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when can nutrition effect the infant?
before,, during and after pregnancy
when is the period of gestation and how is it broken down?
- period from conception till birth
- about 38 weeks
- in 3 trimesters (13 weeks each)
what are the three stages when the infant grows in the mother?
- 1. zygote: ovum + sperm (1-10 days)
- 2. embryo: develop infant from 2-8 weeks after conception; cell divion double every 24 hrs; size (1 oz) and development features +organs
- 3.fetus: from 9 weeks till birth; organs mature; from 1oz to 71/2 oz
what is LBW?
- low birth weight babies, less than 5.5 lbs
- more likely to die 1st yr
- make up 8.2% births
- count for 66% of deaths
what weight are infants not as risk as LWB?
- from 7 lbs 13 oz to 10 lbs
- have better mental status/health
- least likely to die in 1st year
what does poor maternal nutririon/lbw increase risk of?
chances to get chronic dz like heart dz, ad, lung dz, htn, etc
what is a critical period?
- times of intesne development
- must get right amount of nutrients or can not deveopl properly
- periods of rapid multiplication (hyperplasia)
- happen in first 2 months ususall, but can stil happen after
what happens to developing organ systems during critical periods?
they are more vunerable to adverse influences (toxins, lack of nutrients)
what happens if not get right nutrieents during critical periods?
- can lead to stunted develop
- life long defects in organs +tissues
- birth defects
what is an example regarding neural tube dev given in class?
- in brain in nervous systm
- happen between 3-4 weeks after conception
- inadequate folate can lead to defects in briain/cns
- many women not know preg and not take precautions
what is another example given in class regarding pancreas develop?
- it undergoes quick develop in 3rd trimester
- not effected by shortage of folate
what is sga and lga?
- small gestational age: newborn weight less than 10 percentile for gestational age
- large gestational age: birth weight greater than 10 lbs (90th percentile) is excessive for size of gestational age
what influences a infants birth weight?
- 1.weight prior to preg.
- 2.how much she gains during preg.
when are lbw rates higher?
in women who gain too little weight during preg.
what is the weight recommendations for infants?
7 lbs (13 oz) -10 lbs
what is most of the weight the mother puts on?
- in lean tissue (other than fat: placenta, fetus, uterine blood supply)
- some gained by fat later for lactation (best so mom can loose fat)
what are the ranges for weight gain according to BMI?
- normal = 25-35 lbs
- underweight = 28 lbs min
- overwight= 15-25 lbs
- obese= 15 lbs
what comes out of women gaining right weight and too much weight?
- half likely to deliver lbw and sga
- more likely to deliver lga
what increase for mom if deliver lga?
gestaional dm, c-section, postpardum
what is the rate gain of preg?
- 1 lb/week after 13-14 weeks
- majority of weight should be after 1st trim.
- 4 lbs weight increase 1st trimester ( too much can lead to dm)
where does weight do when gained?
- 1/3 to fetus
- rest to maternal tissues: placenta, extra blood, fat store
- ***weight gain is related to lean tissue!!
why are xtra nuteients needed?
- to support things
- for infant growth (bone, muscle, etc)
what are the energy needs and the pattern?
- 1st trim = 340 kcal/day
- 2nd trim= 452 kcal/day
- need more energy as stages progress (1,2,3)
what can alcohol lead to?
- to abnormal mental develpment (perminant)
- just dont drink at all!!
Should preg women worry about increasing their protien need?
- no because consume it normally in diet
- dri increases by 25 g/day
what happens when women get enough epa, lal, dha?
- baby have higher intelligence, vision
- decrease risk of deliver preterm
how would u incease epa and dha?
- taking supplements, prenatal supplements
- also eating cold fish (limit 12 oz/wk)
what fish should be avoided and what is bioaccumulation?
- swordfish, king mackeral, tile fish, shark
- large fish eat smaller fish, higher con.
- can eat white tuna-6 oz/week max
why is folate needed and what happens if not gotten?
- new cells, dna syn, helpwith growth
- involved in rbc production
- can cause anemia in mom/fetus and reduce growth
- help converts methionine to cysteine; if homocysteine builds in blood then cause problems, shortage of methionine
what are the forms of folate and their bioavailabilities (how much is absorbed)?
- 1. monoglutamate (folic acid): found in synthetic/fortified foods; bioavai= 85-100%
- 2. polyglutamate (dietary folate): fruits/veg. bioavai= 50%
what do high levels of homocysteine cause?
ruptered placenta, still birth(death at birth), pre-term deliver, birth defects, reduced birth wt
what can lack of folate after 21-27 days after conception lead to and what are the categories?
- neural tube defects (malform brain/spine):
- 1. spina bifida= spinal cord not form ok, lead to paralysis
- 2. anencephaly= born with no brain
- 3. enceophalocele= brain out of skull
what are the rquired amounts and sources?
- normal= 400 mg
- pregnan= 600 mg
- sources=dry bean, fruit, veg (dglv), process grain (white bread, rice) because of enrichment
what can vit a deficiency lead to?
malformed heart or lungs
what are good sources of vit a?
milk, liver, plant (dglv all the way through color!) fruit
when can vit a be toxic?
- taken in retinoic or retioc acid forms from supplements and animal sources
- acne skin tx can be toxic too
Why is vit d needed and what are sources?
- formation of bone + teeth
- fish, some mushrooms, milk, sun
why do people with dark skin tend to be more vit d deficient?
- they are protected from the sun more and synthesize vit d less
- 83% black, 40% white
risk for vit d defientcy are?
- dark skiinedd people
- not go outside
- heavy sunscrren
- foggy area people
- preg. women
what is recommended to get vit d?
- consume 3 c vit d milk
- take two 15 min sun baths/week
- dark skinned people need 2-5 x more sun
- winter sun not make enough vit d
what are ca main functions?
- build bone + teeth
- nerve transmission and muscle contract( heart stop if not get)
- help maintain bp
what are good sourcesof ca?
dairy, fortified soy, oj, dglv, brocolli, beans
what are the functions of fe?
- make hemoglobin help with O and CO2 transport
- hg in rbc take O to tissues
- hg removes waste of O metabolism, CO2 come out from lungs
what are fe need for preg women?
- normal= 14-50 yrs need 18 mg/day
- preg = 27 mg/day
- fe not get absorbed a lot (10%) and can lead to problem
what is fe deficincy and fe-deficient anemia?
- 1. depleted fe stores;weakness, fatigue, poor appetite, irritable, more infections
- 2. low hg levels; paleness, exhaustion, quick hr
what are issues from fe deficinecy?
- less smarter, language, attention
- speech affected
- postpardum for mom
what are issues withfe supplementation?
- 1. abs of fe from milti mineral supplements is poorly abs (5%); take by itself
- 2.fe supplements have side effects like gi issues, nausea, cramp, gas, constipation; can lead to noncompliacne (make u feel like crap!)
what is the starting recommendation for preg?
30 mg/day by supplment at 12wk of preg!!
what are good sources of fe and other ways to get it?
- flesh foods, dry beans, fe fortified cereals, prunes, aprocits, raisins, dglv
- use fe pans, eat ca rich food, add vit c to foods
when is caffine safe in preg and what happen if get too mcuh?
- less than 200 mg/day (10 oz coffee)
- can lead to miscarrigage etc.
- watch: soda, tea, chocolate, energy drinks, drugs