nutrition 17

Preconception & Pregnancy Health for men

• avoid smoking, alcohol, and drugs, obesity ; need zinc, folate, and antioxidants vitamin C, E, carotenoids, for sperm health.

Preconception & Pregnancy Health women

• Reach a healthy weight before pregnancy.

• Take folic acid (400–600 µg) to prevent neural tube defects.

• Eat safe fish (avoid mercury-heavy fish).

• Limit caffeine (<200 mg/day).

• Avoid alcohol, smoking, drugs, unpasteurized foods, and risky supplements.

• The placenta delivers nutrients and oxygen while filtering waste; harmful substances (like alcohol) can cross it.

calorie needs first trimester

no calorie increase in intake

calorie needs 2nd trimester

+340 kcal/day

calorie needs 3rd trimester

+450 kcal/day

protein Needs during pregnancy

+35% (~71 g/day)

Folate needs during pregnancy

600 µg

Iron needs pregnancy

Supports red blood cells and placenta (take supplement)

Folate needs pregnancy

600 µg

Full-term pregnancy Lasts

39–40 weeks from conception to birth

Trimesters

Divided into three 13-week periods.

Prenatal development

embryo

From week 3 to 8.

Fetus

From week 9 until birth.

Placenta

• Exchanges nutrients, oxygen, and waste via umbilical cord.

• Prevents bacteria and large proteins from passing, but alcohol, drugs, and medications can cross.

• Produces hormones needed for pregnancy support

risks of being overweight during pregnancy

risk of gestational diabetes, preeclampsia

risk of being underweight during pregnancy

SGA or preterm.

During pregnancy rules

Avoid alcohol, drugs, raw meats, unpasteurized dairy, second-hand smoke.

Carbs intake during pregnancy

175g/day minimum.

Zinc & Copper

• Cell division, energy, connective tissue.

Calcium

Fetal bones; absorption increases.

Vitamin D:

Supports calcium use; linked to low birth weight and diabetes.

DHA & Choline

Brain and cell development

Limit Vitamin A

Excess can cause birth defects

Foods/Substances to Avoid during pregnancy

Alcohol, illicit drugs, smoking, unpasteurized dairy/juice, raw meat, raw sprouts

Foods/Substances to limit during pregnancy

• Caffeine: <200 mg/day.

• Fish: Eat 2–3 servings/week, but avoid mercury-heavy types (e.g., shark, swordfish).

• Artificial sweeteners: Use in moderation; avoid aspartame if you have PKU.

Low birthweight

<5.5 lbs

raise risk for complications, delays, and infant death.

SGA:

<10th percentile for gestational age.

raise risk for complications, delays, and infant death.

Pregnancy Weight Gain Recommended (normal BMI)

25–35 lbs total

1st trimester weight gain

1–4.5 lbs.

after first trimester weight gain

1lb / week for the remainder of the pregnancy.

Components of pregnancy weight gain

Fetus = 1/3 of weight;

remainder = placenta, fluid, maternal tissues.

Morning sickness

Often due to heightened smell; eat small carb meals, tart drinks.

Vitamin B6 and ginger can help.

Cravings dont have a link to morning sickness

Hyperemesis gravidarum

Severe vomiting → hospitalization.

Pica

Eating nonfood items (clay, starch); may suggest iron deficiency.

Food Safety

Immune systems of mother and baby are weak.

Listeria monocytogenes

miscarriage, birth defects.

Avoid

Raw meats, unpasteurized cheese/milk/juice, raw sprouts.

Gestational diabetes

• Can cause macrosomia (large baby)

• jaundice,

• breathing issues.

Risk factors for Gestational diabetes

-obesity

-older than 25 y/o

-family history

-ethnicity (Hispanic, Black, Native)

-prior GDM

Pregnancy-induced hypertension

• Gestational

• Preeclampsia

• Eclampsia

preeclampsia

High BP + edema + protein in urine → restricted blood flow to fetus.

eclampsia

Seizures;

life-threatening;

cure = delivery.

gestational hypertension

New high BP

Negative factors that contribute to pregnancy complications

smoking, alcohol, drugs, poor nutrition, certain medications, unmanaged chronic conditions (e.g. PKU, diabetes).

hormones involved in lactation and breast feeding

Prolactin

Oxytocin

prolactin

Milk production.

hormone produced by pituitary gland

stimulates mammary gland development

oxytocin

Triggers letdown reflex (milk ejection).

Colostrum

Early milk; low fat, high protein & immune factors.

Mature milk

Foremilk

Hindmilk

foremilk

Watery, quenches thirst.

Hindmilk

Higher fat, satisfies hunger.

breast feeding benefits for baby

Lower risk of infections, obesity, diabetes, and allergies.

DHA & AA support brain/vision.

breast feeding benefits for moms

-Faster uterine recovery,

-lower cancer risk,

-burns calories.

-Saves $1200/year vs formula.

breast feeding recommendation

Exclusively breastfeed 6 months, continue with solids up to 1 year+.

breast feeding needs

13 cups fluid/day

• +500 kcal/day (first 6 months),

• +400 kcal/day (second 6 months)

first 6 months required calorie intake for breast feeding

+500 kcal/day

second 6 months required calorie intake for breast feeding

+400 kcal/day

Avoid what during breast feeding

Alcohol, smoking, drugs, high-mercury fish.

limit what during breast feeding

Caffeine.

why can babies taste what mom eats in her milk

Baby tastes what mom eats → early flavor exposure can promote solid food acceptance.

Breastfeeding at Work

• Requires support (break time, private space).

• Leads to fewer sick days, more productivity.

Who Should NOT Breastfeed

• HIV/AIDS,

• active TB,

• undergoing chemo,

• using illicit drugs.

• Babies with galactosemia.

• Check prescriptions with doctor.

Babies with galactosemia.

A genetic condition that affects the body's ability to process the sugar galactose, leading to serious health complications. Infants with this condition should not be breastfed as breast milk contains galactose.

Formula as an Alternative

• Safe alternative when needed.

• Mimics breast milk; made from cow’s milk or soy.

• Avoid unmodified cow’s milk (too much protein/sodium).

• Don’t let baby sleep with bottles → tooth decay, ear infections.

Infancy

0-12 months

• Rapid growth: Weight doubles by 6 mo, triples by 1 year.

• Failure to thrive (FTT): Delayed growth/weight gain.

what causes childhood caries

• Caused by letting infants sleep with bottles containing sugary liquids (milk, juice).

• Leads to tooth decay (also known as "nursing bottle caries" or "baby bottle tooth decay").

• Sugars stay on the teeth overnight and feed bacteria that destroy enamel.

Birth–6 months

Breast milk or formula only.

4–6 months

Introduce iron-fortified cereal, pureed vegetables.

6–8 months

Add pureed fruits, strained meats, and mashed beans.

8–10 months

Begin soft finger foods, yogurt, chopped soft fruits.

10–12 months

Add soft table foods, introduce sippy cup.

Failure to Thrive (FTT)

• A condition where a child fails to gain weight or grow at the expected rate.

• Can be caused by malnutrition, neglect, chronic illness, or feeding difficulties.

Why Are Infant’s Nutrient Needs So High?

• Rapid growth and development (brain, body, immune system).

• Weight doubles by 6 months, triples by 12 months.

• Length doubles by the end of the first year.

Food allergy

Immune system overreacts to a protein.

Anaphylaxis

Severe, life-threatening allergic reaction; needs epinephrine.

Food intolerance

Non-immune reaction (e.g., lactose intolerance = digestive issue).

Reaction Occurs in Two Stages

Sensitization Stage

Allergic Reaction Stage:

Sensitization Stage:

• First exposure to allergen.

• Immune system creates antibodies (but no symptoms yet).

Allergic Reaction Stage

• Upon re-exposure, the body reacts: rash, vomiting, breathing trouble, etc.

• Can be immediate or delayed.

When Are Infants Ready for Solid Foods

Usually between 4–6 months, when they meet these milestones:

Once Certain Milestones Are Met

• Able to sit up with support.

• Good head and neck control.

• Shows interest in food.

Tongue-Thrust Reflex

• The natural pushing of the tongue forward when something touches it.

• Must fade before spoon-feeding to prevent choking.

Why Introduce Solids Gradually & One at a Time

• Helps detect food allergies or intolerances.

• Allows the infant to adjust to textures and flavors slowly.

Cow’s Milk for infants

• Avoid until after 12 months.

• Too high in protein, sodium, and potassium, and too low in fat and iron.

Choking Hazards in infants

Avoid hard, round, or sticky foods like:

• Hot dog slices

• Grapes

• Raw carrots

• Nuts

• Popcorn

Honey in infants

• Can cause infant botulism, a rare but serious illness.

• Avoid until after 12 months.

seasoning to avoid with infants

Avoid adding salt, sugar, butter, margarine to foods.