Ch. 17 (Part 1)

is CRITICAL to the HEALTH of a woman's FUTURE CHILD throughout life.

EXTRAORDINARY

• 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.)

BEFORE pregnancy, a woman MUST establish eating habits that will nourish BOTH the growing fetus & herself

• 1.) Vitamin C
• 2.) Vitamin B6
• 3.) Vitamin B12
• 4.) Folate

• 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

SEDENTARY lifestyle & eating too FEW FRUITS & VEGETABLES may affect men's fertility & the fertility of their children

A woman who starts out UNDERWEIGHT and does NOT gain enough DURING pregnancy is VERY LIKELY to have a baby with DANGEROUSLY LOW BIRTHWEIGHT.

the MOST potent single INDICATOR of an infant's FUTURE HEALTH

• 1.) The FETUS is PROTECTED at the EXPENSE of the MOTHER
• 2.) IRON & CALCIUM can be DEPLETED (taken away from) in MOTHER

• 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

• 1.) LOWER adult IQ & other BRAIN impairments
• 2.) EDUCATIONAL disadvantages
• 3.) SHORT stature

Obese women should try to achieve a healthy weight BEFORE pregnancy

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

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

the TIME PERIOD at which the TISSUES & ORGANS DEVELOP in the FETUS

• 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

• 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

• 1st Trimester: 96 kcals/day
• 2nd Trimester: 265 kcals/day
• 3rd Trimester: 430 kcals/day

• 1.) Teenage women
• 2.) Underweight women
• 3.) Physically Active women

They need 1 EXTRA SERVING from EACH food group

an EXTRA 10 to 15g of PROTEIN is needed for TISSUE SYNTHESIS starting in the 2nd MONTH of PREGNANCY

the need for B-complex vitamins & minerals are increased

SUPPLEMENTAL Vitamin A is NOT advised UNLESS there is EVIDENCE of a DEFICIENCY

• 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

• 1.) Preeclampsia (High BP & PROTEIN in URINE)
• 2.) Delivery of premature baby
• 3.) Low-Birthweight (LBW) baby

• 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

• Tooth development begins by: 6th week
• Calcification begins by: 6th month
• Mandible is calcified by: 4th month

• 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

• 1.) Cleft Palate
• 2.) Cleft Lip
• 3.) SHORTENED Mandible
• 4.) SMALLER Teeth
• 5.) Tooth formation INTERFERENCES
• 6.) DELAYED Eruption
• 7.) INCREASED Caries RISK

• The fever will UPSET the calcium & phosphorus balance which will affect the baby's developing teeth
• This leads to hypocalcification

• 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)

EXCESSIVE caffeine consumption DURING pregnancy leads to an INCREASED caries susceptibility for the baby

fluoride that is taken DURING pregnancy has LITTLE benefits for the developing baby

• Carbohydrates
• Protein
• Fats
• Folate
• Vitamin B12
• Calcium
• Vitamin D
• Iron
• Zinc

are NECESSARY to FUEL the fetal brain & SPARE the protein that is NEEDED for fetal growth

• 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

• the DRI of protein for pregnant women is HIGHER than for non-pregnant women
• is HIGHER by 21 grams/day

• 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

• BOTH play a ROLE in cell production
• are needed in LARGE amounts

• 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

• 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

• 1.) ANENCEPHALY
• 2.) SPINA BIFIDA

• the baby is born WITHOUT a brain
• ALL infants with anencephaly die SHORTLY after birth

• 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

• 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

• 1.) growth
• 2.) bone ossification
• 3.) enamel formation
• 4.) calcium homeostasis

• 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

• Women > 19 yrs old: 1000 mg/day
• Women < 19 yrs old: 1300 mg/day

FALSE.

The developing fetus will take the needed Calcium from the mother's bones.

• 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

• 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

TRUE.

• 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

• Must have physician Rx (prescription)
• prenatal supplements provide MORE folate, iron, & calcium
• iron supplements are the ONLY nutrient that is globally-warranted

• 1.) women pregnant with twins/triplets
• 2.) cigarette smokers
• 3.) alcohol abusers
• 4.) drug abusers

FALSE.

Supplements can NOT prevent the majority of destruction from tobacco, alcohol, & drugs.

• ~3.5 lbs TOTAL during the 1st trimester
• 1 lb/week during 2nd & 3rd trimester

Teens have a HARD time meeting their nutrient needs for their rapid growth & development LET ALONE those of pregnancy

• 1.) Vitamin A
• 2.) Vitamin D
• 3.) Folate
• 4.) Iron
• 5.) Calcium
• 6.) Zinc

• 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

• Cigarette smoking
• Mercury
• Vitamin A
• Sugar substitutes (Aspartame)
• Caffeine
• Alcohol

• 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

• 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

• 1.) Fiber
• 2.) Vitamin A
• 3.) Vitamin C
• 4.) Beta-Carotene
• 5.) Folate

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

• 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 ***

• 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

• 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)

• 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

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

• 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

• 1.) irreversible brain damage
• 2.) growth retardation
• 3.) mental retardation
• 4.) facial abnormalities
• 5.) vision abnormatlities

occurs when an abnormal Glucose tolerance appears during pregnancy

it usually resolves AFTER the baby is born

• 1.) Personal history of Gestational Diabetes
• 2.) Family history of Diabetes
• 3.) Obesity
• 4.) Glucose in urine

a nursing mother produces about 24 oz of milk/day

it REQUIRES 500 kcals to produce breast milk

• 1.) Alcohol
• 2.) Caffeine
• 3.) Cigarettes/Nicotine
• 4.) Other Drugs

• 1.) production
• 2.) volume
• 3.) composition
• 4.) ejection

TRUE.

EXCESS caffeine can make infant jittery & wakeful

• 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

up to 1 year

• 1.) Fluoride
• 2.) ECC (Early Childhood Caries)
• 3.) Good child dental care