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 mg/day Increased blood volume, baby’s iron stores High in pre-natal Iron deficiency anemia….supplement 60 mg/day Calcium 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 1 st trimester 2-4 pound weight gain, ↑ nutrients 2 nd and 3 rd trimester 1 pound a week weight gain, 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

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 ) Overweight (BMI ) Obese (BMI >29) Teens Recommended Gain pounds pounds pounds 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 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

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