pregnancy and breastfeeding. objectives- pregnancy identify the 4 nutrients of primary concern...

Pregnancy and Breastfeeding

Objectives- Pregnancy

Identify the 4 nutrients of primary concern during pregnancy

State recommendations on fish consumption, pre-natal vitamin/minerals and alcohol during pregnancy

State side effects of inappropriate weight gain Describe weight gain and goals for normal pre-

pregnancy weight List nutrition related issues and recommendations

Objectives- Breastfeeding

List nutrition needs of the mother List benefits of breastfeeding Describe the breastfeeding process including

suckling, prolactin and oxytocin, amount produced based on demand.

Describe the differences between colostrum and mature breastmilk.

Describe the nutrition content of breastmilk

Nutrition For Pregnancy

Choose My Plate Increased Protein

1.1 grams/kg + 25 grams/day (3 oz protein)

Folate Up to 1000 synthetic mcg/day DNA, reduce neural tube defects Pre-natal vitamin

Nutrition For Pregnancy

Iron 27-30 mg/day Increased blood volume, baby’s iron stores High in pre-natal Iron deficiency anemia….supplement 60 mg/day

Calcium 1000-1300 mg/day (4 cups a day) Last trimester- 300 mg/day transferred to baby Low in pre-natal

Basic Nutrition Guidelines

Prenatal vitamin-mineral supplement 1st trimester

2-4 pound weight gain, ↑ nutrients 2nd and 3rd trimester

1 pound a week weight gain, + 300 calories Moderate caffeine, sugar substitutes Adequate fluids Limit mercury containing fish

12 oz fish a week or less, variety

Alcohol

No safe known level #1 preventable birth defect Lifelong affects, cognitively and physically Fetal Alcohol Syndrome

Fetal Alcohol Syndrome

WIC

Women, Infants, Children Reduced income Pregnant, breastfeeding, infants, children Supplemental food and healthcare program

Appropriate Weight Gain

Helps prevent low-birth weight (less than 5 ½ pounds) Poor growth Delivery complications Undeveloped lungs Physical/neurological/developmental birth defects Susceptible to illness/poor immune system

Helps prevent excess weight gain Gestational diabetes, hypertension, other pregnancy

complications; childhood obesity Comfort for the mother!

Weight Gain Goals Pre-Pregnancy BMI

Low (BMI < 19.8) Normal (BMI 19.8-26) Overweight (BMI 26-

29) Obese (BMI >29) Teens

Recommended Gain

35-45 pounds 25-35 pounds 15-25 pounds 11-20 pounds Upper end of range

Nutrition Related Problems Morning Sickness

Cause- hormonal Eat whatever the mom wants

Fluid Retention Cause- hormonal Salt intake does not effect

Constipation Fiber and fluids

Food Cravings - Aversions Whatever the mom wants, doesn’t want Pica

Heartburn Remain elevated after meals, small meals

Nutrition Needs of Breastfeeding Mom

+ 500 calories/day or more + 20 grams protein or more 8-12 cups of fluids Continue pre-natal supplement Choose My Plate Limit caffeine, alcohol

Breastfeeding Benefits

Breastfeeding Benefits

Amount/Quality of Breastmilk

Poor diet Does not affect milk quality Limits amount produced Uses mom’s nutrient stores

Increase fluids and protein to increase milk supply

Breastfeeding Guidelines

Feed on demand Baby needs more baby nurse more

mom will produce more Proper latching on Establish breastfeeding, then bottle Milk production will adjust to feeding

routine Can breastfeed and bottle feed Pump

Colostrum

First fluid produced Thick, clear-yellow substance Contains antibodies, anti-infective factors

Boost immune system Lactobacillus bifidus factor

Facilitates stool passage

Mature Milk

Thin, watery, slightly bluish Composition changes during feeding time

Foremilk Resembles skim milk ~17% fat, ~74% CHO, ~9% protein

Hindmilk Resembles cream ~66% fat, ~28% CHO, ~6% protein

Nutrition Content changes with growth

Unique Composition

High in essential fats Linoleic, omega-3 (DHA, ARA)

Lactose - CHO Minimal digestion, low kidney solute load 200+ other substances Enzymes present for digestion Probiotics

Breastmilk Points of Interest

Many health benefits Small stools, rarely constipates, no smell Minimal “spitting up” Food flavors transfer History of food allergies, eliminate protein

from moms diet

Who Has Greatest Influence On The Likelihood Of Breastfeeding…

Dad