Chapter 13 LIFE CYCLE NUTRITION Mother and Infant Preparing

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Chapter 13 LIFE CYCLE NUTRITION

• Mother and Infant

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Preparing for Pregnancy

• A mothers nutritional status before and during
  pregnancy can affect a childs health for the
  rest of its life.
• Mothers should establish good eating habits prior
  to becoming pregnant. Nutrient stores are
  especially important for early development even
  before the mother learns she is pregnant.

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Preparing for Pregnancy

• Dads should also focus on good nutrition and
  avoid alcohol.

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Preparing for Pregnancy

• Prepregnancy weight
• Mother too thin-low birth weight babies with a
  variety of health problems
• Low IQ, other brain impairments learning
  difficulties
• Short stature
• Babies under 5 ½ lbs. are 40X more likely to die
  in the 1st year.

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Preparing for Pregnancy

• Prepregnancy weight
• Mother too fat gestational diabetes,
  hypertension infections in the mother. Babies
  are large (even when premature) and may have
• Heart defects
• Neural tube defects

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Preparing for Pregnancy

• Implantation of zygote and development of the
  placenta depends on good nutritional status
  prior to conception.
• Placenta is the connection between the babys and
  the mothers blood, fig 13.2.
• Provides nutrients, hormones antibodies to the
  fetus.
• Removes waste products from the fetus.

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Fig. 13-2, p. 483
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Preparing for Pregnancy

• Placenta also secretes hormones and enzymes that
  support pregnancy and prepare the mothers
  breasts for lactation.

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Events of Pregnancy

• 1st 2 weeks, fig 13.3
• Fertilized egg divides repeatedly and implants in
  the uterine wall.
• Placenta begins to develop and embryonic tissues
  form.
• Problems failure to implant, neural tube
  defects.

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• A newly fertilized ovum is
• about the size of the period
• at the end of this sentence.
• This zygote at less than one
• week after fertilization is not
• much bigger and is ready for
• implantation

Fig. 13-3a, p. 485
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Events of Pregnancy

• 2-8 weeks
• Continued development of the placenta.
• At 8 weeks the embryo has complete nervous and
  digestive systems, a beating heart, defined
  fingers and toes, and beginnings of facial
  features.
• Calcification of the skeleton begins.

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(2) After implantation, the placenta develops and
begins to provide nourishment to the developing
embryo. An embryo five weeks after fertilization
is about 1/2 inch long
Fig. 13-3b, p. 485
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Events of Pregnancy

• 8 weeks term rapid growth and development of
  organ systems in fetus. Mothers uterus expands
  and supporting muscles strengthen, breasts
  prepare for lactation, blood volume increases by
  ½.

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(3)A fetus after 11 weeks of development is just
over an inch long. Notice the umbilical cord and
blood vessels connecting the fetus with the
placenta.
Fig. 13-3c, p. 485
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(4)A newborn infant after nine months of
development measures close to 20 inches in
length. The average birthweight is about 7 1/2
pounds. From eight weeks to term, this infant
grew 20 times longer and 50 times heavier.
Fig. 13-3d, p. 485
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Events of Pregnancy

• Critical periods
• Times during which tissues and organs
  differentiate and mature.
• If proper building blocks (proteins,
  carbohydrates, lipids) are not present the
  tissue/organ does not develop properly and cannot
  catch up.

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Events of Pregnancy

• Good nutrition is vital for the mothers and the
  developing childs health throughout pregnancy.
• Nutritional risk factors, table 13.1
• Teen mother
• Frequent pregnancies, close together
• Poor nutrition, smoking
• Underweight or overweight
• Multiple births
• Gain insufficient or excessive weight during
  pregnancy.

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Nutritional Needs

• Food energy, fig 13.4. Balanced meals are
  especially important.
• 1st trimester none
• 2nd trimester - extra 340 calories per day
• 3rd trimester- extra 450 calories per day
• Protein increase by 25 g/day??. Vegans need to
  be especially vigilant.

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Nutritional Needs

• Carbohydrates extra 175 g/day needed to spare
  protein. Fiber needed to prevent constipation.
• Lipids omega 3 and omega 6 vital for nervous
  system development. BUT - Minimal fish intake
  is recommended because of the mercury, etc.

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Nutritional Needs

• Vitamins especially folate and B12.
  Deficiencies result in neural tube defects
  anencephaly, spina bifida.

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Nutritional Needs

• Minerals
• Calcium, phosphorus magnesium are needed for
  growth of bones and teeth.
• Iron is necessary for RBCs, supplement of 30
  mg/day.
• Zinc is required for protein synthesis and cell
  development.

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Fig. 13-4, p. 486
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Nutritional Needs

• Supplements avoid with the exception of iron
  and a multi-vitamin as prescribed by your doctor.
• Food Assistance - WIC

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Weight Gain

• Depends on prior weight status, table 13.4
• Normal weight 25-35 pounds
• Underweight 28-40 pounds
• Overweight 15-25 pounds
• Obese 15 pounds minimum
• Pregnancy is not a time to diet or overeat.
• Teen mothers need to gain more because they are
  still growing.

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Weight gain (lb)
Increase in breast size 2 Increase in
mother's 4 fluid volume Placenta 1 Increase
in blood supply 4 to the placenta Amniotic
fluid 2 Infant at birth 7 Increase in size
of 2 uterus and supporting muscles
Mother's necessary 7 fat stores
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1st trimester
2nd trimester
3rd trimester
Fig. 13-7, p. 491
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Physical Activity?

• Yes with precautions, fig 13.8. Low impact, safe
  exercise.
• Consult your physician!

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Cravings and Morning Sickness

• Cravings usually do not indicate need but
  different smell and taste sensitivities.
• Morning sickness and other discomforts are due to
  hormonal changes.
• Table 13.5 tips for relieving discomforts.

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What to Avoid

• Cigarette smoking (incl. second-hand)
• Decreases vitamin C absorption
• Produces toxins - nicotine and cyanide
• Causes vasoconstriction
• Is associated with low birth weights, SIDS.
• Medicinal drugs and herbal supplements NO,
  incl. aspirin and ibuprofen consult your
  physician.

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What to Avoid

• Illegal drugs no brainer.
• Environmental contaminants mercury and lead
  (some large ocean fish).
• Mega vitamins/minerals no, especially vitamin
  A. Prenatal vitamins YES.
• Dieting NO
• Sugar substitutes and caffeine avoid or limit.

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What to Avoid

• ALCOHOL NO, NO, NO abnormalities seen with
  intakes as low as 1-2 drinks/day.
• Decreased oxygen and nutrient delivery to fetus.
• Slows cell division and damages DNA.
• During the 1st month it is detrimental to brain
  development.
• Often associated with malnutrition in the mother.
• Before fertilization can damage egg and SPERM.

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Alcohol and Babies

• FAS, ARND, ARBD
• Irreversible brain damage.
• Growth retardation.
• Mental retardation, mild to severe.
• Behavior abnormalities.
• Facial abnormalities, fig 13.10.
• Vision abnormalities.
• Stop before you become pregnant, dads included.

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Head Small head size
Forehead Narrow, receding forehead
Nose Short, upturned nose Flattened nose bridge
Jaw Underdeveloped jaw Receding chin Receding or
flattened upper jaw
Eyes Extra skin folds on eyelids Drooping
eyelids Downward slant of eyes Unusually small
eyes and/or eye openings Short-sightedness Inabili
ty to focus (wandering eyes)
Ears Uneven in placement and size Poorly formed
outer ear Backward curve
Lips Absence of groove in upper lip flat upper
lip Thin upper lip
Fig. 13-10, p. 498
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Pregnancy Problems

• Gestational diabetes - after 24 weeks.
• Usually resolves after birth of baby, but 1/3
  develop Type 2 diabetes.
• Risk is increased in overweight/obese women.

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Pregnancy Problems

• Preeclampsia/eclampsia
• Dangerous increases in blood pressure, protein in
  urine and edema of face hands in addition to
  feet ankles. Convulsions and death.
• Leading cause of maternal death. Increased in
  African American women.
• No clear relationship to dietary intake but is
  increased in areas where nutrition is
  compromised. Inadequate calcium intake may play
  a role.

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Lactation

• Cost to mother is 500 calories/day above normal
  needs. Recommended extra 330 calories/day the
  remainder coming from stored fat.
• Fig 13.4 nutritional requirements are higher
  than those for pregnancy in most categories.

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Lactation

• Volume of milk produced adjusts to babys demand.
• Recommended fluid intake 13 cups per day.
• Nutrient deficiencies usually result in lower
  quantity not quality of milk.
• Avoid excess intake of fat soluble vitamins (esp.
  vit A) and foods that disagree with the baby.

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Lactation

• NO to alcohol, nicotine, and other drugs (except
  as prescribed by a doctor), limit caffeine.
• Most infections, treated properly, are not
  transmitted via breast milk. Exception - HIV.

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Feeding the Infant

• Rapid growth during the 1st year requires an
  ample supply of nutrients, more than twice that
  of adults, per pound body weight, fig 13.12.
• Iodine, vitamins A,D, C are needed in
  especially high quantities.

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Fig. 13-12, p. 504
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Feeding the Infant

• The baby adjusts energy intake to growth rate and
  physical activity. Do not force infants to eat.
• Vitamin K
• Water breast milk and formulas contain plenty.
  No need for other fluids except during episodes
  of vomiting and diarrhea.

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Feeding the Infant

• Breast milk 6 benefits
• Easily digested
• Nutrient rich and adjusts to babys needs (if
  mother practices good nutrition). Exception
  vitamin D and iron.
• Immune factors colostrum provides antibodies
  and WBCs.

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Feeding the Infant

• Breast milk contd
• Promotes growth of beneficial bacteria in
  intestines
• Hormones promote development of digestive tract
• Supplements are not necessary except perhaps
  vitamin D, iron (after 4-6 months and fluoride
  (after 6 months).

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Feeding the Infant

• Breast fed babies
• May have increased intelligence
• Are less likely to become obese
• Breast feeding also benefits the mother, table
  13.7

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Feeding the Infant

• Formulas
• Derived from cows milk that is diluted and
  fortified.
• Plain cows milk is not recommended for babies
  under 1yr low-fat milk only after 2yrs.
• No human antibodies

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Feeding the Infant

• Formulas contd
• Soy based formulas for premature infants, infants
  with allergies and for vegan families.
• Advantages allows for monitoring of intake and
  developing relationships with other family
  members.

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Feeding the Infant

• Solid foods after 4-6 months, depending on
  babys development.
• Fortified cereals rice first, wheat last.
• 4-6 months pureed vegetables and fruits
  introduced one at a time to check for allergies.
• Ability to chew properly does not develop until
  2nd year.

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Feeding the Infant

• Fluids
• Increased need with the introduction of solid
  food.
• Best - water, 2nd - unsweetened fruit juices
  offered in a cup not a bottle.
• Common Allergies wheat, egg whites, soy,
  peanuts, cows milk, citrus fruits.

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Feeding the Infant

• 1st year
• Model and teach good eating habits
• Do not use food as a reward or to stop crying do
  not withdraw food as punishment.
• Do not use a bottle as a pacifier dental
  problems, p.512.
• Do not underfeed or overfeed

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Extreme case of nursing bottle syndrome.
p. 512
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Controversy Childhood Obesity

• Genetic and environmental (incl. poor nutrition).
• Type 2 diabetes obesity, increased blood
  lipids, CVD.
• Obesity risk increased if parents are obese,
  high birth weight ?, formula fed ?, physical
  inactivity.
• Other OYO, pp 514-518