Infant and Child Nutrition Quiz 2 (Chapter 4 and 5) (Pregnancy 1)

Essential Fatty Acids specific nutritional needs

(target fats should include EFAs and choline which include milk, eggs and peanuts)

Protein specific nutritional needs

25 g/day more 1.1 g/kg/day

What are the Energy Needs during First Trimester and how many pounds should you gain?

-Energy needs essentially the same -2 to 4 pound gain during this trimester

What are the 5 Pregnancy side effects specifically related to progesterone?

-*Nausea (ginger helps) -Liquid/Food separate -Avoid triggers -Due to reverse peristalsis -*Hyperemesis gravidarum-Excessive Vomiting -*Constipation -*Hemorrhoids: enlarged veins in the mucous membranes inside or outside of the rectum -*Heartburn -Small, frequent meals -Head-up/avoid triggers

What are the Energy Needs during Second Trimester? How much calorie increase and what is a normal weight gain per week for second trimester?

-340 calorie/day increase in energy needs -Normal wt: 0.75-1# gain/week

How many calories per day increase for energy needs during third trimester?

-452 calorie/day increase in energy needs

Protein & Fat Metabolism: Protein daily need? Increased need for what? RDA for Protein during pregnancy? How many grams per kilogram?

-71 g daily needed -Increased needs for Nitrogen & protein for maternal & fetal tissue synthesis -RDA = 25 grams protein needed above pre-pregnancy levels -1.1 g/kg

Recommendation for Fish when pregnant? What should you limit?

-8-12 oz seafood/week -Limit albacore & white tuna to <6 oz/week

Artificial Sweeteners

-Based on current knowledge...total abstinence is not required -HOWEVER - recent research has shown an increased risk of preterm delivery with daily consumption of artificially sweetened beverages -Women with phenylketonuria must avoid aspartame (Equal) avoid

What is Carbohydrate Matabolism during pregnancy? What is the "diabetogenic effect of pregnancy? What is the RDA for CHO? What percentage of kCals for CHO during pregnancy?

-Changes made to make glucose available to meet fetus' brain requirements -"diabetogenic effect of pregnancy" -RDA for CHO = 175 g/day -45-64% of total kcals as CHO

What is a desirable birth weight and What are they less likely to develop if carried to birth?

-Desirable birth weight: 3500-4500 grams (seven pounds and twelve ounces to ten pounds) -Less likely to develop heart and lung diseases, diabetes, and hypertension

What are the Pregnancy side effects not related to progesterone? (2)

-Edema -fluid accumulation -Taste Alterations

What is listeria? and What should you avoid eating when pregnant in order to avoid getting listeria?

-Food borne infection miscarriage or infection to baby -Avoidance of unpasteurized milk, soft cheese (brie, feta, camembert and blue cheese, queso blanco, queso fresco), refrigerated smoked seafood, raw cabbage, luncheon meats & hot dogs

What constitutes a successful pregnancy? What development is sufficient in a successful pregnancy? What is a surfactant? What is a low birth weight?

-Gestation longer than 37 weeks -Sufficient lung development -Surfactant: A substance lining the air sacs in the lungs which enhances expansion of the lungs during inspiration -Birth weight > 5.5 pounds (2500 g) -Low Birth Weight

Protein & Fat Metabolism: What is there an increase of with fat metabolism? What synthesis and what is formed?

-Increased triglycerides, HDL, LDL & phospholipids -Steroid hormone synthesis -Nerve and Cell membrane formation

The Status of Pregnancy Outcomes: What does infant mortality reflect? What are decreases in Mortality related to?

-Infant mortality reflects general health and socioeconomic status of a population -Decreases in mortality are related to improvements in social circumstances, infectious disease control, and availability of safe and nutritious food -Low income, low pregnancy outcome

What is produced by Fasting Metabolism during pregnancy? What two things are problematic?

-Ketones produced -Resulting from > 12 hour fast breakdown of fatty acids Problematic -Reduced growth -Impaired intellectual development

What weight classification is LGA? What happens when the baby weighs over 10 pounds?

-Large for gestational age >90th percentile > 4500 g (10 lb) or greater, higher risk for shoulder dislocation and other issues *related to mom having diabetes

The Status of Pregnancy Outcomes (cont'd.): What babies are at high risk of dying in first year of life? What percent of births are low birth weight and take up what percent of infant deaths? What percentage are preterm?

-Low birthweight (LBW), preterm delivery, and infant mortality High risk of dying in first year of life -Eight percent of births are LBW, yet comprise 66% of infant deaths -11.4% are born preterm; account for a large number of infant deaths

What does dSGA mean? What two things are normal? What is it also called?

-Newborn weight is less than 10th percentile of weight for gestational age -Length and head circumference are normal -Also called asymmetrical SGA

What is Hemoglobin (Hgb)? How is hemoglobin formed? What are non-pregnant needs? What would low hemoglobin be indicative of?

-Oxygen carrying pigment in red blood cells -Formed by developing RBC in bone marrow -Non preg - 13-14 g/100 mL -Low would be indicative of iron deficiency

What can happen with Smoking While Pregnant? (4) What is a correlation between smoking while pregnant?

-Pre-term -Accounts for 20-30% of LBW babies; 14% of preterm deliveries; 10% of infant deaths -Increased risk of colds, lung problems, learning disabilities and physical growth problems -Childhood cancer -*Correlation between SIDS and Smoking or even others in the house smoking when a woman is pregnant

What does progesterone do?

-Progesterone relaxation of GI muscles; allows greater absorption of nutrients

What weight classification pSGA? What is pSGA mean? What percentile is pSGA? What is it also called?

-Proportionately small for gestational age -Newborn weight, length and head circumference are less than -10th percentile for gestational age -Also call symmetrical SGA

What three things are Off limits when pregnant?

-Raw fish -Raw sprouts -Unpasteurized juice

What does research say about Caffeine Intake While Pregnant? (4)

-Research is mixed. > 300-500 mg increased risk of miscarriage & delays conception Increased caffeine LBW baby -Former Advice: limit to 200 mg daily -3 cups or less coffee daily is acceptable.

What weight classification is SGA? What does it mean? What percentile? What is it also called?

-Small for gestational age < 10th percentile for gestational age -Also called small for date (SFD)

What is Hematocrit? What is the percentage needed for non pregnant and pregnant?

-Volume percentage of RBC in whole blood -Non preg - 35% -Pregnant - 29-31%

What is hemodilution?

-fewer RBCs; amount of Hgb decreases naturally

**Know This-Table 4.16: How much weight gain for pregnancy is recommended for Twin Pregnancy?

25-54 Ib (11.4-24.5 kg)

Water specific nutritional needs

8-10 c fluid daily

What is Low Birth Weight (LBW) in Grams and Pounds and What contributes to it? (3)

< 2500 grams (about 5 1/2 pounds) -Underweight prior to pregnancy -Low pregnancy weight gain -Smoking during pregnancy

What is considered Preterm and what are two common causes of preterm birth?

< 37 weeks -Maternal infections -Iron deficiency anemia early in pregnancy

What are Specific Nutritional Needs for Calcium ?

Calcium 1000 mg/day Increased absorption

Choline specific nutritional needs

Choline Structural component of cell membranes; necessary for brain development Milk, liver, eggs, peanuts

Pica: Amylophagia

Consuming Uncooked Starch, like Corn Starch & Flour

Pica: Pagophagia

Eating Ice, extreme craving for Ice

Pica: Geophagia

Eating/ craving things that have to do with the earth, like dirt, rock and clay

Folic Acid specific nutritional needs

Folic Acid 600 micrograms/day NTDs have decreased by ~ 70% since fortification.

Iodine Specific Nutritional Needs

Iodine Deficiency early in pregnancy hypothyroidism in offsrping Worldwide deficiency is leading cause of mental retardation 220 mg/day

What are Specific Nutritional Needs for Iron?

Iron 27 mg/day RDA 30 mg/day

Magnesium specific nutritional needs

Magnesium Inadequate intake common among US women

What is pica usually more common to happen with?

More likely to happen with iron deficiency

**Know This-Table 4.16: How much weight gain for pregnancy is recommended for Normal Weight BMI?

Normal Weight, 18.5-24.9 kg/m2 25-35 Ib (11.4-15.9 kg)

**Know This-Table 4.16: How much weight gain for pregnancy is recommended for Obese BMI?

Obese, 30 kg/m2 or higher 11-20 Ib (5.0-9.1 kg)

**Know This-Table 4.16: How much weight gain for pregnancy is recommended for Overweight BMI?

Overweight, 25-29.9 kg/m2 15-25 Ib (6.8-11.4 kg)

What is a Pro of eating fish when pregnant?

Pro: -healthy fats -Brain & eye development

What are the Problems with eating fish when pregnant?

Problem: -Mercury -Damage to nervous system

**Know This-Table 4.16: How much weight gain during pregnancy recommended for Underweight BMI?

Underweight, <18.5 kg/m2 28-40 Ib (12.7-18.2 kg)

Vitamin A specific nutritional needs

Vitamin A < 3000 micrograms/day

Vitamin D Specific Nutritional Needs

Vitamin D 3 cups milk daily Sunlight Other sources: fatty fish, liver, egg yolks)

What are Zinc's Specific Nutritional Needs?

Zinc 11 mg/day; advise 15 mg/day for vegan pregnant women