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Pregnancy and Breastfeeding
Objectives- Pregnancy
Identify the 4 nutrients of primary concern during pregnancy
State recommendations on fish consumption, pre-natal vitamin/minerals and alcohol during pregnancy
State side effects of inappropriate weight gain Describe weight gain and goals for normal pre-
pregnancy weight List nutrition related issues and recommendations
Objectives- Breastfeeding
List nutrition needs of the mother List benefits of breastfeeding Describe the breastfeeding process including
suckling, prolactin and oxytocin, amount produced based on demand.
Describe the differences between colostrum and mature breastmilk.
Describe the nutrition content of breastmilk
Nutrition For Pregnancy
Choose My Plate Increased Protein
1.1 grams/kg + 25 grams/day (3 oz protein)
Folate Up to 1000 synthetic mcg/day DNA, reduce neural tube defects Pre-natal vitamin
Nutrition For Pregnancy
Iron 27-30 mg/day Increased blood volume, baby’s iron stores High in pre-natal Iron deficiency anemia….supplement 60 mg/day
Calcium 1000-1300 mg/day (4 cups a day) Last trimester- 300 mg/day transferred to baby Low in pre-natal
Basic Nutrition Guidelines
Prenatal vitamin-mineral supplement 1st trimester
2-4 pound weight gain, ↑ nutrients 2nd and 3rd trimester
1 pound a week weight gain, + 300 calories Moderate caffeine, sugar substitutes Adequate fluids Limit mercury containing fish
12 oz fish a week or less, variety
Alcohol
No safe known level #1 preventable birth defect Lifelong affects, cognitively and physically Fetal Alcohol Syndrome
Fetal Alcohol Syndrome
WIC
Women, Infants, Children Reduced income Pregnant, breastfeeding, infants, children Supplemental food and healthcare program
Appropriate Weight Gain
Helps prevent low-birth weight (less than 5 ½ pounds) Poor growth Delivery complications Undeveloped lungs Physical/neurological/developmental birth defects Susceptible to illness/poor immune system
Helps prevent excess weight gain Gestational diabetes, hypertension, other pregnancy
complications; childhood obesity Comfort for the mother!
Weight Gain Goals Pre-Pregnancy BMI
Low (BMI < 19.8) Normal (BMI 19.8-26) Overweight (BMI 26-
29) Obese (BMI >29) Teens
Recommended Gain
35-45 pounds 25-35 pounds 15-25 pounds 11-20 pounds Upper end of range
Nutrition Related Problems Morning Sickness
Cause- hormonal Eat whatever the mom wants
Fluid Retention Cause- hormonal Salt intake does not effect
Constipation Fiber and fluids
Food Cravings - Aversions Whatever the mom wants, doesn’t want Pica
Heartburn Remain elevated after meals, small meals
Nutrition Needs of Breastfeeding Mom
+ 500 calories/day or more + 20 grams protein or more 8-12 cups of fluids Continue pre-natal supplement Choose My Plate Limit caffeine, alcohol
Breastfeeding Benefits
Breastfeeding Benefits
Amount/Quality of Breastmilk
Poor diet Does not affect milk quality Limits amount produced Uses mom’s nutrient stores
Increase fluids and protein to increase milk supply
Breastfeeding Guidelines
Feed on demand Baby needs more baby nurse more
mom will produce more Proper latching on Establish breastfeeding, then bottle Milk production will adjust to feeding
routine Can breastfeed and bottle feed Pump
Colostrum
First fluid produced Thick, clear-yellow substance Contains antibodies, anti-infective factors
Boost immune system Lactobacillus bifidus factor
Facilitates stool passage
Mature Milk
Thin, watery, slightly bluish Composition changes during feeding time
Foremilk Resembles skim milk ~17% fat, ~74% CHO, ~9% protein
Hindmilk Resembles cream ~66% fat, ~28% CHO, ~6% protein
Nutrition Content changes with growth
Unique Composition
High in essential fats Linoleic, omega-3 (DHA, ARA)
Lactose - CHO Minimal digestion, low kidney solute load 200+ other substances Enzymes present for digestion Probiotics
Breastmilk Points of Interest
Many health benefits Small stools, rarely constipates, no smell Minimal “spitting up” Food flavors transfer History of food allergies, eliminate protein
from moms diet
Who Has Greatest Influence On The Likelihood Of Breastfeeding…
Dad