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
    • SGA (Small for Gestational Age)
  • Excessive weight gain may lead to complications.

Recommended Weight Gain During Pregnancy

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

Pattern of Weight Gain

  • The pattern of weight gain is as important as the amount of weight gained.
  • Average woman should gain 0.5-2 kg (1.1-4.4 lbs) during the first trimester.
  • Thereafter, weight gain should be 0.35-0.5 kg (0.8-1 lb) per 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

  • Energy
    • Carbohydrates
    • Fats
    • Calories (nutrient density)
  • Protein
  • Vitamins
    • Folic acid: Neural tube deficit prevention
  • Minerals
    • Iron
    • Sodium
    • Calcium
      • Lactose intolerance
  • Nutritional supplements
    • Disadvantages and dangers
  • Water

Calcium Sources (Approximately Equivalent to 1 Cup of Milk)

  • ¾ cup yogurt, fruit, 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.
  • Do not consume pâté or meat spreads or raw (unpasteurized) milk products.

Factors That Influence

  • Age
  • Nutritional knowledge
  • Exercise
  • Culture

Nutritional Risk Factors

  • Socioeconomic status
    • Poverty (food supplement programs – WIC)
  • Adolescence: Nutritional needs are greater
  • Vegetarianism
  • Lactose intolerance
  • Nausea and vomiting
  • Abnormal pre-pregnancy weight
  • Multiparity and multifetal pregnancy
  • Substance use and abuse
    • Smoking, caffeine, alcohol, or drugs

Nutritional Assessment

  • Interview
    • Appetite
    • Eating habits
    • Food preferences
    • Psychosocial influences
  • Physical assessment
    • Weight at initial visit
    • Weight at subsequent visits
    • Signs of nutrient deficiency
  • Laboratory tests
  • Diet history
    • 24-hour recall
    • Food intake records
    • Food-frequency questionnaires

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