help her maintain adequate milk volume and keep her body properly hydrated. For as long as she breastfeeds her baby, the lactating mother should limit her intake of alcohol- and caffeine-containing beverages because her body secretes these drugs into her milk.

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Obese women have a greater risk of developing hypertension as well as type 2 diabetes during pregnancy.Obese pregnant women are also at risk of giving birth to HBW babies. However, women should not try to lose weight while they are pregnant because calorie restriction may harm the fetus.

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Preeclampsia is characterized by sudden, dramatic increase in weight that is due to edema, particularly of the hands, calves, and face; hypertension; and protein in urine.18 If a woman suffering from preeclampsia develops convulsions, her condition is called eclampsia. In the United States, eclampsia is the second leading cause of death among pregnant women

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Pregnancy is not the time to begin an intense fitness regimen or perform high-risk physical activities. Activities that are risky and should be avoided include downhill skiing; contact sports such as judo, soccer, and basketball; and scuba diving. Pregnant women should discuss their physical activity practices and needs with their physicians. Some expectant women, such as those experiencing PIH or premature labor contractions, may need to restrict their physical activity.

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Pregnant females who are 45 to 54 years of age or under 15 years of age are more likely to give birth to low-birth-weight infants than women in other age groups. Additionally, women who smoke during pregnancy are at risk to have LBW babies

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Pregnant women should refrain from practicing pica, especially eating clay or soil. Soil may contain substances that interfere with the absorption of minerals in the intestinal tract. Furthermore, eating soil can be harmful because the dirt may be contaminated with toxic substances, such as lead and pesticides, and pathogenic microbes.

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Prior to pregnancy, sedentary women can begin an exercise regimen; overweight or obese women can lose some excess weight; and women who smoke can join smoking cessation programs. The time to remedy faulty lifestyle practices and increase chances of having a healthy pregnancy and baby is long before pregnancy occurs.

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Rapid physical growth characterizes infancy, the life stage that extends from birth to about 2 years of age.During the first 4 to 6 months of life, a healthy baby doubles its birth weight, and by 1 year of age, an infant's birth weight has tripled.

pregnancy-induced hypertension (PIH)

Rapid weight gain, especially after the fifth month of pregnancy, could be a sign of a serious type of hypertension called _______. PIH is commonly referred to as preeclampsia

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Rather than view pregnancy as a time to splurge by eating energy-dense empty-calorie foods, the mother-to-be should obtain the extra calories from nutrient-dense foods. for example, drinking an additional cup of fat-free milk, eating a bowl of an enriched whole-grain cereal, and taking a prenatal supplement each day can supply extra kilocalories as well as protein, fiber, and micronutrients.

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SIDS is the sudden, unexplained death of an infant younger than 1 year of age and the leading cause of death for babies between 1 month and 1 year of age.

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Signs and symptoms of food allergies typically include the following: -Vomiting, diarrhea, intestinal gas and pain, bloating, or constipation -Itchy, swollen, or reddened skin -Runny nose and breathing difficulties, such as asthma

pica

Some women develop _____, the craving of nonfood items such as laundry starch, chalk, cigarette ashes, and soil. Some studies have linked pica with iron and zinc deficiency, but it is not clear if pica is the result or the cause of such deficiencies.

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Table 13.2 presents a day's meals and snacks for a sedentary 25-year-old woman who is in her second trimester of pregnancy.Her prepregnancy EER was 2000 kcal, so her sample menu is based on MyPlate recommendations for 2400 kcal, enough to cover her increased EER during this trimester.

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The FDA and the EPA also recommend that caregivers should not feed fish that contain high amounts of methylmercury to young children because their nervous systems are still developing.

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The difference between the energy needed for milk production and the recommended energy intake can enable the new mother to lose the extra body fat she accumulated during pregnancy. This loss is more likely to occur if she continues breastfeeding her baby for 6 months or more and increases her physical activity level. A woman, for example, who needed 2000 kcal before becoming pregnant would require about 2400 to 2600 kcal daily during lactation.

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The first trimester is a critical stage in human development because nutrient deficiencies or excesses and exposure to toxic compounds, such as alcohol, are most likely to have devastating effects on the embryo/fetus. However, many women who are in their first trimester do not realize they are pregnant.

embryo

The mass of cells buries itself into the nutrient-rich lining of the uterus and continues to develop.For the next 6 weeks, the rapidly dividing mass of cells, called an _____, increases in size and forms organs. Eight weeks after conception, the developing human being is referred to as a fetus

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The name "morning sickness" is misleading because the queasy feeling can occur at any time of the day. The cause of this unpleasant condition is unclear, but it may be the result of the pregnant woman's body adapting to higher levels of female hormones

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The practice of breastfeeding also provides some important advantages for parents, particularly the new mother. Breastfeeding is more convenient and economical than using infant formula. Human milk is readily available; there is no need to purchase cans of infant formula and have them on hand. As milk leaves the breast, it is always fresh, free of bacteria, and ready-to-feed without mixing, bottling, or warming. Because human milk production requires a considerable amount of energy, lactating women can lose the extra body fat gained during pregnancy faster than mothers who use infant formula.

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The prenatal development is often divided into three stages or trimesters. During the first trimester, the embryo/fetus develops most of its organs, and by the end of this period, the fetus can move.

gestation

The prenatal period (_______) encompasses the time from conception, the moment a male sperm cell enters a female egg cell, until the birth of a full-term infant, about 38 to 42 weeks later.

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The recommendations are higher for women who are pregnant with more than one fetus. For example, a healthy woman who is carrying twins may gain as much as 45 pounds during pregnancy. In 2009, experts with the Institute of Medicine (IOM) issued new weight gain guidelines for obese pregnant women. According to the experts, the obese women should limit their weight gain to 11 to 20 pounds

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The role of the placenta is to transfer nutrients and oxygen from the mother's bloodstream to the embryo/fetus. Additionally, the placenta transfers wastes from the embryo/fetus to the mother's bloodstream, so her body can eliminate them.

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The use of illegal drugs, herbal supplements, and medications during pregnancy can also harm the embryo/fetus. Ideally, the time to quit abusing illegal drugs is before pregnancy. Pregnant women should consult their physicians before using herbal supplements or taking any drugs, even over-the-counter medications.

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The woman's body transfers iron to the fetus to build its stores of the mineral. If women fail to meet their iron needs during pregnancy, their iron stores can be severely depleted, and they can develop iron deficiency anemia. Pregnant women who are iron deficient have high risk of giving birth prematurely and having low-birth-weight infants

placenta

Throughout the prenatal period, the embryo/fetus depends entirely on its mother for survival. During most of the pregnancy, the expectant mother nourishes her embryo/fetus through the _____, the organ of pregnancy that connects the uterus to the embryo/fetus via the umbilical cord

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Thus, women with this form of diabetes often give birth to high-birth-weight babies. After birth, these infants often have difficulty controlling their own blood glucose levels and are at risk of becoming overweight as children.

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To help control mild morning sickness, pregnant women can avoid odors and foods, such as fried or greasy foods, that trigger nausea. Some women find that eating crackers and drinking some water helps reduce the likelihood of feeling nauseated, especially before they get out of bed in the morning. Furthermore, eating smaller but more frequent meals and nutritious snacks can be helpful.

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To help prevent constipation, pregnant women should consume adequate amounts of fiber and fluids. During pregnancy, the Adequate Intake (AI) for fiber is 28 g/day, and the AI for total water is 3 L/day

infant formula

Today, a new mother can choose to nurse her baby or feed the child an ______, a synthetic food that simulates human milk. Although both foods provide adequate nutrition for young babies, breastfeeding provides benefits beyond nutrition for the new mother as well as her infant.

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Two hundred years ago, if a new mother was unable to breastfeed her baby, the child faced certain death—unless a woman who was producing breast milk could be located to suckle (nurse) the infant.

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Typically, a lactating woman produces over 3 cups of milk per day. It is important to recognize that milk production relies on "supply and demand." The more the infant suckles (demand), the more milk its mother's breasts produce (supply). However, if milk is not fully removed from the breasts, milk production soon ceases. This is likely to occur when infants are not hungry because they have been given baby food and formula to supplement breast milk feedings.

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Underweight women who do not gain enough weight during pregnancy are at risk of having preterm or low-birth-weight (LBW) infants. Underweight pregnant women should try to reach healthy weights by the end of the first trimester and then meet the recommended weight-gain goals.

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Unfortunately, the placenta does not filter many microbes and toxic substances, such as alcohol and nicotine, from the mother's blood.agents of infection and harmful chemicals can pass through the placenta, enter the embryo/fetus, and cause disease, birth defects, or embryonic/fetal death.

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Vitamins and minerals are added to the product, and in some instances, infant formula contains higher levels of micronutrients than human milk. Although infant formulas mimic the water, macronutrient, and micronutrient content of human milk, their compositions are not identical to human milk. Formula manufacturers have been unable to duplicate human antibodies and other unique immune system factors that are in breast milk.

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When an infant suckles, nerves in the mother's nipple signal her brain to release prolactin and oxytocin into her bloodstream. Prolactin stimulates specialized cells in breasts to form milk.These cells carry out the lactation process by synthesizing some nutrients and removing others from the mother's bloodstream and adding them to her milk.

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When this occurs, stomach acid can enter the esophagus, causing heartburn . To help avoid heartburn, the pregnant woman can consume smaller meals, avoid lying down after eating, eat less fatty foods, and learn to identify and avoid foods that seem to contribute to heartburn. If heartburn continues to be bothersome, the woman should consult her physician and discuss other ways to treat the condition.

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Women can derive many benefits from being physically active during pregnancy, including enhanced muscle tone and strength, reduced edema, and improved mood and sleep. Most pregnant women can continue their prepregnancy exercise regimens, especially those that included low- or moderate-intensity activities. However, the exercise routine should not result in weight loss. Recommended activities generally include walking, cycling, swimming, or light aerobics.

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Women of childbearing age should take steps to ensure good health before becoming pregnant. For example, women can analyze the nutritional adequacy of their diets and choose to eat foods that correct any marginal or deficient intakes.

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Women who breastfeed their newborns often stop the practice within 6 months. There are many reasons why women discontinue nursing their infants too soon. New mothers often quit because they lack information about and support for breastfeeding their babies. Some women discontinue breastfeeding because of uncertainty over how much milk their babies are consuming. Baby bottles are marked to indicate ounces, so a mother who bottle-feeds her infant can easily measure the amount of formula consumed.

Prenatal care

_____ is specialized to meet the health care needs of pregnant women. Routine prenatal health care includes measuring and monitoring the pregnant woman's weight, blood pressure, blood glucose level, and uterine growth. The prenatal health care provider may also discuss various concerns with the expectant mother, such as morning sickness, safe types of physical activity, what to expect during the birth process, and basic infant care skills.

Low-birth-weight (LBW) infants

______________ generally weigh less than 5½ pounds at birth. In 2009, about 8.2% of infants born in the United States were low birth weight. Additionally, women who smoke during pregnancy are at risk to have LBW babies

Allergies

______are immune system responses to the presence of foreign proteins in the body. Allergies to proteins in foods, especially cow's milk proteins, often begin in infancy and may persist through childhood.

Oxytocin

______plays a different role in establishing successful lactation. This hormone signals breast tissue to "let down" milk. The let-down reflex enables milk to travel in several tubes (ducts) to the nipple area.

sudden infant death syndrome (SIDS).

compared to pregnant women who do not smoke cigarettes, expectant mothers who smoke have higher risk of giving birth too early and having LBW babies. Furthermore, expectant mothers who smoke cigarettes may increase the risk of having babies with birth defects or that die of _______

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emotional stress and certain foods can contribute to nausea. The condition generally begins early in the first trimester, and most women are no longer affected by the sixteenth week of pregnancy. However, some women experience nausea and vomiting occasionally throughout their pregnancies.

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in the first trimester, most women experience physical signs that they are pregnant, such as enlarged breasts and "morning sickness."Other common nutrition-related signs as well as complaints of pregnancy include extreme tiredness, swollen feet, constipation, and heartburn. In most cases, such discomforts do not create serious complications and they resolve within a few months.

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physiological anemia may be responsible for the extreme tiredness experienced by pregnant women during their first trimester. As their red blood cell numbers increase, expectant mothers report having more energy, especially during the second trimester.

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pregnant women who are folate deficient have high risk of giving birth to infants with neural tube defects, such as spina bifida. To obtain adequate folate, women of childbearing age as well as pregnant women should include rich food sources of folate in their diets, such as green leafy vegetables, and take a vitamin/mineral supplement that supplies at least 400 mcg of folic acid, a form of folate.

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to produce artificial milk for babies, infant formula manufacturers alter cow's milk to improve its digestibility and nutrient content. Infant formulas generally contain heat-treated proteins from cow's milk, lactose and/or sucrose, and vegetable oil. Infant formulas generally lack cholesterol, but some of these products have the fatty acids DHA and AA added to them.

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women of childbearing age should plan for pregnancy and receive dietary advice before becoming pregnant. If this is not possible, prenatal care should begin early in pregnancy, because many medical problems that may occur during this life stage can be diagnosed and treated before the health of the mother or her fetus are threatened.

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(Some women report that colostrum leaked from their breasts late in the pregnancy.) By the end of the first week of lactation, colostrum has undergone a transition to mature milk. If you compare the appearance of mature human milk to cow's milk, you will notice that breast milk is more watery than cow's milk and may have a slightly bluish color.

According to recommendations issued by the U.S. Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA), women who may become pregnant, are pregnant, or are breastfeeding their babies should

-Eat up to 12 ounces of various fish and shellfish per week that generally contain small amounts of mercury, such as shrimp, canned light tuna, salmon, pollock, and catfish. (Albacore tuna contains more methylmercury than canned light tuna, but eating up to 6 ounces of albacore tuna per week is allowed.) -Avoid eating types of fish that often contain high amounts of methylmercury, particularly shark, swordfish, king mackerel, and tilefish.