Nutrition in Pregnancy

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Author:
sdelap
ID:
131279
Filename:
Nutrition in Pregnancy
Updated:
2012-01-28 22:23:28
Tags:
Maternal Child Nutrition Pregnancy
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Description:
Maternal Child: Nutrition in Pregnancy
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  1. Optimal wt gain in PG
    Maternal normal wt: 25 - 35lbs

    • Maternal underweight: 28 - 40lbs
    • Maternal overweight: 15 - 25lbs
    • Maternal obesity: 11 - 20lbs

    Twins: 35 - 45lbs
  2. Weight gain distribution
    11lbs + Fetus, placenta, amn fluid

    • 2lbs Uterus growth
    • 4lbs Increased blood volume
    • 3lbs Breast changes
    • 5-10lbs Maternal stores and ECF increae
    • 25+lbs

    Should not restrict calories to lose wt in PG (ketosis) dangerous to fetus.
  3. Pattern of Wt Gain in PG
    "Rule of 1/3, 1/26"

    • 1lb per MONTH, first 3 months
    • 1lb per WEEK next 26 weeks

    >2lb / wk is excessive and should be evaluated
  4. Poor wt gain during first 20 wks causes
    • SGA infant
    • Small for Gestational Age
  5. Poor wt gain 2nd 20 wks causes:
    Preterm birth risks
  6. Obesity and PG Risks
    • Major health concern - "high risk " PG
    • Increased risk for:
    • SAB (spontaneous abortion)
    • Gestational DM
    • Preeclampsia
    • Induction of labor
    • Cecarean birth
    • Fetal anomalies
  7. Recommended supplenents during PG
    • Folic acid - before and during pregnancy
    • Iron (2nd/3rd trimester)
    • Daily vitamin supplement
  8. Iron supplementation in PG
    • Anemia = PTL and SGA infants
    • Sources of Fe: lean meat, dark leafy green vegs, eggs, whole grains, dried fruits, legumes, shell fish, molasses, prune juice
    • Fe absorption better from meats vs. vegs
    • Vit C incr Fe absorption
    • Fe better abs at HS w/food

    • Physiologic anemia of PG "dilutional effect" more fluids
    • Anemic Hct<33%; Hgb<11

    • Compare CBC, H&H from 1st to 3rd trimester
    • Every woman will have dilutional
  9. Folic Acid (folate)
    • Deficient folic acid = neural tube defects (NTD's): Spina bifida, Anecephaly
    • 400mcg daily
    • 4mg daily (high risk group)

    Sources: fresh green leafys, nuts, legumes, OJ, whole grains
  10. PKU (Phenylketonuria)
    • Avoid all sources of aspartame/nutrasweet/equal during PG
    • Read labels

    • Lack enz to digest phenylalanine byproducts
    • Accumulates in body
    • Affects baby brain, causes MR
  11. Fluids
    64 - 80 oz daily / half or more water

    • Dehydration: contractions, cramping, PTL
    • Decreased amn fluid
    • Faffeinated bevs = diuretic, vasoconstriction
  12. Mecury in Fish
    • Fish/shelfish contain trace mercury
    • Developing fetal brain/young child vulnerable
    • High levels: swordfish, shark, tilefish, mackerel, albacore tuna
    • Low levels: canned light tuna, shrimp, salmon, catfish, pollack
    • Avoid: >6oz fish/wk
    • Need some fish - omega 3's!
  13. Food Warnings
    • Raw eggs - Salmonella
    • Unpasteurized milk or un heated ready to eat foods - Listeriosis (hot dogs, deli meats, poultry, etc.)

    Lactose intolerant - lactase deficiency
  14. Increased calories needed during PG
    • +300 calories/day PG
    • +500 calories/day Lactating (2500 - 2700/day)

    • If lactating:
    • Protein - 62 - 65g/day
    • Calcium +1g/day
    • Fluids +++
  15. Fat soluble vitamins
    ADEK
  16. Water soluble vitamins
    • C
    • B's: thiamine (B1), riboflavin (B2), niacin, folic acid, pantothenic, B6 & B12
  17. GRAS
    Generally Recognized as Safe (during pregnancy)

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