Ch. 17 (Part 1)

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Kymberli
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82418
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Ch. 17 (Part 1)
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2011-05-01 18:36:48
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Nutrition Pregnancy Infancy Childhood
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Nutrition Exam 3
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  1. Nutrition during pregnancy:
    is CRITICAL to the HEALTH of a woman's FUTURE CHILD throughout life.
  2. Nutrient demands of pregnancy are:
    EXTRAORDINARY
  3. 3 GOALS OF PREGNANCY:
    • 1.) Baby is healthy, biologically mature, NO complications
    • 2.) Baby's gestational age is MORE THAN 37 weeks
    • 3.) Baby's birth weight is GREATER THAN 2500g (=5lbs.)
  4. Preparing for Pregnancy:
    BEFORE pregnancy, a woman MUST establish eating habits that will nourish BOTH the growing fetus & herself
  5. RECENT use of oral contraceptives (birth control) INCREASES the NEED for 4 NUTRIENTS:
    • 1.) Vitamin C
    • 2.) Vitamin B6
    • 3.) Vitamin B12
    • 4.) Folate
  6. 3 REASONSto be WELL NOURISHED at the OUTSET of Pregnancy:
    • 1.) EARLY in pregnancy: embryo undergoes rapid & significant DEVELOPMENTAL CHANGES that depend on good nutrition
    • 2.) 1st TRIMESTER: birth defects from UNUSUAL dietary habits or DRUG USE occur
    • 3.) 2nd & 3rd TRIMESTERS: birth weights are MORE AFFECTED by nutrient intake
  7. Fathers-to-be:
    SEDENTARY lifestyle & eating too FEW FRUITS & VEGETABLES may affect men's fertility & the fertility of their children
  8. * Pre-Pregnancy Weight:
    A woman who starts out UNDERWEIGHT and does NOT gain enough DURING pregnancy is VERY LIKELY to have a baby with DANGEROUSLY LOW BIRTHWEIGHT.
  9. *Infant BIRTHWEIGHT is:
    the MOST potent single INDICATOR of an infant's FUTURE HEALTH
  10. * If mom is UNDERWEIGHTt:
    • 1.) The FETUS is PROTECTED at the EXPENSE of the MOTHER
    • 2.) IRON & CALCIUM can be DEPLETED (taken away from) in MOTHER
  11. Low-Birthweight (LBW) -
    • baby weighs < 5.5 lbs at birth
    • baby is 40 x MORE LIKELY to DIE in the 1st YEAR of LIFE than a normal-weight baby
  12. 3 THINGS Low-Birthweight (LBW) is associated with:
    • 1.) LOWER adult IQ & other BRAIN impairments
    • 2.) EDUCATIONAL disadvantages
    • 3.) SHORT stature
  13. Obese Women & Pregnancy:
    Obese women should try to achieve a healthy weight BEFORE pregnancy
  14. Babies of Obese Mothers: (2)
    1.) may be LARGER than NORMAL & may NOT be RECOGNIZED as PREMATURE so the may NOT receive special medical care REQUIRED for them

    2.) may be 2x as LIKELY to be BORN with a NEURAL TUBE DEFECT
  15. Nutrition & the PLACENTA:
    The mother's nutrition BEFORE pregnancy DETERMINES whether her UTERUS will be able to SUPPORT the GROWTH of a HEALTHY PLACENTA during the 1st MONTH of GESTATION
  16. *CRITICAL PERIOD -
    the TIME PERIOD at which the TISSUES & ORGANS DEVELOP in the FETUS
  17. *2 Things about the Critical Period:
    • 1.) nutrients & environmental conditions that are REQUIRED during the critical period MUST be SUPPLIED for the organs to REACH their FULL POTENTIAL
    • 2.) the effects of malnutrition during the critical period are IRREVERSIBLE
  18. 3 Effects of Malnutrition During the CRITICAL PERIOD:
    • 1.) defects of the NERVOUS SYSTEM of the embryo
    • 2.) poor DENTAL HEALTH
    • 3.) vulnerability to INFECTIONS & possible HIGHER risks of DIABETES, HYPERTENSION, STROKE, HEART DISEASE
  19. ADDITIONAL Calories Needed Per Trimester:
    • 1st Trimester: 96 kcals/day
    • 2nd Trimester: 265 kcals/day
    • 3rd Trimester: 430 kcals/day
  20. 3 TYPES of WOMEN have HIGHER ENERGY (kcals) NEEDS during pregnancy:
    • 1.) Teenage women
    • 2.) Underweight women
    • 3.) Physically Active women
  21. EXTRA CALORIES: How MUCH do they NEED from the 5 FOOD GROUPS?
    They need 1 EXTRA SERVING from EACH food group
  22. Protein needs:
    an EXTRA 10 to 15g of PROTEIN is needed for TISSUE SYNTHESIS starting in the 2nd MONTH of PREGNANCY
  23. B-Complex Vitamins & Minerals needs:
    the need for B-complex vitamins & minerals are increased
  24. SUPPLEMENTAL Vitamin A:
    SUPPLEMENTAL Vitamin A is NOT advised UNLESS there is EVIDENCE of a DEFICIENCY
  25. 2 Dental Effects of Pregnancy:
    • 1.) Pregnancy Gingivitis: usually appears during the 2nd MONTH of pregnancy b/c of HORMONAL CHANGES
    • 2.) Enamel Erosion: frequent vomiting INCREASES the mouth's exposure to gastric secretions, which cause the enamel erosion
  26. 3 RISKS of Periodontal Disease DURING Pregnancy:
    • 1.) Preeclampsia (High BP & PROTEIN in URINE)
    • 2.) Delivery of premature baby
    • 3.) Low-Birthweight (LBW) baby
  27. 3 THINGS About BIRTH CONTROL (Oral Contraceptives):
    • 1.) they MIMIC pregnancy because they CONTAIN hormones
    • 2.) they can cause gingivitis with LONG-TERM use
    • 3.) women that use them are 2x MORE LIKELY to develop dry sockets
  28. *Oral Development Dates of the Baby:
    • Tooth development begins by: 6th week
    • Calcification begins by: 6th month
    • Mandible is calcified by: 4th month
  29. *The Baby's Teeth:
    • NUTRIENTS that are supplied by the mother MUST be AVAILABLE in the correct SEQUENCE for the DEVELOPMENT of pre-eruptive teeth & soft tissues
    • AFTER eruption, the teeth do NOT have a mechanism for self-repair
  30. *7 MALFORMATIONS caused by SEVERE Nutrient Deficiencies:
    • 1.) Cleft Palate
    • 2.) Cleft Lip
    • 3.) SHORTENED Mandible
    • 4.) SMALLER Teeth
    • 5.) Tooth formation INTERFERENCES
    • 6.) DELAYED Eruption
    • 7.) INCREASED Caries RISK
  31. *If the mother gets a FEVER while pregnant:
    • The fever will UPSET the calcium & phosphorus balance which will affect the baby's developing teeth
    • This leads to hypocalcification
  32. ORAL DEVELOPMENT & NUTRIENTS
  33. 6 THINGS that Dentin & Enamel DEPEND ON:
    • 1.) Vitamin A (keratin in enamel)
    • 2.) Vitamin C (formation of collagen matrix)
    • 3.) Vitamin D (mineralization)
    • 4.) Calcium (mineralization)
    • 5.) Phosphorus (mineralization)
    • 6.) Magnesium (mineralization)
  34. Caffeine consumption:
    EXCESSIVE caffeine consumption DURING pregnancy leads to an INCREASED caries susceptibility for the baby
  35. Fluoride exposure during pregnancy:
    fluoride that is taken DURING pregnancy has LITTLE benefits for the developing baby
  36. NUTRIENT NEEDS DURING PREGNANCY:
    • Carbohydrates
    • Protein
    • Fats
    • Folate
    • Vitamin B12
    • Calcium
    • Vitamin D
    • Iron
    • Zinc
  37. Carbohydrates (CHO):
    are NECESSARY to FUEL the fetal brain & SPARE the protein that is NEEDED for fetal growth
  38. Carbohydrates (CHO):
    • the fiber from them can help ALLEVIATE constipation
    • LOW CHO diets or fasting, which causes ketosis DEPRIVES the fetal brain of glucose & may IMPAIR brain development
  39. Protein:
    • the DRI of protein for pregnant women is HIGHER than for non-pregnant women
    • is HIGHER by 21 grams/day
  40. Fats:
    • essential fatty acids (EFA's) are IMPORTANT for the growth & development of the fetus brain is composed MAINLY of lipid material & DEPENDS HEAVILY on omega-3 & omega-6 fatty acids for its growth, function, & structure
    • hormonal changes CAUSE serum cholesterol & triglycerides to become significantly ELEVATED
  41. Folate & Vitamin B12:
    • BOTH play a ROLE in cell production
    • are needed in LARGE amounts
  42. 5 things about Folate:
    • 1.) needs for folate during pregnancy INCREASE from 400 to 600 micrograms/day
    • 2.) women should start taking folate supplements BEFORE getting pregnant
    • 3.) Folate is absorbed BETTER from SUPPLEMENTS than from FOOD
    • 4.) it is REQUIRED for red blood cell (RBC) formation
    • 5.) it plays a ROLE in PREVENTING neural tube defects
    • 6.) folate intake should NOT exceed 1 mg/day
  43. Neural Tube Defects (NTD) -
    • occurs when the neural tube FAILS to close PROPERLY
    • by the time a woman suspects she is pregnant (6th week), the embryo's neural tube has ALREADY normally closed
    • AFFECTS 30 of every 100,000 newborns
  44. 2 TYPES of Neural Tube Defects (NTD):
    • 1.) ANENCEPHALY
    • 2.) SPINA BIFIDA
  45. 1.) ANENCEPHALY -
    • the baby is born WITHOUT a brain
    • ALL infants with anencephaly die SHORTLY after birth
  46. 2.) SPINA BIFIDA -
    • occurs when the spinal cord & backbone do NOT develop NORMALLY
    • membranes covering the spinal cord PROTRUDE from the spine sac
    • sometimes a PORTION of the spinal cord is contained INSIDE OF the spine sac
  47. Vitamin B12:
    • more B12 is NEEDED to HELP folate make new cells
    • the RDA for B12 is 600 micrograms
    • you can get MOST from a normal diet with meat, eggs, & dairy
  48. 4 things Vitamin D is need for:
    • 1.) growth
    • 2.) bone ossification
    • 3.) enamel formation
    • 4.) calcium homeostasis
  49. * Calcium:
    • Calcium (along with phosphorus & magnesium) is in GREAT demand during pregnancy
    • it aids in the development of the bones & teeth
    • during pregnancy the intestinal absorption of calcium doubles
    • it is stored in the mother's bones during pregnancy & when the baby's bones begin to calcify, the mother's milligrams of calcium/day are transferred to the fetus through the placenta
  50. * Daily Requirement of Calcium during Pregnancy:
    • Women > 19 yrs old: 1000 mg/day
    • Women < 19 yrs old: 1300 mg/day
  51. T/F: If a mother is deficient in Calcium intake, the developing fetus will take its needed Calcium from the mother's teeth?
    FALSE.

    The developing fetus will take the needed Calcium from the mother's bones.
  52. 3 things about Iron:
    • 1.) during pregnancy the body avidly (greedily) conserves (saves) iron
    • 2.) the developing fetus relies heavily on its mother's iron stores to carry it through the first 3-6 months of life
    • 3.) the mother's blood losses during a c-section delivery drain her iron supply
  53. Iron supplements:
    • daily iron supplement containing 27-30 mg during the 2nd & 3rd Trimesters are recommended
    • take them between meals & with liquids OTHER THAN milk, coffee, or tea because these INHIBIT iron absorption
  54. T/F: iron deficiency anemia is common in women who are NOT pregnant.
    TRUE.
  55. Zinc:
    • is REQUIRED for protein synthesis & cell development
    • severe deficiency during pregnancy can cause Low Birth Weight (LBW)
    • is PROVIDED by protein-rich foods
    • iron INTERFERES with zinc absorption
    • RDA = 12 milligrams/day
  56. Prenatal Supplements & Pregnancy:
    • Must have physician Rx (prescription)
    • prenatal supplements provide MORE folate, iron, & calcium
    • iron supplements are the ONLY nutrient that is globally-warranted
  57. 4 high-risk groups that prenatal supplements are recommended for:
    • 1.) women pregnant with twins/triplets
    • 2.) cigarette smokers
    • 3.) alcohol abusers
    • 4.) drug abusers
  58. T/F: supplements CAN prevent the majority of destruction from tobacco, alcohol, & drugs.
    FALSE.

    Supplements can NOT prevent the majority of destruction from tobacco, alcohol, & drugs.
  59. How much does the normal-weight woman gain during pregnancy?
    • ~3.5 lbs TOTAL during the 1st trimester
    • 1 lb/week during 2nd & 3rd trimester
  60. TEEN PREGNANCY
  61. Nutrient needs for teens:
    Teens have a HARD time meeting their nutrient needs for their rapid growth & development LET ALONE those of pregnancy
  62. 6 NUTRIENTS that many teens ENTER pregnancy deficient in, which places them & the fetus at RISK:
    • 1.) Vitamin A
    • 2.) Vitamin D
    • 3.) Folate
    • 4.) Iron
    • 5.) Calcium
    • 6.) Zinc
  63. 2 Teen/Adolescent Pregnancy Statistics:
    • babies that are born to teens are 2x MORE LIKELY to be preterm & Low Birth Weight (LBW)
    • Neonatal death rate of teens is about TRIPLE (3X) that of babies that are born to adult women
  64. CAUTIONS FOR PREGNANT WOMEN:
    • Cigarette smoking
    • Mercury
    • Vitamin A
    • Sugar substitutes (Aspartame)
    • Caffeine
    • Alcohol
  65. Weird Pregnancy Cravings:
    • they may occur in those with nutrient-POOR diets
    • deficient in: iron, zinc, etc.
    • cravings: pickles, soil, clay, ice, starch, & other non-nutritious substances like pica
  66. Cigarette Smoking & Pregnancy:
    • parental smoking can kill an otherwise healthy fetus or newborn
    • nicotine & cyanide are TOXIC to a fetus
    • it restricts the blood supply to the fetus & limits the delivery of oxygen & nutrients & limits the removal of wastes
    • impairs fetal nutrition/development
  67. 5 things smokers tend to have LOWER intakes of:
    • 1.) Fiber
    • 2.) Vitamin A
    • 3.) Vitamin C
    • 4.) Beta-Carotene
    • 5.) Folate
  68. 4 Mercury limits:
    women who may become pregnant, lactating (breast feeding) mothers, & young children should NOT eat the following large ocean fish bc they contain mercury:

    • 1.) King fish
    • 2.) Swordfish
    • 3.) Shark
    • 4.) Tilefish
  69. 5 Mercury allowances:
    • They can eat a variety of safe fish & shellfish instead: (up to 12 ounces/week)
    • 1.) canned light tuna
    • 2.) salmon
    • 3.) pollock
    • 4.) catfish
    • 5.) shrimp

    ***albacore "white" tuna should be LIMITED to 6oz or LESS/week because is has MORE mercury than canned light tuna ***
  70. *3 Things about Vitamin A & Pregnancy: (3)
    • A single massive dose of preformed (supplement) vitamin A (100x RDA) has caused birth defects
    • CHRONIC use of lower doses of Vitamin A supplements (3-4x RDA) may also cause birth defects
    • ADDITIONAL Vitamin A is NOT recommended DURING pregnancy
  71. Sugar Substitutes & Pregnancy:
    • artificial sweeteners have been found to be acceptable during pregnancy
    • women with phenylketonuria (can't break down amino acid called phenylalanine) should NOT use aspartame (artificial sweetener)

  72. Caffeine & Pregnancy:
    • caffeine CROSSES the placenta
    • the fetus has LIMITED ABILITY to metabolize caffeine
    • pregnant women who drink MORE THAN 3 cups of coffee/day may INCREASE their RISK of spontaneous abortion
  73. Alcohol & Pregnancy:
    EVERY container of beer, wine, or liquor for sale in the U.S. is REQUIRED to WARN pregnant women about the DANGERS of drinking DURING pregnancy
  74. * 6 Effects of drinking Alcohol during pregnancy:
    • 1.) it crosses the placenta freely & is toxic
    • 2.) it HALTS the delivery of Oxygen through the umbilical cord
    • 3.) slows down cell division - during 1st month, the fetal brain is growing at the rate of 100,000 new brain cells per minute
    • 4.) even a few minutes of alcohol exposure during the critical period can exert a major detrimental effect
    • 5.) it can cause malnutrition in the mother
    • 6.) BEFORE fertilization, alcohol can damage the ovum or sperm in the mother- or father-to-be, which can lead to abnormalities in the child
  75. 5 things Fetal Alcohol Syndrome threatens the fetus with:
    • 1.) irreversible brain damage
    • 2.) growth retardation
    • 3.) mental retardation
    • 4.) facial abnormalities
    • 5.) vision abnormatlities
  76. Gestational Diabetes -
    occurs when an abnormal Glucose tolerance appears during pregnancy

    it usually resolves AFTER the baby is born
  77. 4 Risk Factors for Gestational Diabetes:
    • 1.) Personal history of Gestational Diabetes
    • 2.) Family history of Diabetes
    • 3.) Obesity
    • 4.) Glucose in urine
  78. Nutrition During Lactation (breastfeeding):
    a nursing mother produces about 24 oz of milk/day

    it REQUIRES 500 kcals to produce breast milk
  79. 3 Contraindications to Breastfeeding/Lactation:
    • 1.) Alcohol
    • 2.) Caffeine
    • 3.) Cigarettes/Nicotine
    • 4.) Other Drugs
  80. ALCOHOL enters the breast milk & can adversely affect its:
    • 1.) production
    • 2.) volume
    • 3.) composition
    • 4.) ejection
  81. T/F: Alcohol can overwhelm an infants immature alcohol-degrading system.
    TRUE.
  82. Why is CAFFEINE contraindicated while breastfeeding?
    EXCESS caffeine can make infant jittery & wakeful
  83. 2 main reasons why are cigarettes/nicotine contraindicated during pregnancy:
    • 1.) mother produces LESS breast milk, with LOWER fat content:
    • infants gain less weight
    • transfers nicotine & other chemicals to infant
    • exposes infant to secondhand smoke
    • 2.) baby can experience a wide array of health problems:
    • poor growth
    • hearing impairments
    • vomiting
    • breathing difficulties
    • unexplained death
  84. How long should a mother breast feed?
    up to 1 year
  85. 3 things to educate parents about:
    • 1.) Fluoride
    • 2.) ECC (Early Childhood Caries)
    • 3.) Good child dental care

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