1. Life Cycle Nutrition: Pregnancy and Lactation
Chapter 15

2. Nutrition Prior to Pregnancy
Nutrition may affect fertility
Preparation before pregnancy
Achieve and maintain healthy body weight
Choose an adequate and balanced diet
Be physically active
Receive regular medical care
Manage chronic conditions
Avoid harmful influences

3. Growth and Development During Pregnancy
Placental development
Develops in uterus
Amniotic sac and umbilical cord
Expelled during childbirth
Interweaving of fetal and maternal blood vessels
Metabolically active organ
Requires energy and nutrients
Produces hormones

4. Growth and Development During Pregnancy
Fetal growth and development
Fertilization of an ovum by a sperm
Zygote
Rapidly divides to become blastocyst
Implantation
Embryo
Eight weeks
Fetus
Full-term

5. Growth and Development During Pregnancy
Critical periods
Times of intense development
Cellular activities can occur only during these times
Adverse influences on organ and tissue development

6. Growth and Development During Pregnancy
Neural tube defects
Anacephaly
Brain either missing or fails to develop
Spina bifida
Incomplete closure of spinal cord & its bony encasement
Folate supplementation

7. Growth and Development During Pregnancy
Chronic diseases
Adverse influences at critical times during fetal development
Malnutrition – type 2 diabetes
Inadequate growth during placental & gestational development – hypertension
Fetal programming
Mother’s nutrition may change gene expression in fetus

8. Maternal Weight
Birthweight is most reliable indicator of infant’s health
Weight prior to conception
Influences fetal growth
Underweight
Rates of preterm births and infant deaths
Overweight & obesity
Medical complications
Risks for infant

9. Maternal Weight Weight gain during pregnancy
Fetal growth and maternal health
Correlates closely with infant birthweight
Predictor of health and development
Recommended weight gains

10. Recommended Weight Gains

11. Maternal Weight Weight gain patterns Components of weight gain
3.5 pounds in first trimester
1 pound per week thereafter
Large weight gain over short time
Preeclampsia
Components of weight gain
Placenta, uterus, blood, breasts, fluid volume, baby

13. Maternal Weight Weight loss after pregnancy
Return to prepregnancy weight
Not typical
Retain a couple of pounds with each pregnancy
Seven or more pounds; BMI increase 1 unit

14. Exercise During Pregnancy
Can continue exercise throughout pregnancy
Adjust duration and intensity
Benefits
“Low-impact” activities
Fetal development
Excessively high internal body temperature
Dehydration

15. Energy & Nutrient Needs During Pregnancy
Needs tend to be higher than any other time in life
To meet needs
Make careful selections
Body maximizes absorption
Body minimizes losses

16. Energy & Nutrient Needs During Pregnancy
Increase in basal metabolic rate
Second and third trimester
Food energy
15 to 20% more energy than before pregnancy
Nutrient-dense foods

17. Energy & Nutrient Needs During Pregnancy
Carbohydrate
Ample carbohydrate is necessary
Protein
RDA – additional 25 grams per day
Supplements are discouraged
Essential fatty acids
Omega-3 and omega-6 fatty acids for brain material

18. Energy & Nutrient Needs During Pregnancy
Blood production and cell growth
Fetal growth and development
Maternal red blood cell mass
Needs for synthesis of DNA and new cells
Folate
Vitamin B12
Iron
Zinc

19. Energy & Nutrient Needs During Pregnancy
Nutrients for bone development
Vitamin D
Deficiency interferes with calcium metabolism
Calcium
Absorption and retention increase
Intake usually falls below recommendations
Other nutrients
Optimal interval between pregnancies

20. Energy & Nutrient Needs During Pregnancy
Prenatal supplements
Calcium
Folate
Iron
Benefits of use

21. Vegetarian Diets During Pregnancy & Lactation
Can support healthy pregnancy and lactation
Well planned
Food sources
Vegan diets
Additional supplementation

22. Common Nutrition-Related Concerns of Pregnancy
Nausea
“Morning sickness”
Hormonal changes
Constipation and hemorrhoids
Heartburn
Food cravings and aversions
Hormone-induced changes
Nonfood cravings

23. High-Risk Pregnancies
Infant’s birthweight
Low birthweight (LBW)
5 ½ pounds or less
Risk of complications
Relationship with socioeconomic status
Gestational age

25. High-Risk Pregnancies
Malnutrition and pregnancy
Fertility
Viable sperm
Sexual interest
Amenorrhea
Early pregnancy
Placenta development
Fetal development
Consequences

26. High-Risk Pregnancies
Food Assistance Programs
WIC
Nutrition education and nutritious foods
Vulnerable populations who qualify for help
Cost-benefit
Remedial and preventive services

27. High-Risk Pregnancies
Maternal health
Preexisting diabetes
Risks associated with unmanaged diabetes
Gestational diabetes
Common consequences
Dietary recommendations

28. High-Risk Pregnancies
Maternal health
Chronic hypertension
Risks
Gestational hypertension
Preeclampsia
Cause is unclear
Risks for mother
Risks for fetus
Eclampsia

29. High-Risk Pregnancies
Maternal age
Ideal childbearing age
Adolescents
Risk of pregnancy complications
Higher rates of stillbirths, preterm births, and LBW infants
Weight gain recommendations
Need to seek prenatal care

30. High-Risk Pregnancies
Maternal age
Older women
Complications often reflect chronic conditions
Cesarean section rates increase
Maternal death rates are higher
Risks for fetus

31. High-Risk Pregnancies
Alcohol consumption
Irreversible mental and physical retardation
Fetal alcohol syndrome (FAS)
Medicinal drugs
No medication use without consulting physician
Herbal supplements
Seek physician advice

32. High-Risk Pregnancies
Illicit drugs
Many drugs easily cross the placenta
Impair fetal growth and development
Other risks to fetus, infant, and child
Smoking and chewing tobacco
Harmful effects magnified during pregnancy
Risks for mother and infant
SIDS

33. High-Risk Pregnancies
Environmental contaminants
Lead
Mercury
Foods to avoid
Supplements
Foodborne illness
Increased risk of listeriosis
Risks associated with illness

34. High-Risk Pregnancies
Vitamin-mineral megadoses
Excessive vitamin A
Fetal malformations
Caffeine
Miscarriage and fetal death
Fetal growth
Weight-loss dieting
Sugar-substitutes

35. Lactation: A Physiological Process
Hormones promote growth and branching of duct system & milk-producing cells
Prolactin
Milk production
Oxytocin
Cause mammary glands to eject milk into ducts

37. Breastfeeding: A Learned Behavior
Lactation is an automatic, physiological process
Breastfeeding is a learned behavior
Some decide not to breastfeed
Factors influencing breastfeeding and its success
Partner
Adequate nutrition and rest

38. Maternal Energy & Nutrient Needs During Lactation
Energy intake and exercise
Almost 500 extra kcalories per day
Exercise is compatible with breastfeeding
Energy nutrients
Recommendations increase for carbohydrates and fibers
Water
Prevent dehydration

39. Maternal Energy & Nutrient Needs During Lactation
Vitamins and minerals
Inadequacies reduce the quantity, not quality of breast milk
Quality maintained at expense of maternal stores
Prolonged inadequate intakes
Impacts several nutrients
Supplements
Iron

40. Maternal Energy & Nutrient Needs During Lactation
Food assistance programs
Participants are less likely to breastfeed
WIC incentives to encourage breastfeeding
Particular foods
Flavors
Allergies

41. Maternal Health HIV infection and AIDS Diabetes – type I
Transmission through breastmilk
Medications
Diabetes – type I
Postpartum amenorrhea
Does not protect from pregnancy
Breast health
Breast cancer

42. Practices Incompatible With Lactation
Alcohol
Easily enters breast milk
Infants eat less when mother consumes alcohol
Medical drugs
Physician consultation
Illicit drugs
Risks

43. Practices Incompatible With Lactation
Smoking
Reduces milk volume
Sleep less
Passive smoking and SIDS
Environmental contaminants
DDT, PCBs, and dioxin
Caffeine
Iron bioavailability