Download
healthy mom healthy baby n.
Skip this Video
Loading SlideShow in 5 Seconds..
Healthy Mom, Healthy Baby PowerPoint Presentation
Download Presentation
Healthy Mom, Healthy Baby

Healthy Mom, Healthy Baby

192 Vues Download Presentation
Télécharger la présentation

Healthy Mom, Healthy Baby

- - - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript

  1. Healthy Mom, Healthy Baby Nutrition as the Foundation of Life Throughout Pregnancy and Beyond

  2. Introduction By the end of this presentation, you will have learned: • The importance of nutrition in achieving a healthy pregnancy. • The specific roles of key nutrients that are especially important during pregnancy. • The various factors that influence a pregnant woman’s ability to obtain these key nutrients. • The implications of both overeating and under-eating during pregnancy. • The importance of nutrition post-partum.

  3. “Healthy Pregnancy” • One without physical or psychological pathology in the mother or fetus and… • Results in the delivery of a healthy baby. Position of the American Dietetic Association: Nutrition and lifestyle for a healthy pregnancy outcome. J Am Diet Assoc 2002;102(10):1479-1490.

  4. Healthy Baby, Healthy Adult Fetal Origins of Adult Disease - term infants who are small for their gestational age are predisposed to obesity and have an increased susceptibility to cardiovascular disease and Type II diabetes (impaired glucose tolerance) in adulthood as a consequence of physiologic adaptations to under-nutrition during fetal life. Robinson R. The fetal origins of adult disease. Brit Med J 2001;322:375-376.

  5. Pregnancy Outcomes inthe U.S. (2002) • Low Birth Weight • 7.8% of live births (1 in 13 babies) • Increased by nearly 10% from 1992 to 2002 • A major contributing factor in 2/3 of all infant deaths • Preterm Births (<37 weeks gestation) • 12.1% of live births (1 in 8 babies) • Cesarean Delivery • 26.1% of live births National Center for Health Statistics. Retrieved from March of Dimes PeriSats on October 17, 2004: www.marchofdimes.com/peristats.

  6. Low Birth Weight 1992 - 2002(% of Live Births)

  7. Pregnancy Outcomes and Maternal BMI • Low birth weight is primarily related to:1 • Low pre-pregnancy BMI (kg/m2) • Low gestational weight gain • These anthropometric factors reflect inadequate food intake, which may be related to:2 • Poverty • Cultural ideals of thinness 1. Ehrenberg HM, Dierker L, Milluzzi C, Mercer BM. Low maternal weight, failure to thrive in pregnancy, and adverse pregnancy outcomes. Am J Obstet Gynecol 2003;198:1726-1730. 2. Moore VM, Davies MJ, Willson KJ, Worsley A, Robinson JS. Dietary composition of pregnant women is related to size of the baby at birth. J Nutr 2004;134:1820-1826.

  8. MACRONUTRIENTS Provide Energy and Building Material Worthington-Roberts B, Williams SR. Maternal nutrition and the outcome of pregnancy. Nutrition in Pregnancy and Lactation, 4th ed. College Publishing: St. Louis, Missouri, 1989. Kline DA. Macronutrient requirements during pregnancy. Today’s Dietitian Jan 2004:20-24.

  9. VITAMINS Promote Metabolism and Tissue Integrity

  10. MINERALS Promote Structural Tissues & Organ System Development Whitney EN, Rolfes SR. Understanding Nutrition, 9th ed. Wadsworth/Thomson Learning: Belmont, CA; 2002. Kline DA. Macronutrient requirements during pregnancy. Today’s Dietitian Jan 2004:20-24.

  11. Dietary Quality and Timing:The First Trimester • Both the amount of a nutrient and its timing of intake are extremely important to fetal development. • The first trimester is a time of rapid cell division, organ development, and preparation for the demands of rapid fetal growth that occur later in pregnancy. • Critical nutrients during this phase include: • Protein • Folic acid • Vitamin B12 • Zinc King JC. Physiology of pregnancy and nutrient metabolism. Am J Clin Nutr 2000;71:1218S-1215S.

  12. Dietary Quality and Timing:The 2nd and 3rd Trimesters • Energy intake is especially important since 90% of fetal growth occurs during the last half of gestation. • Critical nutrients during this phase include: • Protein • Iron • Calcium • Magnesium • B vitamins • Omega-3 fatty acid, docosahexaenoic acid (DHA) King JC. Physiology of pregnancy and nutrient metabolism. Am J Clin Nutr 2000;71:1218S-1215S. Kline DA. Macronutrient requirements during pregnancy. Today’s Dietitian Jan 2004:20-24.

  13. Energy Needs During Pregnancy • Extra Energy Needs for Normal Weight Women:1 • First trimester ~ 0 kilocalories • Second trimester ~ 350 kilocalories • Third trimester ~ 500 kilocalories • There is great variability among pregnant women with regard to energy costs during pregnancy related to differences in body size and lifestyles.1 • Appropriate weight gain and appetite are better indicators of energy sufficiency than the amount of kilocalories consumed.2 1. Butte NF, Wong WW, Treuth MS, Ellis KJ, Smith EO. Energy requirements during pregnancy based on total energy expenditure and energy deposition. Am J Clin Nutr 2004;79:1078-1087. 2. Position of the American Dietetic Association: Nutrition and lifestyle for a healthy pregnancy outcome. J Am Diet Assoc 2002;102(10):1479-1490.

  14. Gestational Weight Gain Patterns • Only 30 to 40% of women actually gain weight within the recommended ranges during pregnancy.1 • Many women gain much more weight than is necessary during pregnancy, which is related to postpartum weight retention.2 1. Hickey CA. Sociocultural and behavioral influences on weight gain during pregnancy. Am J Clin Nutr 2000;71:1364S-1370. 2. Position of the American Dietetic Association: Nutrition and lifestyle for a healthy pregnancy outcome. J Am Diet Assoc 2002;102(10):1479-1490.

  15. Conditions That May Result in Inadequate Nutrient Intake and Weight Gain During Pregnancy • Nausea and vomiting • Heartburn • Constipation • Food aversions – alcohol, caffeinated beverages, and meats. • Food avoidances – milk, lean meats, pork, and liver. • Poor pre-pregnancy diet: • Inappropriate dietary patterns • History of frequent dieting, weight cycling, and/or eating disorders • Excessive physical activity King JC. Physiology of pregnancy and nutrient metabolism. Am J Clin Nutr 2000;71:1218S-1215S. Position of the American Dietetic Association: Nutrition and lifestyle for a healthy pregnancy outcome. J Am Diet Assoc 2002;102(10):1479-1490.

  16. Eating Strategies • Strategies that are recommended to deal with some of these issues include: • Small, frequent meals and snacks • Adequate fiber intake • Adequate fluid intake • Avoiding an empty stomach • Choosing foods that are well tolerated

  17. Conditions That May Result in Excessive Weight Gain During Pregnancy • Food cravings – dairy and sweet foods.1 • Psychological influences on eating behavior:2 • Reduced attempts to control food intake • Pregnancy legitimizes eating more • Reductions in physical activity3 1. King JC. Physiology of pregnancy and nutrient metabolism. Am J Clin Nutr 2000;71:1218S-1215S. 2. Clark M, Ogden J. The impact of pregnancy on eating behaviour and aspects of weight concern. Int J Obes Relat Metab Disor. 1999;23(1):18-24. 3. Butte NF, Wong WW, Treuth MS, Ellis KJ, Smith EO. Energy requirements during pregnancy based on total energy expenditure and energy deposition. Am J Clin Nutr 2004;79:1078-1087.

  18. Life in Balance • The risk of overweight due to excessive pregnancy weight gain needs to be balanced against the risk of poor fetal growth associated with inadequate weight gain.1 • Diet needs to be nutrient dense to supply sufficient nutrients to the developing fetus, since fetal demands may double some micronutrient requirements.2 1. Position of the American Dietetic Association: Nutrition and lifestyle for a healthy pregnancy outcome. J Am Diet Assoc 2002;102(10):1479-1490. 2. King JC. Physiology of pregnancy and nutrient metabolism. Am J Clin Nutr 2000;71:1218S-1225S

  19. An Additional 300 Calories Isn’t Much!

  20. What Are Pregnant Women Really Eating? • A prospective study of lower- to middle-income women had these results: • Foods with poor nutrient density were major contributors to energy, fat, and carbohydrates – such as biscuits, muffins, whole milk, french fries, and fried potatoes. • Carbohydrates were mostly refined and low in dietary fiber, including soft drinks, biscuits, muffins, and white bread. • Median iron intakes were below recommended levels. Siega-Ritz AM, Bodnar LM, Savitz DA. What are pregnant women eating? Nutrient and food group differences by race. Am J Obstet Gynecol 2002;186:480-486.

  21. Eating for Two? • Another study of the dietary intakes of pregnant women enrolled in WIC found the following: • Consumed only 85% of the RDA for energy (kilocalories). • Average energy intake from fat was higher than recommended (37% vs. 30%). • 90% consumed less than 2/3 of the RDA for iron. • 22% had iron-deficiency anemia. Swensen AR, Harnack LJ, Ross JA. Nutritional assessment of pregnant women enrolled in the Special Supplemental Program for Women, Infants, and Children (WIC). J Am Diet Assoc 2001;101:903-908.

  22. The Dilemma • Overeating of total energy/kilocalories • Undereating of total energy/kilocalories • Overconsumption of low nutrient-dense foods • Underconsumption of high nutrient-dense foods

  23. Beyond Pregnancy • Energy and nutrient needs continue to be elevated postpartum, particularly in women who choose to breastfeed or who have had a cesarean section. • The energy required for daily milk production is close to 560 kilocalories.1 • Protein, zinc, and vitamin C promote wound healing.2 • The inherent demands of a newborn are a challenge to the new mother and her family! 1. Worthington-Roberts B, Williams SR. Lactation and human milk: nutritional considerations. Nutrition in Pregnancy and Lactation, 4th ed. College Publishing: St. Louis, Missouri, 1989. 2. Baranoski S, Ayello EA. Wound Care Essentials Practice Principles, pp. 157-160. Lippincott Williams & Wilkins: Philadelphis, PA; 2004.

  24. Meals and Snacks Need to Be… • Healthy • Convenient • Tasty • Economical

  25. In Summary… • Critical nutrients are required in the right amounts at the right time to achieve a “healthy pregnancy.” • The majority of women do not gain weight within the recommended ranges during pregnancy. • Various factors influence eating patterns during pregnancy, resulting in either inadequate or excessive intake of energy (i.e., kilocalories) and certain nutrients. • Studies show that pregnant women eat too many refined carbohydrates and fat, and too little iron and fiber. • Meals and/or snacks should be healthy (nutrient-dense), tasty, convenient, and economical.