Nutrition for Childbearing Notes

Weight Gain During Pregnancy

• Weight gain is an important determinant of fetal growth.
• Poor weight gain in pregnant women is associated with low-birth-weight infants, preterm birth, and SGA.
• Excessive weight gain may lead to complications: macrosomia; cesarean birth; low Apgar scores; hypoglycemia; overweight in children.

Recommended Weight Gain During Pregnancy

• Normal weight [BMI 18.5-24.9]: $11.5-16 \text{kg} \ (25-35 \text{lbs})$
• Underweight [BMI less than 18.5]: $12.5-18 \text{kg} \ (28-40 \text{lbs})$
• Overweight [BMI 25-29.9]: $7-11.5 \text{kg} \ (15-25 \text{lbs})$
• Obese [BMI more than 30]: $5-9 \text{kg} \ (11-20 \text{lbs})$

Pattern of Weight Gain

• The pattern of weight gain is as important as the amount of weight gained.
• The average woman should gain $0.5-2 \text{ kg} \ (1.1-4.4 \text{ lbs})$ during the first trimester.
• Thereafter, weight gain should be $0.35-0.5 \text{ kg/week} \ (0.8-1 \text{ lb/week})$.

Distribution of Weight Gain in Pregnancy

• Breasts
• Uterus
• Fetus
• Placenta
• Amniotic fluid
• Extravascular fluids
• Blood volume
• Maternal reserves

Factors That Influence Weight Gain

• Women at risk for inadequate weight gain:
  • Young
  • Unmarried
  • Low income
  • Poorly educated
  • Poor general health
  • Smoking or substance abuse
  • Lack of prenatal care

Nutritional Requirements During Pregnancy

• Carbohydrates
• Fats
• Calories (energy) / Calories (nutrient density)
• Protein
• Vitamins
• Neural tube deficit prevention: Folic acid

Iron, Minerals, Sodium, Calcium

• Iron
• Minerals
• Sodium
• Calcium
• Lactose intolerance
• Nutritional requirements during pregnancy
• Nutritional supplements
• Disadvantages and dangers
• Water

Calcium Sources

• Calcium sources approximately equivalent to 1 cup of milk:
  • ¾ cup yogurt (low-fat)
  • 1.5 oz cheddar cheese
  • 1 ¼ oz almonds
  • 3 ¾ oz dried pinto beans
  • 2 cups Cheerios cereal
  • 3 packets instant oatmeal
  • 3 English muffins

Foods High in Sodium

• Foods with sodium should be consumed in moderation during pregnancy:
  • Products with the words salt, sodium, or soda
  • Popcorn, potato chips, pretzels
  • Condiments such as pickles, olives, relish, ketchup, horseradish
  • Canned foods such as soups
  • Smoked, dried, or processed foods
  • Packaged mixes for sauces and gravies

Food Precautions

• Do not eat shark, swordfish, mackerel, or tile fish.
• Do not eat raw or undercooked fish, meats, poultry, or eggs.
• Avoid luncheon meats and hot dogs.
• Avoid soft cheeses.
• Pâté or meat spreads or raw (unpasteurized) milk products.
• Do not consume [incomplete in source]

Factors That Influence Nutrition

• Age
• Nutritional knowledge
• Exercise
• Culture
  • Southeast Asian dietary practices
  • Hispanic dietary practices

Socioeconomic and Other Risk Factors

• Socioeconomic status
  • Poverty (food supplement programs – WIC)
• Adolescence
  • Nutritional needs are greater
• Vegetarianism
• Lactose intolerance
• Nausea and vomiting
• Anemia
• Abnormal pre-pregnancy weight
• Eating disorders
• Food cravings and aversions
• Pica
• Multiparity and multifetal pregnancy
• Substance use and abuse
  • Smoking, caffeine, alcohol, or drugs
• Other risk factors
  • Food fads

Nutrition After Birth

• A lactating woman should consume an added 330 calories daily during the first 6 months.
• Maternal stores supply an additional 170 calories per day.
• Daily intake of 400 calories over non-pregnant requirements is needed daily during the second 6 months after birth.
• The postpartum woman who is not breastfeeding requires no added caloric intake.

Specific Concerns During Lactation

• Dieting or inadequate diet
• Adolescence
• Vegan diets
• Avoidance of dairy products
• Use of alcohol
• Use of caffeine
• Excess fluids
• Foods to avoid