Chapter 13
Life Cycle Nutrition:
Mother and Infant
Nutrition: Concepts & Controversies, 12e
Sizer/Whitney
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.”
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.
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.
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
Infant Mortality Decline Over Time
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
The Placenta
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
Stages of Embryonic and Fetal
Development
Increased Need for Nutrients
 Energy
 Vary with
progression of
pregnancy
 Carbohydrate
 Protein
 DRI for pregnancy
 Supplements
 Discretionary
calories
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
Spina Bifida
Rich Folate Sources
Increased Need for Nutrients
 Vitamin D
 Rickets
 Calcium
 Absorption doubles during pregnancy
 Recommendations are aimed at preserving
maternal bone mass
 DRI recommendations
Increased Need for Nutrients
 Iron
 Iron needs of fetus take priority
 Iron supplements
 Enhancing absorption
 Zinc
 Supplementation during pregnancy is not
advised
 Prenatal supplements
Example of a Prenatal
Supplement Label
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
Weight and Pregnancy
 Weight gain
 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
Recommended Weight Gains
Based on Prepregnancy Weight
Components of Weight Gain
During Pregnancy
Pregnancy and Physical Activity
 Benefits of physical
activity
 Consult physician
 Types of activities
 Recommendations
 Prevent
dehydration
 Prevent high
internal temp.
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
Cravings and Aversions in
Pregnancy
 Cravings and aversions are common
 Do not reflect physiological needs
 Pica
 Often associated with iron deficiency
 “Morning” sickness
 Hormones
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
Some Cautions for the Pregnant
Woman
 Drugs of abuse
 Cross the placenta
 Complications of use
 Environmental contaminants
 Lead
 Mercury
 Fish consumption
Some Cautions for the Pregnant
Woman
 Foodborne illness
 Listeriosis
 Foods to avoid
 Vitamin-mineral megadoses
 Vitamin A
 Dieting
 Sugar substitutes
 Caffeine
Drinking During Pregnancy
 Labeling of
alcoholic beverages
 Alcohol crosses
placenta & is toxic
 Direct effects in
fetus
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
Typical Facial Characteristics of
FAS
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
Troubleshooting – Hypertension &
Preeclampsia
 Hypertension
 Chronic vs. gestational hypertension
 Risks for mother and fetus
 Preeclampsia
 High blood pressure and protein in urine
 Occurrence
 Advancement to eclampsia
Lactation
 Preparation before birth
 Read books
 Consult a certified lactation consultant
 Learn about nutritional requirements
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
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
When Should a Woman Not
Breastfeed?
 Environmental contaminants
 Maternal illness
 Common cold
 Hepatitis or tuberculosis
 HIV
 World Health Organization (WHO)
Feeding the Infant
 Nutrient needs
 Growth rate
 Weight and
length
 Basal metabolic
rate
 Energy nutrients
 Vitamins
 Water
Nutrient Recommendations for an
Infant & an Adult Male Compared on
the Basis of Body Weight
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
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
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
Percentages of Energy-Yielding
Nutrients in Breast Milk, Infant
Formula, & Cow’s Milk
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
Infant’s First Foods
 Choices of foods
 Variety, balance,
moderation
 Fat restriction
 Foods to omit
 Sweets and baby
desserts
 Sugar alcohols
 Canned foods
 honey
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
Childhood Obesity and Early
Chronic Diseases
Controversy 13
Childhood Obesity
 Increase in
childhood obesity
rates
 Associated health
problems
 Characteristics of
obese children
The Challenge of Childhood
Obesity
 Physical perils
 Blood lipids
 Hypertension
 Cardiorespiratory fitness
 Asthma
 Emotional perils
 Discrimination
 Rejection
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
Development of Type 2 Diabetes
 Connection with obesity
 Ethnicity and risk
 Symptoms of diabetes
 Type 1
 Type 2
Development of Heart Disease
 Atherosclerosis
begins in youth
 High blood
cholesterol
 Family history
 Sedentary lifestyle
 High blood
pressure
 Aerobic activity
 Limit of salt intake
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
Prevalence of Obesity by Hours of TV
per Day, Children Ages 10-15 Years
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
Diet Moderation, No Deprivation
 Limits on fats
 Consumption of healthy foods
 Fatty foods
 Avoid “children’s menu”
 Some healthier choices
 Soft drinks
Physical Activity
 Benefits of physical activity
 Better lipid profile
 Lower blood pressure
 Increased muscle strength
 Improved heart conditions
 2008 Physical Activity Guidelines for
Americans
Physical Activity Pyramid for Kids