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Nutrition During Pregnancy PowerPoint 03 20 2021
- 2. ©McGraw-Hill Education Nutrition and Pregnancy Learning Outcomes • Discuss the roles of the placenta and uterus during pregnancy. • Explain why an infant’s birth weight is an important aspect of the baby’s health during its first year of life. • List major physiological changes that occur during pregnancy, and identify nutrition-related discomforts associated with this stage of life.
- 3. ©McGraw-Hill Education Nutrition in Pregnancy2 Learning Outcomes • Discuss the importance of appropriate weight gain during pregnancy, and identify recommended ranges of weight that pregnant women should gain. • Explain why prenatal care and a nutritious diet are important for the health of the pregnant woman and her unborn offspring.
- 5. ©McGraw-Hill Education Pregnancy: Key Terms Conception - moment when a sperm enters an egg (fertilization) Uterus - female reproductive organ that protects the developing organism during pregnancy Embryo - human organism from 14 days to 8 weeks after conception Fetus - human organism from 8 weeks after conception until birth
- 6. ©McGraw-Hill Education Prenatal Development: Conception to Fetus Figure 13.1
- 7. ©McGraw-Hill Education The Placenta What is the placenta? • Organ of pregnancy that connect the uterus to the embryo/fetus via the umbilical cord What does the placenta do? • Transfers nutrients and oxygen to embryo/fetus • Removes wastes from embryo/fetus
- 9. Gestation Period 1st Trimester 0 – 13 Weeks (0 – 3 MONTHS) 2nd Trimester 14 - 26 Weeks (4 – 6 MONTHS) 3rd Trimester 27 - 40 weeks (7 – 9 MONTHS) • Calculation of weeks gestation begins with first day of the last menstrual period -OR- • Estimated date of confinement (EDC) or Estimated Due Date (EDD) 9
- 10. Weight Gain Recommendations Gaining an appropriate amount of weight is crucial. Recommendation depends on Prepregnancy weight. Important to gain appropriate weight. Pre-Pregnancy BMI 1st Trimester (lbs.) 2nd & 3rd Trimesters (lbs./week) Pregnancy Total (lbs.) Pregnant with Multiples (lbs.) Less than 18.5 Underweight 2.2 – 6.6 1 – 1.3 28 – 40 Talk to HCP 18.5 – 24.9 Normal Weight 2.2 – 6.6 0.8 – 1.1 25 – 35 37 – 54 25.0 – 29.9 Overweight 2.2 – 6.6 0.5 – 0.7 15 – 25 31 – 50 Greater than 30.0 Obese 0.5 – 4.4 0.4 – 0.6 11 – 20 25 – 42 10
- 12. Dietary needs vary by stage of pregnancy and rate of fetal growth. Increased Calorie Needs • Do not “Eat for Two”; During Pregnancy, Extra dietary energy is required to meet increased growth needs • Approx. 300 additional calories/day needed • During second and third trimester • Should come from nutrient dense foods • “Eating for two” is a old saying; Pregnant women do have increased energy and nutrient needs 12
- 13. Increased Nutrient Needs Protein • Builds tissues to support fetus • Growth and development of baby Iron • Forms new blood cells and tissues Folic Acid • Necessary for normal cell growth and healthy blood • Aids in prevention of neural tube defects 13
- 14. Increased Nutrient Needs Calcium • Strong bones and teeth, blood clotting, enzyme activity • Nerves, heart, and muscles development and functioning Vitamin D • Strong bones and teeth, healthy skin, eye sight Iodine • Cognitive function 14
- 15. Increased Nutrient Needs Protein Iron • 27 mg/day Folic Acid • 600 mcg/day Calcium • Ages 18 and under: 1300 mg/day • Ages 19 and over: 1000 mg/day Vitamin D • 600 IU/day Iodine • 220 mcg/day 15
- 16. Low-Birth-Weight (LBW) Infants A low-birth-weight (LBW ) baby generally weighs less than 5.5 pounds at birth. • Second leading cause of infant death (U.S.) LBW infants are more likely to occur: • Younger moms (less than 15 years of age) • Older moms (45-54 years of age) • Women who smoke during pregnancy LBW usually are not carried to full term (40 weeks or 9 month). LBW babies usually come early. • LBW may be born before 37th week of pregnancy • Very preterm baby: Born before 32nd week of pregnancy • LBW Premature or Preterm Babies usually have many health problems.
- 19. Pregnancy and Increased Fluid Needs •“Drink to thirst” to keep hydrated; This means drink whenever thirsty in pregnancy. •Last few months, ankles and feet with swell; Keep hydrated; Avoid fluid restrictions •Avoid “water pills” or Diuretics 19
- 20. • Contains 600mcg folic acid and 27mg iron • Many “gummy” varieties don’t contain adequate iron for pregnancy • Review iodine content Prenatal Vitamin • Supplementation may be needed if on a vegetarian or vegan diet • Enriched grain products, eggs, and dairy contain much less B12 than meat sources Vitamin B12 Vitamins, Minerals, Supplements 20
- 21. Recommendations for Special Diets • Vegetarian • Protein from soy milk, beans, eggs, cheese, tofu • Iron-rich fruits and vegetables, along with good sources of vitamin C • Calcium from dark leafy greens, calcium enriched products • B12 from fortified cereals and milk • Lactose Intolerant • Lactose-free milk, seeds, nuts, soy • Celiac Disease • Fruits, vegetables, beans, meat, poultry 21
- 23. Food Safety • Higher risk of food-borne illness • Listeria • Soft cheeses and unpasteurized milk products • Undercooked poultry • Hot dogs, cold cuts/deli meat • Toxoplasma • Undercooked meat • Unwashed fruits and vegetables • Cat-litter boxes • Methylmercury • Certain fish and shellfish 23
- 24. Food Safety • Clean: wash hands and surfaces, rinse fruits and vegetables • Separate: don’t cross contaminate • Cook: cook to safe internal temperatures • Chill: defrost food safely, refrigerate promptly 24
- 25. Fish and Seafood Concerns https://www.fda.gov/downloads/Food/ResourcesForYou/Consumers/UCM536321.pdf 25
- 26. Foods to Avoid or Limit Unpasteurized /Raw milk and soft cheeses Raw or undercooked meat, poultry, eggs, seafood Cold cuts/Deli meat (unless heated) High mercury containing seafood Caffeine 26
- 27. COMMON CONCERNS IN PREGNANCY MODULE 6 27
- 28. ©McGraw-Hill Education What About Cravings? Cravings are common in pregnancy. • Cause is unknown but may be related to hormonal changes. What is pica? • Craving (and eating) nonfood substances such as laundry starch, coal, cigarette ashes, and dirt • May be associated with iron and zinc deficiencies • Not known if pica is the cause or result of dietary deficiencies • Pregnant women should not engage in pica.
- 29. Food Cravings and Aversions • Reasons for food avoidance: • Enhanced perception of aromas • Heightened gag response • Getting ill while eating particular foods • Altered gastric comfort • Pica • Compulsive eating of non-food substances • Linked to lead poisoning, exposure to toxicants, anemia, excess calories, displacement of nutrients, parasitic infection, gastric or bowel obstruction 29
- 30. Discomforts in Pregnancy • Nausea and Vomiting • Common during 1st trimester, generally resolves by 17 weeks; Commonly Called “Morning Sickness”; Can happen anytime; Smell of food may make her sick • Recommend: • Frequent snacks of carbohydrates or protein • Ginger may decrease and relieve nausea symptoms • Hyperemesis Gravidarum • Severe Nausea and Vomiting in Pregnancy; Requires Medical Treatment • Heartburn • Common during 2nd and 3rd trimester when baby is pressing against mother’s organs • Fetus pushes upward on mother’s abdominal cavity, causing stomach acid to enter esophagus • Recommend: • Eat small, frequent meals • Pregnant woman should stay upright after eating a meal; 30
- 31. Other Discomforts in Pregnancy • Constipation and Hemrrohoids • Hormonal changes slow intestines which slows digestion. Slow digestions leads to more water withdrawn from intestines making body’s solid wastes hard. • Recommend: • Drink more Fluids • Eat Fiber-rich Foods • Take a Warm Bath • Fluid Retention & Swelling (Edema) • Increase in blood and fluid volume within the body that is needed to support pregnancy and prepare for delivery • Recommend: • Take pressure off large vein that returns blood from body to heart; Lie on left side • Elevate feet • Stay cool • Loose fitting clothes 31
- 33. Risks of Tobacco, Alcohol & Drugs • Nicotine passes from mother to baby • less oxygen and nutrients, damage to brain and lungs • Increased risk of preterm birth, colic, SIDS, asthma, obesity • Avoid secondhand smoke Tobacco • Interferes with normal growth of baby • Increased risk of birth defects Alcohol • Increased risk of miscarriage, birth defects, preterm birth, stillbirth, attention and behavioral problems • Baby may need specialized care after birth Drugs • Refer to healthcare provider and/or pharmacist for guidance Medications 33
- 34. • Benefits: • Reduces back pain, eases constipation, promotes healthy weight, decreases risk of some pregnancy induced conditions, like gestational diabetes or • Encourage 2 ½ hours/week • Activities lasting at least 10 minutes, spread throughout the week • Do not exercise while lying on back; Uterus presses against large vein that returns blood to heart • Do not perform exercise that require you to stand still; May cause blood to accumulate in legs and feet • Avoid high risk of falling or any exercise that may cause abdominal pain • Stay hydrated • Avoid becoming overheated; High Body Temperatures Physical Activity and Exercise Pregnancy 34
- 36. ©McGraw-Hill Education What About Physical Activity? Benefits of physical activity: • Enhanced muscle tone and strength • Reduced edema • Improved mood and sleep Recommended activities: • Walking • Cycling • Swimming • Light aerobics Avoid “contact” sports, horseback riding, & downhill skiing. Discuss fitness concerns with physician.
- 37. • Pregnancy hormone level changes may cause gums to swell and bleed • Periodontal disease (gums pull away from teeth forming pockets where bacteria can cause infection; During pregnancy, this can increase risk of premature birth and delivering a low birth weight infant. • It is important for a pregnant woman to: • Practice good oral hygiene • Eat Balanced diet • Have routine dental care and dental visits • Stop Smoking Dental Health 37