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2. Preconception Nutrition
• Human reproduction involves a complex interplay of genetic,
biological, environmental, and behavioral factors.
• In healthy individuals, these processes proceed smoothly for
both males and females, facilitating successful reproduction.
• Certain factors like acute undernutrition or excessive alcohol
intake in less healthy individuals can disrupt these processes,
reducing reproductive capacity.
• Conception can still occur despite poor nutritional or health
status, but it increases the risk of compromised fetal growth and
development, maternal health during pregnancy, and the future
health of the offspring

3. Hormones that regulate fertility processes

4. Factors related to altered fertility in women and men

6. Preconception Nutrition (Condition and Intervention)
1. Nutrition and other lifestyle changes are a core component of the
treatment of a variety of common health problems of women and men
prior to conception.
2. Nutrition and health status during the periconceptional period influences
embryonic development and the risk of complications during pregnancy.
3. Obesity is related to a number of hormonal and metabolic changes that
may compromise fertility and health status in men and women.
4. Rates of diseases and disorders associated with obesity such as
metabolic syndrome, polycystic ovary syndrome, gestational diabetes,
and type 2 diabetes are increasing in the United States and other
countries. Obesity-related health problems affecting fertility and the
course and outcome of pregnancy are being seen increasingly in clinical
practice.

7. Variation in clinical signs associated with PCOS

8. Key features of the Nutrition Care Process for
individuals with celiac disease
Treatment of celiac disease focuses on the goals of elimination of gluten
from the diet, correction of vitamin and mineral deficiencies, and the long-
term maintenance of health. The cornerstone of treatment—elimination of
gluten—can be challenging.

9. Nutrition During Pregnancy
• Pregnancy represents the most significant period of growth and
development for humans, lasting nine months.
• The outcome of pregnancy depends on various factors, many of
which can be modified. Among these, nutritional status plays a
crucial role.
• Optimal nutritional status during pregnancy is essential for the
well-being of both the mother and the developing fetus.
• Physiological changes that occur during pregnancy and their
impact on maternal nutritional.

10. Normal changes in maternal physiology during pregnancy

11. Mechanisms of nutrient transport across the placenta

12. Notes on normal embryonic and fetal growth and development

13. Range of daily dose levels of nutrients in 12 prenatal supplements and comparison
with recommended intake levels during pregnancy and mean intakes of nutrients for
women age 20–29 years

14. Nutrition During Pregnancy (condition and
Intervention)

15. The American Diabetes Association recommendations for the
management of type 2 diabetes in pregnancy

16. Best practice recommendations for
nutrition during multifetal pregnancy
• Nutritional recommendations for women with multifetal
pregnancies are largely based on logical assumptions and
theories due to a lack of study results.
• For example, caloric needs for twin pregnancies are reasoned to
be extrapolated from weight gain.
• Theoretically, to achieve a 40-pound (18.2 kg) weight gain, or 10
pounds (4.5 kg) more than in singleton pregnancies, women with
twins would need to consume approximately 35,000 extra calories
during pregnancy compared to women with singleton pregnancies.
• This increase would amount to about 150 extra calories per day
above the level for singleton pregnancies, or an average of 450
extra calories per day compared to pre-pregnancy levels.

17. Nutrition recommendations for pregnant women with HIV

18. Nutrition During Lactation

19. Nutrition During Lactation

20. Nutrition During Lactation
• Maternal benefits of breastfeeding include minimization of postpartum blood
loss, delayed fertility, greater self-confidence and bonding with the baby, and
reduced risk of ovarian and breast cancers.
• Newborns who are getting adequate human milk have about six wet diapers and
three to four soft, yellowish stools per day by 5–7 days postpartum. Even slow
gainers are alert, bright, and responsive, whereas infants who are failing to thrive
are apathetic, hard to arouse, and have a weak cry.
• Removal of milk from the breast is the stimulus for making more milk. Most
women can make enough milk for their infant, although storage capacity (breast
size) differences may determine how often the infant feeds in 24 hours.
• Breastfed infants should be supplemented with vitamin K at birth and with 400 IU
of vitamin D per day beginning at 2 months.

21. Nutrition During Lactation: Conditions and Interventions
• Successful breastfeeding management relies on providing
informed, consistent, and individualized support to the mother–
infant breastfeeding pair, both during their hospital stay and
after discharge.
• Health care professionals play a crucial role in offering guidance
and assistance to ensure a smooth breastfeeding experience
for both the mother and the infant.
• The emphasis is on proactive measures, such as prenatal
education, to prevent common breastfeeding challenges and
create a supportive environment from the start.

22. Common breast problems and their symptoms

23. Hyperbilirubinemia and Breastfeeding
• Jaundice in breastfed infants is categorized into early or late onset types
based on the age of onset.
• Early onset jaundice (breastfeeding jaundice) occurs when there is an
unexplained elevation of unconjugated bilirubin in the first few days after birth
due to inadequate feeding.
• Late onset jaundice, occurring after day 5, is termed breast milk jaundice. It
involves prolonged elevation of unconjugated bilirubin associated with the
ingestion of breast milk.
• Differentiating between these types of jaundice is crucial for establishing
effective prevention and treatment strategies.

24. When should a mother avoid breastfeeding?

25. Storage duration of fresh human milk for use
with healthy full-term infants

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