PRENATAL DEVELOPMENT

Conception Through The Later Years Nutrition shares with other lifestyle factors the Responsibility for maintaining good health Some of these factors are not in our control and few of them are Your Nutritional Health can be controlled and it deserve your sincere attention

COMPLETE PRICSRIPTON FOR GOOD HEALTH AVOID EXCESS ALCOHOL DON’T SMOKE MAINTAIN A DESIRABLE WEIGHT EXERCISE REGULARLY GET REGULAR SLEEP EAT NUTRITIOUS, REGULAR MEAL

Nutrition for the Life Cycle Nutritional needs change at each stage of the life cycle. Pregnancy Infancy Early and middle childhood Adolescence Adulthood Senior adulthood

Pre-Conceptual Nutrition Nutrition affects: Fertility Conception Implantation and Embryonic development Normal healthy body weight Especially important is sufficient folic acid and iron

Nutrition and Fertility Celiac Disease and Infertility Celiac disease is an autoimmune disease causing intestinal damage Dietary gluten from wheat, barley, and rye trigger the autoimmunity and malnutrition Breastfeeding, delaying introduction of gluten and amount of gluten exposure in infancy may reduce disease risk Female reproduction: Delayed menarche (m ə -NAR-kee)m ə -NAR-kee amenorrhea early menopause infertility hypogonadism, recurrent abortions, and low-birth-weight or preterm deliveries Male reproduction: Impotence

Nutrition and Fertility Polycystic Ovarian Syndrome Endocrine disorder affecting 5-10% of women Caused by insulin resistance 60% have weight management issues, increased risk of diabetes and gender cancers Irregular or no menstrual periods or irregular ovulation, with or without monthly bleeding. Painful un-ruptured follicles on the periphery of the ovaries

CHANGES IN THE BODY DURING PREGNANCY Life begin with single cell. Over the course of 40 weeks this cell grows and develops into a fully formed human baby. Prenatal growth and development are carefully orchestrated processed that require adequate supplies of all the essential nutrients.

CHANGES IN THE BODY DURING PREGNANCY After fertilization, single cell divides rapidly to form a ball of cells. The cells than begin to differentiate and move to form body structures. During these early development, these cells obtains the nutrients from the fluid around it

CHANGES IN THE BODY DURING PREGNANCY About a week after fertilization the developing embryo begin to settle with the lining of the uterus By two weeks implantation is complete and it is now an EMBRYO. The embryonic stage of development last until 8 th week after fertilization. During this time, the cell differentiate to form multitude of specializes cell types— Embryo is about 3 inches at this stage and has beating heart.

CHANGES IN THE BODY DURING PREGNANCY The early embryo gets its nourishment by breaking down the lining of the uterus. After about 5 weeks Placenta takes over the role of nourishment. The placenta also secretes hormones that are necessary to maintain pregnancy

CHANGES IN THE BODY DURING PREGNANCY From 9 weeks on the developing offspring is a fetus. Length of the fetus grow from 3 cm to 50cm Fetal period usually end after 40week Weight of healthy baby is usually between 6.5 to 9 pounds at birth

CHANGES IN THE BODY DURING PREGNANCY Important Terms Small for gestational age: Infant who born on time but have failed to grow Preterm or premature: born before 37 weeks of gestation Whether born too soon or too small, low-birth-weight infants and very-low-birth-weight infants are at increased risk for illness and early death

Pregnancy: The Impact of Nutrition on the Future The woman who is pregnant, or who soon will be, must understand that her nutrition is critical to the health of her future child throughout life The nutrient demands of pregnancy are extraordinary

Preparing for Pregnancy She must be well nourished at the outset because early in pregnancy the embryo undergoes rapid and significant developmental changes that depend on good nutrition

Preparing for Pregnancy Before a woman becomes pregnant, she must establish eating habits that will optimally nourish both the growing fetus and herself

Preparing for Pregnancy Uterus – The muscular organ within which the infant develops before birth Placenta – The organ of pregnancy in which maternal and fetal blood circulate in close proximity and exchange nutrients and oxygen (flowing into the fetus) and wastes (picked up by the mother’s blood)

Preparing for Pregnancy The mother’s nutrition before pregnancy determines whether her uterus will be able to support the growth of a healthy placenta during the first month of gestation The only way nutrients can reach the developing fetus is through the placenta, the special organ that grows inside the uterus to support new life.

Preparing for Pregnancy If the mother’s nutrient stores are inadequate during the period when her body is developing the placenta, then the placenta will never form and function properly As a consequence, no matter how well the mother eats later, her fetus will not receive optimal nourishment, and a low birthweight baby with all of the associated risks is likely

Preparing for Pregnancy If a girl is born with low birth weight, she may be ill equipped, even as an adult, to store sufficient nutrients, and she may be unable to grow an adequate placenta or bear healthy full-term infants A woman’s poor nutrition during her early pregnancy could affect her grandchildren as well as her child

Preparing for Pregnancy Infants born of malnourished mothers are more compare to healthy women’s infants are more likely to: become ill have birth defects, and suffer retarded mental or physical development. Malnutrition in the prenatal and postnatal periods also affects learning ability and behavior.

Preparing for Pregnancy Pre-pregnancy Weight Before pregnancy, all women, but underweight women in particular, should strive for appropriate body weights A woman who starts out underweight and who fails to gain sufficiently during pregnancy is very likely to bear a baby with dangerously low birth weight Infant birth weight is the most potent single indicator of an infant’s future health

Preparing for Pregnancy Low-birth weight Weight of less than 5.5 pounds at birth Low birth weight used as a predictor of probable health problems in the newborn and as a probable indicator of poor nutrition status of the mother before and/or during pregnancy They are 40 times more likely to die in the first year of life than a normal-weight baby

Preparing for Pregnancy Not all cases of low birthweight reflect poor nutrition Heredity, disease conditions smoking, and drug (including alcohol) use during pregnancy all contribute Even with optimal nutrition and health during pregnancy, some women give birth to small infants for unknown reasons

Preparing for Pregnancy Low birthweight is associated with Lower adult IQ and other brain impairments Short stature Educational disadvantages Nutrient deficiency coupled with low birthweight is the underlying cause of more than half of all deaths worldwide of children under 5 years of age

Preparing for Pregnancy Both overweight and obese women have a greater risk of giving birth to infants with heart defects and other abnormalities

Pregnancy Trimester: one-third of the normal duration of pregnancy. First trimester is 0 to 13 weeks. Second trimester is 13 to 26 weeks. Third trimester is 26 to 40 weeks.

Pregnancy Need for Nutrients Due to UNDER or OVER supply of nutrient intake specially at critical phases of FETAL DEVELOPMENT long term alterations in tissue function may occur.

Pregnancy Need for Nutrients Most nutrient needs are much higher than usual, but energy needs are not. An average increase of energy need is only about 17% of maintenance calories during pregnency.

Pregnancy Need for Nutrients Energy, Carbohydrate, Protein, and Fat Energy needs vary with the progression of pregnancy First trimester No additional needs Second trimester An additional 350 daily calories Third trimester An additional 450 daily calories

Pregnancy Need for Nutrients Nutrients deserving special attention during pregnancy include: protein -20 to 25g or 50% higher Folate – 50% higher iron– 50% higher zinc, and calcium, as well as vitamins which known to be toxic in excess amounts.

Nutritional Needs During Pregnancy Protein DRI recommendation for pregnancy is higher than for non pregnant women by grams/day Most women in the U.S. need not add protein-rich foods to their diets They already exceed the recommended protein intake for pregnancy

Nutritional Needs During Pregnancy Carbohydrate Ample carbohydrate is necessary to fuel the fetal brain and spare the protein needed for fetal growth Fiber can help alleviate the constipation that many pregnant women experience

Nutritional Needs During Pregnancy Special Interest: Folate and Vitamin B 12 Play a role in cell production Are needed in large amounts during pregnancy Plays an important role in preventing neural tube defects

Nutritional Needs During Pregnancy Vitamin B 12 Folate fortification raises one safety concern The pregnant woman needs a greater amount of B 12 to assist folate in the manufacture of new cells

Nutritional Needs During Pregnancy Certain Vitamins such as Vitamin A & D can cause fetal malformation

Nutritional Needs During Pregnancy Iron During pregnancy, the body avidly conserves iron Menstruation ceases and absorption of iron increases up to threefold Despite these conservation measures, iron stores dwindle because the developing fetus draws heavily on its mother’s iron store up to a supply sufficient to carry it through the first three to six months of life

Nutritional Needs During Pregnancy Fat The essential fatty acids are particularly important to the growth and development of the fetus The brain is composed mainly of lipid material and depends heavily on long-chain omega-3 and omega-6 fatty acids for its growth, function, and structure

Nutritional Needs During Pregnancy Calcium, Magnesium, Iron, and Zinc Among the minerals, calcium, phosphorus, and magnesium are in great demand during pregnancy Necessary for normal development of the bones and teeth The DRI recommendation for calcium is the same for non pregnant and pregnant women in the same age group

MATERNAL WEIGHT GAIN Normal Weight Gain & Adequate Nutrition Support The Health Of The Mother & The Fetus

MATERNAL WEIGHT GAIN Low weight gain is associated with increase risk of Low-Birth Weight Excessive Weight Gain Increase the Risk of : Complication during labor Postpartum Obesity

MATERNAL WEIGHT GAIN Obese women have increased risk of: HYPRTENSION GESTSTIONAL DIABETES

MATERNAL WEIGHT GAIN First trimester weight gain should be only 3 to 4 lbs Followed by about a pound per week If Weight gain is higher in early pregnancy, mother should not try to diet in the last weeks DIETING IS NOT RECOMMENDED DURING PREGNANCY

MATERNAL WEIGHT GAIN An Infant at Birth Weigh only about 6.5 to 9 lbs Mother gains more than 20lbs because mother’s body built-up body tissues: BLOOD BLOOD VESSELS MUSCLES FAT STORES

MATERNAL WEIGHT GAIN Some of the weight lost at delivery Remainder is generally lost within a few months because: Blood volume return to normal Loses fluids she accumulate

Teratogen. Any chemical, biological, or physical agent that causes a birth defect is called a teratogen. Each organ system develops at a different time and rate, each has a critical period. During Critical Period exposure to a teratogen is most likely to disrupt development and cause irreversible damage. Severe damage can result in miscarriage.

Practices to Avoid During Pregnancy Optimal pregnancy outcome is influenced by maternal nutrient intake but also affected by: EXCESS CAFEINE ALCOHOL TOBACCO LOW CALORIE DIET MEGA DOSES OF CERTAIN VITAMINS DRUGS

Practices to Avoid During Pregnancy Pica: the craving of nonfood items such as clay, ice, and laundry starch. Pica does not appear to be limited to any particular geographic area, race, sex, culture, or social status.

Practices to Avoid During Pregnancy Low-carbohydrate or low-calorie diets that cause Ketosis. That can cause CONGENITAL DEFORMITIES Can deprive the fetus's brain of needed glucose

Practices to Avoid During Pregnancy Smoking restricts blood supply to the fetus There by limit supply of Oxygen & Nutrient to Fetus and stunts growth, thus increase Risk of: PREMATURE DELIVERY LOW BIRTH WEIGHT RETARDED DEVELOPMENT AND SPONTANEOUS ABORTION SUDDEN INFANT DEATH SYNDROME (SIDS) Smoking is responsible for 20-30% of all low-birth weight deliveries in the United States.

Practices to Avoid During Pregnancy SUDDEN INFANT DEATH SYNDROM (SIDS) HAS BEEN LINKED TO SMOKING DURING PREGNANCY & SECOND HAND SMOKE

Practices to Avoid During Pregnancy ALCOHOL Consumption affect fetal development. Even 1 or 2 drinks can cause - THE MOST SEVERE IMPACT OF MATERNAL DRINKING IS LIKELY TO OCCUR IN THE FIRST MONTH OF PREGNANCY - BEFORE THE WOMEN IS SURE SHE IS PREGNANT. - ALCOHOL IS THE LEADING CAUSE OF MENTAL RETARDATION IN U.S IT OCCUR IN APPROXIMATELY 2 TO 3 PER 1000 LIVE BIRTHS IN U.S

Practices to Avoid During Pregnancy Fetal Alcohol Syndrome (FAS): the cluster of symptoms seen in an infant or child whose mother consumed excess alcohol during pregnancy. Those include: RETARDED GROWTH IMPAIRED DEVELOPMENT OF THE CENTRAL NERVOUS SYSTEM MENTAL & PHYSICAL RETARDATION FACIAL MALFORMATION Fetal alcohol effect (FAE): A lesser condition that causes learning impairment and other more subtle abnormalities in infants exposed to alcohol during pregnancy.

FAS

Alcohol Not all babies who are exposed to alcohol while in the uterus have FAS, but many have some alcohol-related problems. Alcohol-related neurodevelopmental disorders (ARND) are functional or mental impairments linked to prenatal alcohol exposure, and Alcohol-related birth defects (ARBD) are malformations in the skeleton or major organ systems. These conditions are less severe than FAS but occur about three times more often.

Practices to Avoid During Pregnancy EVIDENCE SHOW THAT EVEN ONE DRINK MAY BE TOO MUCH FOR PREGNANT WOMAN, THAT LED THE AMERICAN ACADEMY OF PEDIATRICS TO TAKE THE POSITION THAT: WOMAN SHOULD STOP DRINKING AS SOON AS THEY PLAN TO BECOME PREGNANT.

Practices to Avoid During Pregnancy DRUGS DRUGS AND MEDICATIONTAKEN DURING PREGNANCY CAN ALSO CAUSE BIRTH DEFECT. Avoid taking all drugs and herbal supplements except for physician-advised medicine.

Practices to Avoid During Pregnancy Avoid lead exposure: Avoid ceramic and leaded crystal ware. Reduce exposure to mercury: Avoid large ocean fish such as shark, swordfish, king mackerel and tilefish. Pregnant women can safely eat 12 ounces of cooked fish including canned fish, shellfish, and smaller ocean or farm-raised fish.

CAFFEINE When consumed in excess, coffee and other caffeine- containing beverages have been associated with increased risks of miscarriage or low birth weight. It is recommended that pregnant women avoid consuming more than 200 mg of caffeine per day

Common Nutrition-Related Problems of Pregnancy Morning Sickness Constipation Cravings Pregnancy-induced hypertension (PIH) Gestation diabetes

Common Nutrition-Related Problems of Pregnancy Morning sickness seems unavoidable Certain strategies may reduce the problem, such as eating: SODA CRACKERS HARD CANDIES DRY STARCHY FOOD EAT SMALL FREQUENT MEALS AS SOON AS FEEL HUNGRY

Common Nutrition-Related Problems of Pregnancy HIGH BLOOD PRESSURE SIGNALS THE ONSET OF PREGNANCY-INDUCED HYPERTENSION (PIH) PREELAMPSIA ECLAMPSIA

Common Nutrition-Related Problems of Pregnancy Preeclampsia: a condition characterized by hypertension, fluid retention (Generalized edema) Sudden Large Weight Gain and protein in the urine. WARNING SIGNS OF PREECLAMPSIA Sever & Constant Headache Sudden weight Gain (1lb/day) Swelling of Face, Hand & Feet Dizziness & Blurred vision

Common Nutrition-Related Problems of Pregnancy Eclampsia: a severe extension of preeclampsia characterized by : Convulsions that may lead to Coma PREGNANCY-INDUCED HYPERTENSION (PIH) CAN CAUSE: RETARDED FETAL GROWTH THE PLACENTA TOSEPARATE FROM THE UTRUS RESULT IN STILL BIRTH

INFANTS BORN TO WOMEN WITH DIABETES ARE AT GREATER RISK FOR: PREMATURE BIRTH CONGENTAL DEFECTS EXCESSIVELY HIGH BIRTH WEIGHT AND RESPIRATORY DISTRESS SYNDROME

Adolescent Pregnancy More than 700,000 teenagers become pregnant in the United States each year. One out of every eight babies is born to a teenager. More than a tenth of these mothers are under age 15. Pregnancy places adolescent girls, who are already at risk for nutrition problems, at even greater risk because of the increased energy and nutrient demands of pregnancy.

Adolescent Pregnancy MEDICAL & NUTRITIONAL RISKS ARE PARTICULARLY HIGH WHEN TEENAGERS IS 15 YEAR OF AGE OR YOUNGER: HIGH RATE OF HYPERTENSION IRON DEFICIENY PREMATURE BIRTHS STILLBIRTHS LOW-BIRTHWEIGHT PROLONG LABOR

Adolescent Pregnancy To support the needs of both Mother and Infant, teenagers are encouraged to gain UPPER LIMIT of weight gain. Those who gain between 30 to 35 lbs during pregnancy may have lower risk.

Pregnancy After Age 35 Older women are more likely to have one or more medical conditions They have a higher incidence of low-birth-weight infants. Their infants are more likely to have chromosomal abnormalities, especially Down syndrome An interval of less than 18 months between pregnancies increases the risk of delivering a small-for-gestational age infant

Nutrition of the Breastfeeding Mother Adequate nutrition of the mother makes a highly significant contribution to successful lactation. A nursing mother produces 30 ounces of milk a day, on the average, with wide variations possible.

LACTATION Lactation involves both the synthesis of milk components: proteins lactose, and lipids—and the movement of these components through the milk ducts to the nipple. Milk production and let-down are triggered by hormones that are released in response to an infant's suckling. The pituitary hormone prolactin stimulates milk production the more the infant suckles, the more milk is produced

LACTATION Let-down is caused by oxytocin, another pituitary hormone. Oxytocin release is also stimulated by suckling Let-down can be inhibited by: nervous tension, fatigue, or embarrassment.

Postnatal Nutrition BABY GROW FAST DURING THE FIRST YEAR OF LIFE THAN EVER AGAIN. FIRST 4 TO 6 MONTHS - WEIGHT DOUBLE END OF THE FIRST YEAR - TRIPLE ITS BIRTH WEIGHT ADEQUATE NUTRITION IS CRITICAL THIS RAPID RATE OF GROWTH FIRST YEAR IS THE MOST IMPORTANT YESR OF A PERSON’S LIFE

Nutrition of the Breastfeeding Mother PERIOD OF LACTATION IS THE NATURAL TIME FOR WOMEN TO LOSE EXTRA BODY FAT. Beginning 1 month after birth, most lactating women lose 0.5 to 1 kg (1 to 2 lbs)/month for 6 months TOO LARGE DEFICET WILL INHIBIT LACTATION

Milk for the Infant: Breastfeeding Breast milk is tailor made to meet the nutrient needs of the young infant. With the exception of vitamin D, its vitamin contents are ample. The American Academy of Pediatrics recommends that infants receive breast milk for the first twelve months of life.

Nutrition of the Breastfeeding Mother Breastfeeding has both emotional and physical health advantages. Colostrum (co-LAHS-trum): a milklike secretion from the breast, rich in protective factors, present during the first day or so after delivery and before milk appears. Bifidus factor (BIFF-id-us): a factor in colostrum and breast milk that favors the growth in the infant’s intestinal tract of the “friendly” bacteria Lactobacillus bifidus so that other, less desirable intestinal inhabitants will not flourish. Lactoferrin (lak-toe-FERR-in): a factor in breast milk that binds and helps absorb iron and keeps it from supporting the growth of the infant’s intestinal bacteria.

Nutrition of the Breastfeeding Mother BREAST MILK ALSO CONTAIN: SEVERAL ENZYMES SEVERAL HORMONS LIPIDS THAT HELP TO PROTECT AGAIST INFEATION OFFER CARBOHYDRATE OMEGA 6 FATTY ACIDS EASILY DIGESTABLE PROTEIN Ca, P & Mg PRESENT IN ADEQUATE AMOUNT LOW IN SODIUM IRON IN HIGHLY ABSORBALE FORM

Milk for the Infant: Breastfeeding Feeding Formula Infant formulas are manufactured with the approximate nutrient composition of breast milk. The parents can see that the baby is getting enough milk during feedings. The mother can offer similar closeness, warmth, and stimulation during feedings as the breastfeeding mother does. Other family members can get close to the baby and develop a warm relationship in feeding sessions.

Milk for the Infant RAPID GROWTH AND METABOLISM DEMAND ADEQUATE SUPPLY OF ALL NUTRIENTS SOLD FOOD MAY BE GIVEN AFTER 6 MONTHS EARLY INTRODUCTION OF SOLID FOOD CAN DEVELOP ALLERGIES

Healthy Infants Nutrition-Related Problems of Infancy Iron deficiency remains a prevalent nutritional problem in infancy. It has declined in recent years in large part because of the increasing use of iron-fortified formulas. Food allergies are common and genetics is probably the most significant factor affecting an infant’s susceptibility to food allergies. At-risk infants can be identified by means of careful skin testing and by a family history. To detect food allergies, new foods should be introduced one at a time.