NUTRITION IN PREGNANCY & LACTATION

PREGNANCY

when the fertilized ovum implants itself in the uterus, undergoes differentiation and grows until it can support extra-uterine life.

266-280 days or 37-40 weeks.

-Human pregnancy lasts for a period of _______ or ______

implantation

organogenesis

growth

-With 3 trimesters that correspond to the 3 main phases:

80,000 kcal

During the course of pregnancy, the total energy cost of storage plus maintenance (additional work for maternal heart and uterus and a steady rise in basal metabolism) amounts to approximately_____

300 kcal

The energy cost of pregnancy then is about ______ per day.

36 kcal

The energy intake should be ___ per kg of pregnant weight per day.

500 calories

average energy increase of ____ on the 2nd half

constant

The weight of the blood volume and the

enlargement of the reproductive organs are

_____.

reserves of the mother

If the weight gain is less than the weight of the

maternal components in pregnancy, the growth

of the fetus calls on the _____.

Sigmoid

The normal curve of weight gain is ____ in

shape.

first trimester

Small weight gain is observed during the _____.

second trimester

More rapid weight gain happens in the ______.

3rd trimester

Slower weight gain recorded during the _____.

24

15-20

average gain is lbs during pregnancy or __

lbs (divided into 3, 7, and 7 lbs in 3 trimesters)

1.5-3.0

____ lb for the 1st trimester

0.8

_____lb per week for the remaining duration of

pregnancy

Patterns

____ of weight gain are more important than

the total amount gained.

20th

Sudden weight gain after the ____ week of

pregnancy may indicate water retention and

possible onset of pre- eclampsia.

7.5

Fetus

2.0

Uterus

1.5

Placenta

2.0

Amniotic Fluid

3.0

Blood Volume

2.0

Extracellular Fluid Accretion

1.0

Breast Tissue

9.0

Fat

28.0

MATERNAL WEIGHT GAIN TOTAL:

Underweight

• high risk of LBW infants

• high rates of pre-term deaths and infant deaths

HPN

Gestational diabetes

pp infections

Overweight

●high risk of complications

Overweight

• complications of labor and delivery

• difficult labor for large newborns - trauma and

CS

• double risk for neural tube defects

9.5

900-950

PROTEIN ALLOWANCES

• additional ___ grams/day, total of ____ g for 9

months of pregnancy.

14

68

PROTEIN ALLOWANCES:

___grams/day or a total of ___ grams/day for an

adult pregnant Filipino woman

14g

73g

PROTEIN ALLOWANCES:

pregnant adolescent (16-19 yo): additional

__ g/day, ___g total

provide storage for nitrogen

protect mother against many complications

growth of the woman's uterus, placenta, and

associated tissues.

Meet the needs for fetal growth and development.

Growth of mammary tissues

Hormonal preparation for lactation

Reasons for additional protein:

0.9

CALCIUM ALLOWANCES

700-1000mg throughout pregnancy

IRON ALLOWANCES

regular use of iodized salt in food

IODINE ALLOWANCES

Vitamin A

is increased due to its importance in organogenesis

Vitamin B6

important in preventing nausea and vomiting

1 ox or 30 g

_____ of meat or its equivalent and an extra pint

of milk to the normal diet.

whole grain cereals

enriched bread

rice

leafy

green and yellow vegetables

fresh and dried fruits

Daily consumption of:

once

Liver at least___ a week

Egg

___ in daily diet

vitamin D or fish liver oil

Fortified milk with ____

6-8

__ glasses of water daily

Nausea

Vomiting

Improper body weight

Toxemia

COMPLICATIONS OF PREGNANCY AND

POSSIBLE DIETARY MODIFICATIONS:

Small frequent feedings, high in carbohydrates, low-fat foods

Liquids between meals

So for those pregnant women ages 16-19 yrs old:

3 kg

Excessive weight gain in pregnancy is defined as

an increase of ___ or more per month in the 2nd

and 3rd trimesters.

eclampsia

Sudden increase in weight after 20th week AOG

is a warning sign of impending ____.

Above 500

250

Weight gain of ____ g per month during 1"

trimester and ____g during 2nd trimester can

lead to LBW or premature infants with brain and

nerve damage.

TOXEMIA

rapid weight gain

edema with high BP

excretion of albumin in urine

convulsions

TOXEMIA

1. Optimum nutrition with emphasis on protein

foods, iron, calcium, and minerals

2. Restricted salt intake for those with edema.

ANEMIA

• Macrocytic anemia is a combination of deficiency of iron and folic acid.

• Enhance absorption by inclusion of ascorbic acid-rich foods

DIABETES

rigid control of maternal blood glucose

concentration

CONSTIPATION

fresh fruits, vegetables, fluid and regular

exercise

ALCOHOL, CAFFEINE, NICOTINE

• smoking decreases oxygenation of fetus

• alcohol is linked to CNS disorders

• caffeine crosses the placenta rapidly limiting its

drug metabolizing ability

REPEATED PREGNANCIES

Increased parity tends to lower nutrient intake.

close interval between gestation depletes the

maternal reserves of nutrients

LACTATION

increase in calories, proteins, calcium, vitamin A,

thiamin, riboflavin, niacin, and ascorbic acid

700-1500

CALORIE ALLOWANCES

approximately ____ calories of food for

500-1000ml of milk

20.2

PROTEIN ALLOWANCES

average is additional ____ grams

1.0 g daily

calcium

400 IU

vitamin D

Colostrum

(first 3-4 days) - high in protein and antibodies

vitamin A

Niacin

Riboflavin

Thiamine

Ascorbic Acid

VITAMIN ALLOWANCES

Diet

Nutritional State of Mothers

Emotional and Physical State

Suckling

Use of contraceptives and drugs

FACTORS AFFECTING MILK SECTERION: