Term
| What is low birth weight defined as? |
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Definition
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Term
| What are the fetal consequences of poor fetal nutrition? |
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Definition
Low birth weight:
Preterm labor
Increased risk of fetal and newborn mortality and morbidity |
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Term
| What is the recommended weight gain of a normal person during pregnancy? |
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Definition
Normal pre-pregnant wt
(BMI 19.8-26.0): 25-35lb |
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Term
| If you're underweight, how much weight should you gain with your pregnancy? |
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Definition
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Term
| If you're overweight, how much weight should you gain with your pregnancy? |
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Definition
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Term
| If you're obese, how much weight should you gain with your pregnancy/ |
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Definition
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Term
| If you are having multiples, how much weight should you gain? |
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Definition
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Term
| if you're Height<62 inches? |
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Definition
| lower limits of normal range |
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Term
| If you are an Adolescents? |
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Definition
| Upper limits of normal range |
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Term
| How much weight should you gain in your 1st trimester? |
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Definition
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Term
| How much weight should you gain in your 2nd trimester? |
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Definition
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Term
| Where does weight go that is gained during pregnancy? |
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Definition
Baby 7½
Placenta 1½
Amniotic fluid 2
Mother
Breasts 2
Uterus 2
Body fluids 4
Blood 4
Maternal stores of fat, protein, and other nutrients 7
TOTAL 30 lbs. |
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Term
| What should you eat while pregnant? |
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Definition
-Calories up to 2500
-Protein up to 80
-Water up to 8 glasses
-A up to 770
-C 85 mcg
-D 5 mcg
-E 15 mcg
-B1 - 1.5
-B2 - 1.4
-B3 18 mg
-B6 - 1.9 mg
-B12 - 2.6 mcg
-Folate 600 mcg
-Clacium 1,000 mg
-Phos 700 mg
-Iodine 220 mg
-Mag - 350 mg
Zinc - 11 mg
Increase protein servings to at least 3
Increase dairy servings to at least 4 |
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Term
| How are calories effected by pregnancy? |
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Definition
Calories obtained via: carbs, proteins, fats
2500 calories/day (increase of 300/day)
2nd & 3rd Trimesters
Purpose of additional calories
Energy for production and maintenance of the fetus, placenta, added maternal tissues, and increased BMR. |
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Term
| How do you know if caloric needs are met during pregnancy? |
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Definition
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Term
| How many carbs should you eat? |
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Definition
| Increased from 130g to 175g daily |
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Term
| What kind of carbs should you eat |
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Definition
COMPLEX
Supply vitamins, minerals, and fiber
Should be major source of carbs |
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Term
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Definition
| DHA and Omega-3: help w/ placenta formation, fetal brain development |
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Term
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Definition
Fish, red meat
Vegetable oils, safflower, corn, olive, peanut, & cottonseed |
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Term
| What at the protein needs of a pregnant woman? |
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Definition
Increased from 46g to 71g daily (to expand blood volume & support tissue growth)
Meat, poultry, fish, yogurt, eggs, & milk |
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Term
| How is iron intake changed when pregnant? |
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Definition
Present in many foods but in small amts
Supplements: 30mg/day-120mg/day
Absorption?
Meats, green leafy vegetables, eggs, grain products, nuts, legumes |
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Term
| How is calcium intake changed in pregnancy? |
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Definition
Bone formation, coagulation, neuromuscular function
Transferred to fetus esp in 3rd trim (fetal bones & teeth)
Requirements are unchanged during pregnancy
Dairy products, salmon, legumes, nuts
Absorption? |
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Term
| What minerals are needed during pregnancy? |
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Definition
Iron
Zinc
Magnesium
Calcium |
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Term
| What should you do to increase iron absorption? |
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Definition
| Absorption enhanced w OJ or other source of Vit C; DO NOT take with coffee, tea, or milk because that decreases absorption; empty stomach enhances absorption but is difficult to tolerate without GI s/s |
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Term
| What vitamins and minerals are potentially toxic to the fetus? |
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Definition
Vitamin A, B6, C, D
Iron, selenium, zinc |
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Term
| What should you avoid during pregnancy? |
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Definition
Caffeine
Alcohol
Artificial Sweetners
Weight loss diets |
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Term
| What is important regarding caffeine? |
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Definition
Increased awareness of foods with caffeine
Limited intake recommended: 300mg/day=2-3 cups of coffee
Consequences: more research needed |
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Term
| What is involved in a nutritional assessment? |
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Definition
24-hour Dietary Recall
Instructions
Analysis
Blood Tests
Hemoglobin & Hematocrit: to detect anemia
Urinalysis
Ketones, glucose
Specific gravity |
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Term
| What do ketones in urine indicate? |
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Definition
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Term
| What should you do to promote nutritional health during pregnancy? |
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Definition
Setting Goals
Family Considerations
Financial Considerations
Cultural Considerations
Language
Hot & cold foods |
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Term
| Who are women with special nutritional needs? |
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Definition
-Poverished
- Adolescents
- Vegetarians
- Lactose intolerants
- Underweight
- Overweight
- Eating disorders
- Smoker/Drug user
- Multiple pregnancy |
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Term
| What is important to note with adolescent diets? |
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Definition
Weight gain should be in upper range
(expected growth + 35 pounds)
Nutrient needs are the same as for older pregnant women but increase iron, Ca
Pre-pregnant nutritional habits
Low in vitamins C & A
Fast food
Suggestions??
Explore likes and dislikes
Focus only on necessary changes
Include snacks
Educate on fast food choices that will let her fit in with her friends and still be nourishing
because they’re still growing, they continue to add fat to their own bodies in late pregnancy rather than use it for support of the fetus-means they tend to have smaller infants even with good weight gain
Take expected weight gain based on normal growth pattern for teenager and ADD 35 pounds! |
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Term
| What is important with impoverished women? |
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Definition
| lack financial resources and nutritional education; Carbs less expensive therefore diet is going to be high in calories but low in vitamins and minerals. |
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Term
| What is important to note with vegetarians? |
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Definition
May lack adequate Ca, Fe, Zinc, Vit D &B12
Food plan
Concerns: Protein, Calcium, Iron |
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Term
| What can you do for lack of nutrients w/ vegetarians? |
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Definition
animal protein=complete: contains all essential amino acids
plant protein=lacks one or more of the essential amino acids
-incomplete plant proteins can be combined w/ other plant food that have complementary amino acids allows intake of all essential amino acids EXAMPLE: grains (wheat, rice, corn) and legumes (garbanzo, navy, kidney, pinto or soy beans; peas; peanuts) are compelmentary
-combine plant incompletes w/ small amounts of complete protein foods like cheese provide all amino acids.
CALCIUM: veggies have calcium but high-fiber diet may interfere w/absorption; Calcium-fortified soy products
IRON: lack of heme iron (from meats) which improves absorption; may need supplementation
ZINC: fish and meat; may need supplement |
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Term
| What do you do for an underweight woman? |
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Definition
Reasons for underweight state
Consequences of being underweight
Increased calorie need (by 500)
Dietary counseling |
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Term
| What do you do for an overweight woman? |
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Definition
Consequences: Pre-preg wt>200lb is associated with:
Gestational diabetes
PIH
Neural tube defects
Cesearean birth
Postpartum infection |
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Term
| What is important to note with eating disordered? |
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Definition
Anorexia: generally amenorrhea, therefore generally don’t get pregnant
Bulimia: will probably return to pattern after baby is born |
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Term
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Definition
Ice, clay, dirt, solid laundry starch
Cause: unknown
Decreases intake of food: essential nutrients
May cause iron deficiency anemia
clay and dirt in the gut may decrease the absorption of iron, be contaminated w/organisms, cause intestinal blockage, or contain toxic substances like lead. |
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Term
| What do you do for multiple pregnancy women's? |
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Definition
Gain on upper end of range: 35-45lb
Protein Need remains the same; may have increased need for Ca, Fe & Folic Acid |
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Term
| What do you do for women who abuse drugs/ |
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Definition
Smoking: prematurity, spontaneous ab
Alcohol: fetal alcohol syndrome
Drugs:
Marijuana: increases appetite
Heroin: interferes w/insulin response-malnourished
Cocaine: appetite suppressant
Amphetamines: depress appetite |
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Term
| What other conditions required counseling from registered dietitians? |
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Definition
Diabetes
HTN
Cystic Fibrosis
Celiac disease
Hypercholesterolemia
Woman with Phenylketonuria(PKU) |
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Term
| What are the common problems that effect nutritional health? |
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Definition
Nausea & Vomiting
Morning sickness
Avoid home remedies
(Antacids or Antiemetics)
Cravings
Inclusion in diet & calories
Pyrosis (Heartburn)
Suggestions
Use of Amphojel or Maalox |
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Term
| What is different about nutrition AFTER birth? |
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Definition
Additional 640 kcal/day
Protein=71g/day
Vitamins/minerals
Dieting:
postpone for at least 3 weeks after birth
No appetite suppressants
Usually lose body fat without dieting
Vegetarian
(Nursing Moment submitted by Gina Casamenti-Brooks . Image obtained 1/12/06 from: http://www.promom.org/gallery/fine_art?page=5) |
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Term
| DO you need to eat more with breastfeeding? |
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Definition
yes
500=energy, 140=drawn from maternal stores to produce breast milk
VITAMINS/MINERALS: generally don’t need supplements but are advised to continue PNV
-breast milk content may be low in vitamins if mom’s diet is also low in vits
-minerals in breast milk generally remain constant because mins like calcium are drawn from mom’s stores if intake is low.
VEGETARIAN: inadequate Vit B12-might need supplements |
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Term
| What should you avoid while breastfeeding? |
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Definition
-Dairy products
-Inadequate Diet: cultural or other
-Alcohol
-Caffeine
-Fluids: 8-10 glasses of fluids (those not containing caffeine)
-Foods to avoid:
Allergies
If infant is irritable, do a review of intake for previous 8-12 hours
Cabbage, onions, garlic, nuts, chocolate, large amts of fresh fruits, spicy or acidic foods. |
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Term
| Why should you avoid alcohol? |
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Definition
| Occasional single beverage may not be detrimental BUT larger amounts may interfere w/milk-ejection reflex and be harmful to the infant |
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Term
| Why should you avoid caffeine? |
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Definition
| : limit to 2 cups coffee-same as for pregnancy; can make infant irritable and may decrease the iron content of the milk |
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Term
| What is the diet for the non lactating mother? |
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Definition
Protein and vitamin C to promote healing
PNV until supply finished
Wait at least 3 weeks to start dieting
Need energy to heal and care for baby |
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