1. Chapter 13 Life Cycle Nutrition: Mother and Infant
Nutrition: Concepts & Controversies, 12e Sizer/Whitney

2. Learning Objectives
Explain why a nutritionally adequate diet is important long before a pregnancy is established.
Identify the special nutritional needs of a pregnant teenager as compared to a pregnant adult.
Evaluate the statement that “no level of alcoholic beverage intake is safe or advisable during pregnancy.”

3. Learning Objectives
Describe the impacts of gestational diabetes and preeclampsia on the health of a mother and her unborn child.
Discuss the nutrition and health benefits of breastfeeding to both the mother and the child.
Discuss some relationships between childhood obesity and chronic diseases.

4. Learning Objectives
Develop a healthy eating and activity plan to help an obese child improve his or her short-term and long-term health overall.

5. Preparing for Pregnancy
Establish eating habits before pregnancy
Fathers-to-be
Mothers-to-be
Pregnancy weight
Appropriate body weight before pregnancy
Obese and underweight women
Low birthweight infant
Infant mortality rate

6. Infant Mortality Decline Over Time

7. Preparing for Pregnancy
Healthy placenta and other organs
Placenta
Supply depot and waste-removal system
Two bloods never mix
Metabolically active organ
Umbilical cord
Amniotic sac
Poor maternal nutrition prior to pregnancy could affect her grandchildren and children

8. The Placenta

9. The Events of Pregnancy
Fertilized ovum is called a zygote
Implantation
Within two weeks of fertilization
Fetus at eight weeks
Physical changes
Fetal period
Gestation = 40 weeks
Trimesters
Critical periods

10. Stages of Embryonic and Fetal Development

11. Increased Need for Nutrients
Energy
Vary with progression of pregnancy
Carbohydrate
Protein
DRI for pregnancy
Supplements
Discretionary calories

12. Increased Need for Nutrients
Folate
Recommendation increases during pregnancy
Neural tube defects (NTD)
Anencephaly
Spina bifida
Enrichment of grain products
Vitamin B12
Assists folate with manufacture of new cells

13. Spina Bifida

14. Rich Folate Sources

15. Increased Need for Nutrients
Vitamin D
Rickets
Calcium
Absorption doubles during pregnancy
Recommendations are aimed at preserving maternal bone mass
DRI recommendations

16. Increased Need for Nutrients
Iron
Iron needs of fetus take priority
Iron supplements
Enhancing absorption
Zinc
Supplementation during pregnancy is not advised
Prenatal supplements

17. Example of a Prenatal Supplement Label

18. Food Assistance Programs
Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)
Nutritious foods
Nutrition education
Referrals to health and social services
Benefits of the program
Supplemental Nutrition Assistance Program

19. Weight and Pregnancy Weight gain Weight loss and pregnancy
Women must gain weight during pregnancy
Benefits of appropriate weight gains
Ideal weight-gain pattern
Nearly all lean tissue
Weight loss and pregnancy
Typical woman does not return to prepregnancy weight

20. Recommended Weight Gains Based on Prepregnancy Weight

21. Components of Weight Gain During Pregnancy

22. Pregnancy and Physical Activity
Benefits of physical activity
Consult physician
Types of activities
Recommendations
Prevent dehydration
Prevent high internal temp.

23. Teen Pregnancy Special case of intense nutrient needs
Frequent teen deficiencies
Less likely to receive prenatal care
More likely to smoke
Risks associated with teen pregnancy
Infant
Mother

24. Cravings and Aversions in Pregnancy
Cravings and aversions are common
Do not reflect physiological needs
Pica
Often associated with iron deficiency
“Morning” sickness
Hormones

25. Some Cautions for the Pregnant Woman
Smoking
Damage to fetal DNA
Developmental defects or diseases
Complications of birth
Risk of SIDS
Medicinal drugs and herbal supplements
No OTC drugs or herbal supplements
Prescriptions only with doctor’s advice

26. Some Cautions for the Pregnant Woman
Drugs of abuse
Cross the placenta
Complications of use
Environmental contaminants
Lead
Mercury
Fish consumption

27. Some Cautions for the Pregnant Woman
Foodborne illness
Listeriosis
Foods to avoid
Vitamin-mineral megadoses
Vitamin A
Dieting
Sugar substitutes
Caffeine

28. Drinking During Pregnancy
Labeling of alcoholic beverages
Alcohol crosses placenta & is toxic
Direct effects in fetus

29. Fetal Alcohol Syndrome
Drinking alcohol during pregnancy
Fetal Alcohol Spectrum Disorders (FASD)
Fetal Alcohol Syndrome (FAS)
Alcohol-Related Neurodevelopmental Disorder (ARND)
Alcohol-Related Birth Defects (ARBD)
Expert advice

30. Typical Facial Characteristics of FAS

31. Troubleshooting - Diabetes
Special challenges for disease management
Problems with poor glycemic control
Continuation of intensified management after pregnancy
Gestational diabetes
Diabetes risk later in life
Increased odds of surgical birth and high infant birthweight

32. Troubleshooting – Hypertension & Preeclampsia
Chronic vs. gestational hypertension
Risks for mother and fetus
Preeclampsia
High blood pressure and protein in urine
Occurrence
Advancement to eclampsia

33. Lactation Preparation before birth Read books
Consult a certified lactation consultant
Learn about nutritional requirements

34. Nutrition During Lactation
Energy cost
500 calories per day above a woman’s need
Fluid need
Prevent dehydration
Variations in breast milk
Quantity vs. quality of milk
Food sensitivities and allergies
Weight loss
Gradual

35. When Should a Woman Not Breastfeed?
Alcohol and illicit drugs
Alcohol concentration peak within 1 hour
Illicit drug users should not breastfeed
Tobacco and caffeine
Medicines
Danger levels vary – consult physician
Oral contraceptives

36. When Should a Woman Not Breastfeed?
Environmental contaminants
Maternal illness
Common cold
Hepatitis or tuberculosis
HIV
World Health Organization (WHO)

37. Feeding the Infant Nutrient needs Growth rate Basal metabolic rate
Weight and length
Basal metabolic rate
Energy nutrients
Vitamins
Water

38. Nutrient Recommendations for an Infant & an Adult Male Compared on the Basis of Body Weight

39. Why Is Breast Milk So Good for Babies?
AAP and ADA position
Excels as source of nutrients
Vitamin D
Immune factors
Easily digested
Energy-nutrient balance
Lipids

40. Why Is Breast Milk So Good for Babies?
Vitamins and minerals in breast milk
Vitamin D supplements
Supplements for infants
Vitamin D, iron, fluoride, vitamin K
Immune factors
Colostrum
Benefits of breast milk with infection
Other possible benefits

41. Formula Feeding Offers an acceptable alternative to breastfeeding
Nutrient composition
Special formulas
Transition to cow’s milk
1 year of age
Dietary indicators of readiness for cow’s milk

42. Percentages of Energy-Yielding Nutrients in Breast Milk, Infant Formula, & Cow’s Milk

43. Infant’s First Foods Governing considerations Nutrient needs
Iron and vitamin C
Physical readiness
Ability to swallow
Need to detect & control allergic reactions
Introduce single-ingredient foods one at a time

44. Infant’s First Foods Choices of foods Foods to omit
Variety, balance, moderation
Fat restriction
Foods to omit
Sweets and baby desserts
Sugar alcohols
Canned foods
honey

45. Looking Ahead First year of life lays the foundation for future health
Encourage healthy eating habits
Avoid concentrated sweets
Encourage physical activity
Nursing bottle syndrome

46. Childhood Obesity and Early Chronic Diseases
Controversy 13

47. Childhood Obesity Increase in childhood obesity rates
Associated health problems
Characteristics of obese children

48. The Challenge of Childhood Obesity
Physical perils
Blood lipids
Hypertension
Cardiorespiratory fitness
Asthma
Emotional perils
Discrimination
Rejection

49. The Challenge of Childhood Obesity
Overweight or chubby and healthy
Body mass index (BMI)
Be careful not to set unrealistic expectations
Genetic inheritance
Environmental influence

50. Development of Type 2 Diabetes
Connection with obesity
Ethnicity and risk
Symptoms of diabetes
Type 1
Type 2

51. Development of Heart Disease
Atherosclerosis begins in youth
High blood cholesterol
Family history
Sedentary lifestyle
High blood pressure
Aerobic activity
Limit of salt intake

52. Early Childhood Influences on Obesity
Calories – and cautions
Family influence
Avoid being overly restrictive
Physical activity
“Screen time”
Food advertising to children
40,000 television ads per year
Internet

53. Prevalence of Obesity by Hours of TV per Day, Children Ages 10-15 Years

54. Preventing and Reversing Overweight in Children
Parents are a starting point
Begin before adolescence
Parents set an example
Lifestyle changes first
Medications later
Obesity surgery
Positive, loving support

55. Diet Moderation, No Deprivation
Limits on fats
Consumption of healthy foods
Fatty foods
Avoid “children’s menu”
Some healthier choices
Soft drinks

56. Physical Activity Benefits of physical activity Better lipid profile
Lower blood pressure
Increased muscle strength
Improved heart conditions
2008 Physical Activity Guidelines for Americans

57. Physical Activity Pyramid for Kids