Unit 13 Nutritional Health for Pregnant and Lactating Women. Dr. Banan T. Awawdeh

objectives To relate the importance of preconception nutrition to factors associated with healthy pregnancy outcomes. To examine the macro- and micronutrients required during pregnancy and lactation. To translate appropriate nutrition interventions for medical conditions that affect both diet and pregnancy outcome. To compare the nutritional recommendations for pregnant females who have unique needs.

Preconception health care intervention = positive pregnancy outcomes 2. Unhealthy lifestyle and nutritional practices = negative pregnancy outcomes

Poor pregnancy outcomes are attributed to: • Obesity • Diabetes • Folic acid deficiency • Alcohol use

The foundation of a healthy pregnancy and breastfeeding: Macro- and Micronutrients • Adequate weight gain in pregnancy • Energy and kcalories increase during both • Breast milk nutrients adapt to growing infant needs

Macronutrients for pregnancy per day: • Protein = 25 mg increase • Fat = 200–300 mg DHA • Carbohydrate = min 175 mg

Micronutrients for pregnancy: • Calcium = 1000 mg/day to develop fetal bones • Vitamin D = 5mcg/day to develop fetal bones • Folic acid and folate = 600 mcg/day for cell division, red blood cell volume • Iron = 27 mg/day to develop red blood cells, fetus, placenta, umbilical cord

Pregnant females should add many nutrients to their diets Lean meats, poultry, fish, and legumes provide protein as well as needed iron. Dairy proteins such as milk, yogurt, and cheese provide needed calcium; important in last 2 trimesters. Deep, cold water fish provide omega-3 fatty acids. Folic acid is found in supplements and fortified foods; folate is found in green leafy vegetables, oranges, and legumes, such as dried beans; important in first trimester

Pregnant females should add many nutrients to their diets Iron supplements High fiber for digestive system 40,000 kcal energy requirement for new protein and fat tissues during total duration of pregnancy; client requires 340–452 kcals/day during the second and third trimesters

Nutrients found in breast milk: • Vitamins A, B-12, D, and E, thiamine, riboflavin, pyridoxine, selenium, iodine • Proteins, carbohydrates, fats, water

Average amount of breast milk produced: 750 ml/day = 630 kcals to produce energy • First 6 months = 500 kcals/day • After 6 months 400 kcals/day

Pica: the consumption of nonfood items • Geophagia: consumption of soil, dirt, clay, or baked clay • Amylophagia: consumption of laundry starch, corn starch, and other starches • Pagophagia: consumption of ice and freezer frost

Normal symptoms of pregnancy can affect nutritional health if self-prescribed treatment includes remedies that interact with food and nutrient absorption • Nausea and vomiting • Heartburn • Constipation

To control the mother’s disease during pregnancy, nutritional intervention must begin before conception.

Diseases with a high risk of an unhealthy pregnancy: • Obesity • Diabetes • Eating disorders • Phenylketonuria • Gestational hypertension

Vegetarian and vegan diets must be well planned with attention to: • Vitamin B • Vitamin D and calcium • Iron • Essential fatty acids

Adolescent pregnancy nutritional needs for healthy fetal development: • Adequate weight gain • Iron =1300 mg/day • Folic acid • Calcium

Assessment of the lifestyle and nutritional habits of the client. • Individualized plans to meet energy and nutrient requirements based on: o Height o Weight o Age o Physical activity level o Pregnancy trimester

Limit or eliminate exposure to teratogens: o Alcohol o Caffeine o Methylmercury o Some dietary supplements

Educate the client about the role of nutritional needs: • Preconception health care • A well-balanced diet • Increase in energy intake • Adequate intake of vitamins and minerals • Sufficient amount of exercise • Adequate weight gain • Medical conditions that require nutritional intervention kept under control

Outline the need for: • Nutrient and lifestyle change  healthy pregnancy • Positive effects on the client and fetus when guidelines are followed • Negative effects when guidelines are not followed

Recommendations for nutritional sources: • MyPyramid for Moms • Dieticians, nurses and other health care professionals

Thank You …