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  • Slide 1
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  • Chapter 15 Pregnancy & Lactation
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  • Prior To Pregnancy Goals-essential to conception & healthy infant development Achieve and maintain a healthy body weight Choose an adequate and balanced diet Be physically active Avoid harmful influences Copyright 2005 Wadsworth Group, a division of Thomson Learning
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  • Fetal Growth & Development Ovum + sperm zygote Zygote the first 2weeks after fertilization Implantation Embryo 2 to 8 weeks after conception Fetus from 8 weeks after conception to full-term Copyright 2005 Wadsworth Group, a division of Thomson Learning
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  • Critical Periods- if cell division and number are limited during a critical period full recovery is not possible Copyright 2005 Wadsworth Group, a division of Thomson Learning
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  • Critical Periods Neural tube defects Anencephaly-the neural tube fails to close so the brain is either missing or fails to develop Spina bifida-incomplete closure of the spinal cord and its bony encasement Folate supplementation reduces the risk Copyright 2005 Wadsworth Group, a division of Thomson Learning
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  • Weight Prior To Conception Increased medical risks if a woman is under- or overweight prior to pregnancy Prepregnancy weight affects development of healthy support tissues placenta, amniotic sac, etc. Prepregnancy weight affects infant birthweight Infant birthweight is the most potent predictor of infants future health & survival Copyright 2005 Wadsworth Group, a division of Thomson Learning
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  • Weight Prior To Conception Underweight Preterm Overweight and obesity Post term Cesarean section Dieting is dangerous because ketosis from fasting/low-CHO diets impairs fetal brain development Copyright 2005 Wadsworth Group, a division of Thomson Learning
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  • Weight Gain Copyright 2005 Wadsworth Group, a division of Thomson Learning
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  • Weight Gain Copyright 2005 Wadsworth Group, a division of Thomson Learning
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  • Weight Gain Copyright 2005 Wadsworth Group, a division of Thomson Learning
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  • Nutrient Needs Energy Extra food energy needed 1. No additional allowance is provided during the 1 st trimester 2. During the 2 nd & 3 rd trimesters RDA + 350-450 kcals/day 3. More if teenager, underweight, very active, or multiple gestation Protein RDA +25 grams/day (~70 gms); usually not a problem since most diets already exceed recommendation
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  • Nutrient Needs Vitamins Folate & Vitamin B12 needed in large amounts for rapid cell proliferation Folate needed for increased red blood cells and to help prevent neural tube defects 1. Recommendation increases from 400 micrograms/day during childbearing years to 600 micrograms/day during pregnancy usually from supplements Vitamin B-12 RDA during pregnancy is 2.6 mcg/day; supplements recommended for vegans
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  • Nutrient Needs Minerals needed for: 1. Bones & teeth calcium, phosphorous, fluoride involved in magnesium & fluoride involved in building the skeleton building the skeleton 2. Blood iron necessary for 50% increase in maternal blood volume and accumulation of fetal iron stores during the 3 rd trimester 3. Protein synthesis- zinc vital for DNA & RNA synthesis
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  • Nutrient Needs Calcium 1200 mg/day recommended to conserve maternal bone mass while supplying fetal needs Flouride supplements not recommended if water flouridated Iron increased need cannot be met by diet or existing stores so supplements (30 mg/day) recommended during 2 nd & 3 rd trimesters
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  • Copyright 2005 Wadsworth Group, a division of Thomson Learning
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  • High-Risk Pregnancies Copyright 2005 Wadsworth Group, a division of Thomson Learning
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  • High-Risk Pregnancies Copyright 2005 Wadsworth Group, a division of Thomson Learning
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  • Food Assistance Programs WIC Program helps low income pregnant women & their children (
  • Mothers Nutrient Needs During Lactation Fluids - >2 qts./day to prevent dehydration Prenatal vitamin supplements routinely prescribed - RDAs same or slightly higher for most nutrients except iron until menstruation resumes
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  • Mothers Nutrient Needs During Lactation Recommendation for protein the same as during pregnancy Vitamins & Minerals supplements generally recommended to replete maternal stores; prolonged inadequate intakes reduce the quality of the milk Water 3 L/day to prevent dehydration
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  • Lactation Certain foods, esp. with strong or spicy flavors, are avoided only if baby seems sensitive Caffeine may cause irritability & difficulty sleeping Alcohol easily enters breast milk Smoking decreases milk production Medicinal Drugs most are compatible but need to check with physician for those contraindicated Illicit Drugs high doses delivered in breast milk
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  • Lactation Breastfeeding considered the gold standard for infant feeding due to immunologic, health & social benefits Contraindications Communicable diseases (TB, hepatitis, HIV, etc.) and certain meds/drugs that adversely affect infant
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  • Energy & Nutrient Needs Copyright 2005 Wadsworth Group, a division of Thomson Learning
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  • Nutrient Needs