Chapter 10 - Nutrition through the Life Span: Pregnancy and Infancy

Nutrition for Health and Health Care, 5th Edition
DeBruyne ■ Pinna © Cengage Learning 2014
Nutrition through the
Life Span: Pregnancy
and Infancy
Chapter 10

Pregnancy: The Impact of Nutrition
on the Future
• Before pregnancy
– Full nutrient stores are essential
– Habits to establish
• Achieve and maintain a healthy body weight
• Choose an adequate and balanced diet
• Be physically active
• Receive regular medical care
• Avoid harmful influences

on the Future (cont’d.)
• Pregnancy weight
– Underweight
• High risk of low-birthweight infant
– Overweight
• Difficult labor and delivery, birth trauma, and
cesarean section
• Increased risk of neural tube defect and other
defects

• Healthy placenta
– Prepregnancy nutrition is crucial
– Supplies nutrients and removes waste from
the fetus
– What is the pipeline from the placenta to the
fetus?
– Produces hormones
• Help maintain pregnancy and prepare for lactation

• First week of pregnancy
– Fertilized ovum (zygote) → blastocyst
– Smoking, drug abuse, and malnutrition
• May lead to implantation failure or to abnormalities
• Weeks two through eight
– Embryo
• Week eight through birth
– Fetus

• Successful pregnancy
– 38 to 42 weeks
– Infant weighing between 6.8 and 7.9 pounds
• Why are the effects of malnutrition during
critical periods irreversible?
• What are some high-risk pregnancy
factors? (Table 10-1)

• Compare nutrient recommendations for
nonpregnant, pregnant, and lactating
women (Figure 10-4)
• Energy requirements
– Second trimester: extra 340 kcalories/day
– Third trimester: extra 450 kcalories/day
• Importance of nutrient-dense foods

• Other dietary considerations
– Ample carbohydrates: 175+ grams/day
– Fiber: alleviates constipation
– Protein: 25 grams/day higher
– Essential fatty acids
• Special interest: folate and vitamin B12
– Needed in large amounts
• Roles in cell reproduction

• Neural tube defects
– Prevented by folate taken prior and during
pregnancy
– Common types
• Anencephaly
• Spina bifida
– Recommended
• Supplements, enriched foods, and folate in foods

• Vitamin D, calcium, phosphorus,
magnesium, and fluoride
– Needed for developing fetal bones and teeth
– Calcium intake levels
• Conserve mother’s bone mass while supplying
fetal needs

• Iron recommendations
– Prior and during pregnancy
• Choose foods that supply heme iron
• Select additional iron-rich sources
• Consume foods that enhance iron absorption
– Fetus’ iron needs regulated by the placenta
• Given priority over those of mother
• Daily multivitamin-mineral supplements

• Federal food assistance program
– Special Supplemental Nutrition Program for
Women, Infants, and Children (WIC)
• What benefits are specific to participation during
pregnancy?
• Weight gain during pregnancy
– Recommended range for optimal outcomes

• Weight loss after pregnancy
– Cumulative weight gain best avoided by:
• Healthy weight prior to first pregnancy
• Maintaining healthy weight between pregnancies
• Physical activity
– Continue exercise throughout pregnancy
– Choose “low impact” activities
– Follow guidelines (Figure 10-8)

• Common nutrition-related concerns
– Food cravings and food aversions
– Pica
– Morning sickness
– Heartburn
– Constipation
• Strategies to alleviate maternal
discomforts (Table 10-5)

• Problems in pregnancy
– Aided by healthcare and nutritional measures
• Preexisting diabetes
• Gestational diabetes
• Chronic or gestational hypertension
• Preeclampsia

• Practices to avoid
– Cigarette smoking
– Drugs of abuse
– Environmental contaminants
– Caffeine
– Alcohol
• What are some other harmful practices to
avoid?

• Adolescent pregnancy
– Less likely to receive early prenatal care
– More likely to smoke during pregnancy
– Mothers younger than 16 years of age
• Bear more infants who die within the first year than
do women in any other age group

Breastfeeding
• American Academy of Pediatrics (AAP)
and Academy of Nutrition and Dietetics
(AND)
– Optimal feeding pattern for infants
• Exclusive breastfeeding for six months and
breastfeeding with complementary foods for at
least 12 months

Breastfeeding (cont’d.)
• Nutrition during lactation (Figure 10-4 and
Table 10-2)
– Energy
• Extra 330 kcal/day and 170 kcal from fat stores
– Gradual weight loss
– How is milk production affected by nutritional
deprivation?
– Water: about 13 cups/day

Breastfeeding (cont’d.)
• Contraindications to breastfeeding
– Alcohol
– Tobacco and caffeine
– Medications and illicit drugs
– Maternal illness

Nutrition of the Infant
• Infants and children
– Growth directly reflects nutritional well-being
• Five months: birthweight doubles
• One year: birthweight triples
– Infants: high basal metabolic rate
• Nutrients particularly important for infants
– Energy nutrients
– Vitamins and minerals for growth

Nutrition of the Infant (cont’d.)
• As a percentage of body weight
– Infants need more than twice as much of most
nutrients as an adult (Figure 10-10)
• Age: six months
– Infants spontaneously reduce energy intakes
• What conditions may require an electrolyte
solution for infants?

• Breast milk
– Nutrient source for first six months
– More easily digested than formula
– Approximately 8 to 12 feedings per day
– Carbohydrate: lactose
• Enhances calcium absorption
– What is the benefit of oligosaccharides in
breast milk?

• Breast milk
– Protein: alpha-lactalbumin
– Lipids
• Main form of energy in infant’s diet
– What factors contribute to the likelihood of
vitamin D deficiency in infants?
– Generous amounts of vitamin C
– Ideal calcium content

• Breast milk
– Iron and zinc: highly absorbable
• Supplements
– After six months
• Vitamin D, iron, and fluoride
– Vitamin K
• Single dose at birth

• Immunological protection
– Provided by colostrum and breast milk
• Maternal antibodies
• Oligosaccharides
• Bifidus factors
– Present in breast milk
• Lactoferrin, lactadherin, growth factor, and lipase
enzyme
• Breast milk: what are other benefits?

• Infant formula
– Fortified with iron
– U.S. standards
• Based on AAP recommendations
• FDA: quality control procedures
– Special formulas
• Soy protein
• Hydrolyzed protein

• Infant formula
– What risks are associated with formula
feeding?
• Nursing bottle tooth decay
– Child should not be put to bed with a bottle
as a pacifier
• Cow’s milk
– AAP advises after the first year

• Purpose of introducing solid foods
– Provide needed nutrients
• No longer supplied adequately by breast milk or
formula alone
– Factors governing addition of foods
• Infant’s nutrient needs
• Infant’s physical readiness
• Need to detect and control allergic reactions

• Choice of infant foods
– Provide variety, balance, and moderation
• Foods to omit
– Sweets, canned vegetables, honey, and corn
syrup
– Foods that might cause choking

• During child’s first year
– Encourage healthy eating habits
• Introduce a variety of nutritious foods
• Do not force child to finish the bottle or baby food
• Avoid empty-kcalorie foods
• Do not use food as a reward or punishment
– Provide a safe, loving, and secure
environment

Chapter 10 - Nutrition through the Life Span: Pregnancy and Infancy

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