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Chapter 17: Life Cycle Nutrition: Pregnancy through Infancy

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Title: Chapter 17: Life Cycle Nutrition: Pregnancy through Infancy


1
Chapter 17 Life Cycle Nutrition Pregnancy
through Infancy
2
Stages of Pregnancy and Importance of the Placenta
  • During pregnancy, the diet must support the
    health of a woman and her growing baby
  • Full-term pregnancy averages 38 weeks from
    conception to birth (divided into three
    trimesters)

3
Stages of Pregnancy and Fetal Development
Figure 17.1
4
Stages of Pregnancy and Importance of the Placenta
  • Nutrients are delivered to and wastes are
    transported from the developing embryo through
    the placenta
  • Prevents passage of red blood cells, bacteria,
    and many large proteins from mother to fetus
  • Alcohol, drugs, and other potentially harmful
    substances can cross the placenta
  • Releases hormones required to support the
    physiological changes of pregnancy

5
The Placenta
Figure 17.2
6
Stages of Pregnancy and Importance of the Placenta
  • Critical periods impact fetal development
  • Periods of rapid cellular activity are highly
    vulnerable to nutritional deficiencies, toxins,
    and other insults
  • Famine associated with a high cumulative
    incidence of heart disease
  • Inadequate iron during early pregnancy associated
    with poor cognitive development
  • Metabolic or fetal programming may be able to
    alter how genes are expressed during critical
    periods of development

7
Critical Periods of Development
Figure 17.3
8
Quick Review
  • A healthy pregnancy lasts 38 weeks and is divided
    into three trimesters
  • The placenta is the site through which the
    developing fetus accesses the mothers organ
    systems for respiration, absorption, and
    excretory purposes
  • Harmful toxins or inadequate nutrition can cause
    irreversible damage to the fetus, especially
    during critical periods
  • Metabolic programming examines the interaction of
    the prenatal environment on genetic and other
    factors to produce permanent change

9
Nutrients and Behaviors Are Important for a
Healthy PregnancyThe Father
  • Before conception, fathers-to-be need to eat well
    for healthy sperm production
  • Smoking, alcohol and drug abuse, and obesity are
    associated with decreased sperm production and
    function
  • Zinc, folate, and antioxidants are associated
    with healthy sperm

10
Nutrients and Behaviors Are Important for a
Healthy PregnancyThe Mother
  • Before conception, mothers need to adopt a
    healthy lifestyle
  • Attain a healthy weight before conception
  • Obesity and overweight are associated with
    infertility, pregnancy complications, potential
    birth defects
  • Underweight women are at risk of delivering low
    birth weight or small for gestational age babies
  • Get plenty of folic acid400 micrograms daily
  • Reduces risk of neural tube defects
  • Moderate fish and caffeine consumption

11
Nutrients and Behaviors Are Important for a
Healthy PregnancyThe Mother
  • Avoid cigarettes, alcohol, and illicit drugs
  • Smoking increases the risk of infertility, a low
    birth weight baby, stunted growth or intellectual
    development, and sudden infant death syndrome
    (SIDS)
  • Drinking alcohol during pregnancy can lead to
    fetal alcohol spectrum disorders (FASD) pregnant
    women are advised to abstain completely from
    alcohol

12
Nutrients and Behaviors Are Important for a
Healthy Pregnancy
  • Managing chronic conditions
  • Diabetes, hypertension, PKU or sexually
    transmitted disease can increase maternal and
    fetal complications if not controlled before
    conception
  • Medications may be contraindicated during
    pregnancy, so prepregnancy counseling is essential

13
Quick Review
  • Good nutrition and healthy lifestyle habits
    before conception are important for both men and
    women
  • Factors such as smoking, alcohol abuse, and
    obesity decrease sperm production and function
  • Conception is easier for women if they are at a
    healthy body weight
  • Getting plenty of folic acid, avoiding fish high
    in methylmercury, limiting caffeine consumption,
    avoiding cigarettes, alcohol and drugs, and
    managing chronic conditions are essential for a
    healthy pregnancy
  • Proper nutrition and a healthy lifestyle can
    prevent birth defects and may reduce future
    health risks

14
Nutrition During the First Trimester
  • Morning sickness
  • Begins during the first trimester and often ends
    by the 20th week of pregnancy
  • Cause is unknown, but estrogen is thought to play
    a role
  • Small, frequent meals, avoiding an empty stomach,
    high carbohydrate foods, ginger, and salty foods
    combined with sour and tart beverages help manage
    nausea
  • Vitamin B6 may reduce nausea and vomiting
  • In rare cases, women experience hyperemesis
    gravadarum, severe vomiting which can lead to
    dehydration, electrolyte imbalances, weight loss
    and may require hospitalization

15
Nutrition During the First Trimester
  • Cravings
  • Researchers have not found a physiological
    explanation for food cravings
  • Pica is the abnormal, compulsive intake of
    nonedible items such as laundry starch, burnt
    matches, clay, dirt, paint chips, and/or baking
    soda
  • More common in African-American women and
    associated with low blood levels of iron

16
Nutrition During the First Trimester
  • Avoiding botanicals
  • Botanicals are parts of a plant believed to have
    medicinal or therapeutic effects
  • Herbs such as blue cohosh, juniper, goldenseal
    and raspberry tea may cause contractions of the
    uterus leading to miscarrage or premature labor

17
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18
Components of Weight Gain During Pregnancy
Figure 17.5
19
Nutrition During the First Trimester
  • Dietary considerations
  • 50 increase in needs for folate, zinc, and iron
  • Kilocalorie needs are not significantly increased
    during the first trimester
  • Focus should be on intake of nutrient-dense foods
  • A prenatal supplement is necessary
  • Vegetarians and vegans should be mindful of
    meeting needs for essential fatty acids and
    vitamin B12
  • Drink milk to meet needs for calcium and vitamin D

20
Nutrition During the First Trimester
  • Foodborne illness
  • The immune system is weakened during pregnancy,
    so mother and baby are at greater risk
  • Listeria monocytogenes may cause miscarriage,
    premature labor, low birth weight, developmental
    problems, or infant death
  • Pregnant women should avoid raw or undercooked
    meats, fish, or poultry unpasteurized milk,
    cheese, and juices and raw sprouts

21
Quick Review
  • Women commonly experience morning sickness and
    cravings during the first trimester of pregnancy
  • Recommended weight gain during pregnancy depends
    on prepregnancy weight
  • The needs for many nutrients are increased during
    pregnancy, but most can be met with a balanced
    diet
  • It is difficult to consume adequate iron from
    foods during pregnancy, so a supplement is often
    prescribed
  • Pregnant women should avoid excess amounts of
    preformed vitamin A and D
  • Risk of foodborne illness is increased during
    pregnancy, so women should handle raw foods
    carefully and avoid certain raw, undercooked, or
    unpasteurized foods

22
Nutrition During the Second Trimester
  • Consume adequate kilocalories, carbohydrate, and
    protein
  • An additional 340 kcals daily is needed during
    the second trimester
  • Need a minimum of 175 grams carbohydrate per day
  • Protein needs increase 35 to about 71 grams daily

23
Activity During the Second Trimester
  • 30 minutes or more of moderate exercise on most
    days is recommended
  • Low-impact activities pose less risk for injury
    to mother or baby
  • Must take care to avoid significant increases in
    body core temperature and drink plenty of fluids
    to avoid dehydration

24
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25
Complications During the Second Trimester
  • Potential complications gestational diabetes and
    hypertension
  • Gestational diabetes occurs when a woman develops
    high blood glucose levels during her pregnancy
  • May result in macrosomia, jaundice, breathing
    problems, birth defects, or hypoglycemia after
    birth
  • Eating healthfully, maintaining a healthy weight,
    and exercising regularly can reduce risk

26
Complications During the Second Trimester
  • Pregnancy-induced hypertension includes three
    categories
  • Gestational hypertension occurs early in
    pregnancy in women with no history of
    hypertension
  • Preeclampsia characterized by hypertension,
    severe edema and protein losses in the urine
    deprives fetus of oxygen and nutrient rich blood
    from the placenta
  • Eclampsia can cause seizures and is a major
    cause of death of women during pregnancy
  • The only cure for preeclampsia and eclampsia is
    to deliver the baby

27
Quick Review
  • Pregnant women need to consume an additional 340
    kcals during the second trimester
  • Exercise can provide numerous benefits during
    pregnancy, but should be limited to low-impact
    activities to reduce risk of injury to Mom or
    baby
  • Complications that often appear during the second
    trimester of pregnancy include gestational
    diabetes and pregnancy induced hypertension
    women with these conditions should be closely
    monitored by a health care professional

28
Nutrition During the Third Trimester
  • Eating frequent small meals and a high-fiber diet
    can help with heartburn and constipation
  • An extra 450 kcals are needed during the third
    trimester
  • The growing baby exerts pressure on the Moms
    intestines and stomach which can cause heartburn
  • Hormonal changes slow movement of food through
    the GI tract which may cause constipation

29
Special Concerns of Younger or Older Mothers-to-Be
  • Teenage mothers
  • Still growing, therefore nutrient needs are even
    higher than an adult woman, yet more likely to
    have an unbalanced diet
  • More likely to develop pregnancy-induced
    hypertension, iron-deficiency anemia, and deliver
    premature babies
  • Older mothers
  • Higher risk for complications including
    gestational diabetes and pregnancy-induced
    hypertension
  • Babies are more likely to have Down syndrome or
    other developmental disabilities

30
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31
Breast-Feeding
  • Lactation is the production of milk in a womans
    body after birth
  • The breast is best when nourishing an infant
  • Breast-feeding provides physical, emotional, and
    financial benefits for mothers
  • Helps stimulate recovery from pregnancy including
    contraction of the uterus and weight loss
  • May reduce risk of certain chronic diseases later
    in life
  • Less expensive and more convenient than formula
  • Reduces stress and promotes bonding

32
The Letdown Response
Figure 17.8
33
Benefits of Breast-Feeding
  • Breast-feeding provides nutritional and health
    benefits for infants
  • Nutritional composition of breast milk changes as
    the infant grows
  • Colostrum is lower in fat, higher in protein,
    vitamin A, minerals, and antibodies
  • Breast milk is high in lactose, fat, B vitamins
    and lower in fat-soluble vitamins, sodium, and
    other minerals
  • The American Academy of Pediatrics recommends
    supplementing breast-fed babies with vitamin D
    drops to meet needs

34
Benefits of Breast-Feeding
  • Breast-feeding protects against infections,
    allergies, and chronic disease and may enhance
    brain development
  • Provides beneficial compounds including
    antioxidants, hormones, enzymes, and growth
    factors
  • If continued beyond six months, may reduce risk
    of childhood obesity
  • Breast milk is rich in docosahexaenoic acid (DHA)
    and arachidonic acid (AA) which are important for
    development of vision and the central nervous
    system
  • The American Dietetic Association recommends
    exclusive breast feeding until 6 months of age
    and continuation to at least one year with
    appropriate solid foods

35
Quick Review
  • Breast-feeding provides numerous benefits to
    mothers and their babies
  • It can help mothers recover from pregnancy and
    may help prevent certain chronic diseases later
    in life
  • It is the least expensive and most convenient way
    to nourish an infant and promotes bonding between
    Mom and baby
  • Human milk is rich in nutrients, antibodies, and
    other compounds that can protect against
    infection, allergies, and chronic disease, and
    may enhance cognitive development
  • Women are advised to breast-feed exclusively for
    the first six months and then breast-feed to
    supplement solid foods for the first year

36
Nutrient Needs and Habits for a Breast-Feeding
Mother
  • Should drink 13 cups of fluid per day to meet
    increased fluid needs
  • Needs additional kcals
  • A well-balanced diet should meet nutrient needs
    during lactation
  • Substances in the mothers body are transmitted
    through breast milk nursing Moms should avoid
    alcohol, drugs, tobacco, and limit caffeine
  • Children from families with a strong family
    history of foods allergies may benefit from
    breast-feeding

37
Formula Is an Alternative to Breast Milk
  • Some women may not be able to breast-feed
  • Women with AIDS, human T-cell leukemia, or active
    tuberculosis, who are receiving chemotherapy
    and/or radiation, or who use illegal drugs should
    not breast-feed
  • Infants with galactosemia cannot metabolize
    lactose and should not be breast-fed

38
Formula Is an Alternative to Breast Milk
  • Formula can be a healthy alternative to
    breast-feeding
  • Developed to be as similar as possible to breast
    milk
  • Standard formula is made from cows milk.
  • Unmodified cows milk it too high in protein,
    sodium, potassium, and too low in fat and
    linoleic acid for infants
  • To avoid nursing bottle tooth decay and risk of
    ear infections, infants should not be allowed
    to sleep with a bottle containing sugary liquids

Figure 17.9
39
Quick Review
  • If a women is unable or chooses not to
    breast-feed, formula is the only healthy
    alternative for babies
  • Commercially made formulas are modified from soy
    or cows milk and designed to resemble human
    breast milk
  • Cows milk should not be given before age 1, as
    it is too high in protein and certain minerals
    and too low in fat
  • Powdered and concentrated formula should be
    diluted and mixed carefully to ensure babies are
    getting the correct calories and nutrients
  • To avoid tooth decay and ear infections, babies
    should not be put to sleep with bottles

40
Nutrient Needs of Infants
  • Infants grow at an accelerated rate
  • Doubles birth weight by 6 months of age and
    triples it by 12 months
  • Length doubles by 1 year of age
  • Significant intellectual and social development
    occurs during infancy
  • Adequate nutrition is needed to meet physical,
    social and intellectual milestones
  • Failure to thrive (FTT) occurs when a child is
    delayed in physical growth or size or does not
    gain enough weight
  • Growth charts are used to track physical
    development

41
Growth Chart
Figure 17.11
42
Quick Review
  • Growth occurs at a dramatic rate during the first
    year of life
  • Infant growth can be monitored by tracking
    developmental milestones and using growth charts
  • Nutrient needs during the first year of life are
    substantial, and supplements may be needed in
    some circumstances

43
Switching to Solid Foods
  • Solid foods are introduced around 46 months of
    age once certain milestones are met
  • Solid foods should be introduced gradually
  • Parents should watch for signs of allergies after
    a new food is introduced

44
Food Allergy
45
Switching to Solid Foods
  • Certain foods are dangerous and should be avoided
  • Egg whites, cows milk, and peanut butter
  • Honey may carry Clostridium botulinum and cause
    botulism in infants
  • Seasonings are not needed
  • Juice often displaces necessary nutrients and
    should be limited to 100 juice and given in
    moderation
  • Infants should never be put on weight-loss diets

46
Quick Review
  • An infant must be physically, physiologically,
    and nutritionally ready before being introduced
    to solid foods
  • Solid foods should be introduced gradually and
    cautiously
  • Foods that may pose a choking hazard should be
    avoided and infants should always be supervised
    when eating
  • Common food allergens, honey, and herbal teas
    should be avoided for the first year of life and
    seasonings should not be added to infant food
  • To keep their children healthy parents need to
    educate themselves about foods that are safe and
    appropriate for infants

47
Summary of Nutritional Guidelines
Figure 17.12
48
Putting It All Together
  • Both the father and mother should make healthy
    diet and lifestyle changes prior to pregnancy
  • During pregnancy, nutrients, oxygen and waste
    products are exchanged between mother and fetus
    through the placenta harmful toxins or
    inadequate nutrition can cause irreversible
    damage to the fetus, especially during critical
    periods
  • Recommended weight gain during pregnancy depends
    on prepregnancy weight caloric needs are
    increased during the second and third trimester
    of pregnancy to support weight gain a prenatal
    supplement is needed for iron
  • Breast-feeding is the gold standard for infant
    nutrition it provides physical, emotional,
    convenience, and financial benefits to Mom and
    nutritional and health benefits to baby
  • Infancy is characterized by rapid growth and
    important developmental milestones
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