1. Life Cycle: Maternal and Infant Nutrition
Chapter 16
Life Cycle: Maternal and Infant Nutrition

2. Pregnancy Nutrition before conception
Risk assessment, health promotion, intervention
Weight
Maintain a healthy weight
Vitamins
400 micrograms folic acid/day
Avoid high doses of retinol
Substance use
Eliminate prior to pregnancy
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3. Pregnancy Physiology of pregnancy Stages of human fetal growth
Blastogenic stage: first 2 weeks
Cells differentiate into fetus, placenta
Embryonic stage: weeks 3–8
Development
of organ systems
Fetal stage:
week 9–delivery
Growth

4. Physiology of pregnancy
Maternal changes
Growth of adipose,
breast, uterine tissues
Increase blood volume
GI changes

5. Pregnancy Maternal weight gain Energy and nutrition during pregnancy
Recommendations depend on BMI
Normal weight (BMI = 19.8–26 kg/m2)
Gain 25–35 pounds
Energy and nutrition during pregnancy
Energy
Nutrients to Support Pregnancy
Macronutrients
Low-fat, moderate-protein, high-carbohydrate

6. Pregnancy Energy and nutrition during pregnancy
Micronutrients
Increase need for most vitamins and minerals
Highest increase for iron and folate
Food choices for pregnant women
Pyramid-style diet
Supplements of iron and folate
Foods to avoid
Substance use
Risk for birth defects,
low birth weight, preterm delivery

7. Special Situations During Pregnancy

8. Special Situations During Pregnancy
Food cravings and aversions
Hypertension
Diabetes
Gestational diabetes
HIV/AIDS
Adolescence
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9. Lactation Physiology of lactation Changes during pregnancy
Increased breast tissue
Maturation of structure
After delivery
Hormonal controls
Prolactin
Oxytocin

10. Lactation Nutrition for breastfeeding women Energy Protein
Higher needs than pregnancy
Vitamins and minerals
Most are higher or same as pregnancy
Iron and folate needs are lower
Water
Food choices

11. Lactation Supplementation Practices to avoid while breastfeeding
Alcohol, drugs, smoking, excess caffeine

12. Lactation Benefits of breastfeeding Benefits for infants
Optimal nutrition
Reduced incidence of respiratory, GI, and ear infections
Convenience
Other benefits
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13. Lactation Benefits of breastfeeding Benefits for mother
Convenience
Enhanced recovery of uterus size
Other benefits
Contraindications to breastfeeding

14. Resources for Pregnant and Lactating Women and Their Children
Agencies and education programs
March of Dimes
La Leche League
WIC

15. Infancy Growth is the best marker of nutritional status
Evaluated using growth charts
Weight gain
Double birth weight by 4–6 months
Triple birth weight by 12 months
Length gain
Increase length by 50 percent by 12 months
Head circumference

16. Infancy Energy and nutrient needs of infants
Based on composition of breast milk
Energy
Highest needs of any life stage
Protein
Carbohydrate and fat
Fat: major energy source
Carbohydrates: simple sugars
Water

17. Infancy Energy and nutrient needs of infants Key vitamins and minerals
Vitamin D
Vitamin K
Vitamin B12
Iron
Fluoride
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18. Infancy Newborn breastfeeding Alternative feeding: Infant formula
Standard
Soy-based
Other
Formula preparation

19. Infancy
Breast Milk or Formula: How Much Is Enough?
Feeding Technique

20. Infancy Introduction of solid foods Readiness for solids
Increased digestive enzymes
Loss of extrusion reflex
Able to sit without support
Age of about 4–6 months

21. Infancy Developmental Readiness for Solid Foods
Start Healthy Feeding Guidelines
Baby rice cereal
Strained fruits, vegetables, and meats
Add one food at a time

22. Infancy Feeding Problems During Infancy Colic Early childhood caries
Iron-deficiency anemia: milk anemia
Gastroesophageal reflux
Diarrhea
Failure to thrive

23. Promoting and Supporting Breastfeeding
It is the position of the Academy of Nutrition and Dietetics (AND) that exclusive breastfeeding provides optimal nutrition and health protection for the first 6 months of life, and breastfeeding with complementary foods for at least 12 months is the ideal feeding pattern for infants. Breastfeeding is also a public health strategy for improving infant and child health survival, improving maternal morbidity, controlling health care costs, and conserving natural resources.

24. Eating for Two
Pregnant women do not obtain adequate iron from diet alone, and should follow current recommendations for iron supplementation during pregnancy.
For other nutrients, the mother’s diet quality should be evaluated before recommending nutrient supplements.
Most pregnant women probably need folic acid supplements to meet increased requirements of pregnancy.

25. Energy-Yielding Nutrients for Infants
To support growth, protein needs (per kg body weight) are higher in infancy than in any other life stage.
The best diets for infants are high in fat and moderate in carbohydrate.

26. Nutrition to Prepare for Pregnancy
Ideally, the time to prepare nutritionally for pregnancy is well before conception. A woman who has adequate nutrient stores, particularly of folic acid, and is at a healthy weight can reduce the risk for maternal and fetal complications during pregnancy.
In addition to healthful diet selections, avoiding cigarettes, alcohol, and other drugs is important when contemplating pregnancy.

27. Cow’s Milk and Iron Deficiency
The use of cow’s milk for children younger than 1 year is a common cause of iron deficiency.
Cow’s milk is low in iron, and drinking cow’s milk can cause intestinal bleeding in infants.
The amount of iron in breast milk is low, but this iron is highly bioavailable.

28. ADA: Key Recommendations
Women of childbearing age who may become pregnant. Eat foods high in heme iron and/or consume iron-rich plant foods or iron-fortified foods with an enhancer of iron absorption, such as vitamin C-rich foods.
Women of childbearing age who may become pregnant and those in the first trimester of pregnancy. Consume adequate synthetic folic acid daily (from fortified foods or supplements) in addition to food forms of folate from a varied diet.

29. Weight During Pregnancy
Maternal obesity can complicate pregnancy and delivery and may compromise a baby’s health. Being too thin, meanwhile, carries its own risks.
Lean women with a BMI less than 20 kg/m2 have increased risks of preterm delivery and delivering a low-birth-weight infant.

30. Weight During Pregnancy
Overweight and obese women have increased risks of several problems, including preterm delivery and stillbirth.
In addition, obese women are at higher risk for:
high blood pressure
gestational diabetes (a form of diabetes that is associated with pregnancy; it often is controlled through diet alone)
preeclampsia (a condition marked by high blood pressure, fluid retention, and protein in the urine)
prolonged labor
unplanned cesarean section
difficulty initiating and continuing breastfeeding