Nutrition in Pregnancy and Lactation

1. Nutrition in Pregnancy and Lactation M. Burns FCS 3755

2. Pre-conception • Achieve and maintain a healthy body weight • Choose an adequate and balanced diet • Be physically active • Avoid harmful influences – both parents Burns, 2008

3. Placenta Amniotic sac Umbilical cord Burns, 2008

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5. Maternal Weight • Prior to conception • Underweight increases risk for LBW • Overweight increases risk for medical complications • During pregnancy • Total weight gain • Weight gain patterns Burns, 2008

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7. Weight gain patterns Burns, 2008

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9. Nutrition during Pregnancy • Energy needs • Protein • Essential fatty acids • Vitamins and minerals • Folate, B12, iron and zinc for synthesis of DNA and new cells • Vitamin D, Ca, Mg, P, and F for bone development Burns, 2008

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11. Nutrition-related Concerns of Pregnancy • Nausea due to hormonal changes • Constipation and hemorrhoids due to fetus crowding intestinal organs • Heartburn due to fetus putting pressure on mother’s stomach and hormones • Food cravings and aversions • Non-food cravings (pica) Burns, 2008

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13. Malnutrition and Pregnancy • Fertility issues • Amenorrhea and low sperm count • Early pregnancy • 18-23 months between infants • Fetal development • Women, Infants, and Children (WIC) food assistance program Burns, 2008

14. Maternal Health • Pre-existing diabetes • Gestational diabetes • Screen at 24-28 weeks gestation • Pre-existing HTN • Pre-eclampsia • HTN, fluid retention, and protein in urine • Eclampsia • Includes convulsions Burns, 2008

15. Medicinal drugs Herbal supplements Illicit drugs Smoking and chewing tobacco Environmental contaminants (lead and mercury) Food borne illness Vitamin/mineral megadoses Caffeine Weight-loss dieting Sugar substitutes Alcohol Practices Incompatible with Pregnancy Burns, 2008

16. Fetal Alcohol Syndrome • Cluster of physical, mental, and neurobehavioral symptoms • Pre and postnatal growth retardation • Impairment of brain and CNS • Increased frequency of major birth defects, such as cleft palate • Abnormalities of the face Burns, 2008

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18. Lactation: A Physiological Process • Mammary glands secrete the milk • Prolactin • Hormone that tells the mammary glands to initiate and sustain milk production • Oxytocin • Hormone that stimulates the mammary glands to eject the milk (let-down response) and to contract the uterus during childbirth Burns, 2008

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20. Nutrient Needs of Mother • Energy intake and exercise • Energy nutrients • Vitamins and minerals • B6, B12, A, D, folate, iron, and calcium • Water • Nutrient supplements (iron, maybe) • Particular foods Burns, 2008

21. Practices Incompatible with Lactation • Alcohol use • Medicinal drugs • Illicit drugs • Smoking • Caffeine Burns, 2008

22. Maternal Health • HIV infection and AIDS • HIV is spread via breast milk • Diabetes • Adjust insulin to energy needs • Postpartum amenorrhea • No period while breastfeeding • Breast health • Inconclusive evidence between breastfeeding and breast cancer Burns, 2008