Nutrition and Pregnancy: A Comprehensive Guide, Exams of Public Health

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what does the placenta do?

**1. provide nutrients from the mother's blood to the fetus

2. allow for the transfer of waste from the fetus into the mother's** system for excretion

list and describe the developmental stages of pregnancy

1. Fertilization (Day 0): An egg and sperm unite and produce a **zygote.

2. Blastogenic stage (Day 1 to 14): A period of rapid cell division** **Day 14: An embryo is formed.
3. Embryonic stage (Week 2 to 8): The organ system** develops.Week 5: The heart begins to beat. Week 8: The embryo **is now known as a fetus.
4. End of first trimester: Most organs are formed, and the fetus can** **move.
5. Fetal Stage (Week 9 to 40): Period of continual growth and** development why is extra iron needed during pregnancy? to increase blood volume to provide iron stores to the fetus

-animal products and fortified breakfast cereals

iron deficiency anemia of mom can lead to preterm delivery, low birth eight infants, and increased risk for fetal death calcium is needed for what in pregnancy? formation of the baby's teeth, bones, muscle, and heart

-if moms levels are inadequate, fetus will rob mom of her calcium stores true or false: moderate levels of physical activity are encouraged daily during pregnancy true A healthy body weight, properly controlling existing health conditions, and the avoidance of teratogens teratogens ompounds that can increase the risk of a birth defect examples: smoking, medications, recreational drugs, tobacco and alcohol by what week is the embryo known as a fetus? week 8 what is the best way to track an infant or child's growth?

through a growth chart describe what a growth chart measures From birth to 36 months, the length, weight, and head circumference

this is compared to infants of the same age based on percentiles a BMI of what can indicate a risk for obesity in children? of 85% or higher failure to thrive a condition in children younger than 2 years of age where poor growth is observed

mostly occurs due to inadequate feeding practices

can also occur if inadequate intake is due to disease (diarrhea, intestinal issues, etc) failure to thrive can lead to poor growth, impaired mental development, and behavioral issues infants require how much more calories per kg or body weight (compared to adults)? 2-4 times more Arachidonic acid (AA) and docosahexaenoic acid (DHA)

long chain fatty acids essential for brain and eye development

provided by breast milk, especially if the mother eats fish for infants, carb and protein needs can be met through intake of what? human milk or formula and solid foods In infants, excess protein can lead to what? it puts extra stress on the kidneys as they try to clear the waste products

can also lead to a food allergy as the immune system reacts to the protein true or false: breastfed infants require a vitamin D supplement true if a nursing mother is vegan, their infant will require supplementation of what vitamin? B- untreated anemia during infancy can lead to long-term effects of impaired mental development, motor development, and behavioral issues later in life

this is why iron fortified formula is recommended for non-breastfed infants signs of dehydration in infants dark yellow or strong-smelling urine, lack of wet diapers, dry mouth and lips, lethargy, and absence of tears when crying

in extreme cases, dehydration may lead to loss of kidney function when can solid foods be introduced into the diet? around 6 months of age extrusion reflex thrusting of the tongue forward to push food out of the mouth

disappears around 4-6 months, is a physical cue of being ready for solid foods how many days apart should new foods be introduced into an infant's diet? why? 7 days

what factors will improve the odds of a healthy pregnancy for both mom and baby? a normal pregnancy is about how long? how many trimesters?

40 weeks; 3 first trimester -important for fetus development and growth -quality of mom's diet is more important than the quantity second trimester development of hands, feet, arms, and legs

physiological changes in mom to prepare her for birth third trimester critical period of growth as fetus doubles in length and will increase weight to about 7-9 pounds what is the benchmark period for an infant to be born? after 37 weeks preterm an infant born prior to the 37 weeks benchmark

likely to have increased medical conditions and delayed growth in their first few months of life low birth weight (LBW) An infant weighing less than 5.5 pounds, regardless of their gestational age

small for gestational age (SGA) An infant small in size, measured relative to its gestational stage what factors can increase the chances of a successful pregnancy? an adequate diet, accurate education, and proper prenatal care during pregnancy, one should consider what? calories, adequate weight gain,increased protein and carbohydrate needs, vitamin needs, increased mineral needs, fitness and teratogens, , and a balanced died calories and pregnancy -limiting foods high in sugar and fats, focus on nutrient dense foods calorie needs during the second and third trimester increase by.. about 20% adequate weight gain -a healthy weight gain of 25-35 pounds during pregnancy (1-4 during T1, then 1 per week after that) weight gain recommendation during pregnancy for each BMI group underweight: 28-40lbs normal: 25-35lbs overweight: 15-25lbs obese: 11-20lbs increased protein and carb needs

pregnant moms require an addition of 25g/day what happens if an inadequate amount of carbs are ingested during pregnancy? the body will turn to fat for energy, producing ketones, inhibits brain development of the fetus vitamin needs vitamin demand increases, especially B vitamins folate and pregnancy folate is needed for cell development, synthesis of DNA, proper RBC development

without proper intake, mom may develop anemia increased mineral needs iodide, zine, iron, and calcium

iodide and zinc: animal products, iodized salt, and fortified breakfast cereals tobacco use during pregnancy can lead to increased risk for miscarriage, stillbirth, preterm delivery, and low birth weight infants fetal alcohol syndrome

results in physical and mental disabilities and growth slowness drugs during pregnancy increase the risk for low birth weight, preterm delivery, miscarriage, birth defects, and infant addiction a balanced diet consists of whole grains, a variety of fruits, a variety of colorful vegetables, low-fat or fat-free dairy products, healthy fats, and protein

-lean cuts of meat, avoiding processed meat -avoiding certain fish due to high levels of mercury what physical changes are common during pregnancy? heartburn, morning sickness, and constipation heartburn occurs when the backflow of stomach acid enters the esophagus and causes a burning sensation why are pregnant women more susceptible to heartburn? hormones produced by the placenta relax muscles in the gastrointestinal tract responsible for preventing this backflow

avoid high foods that rigger the reflux, spicy foods, and lying down for an hour after eating

morning sickness pregnancy related nausea

avoid greasy foods, eat smaller meals, good ventilation while cooking, and avoid large amounts of liquid at one time why does constipation occur in pregnancy? intestinal muscles relax as the fetus grows, hinders the natural process

alleviate this by intaking more fluid or moderate exercise with your doctor's approval physiological anemia blood volume increases and the concentration of red blood cells is diluted gestational diabetes blood glucose levels rise because the insulin levels are insufficient to transport glucose from the blood to the cells

occurs between the 24th and 28th week of pregnancy

at risk: women over 35, family history of diabetes, overweight women uncontrolled diabetes during pregnancy can lead to

large baby, needing a C-section, increased risk of trauma at birth preeclampsia (pregnancy induced hypertension) Edema, or swelling of the tissues, occurs as well as increased blood pressure, protein in the urine, and changes in blood clotting

may lead to kidney failure, convulsions, or death if left untreated

women under 17 or over 35, history with this condition, and overweight/obese women are most at risk

limit sodium and increased calcium and potassium to help prevent onset pica an abnormal craving for both food and nonfood items

usually caused by a nutrient deficiency what factors may influence a woman's decision to breast or bottle feed her infant? education, social concerns, working, or physical inability to nurse education and baby feeding

misinformation causing a new mother to choose bottle feeding over breast feeding

La Leche League offers classes in breast feeding working and baby feeding working outside the home and breast feeding may be hard to maintain

the use of breast pumps has helped to alleviate this physical inability to nurse -impossible to nurse due to breast or nipple anatomy -demands of the baby may be too high -production of milk may be inadequate how does the body ready the breasts for breastfeeding? by increasing the amount of fat in the breast tissue and maturation of the structure lobules sac-like structures in the breast for milk storage prolactin secreted by the pituitary gland to produce milk letdown reflex

causes the release of milk from the milk ducts in the breasts during nursing oxytocin stimulates the lobules in the breast, which in turn stimulates the letdown reflex colostrum a thick yellowish substance, is secreted from the breast for the first few days following delivery

-rich in protein and immune factors, protecting the intestinal health of the newborn how long does it normally takefor a feeding routine to be established and for milk supply to meet demand? about 2-3 weeks should cows milk be given to an inant? no, it shouldn't be given to any child under the age of 12 months

it's too hard for an infant to digest due to it's level of protein and minerals

can lead to cow's milk allergies later in life how can a mom ensure adequate milk production?

by getting plenty of rest, finding a relaxed atmosphere in which to nurse, and eating healthy

drinking about 13 cups of fluid per day

diet of at least 1800 calories the need of what vitamins increases during lactation? A, E, C, and riboflavin breastfeeding is linked to a lower risk of what health problems in infants? ear infections, diarrhea, atopic dermatitis, asthma, obesity, etc breastfeeding is linked to a lower risk of what health problems in mom? -Type 2 diabetes -Breast cancer -Ovarian cancer -Postpartum depression (PPD) how does an infant's weight change in their first 4-6 months of life? in their first year of life? weight will double

weight will triple

how does undernutrition present itself in children? they are short and underweight for their age why does undernutrition occur in developing countries? in the US? breastfeeding ceases and they rely on rice as their main source of food

poverty

to monitor for potential allergies what foods should never be given to a child under one year of age? honey (contains sores of Clostridium botulinum, can lead to botulism, can be fatal)

choking hazard foods (small round foods, sticky foods, and hard foods)

excess juice (apple or pear; calcium deficiency, failure to thrive, poor dental health and obesity, diarrhea)

cow, goat, and unpasteurized milk (inability to digest the proteins, can result in food posioning) when can self-feeding skills be practiced? by 6-7 months of age

offering what kinds of foods will help to establish a healthy eating pattern in toddlers? nutrient-dense foods with limited sugar, fat, and sodium one bite rule encourages the child to try one bite of each food food jags the desire to eat the same foods or only a certain color at each meal feeding difficulties with preschoolers my child is a picky eater, my child always wants a snack, my child won't eat vegetables a good measuring tool for intake for toddlers 1 tablespoon of fruits, vegetables, and meat/beans per year of life how to enable a child to meet their nutrient needs Offering 6 small meals through the day and focusing on nutrient-dense choices

offering whole fruits and vegetables rather than juice, diet soda, milk and water with meals daily juice limit for children 1-6, for children 7- no more than 4-6 ounces per day

no more than 8-12 ounces per day a multivitamins often recommended for children? no

it IS accepted if the multivitamin doesn't exceed 100% of the Daily Values three common conditions affecting nutrient deficient preschoolers iron deficiency anemia, constipation, and dental caries (cavities) iron deficiency anemia in preschoolers

constipation

dental caries manifests between 6 and 24 months; can lead to decreased energy, learning ability, decreased immunity, and increased risk of disease

increasing fiber intake and consuming 4-5 cups of fluid daily; encouraging the child to use the bathroom when the urge arises

when sugar from beverages or food lie on the teeth or gums for an extended period of time; wipe infants gum and teeth after drinking or

eating; for toddlers-avoid sticky, high sugar snacks; brush with a small amount of fluoridated toothpaste For children who avoid animal products, emphasis should be placed on an adequate intake of.. plant sources of protein, vitamin D, vitamin B-12, calcium, iron, and zinc For children who are autistic, nutritional treatment can come from... gluten-free, casein-free diet and supplements of vitamin B-6, magnesium, probiotics, and essential fatty acids for school age students, their diets tend to be lacking in what? but are often high in what? calcium, iron, and zinc

sugar and fat concerns that may occur during the school age years that may impact a child's nutritional status lack of regular meal times, excess consumption of saturated fat, increasing incidence of overweight and obesity, and early onset of cardiovascular disease and type 2 diabetes lack of regular meal times tends to be true for breakfast; "breaking the fast"

breakfast is important for for meeting daily requirements of vitamins and minerals

anything can be eaten for breakfast; it's important to combine a good source of protein with a carbohydrate to provide energy until lunchtime excess consumption of saturated fat small diet changes can lower fat consumption (switching to low-fat milk, baking instead of frying, taking the skin off of chicken, etc)

over restriction of fat can lead to eating disorders later in life what factors are leading to an increase in childhood obesity? Supersized portions, fast food, convenience foods, increased soft drink consumption, and easy access to sugar-laden snack foods

coupled with lack of physical activity, often related to decreased gym time at school, a lack of safe play areas, and increased TV viewing time health professionals recommend how much vigorous activity per day for children and teens? 60 minutes treatment for early onset of cardiovascular disease and type 2 diabetes balanced diet and physical activity to achieve a healthy weight changes during teenage years for females; for males

females (10-13): growth in height, accumulate lean and fat tissue, sexual development, beginning of menstrual cycle

males(12-15): body weight from lean tissue, growth in height of about 1 foot, increase in appetite what factors affect food choices for teens? Peer pressure, concern over physical appearance, and exertion of their independence

most of their diets are low in calcium, iron, zinc, fat-soluble vitamins, and folate what diseases commonly manifested in middle ages can be controlled or prevented? hypertension, diabetes, cardiovascular disease, osteoporosis, and obesity what is the fastest growing population in the US? those of 85 years and older what are the four stages of adulthood? how are they divided? 19-30, 31-50, 51-70, and >

young adulthood: 19- middle adulthood: 51-

older adulthood: >70 aging After age 30, we experience both physical and physiological changes that occur in body structure and function until age __, rates of cell synthesis and breakdown are in balance 30 how does cell synthesis and breakdown change after age 30? breakdown occrs faster than cell synthesis, leading to a decline in body functions what are the components of a healthy lifestyle? a nutritious diet, exercise, adequate sleep, and avoiding poor lifestyle choices (such as smoking and excess alcohol consumption) usual aging the expected progression of cell death with age and the physical changes that occur related to unhealthy lifestyle choices

examples: loss of bone mass, weight gain, high BP, and decreased lean body mass successful aging physical and physiological changes that occur related to growing older but not related to poor lifestyle choices

These individuals age at a slower rate and experience age-related diseases later than usual agers compression of morbidity Delay of disabilities caused by age-related disease what factors directly affect an individual's again process? (1) heredity, (2) lifestyle, and (3) environment what nations have the longest life expectancy? Okinawa, nations that follow the Mediterranean diet what environmental factors can negatively impact our health and speed up the aging process? education and available resources, adequate shelter, sufficient income the consumption of nutrient dense foods will.. delay the onset of some diseases; increase our physical, mental, and social well-being; improve our immune system; and aid in recovery from illness the Dietary Guidelines recommend a diet... low in saturated and trans fats in conjunction with a diet that is low in cholesterol, simple sugars, and sodium

also maintaining a healthy weight through daily exercise and increasing safe food handling practices

by utilizing complex carbohydrates rather than simple carbohydrates, one can lower their risk for colon cancer and heart disease, prevent constipation, and lower blood cholesterol levels nutrients lacking in the older individuals' diet include potassium, calcium, vitamin D, vitamin B12, carotenoids, dietary fiber, and minerals such as iron, zinc, and magnesium what dietary approach was developed in order to ensure that older adults get enough nutrient? the DASH diet symptoms of dehydration disorientation and mental confusion, constipation, bowel impaction, and eventually death what are the two main factors that are related to the nutrient needs or adults and nutrition concerns that occur with aging? physiological and psychosocial physiological factors sarcopenia, skeletal system changes, digestive system changes, chronic disease, and medications sarcopenia a loss of lean muscle, leads to a decreased basal metabolic rate

causes an increase in fat stores (sarcopenic obesity) a sedentary lifestyle influenced by again can lead to decreased mobility, joint issues related to increased weight and decreased physical activity, as well as decreased flexibility skeletal system changes bone loss related to osteoporsis, decreased bone mass digestive system changes related to lactose malabsorption and decreased stomach acid

constipation due to lack of fluids, fiber, exercise, and decreased GI motility

gallbladder, liver, and pancreas functions also decline with age chronic disease related to malnutrition, altered nutrient utilization, and altered nutrient needs affects many of the elderly

those over 65 in an institutional setting are at risk psychosocial factors social isolation (lack of support from family and friends leading to poor intake)

depression (leds to sical withdrawal, poor appetite, weight loss, and malnutrition)

Alzheimer's disease or dementia (loss of memory, confusion, and decreased social contact)

economic factors (inability to purchase food or nutrient-dense choices affecting the quantity and quality of the diet) DETERMINE a nutrition checklist that can be performed by medical personnel, family members, and even the older person themselves to evaluate the individual's needs DETERMINE stands for Disease: Alzheimer's disease, cancer, heart disease, or others

Eating poorly

Tooth loss

Economic hardship