PREGNANCY
Activity 1
Case Study 1—
Difficulty Gaining Weight during Pregnancy
Melissa has been referred to a registered dietitian for assistance with gaining weight.
She is in her 22nd week of pregnancy and was recently diagnosed with hyperemesis
gravidarum. Her physician is concerned that she has only gained five pounds thus far
in her pregnancy. Prior to becoming pregnant, her weight was 135# and she is 5’6”.
Melissa tells you she has been following the dietary advice for nausea provided in a
popular pregnancy magazine, but it just doesn’t seem to be working for her. She also
wonders if she is consuming adequate nutrition for her baby and asks you if she
should be taking any nutrition supplements. She stopped taking her prenatal vitamins
last week to see if this might decrease her nausea. Melissa heard from a friend that
vitamin B12 supplements are supposed to help with nausea, so she has been taking
those for a few days, but they don’t seem to be helping. A 24-hour food recall shows
the following: 3 ounces grains, no vegetables, 3 fruits, 2 cups milk, 3 ounces of meat
and 1-2 servings of fat.
Questions:
1.
Approximately how much weight should Melissa have gained by now? What is
the total recommended weight gain in light of her diagnosis of hyperemesis
gravidarum?
2. What recommendations do you have for management of nausea and vomiting
during pregnancy that would apply to Melissa’s case?
3. Are there nutrition supplements that might be beneficial to Melissa?
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Activity 2
Case study 2: Nutritional Requirements during Pregnancy
1. Heidi, 28 years old, just found out she is pregnant. She is 134# and 5’6.” Calculate
her current BMI and recommend the amount of weight she should gain during her
pregnancy.
2. How many additional calories per day should Heidi consume to support her
pregnancy?
3. How much food would be needed to provide the additional energy needed in the
third semester? Hint: Use the ADA Exchange System to estimate the amount of food
that would be needed.
4. How much additional protein is needed to meet the nutritional requirements of the
pregnancy? How much extra food would this be? Hint: Use the ADA Exchange
System to estimate the amount of food that would be needed.
5. What changes in the DRI for calcium occur to meet the nutritional requirements of
pregnancy?
6. What changes in the DRI for iron occur to meet the nutritional requirements of
pregnancy?
7. What changes in the DRI for folate occur to meet the nutritional requirements of
pregnancy?
8. Considering the answers to the above questions, is the statement “I can eat as
much as I want to during pregnancy because I’m eating for two” really accurate?
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Activity 3
Case Study 4.1: Vegan Diet during Pregnancy. Pg. 112.
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