1. Pregnancy and Breastfeeding

2. 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

3. 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

4. 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

5. 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

6. 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, + 300 calories Moderate caffeine, sugar substitutes Adequate fluids Limit mercury containing fish 12 oz fish a week or less, variety

8. Alcohol No safe known level #1 preventable birth defect Lifelong affects, cognitively and physically Fetal Alcohol Syndrome

10. WIC Women, Infants, Children Reduced income Pregnant, breastfeeding, infants, children Supplemental food and healthcare program

11. 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!

13. 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

15. 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

16. 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

17. Breastfeeding Benefits

19. 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

21. 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

22. Colostrum First fluid produced Thick, clear-yellow substance Contains antibodies, anti-infective factors Boost immune system Lactobacillus bifidus factor Facilitates stool passage

23. 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

24. 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

25. 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

26. Who Has Greatest Influence On The Likelihood Of Breastfeeding… Dad