Chapter 14
Nutrition during
Pregnancy and
Lactation
Amniotic sac: a membrane that surrounds
the fetus containing the amniotic fluid
Placenta: an organ produced during
pregnancy from maternal and embryonic
tissues. The placenta secretes hormones,
transfers oxygen and nutrients from
maternal to fetal blood and removes
wastes.
Gestation: the time between conception
and birth, approximately 40 weeks in
humans
Preterm or premature: an infant born
before 37 weeks of gestation
Very low birth weight: a birth weight of
less than 3.3 lbs (1.5 kg)
Small-for-gestational-age: a birth weight
of less than 5.5 lbs
(2.5Inc.
kg)
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One function of the ________ is to
transfer nutrients and oxygen from the
maternal blood to the baby through a
network of blood vessels.
placenta.
amniotic sac.
zygote.
chorion membrane.
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Infants born at 35 weeks of gestation are
classified as
a)
small-for-gestational-age.
b)
large-for-gestational-age.
c)
premature.
d)
postterm.
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The recommended weight gain during
pregnancy for a healthy, normal weight
women is approximately ___________
pounds.
5 - 10
15 - 20
25 - 30
40 - 50
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Distribution of
Weight during
Pregnancy
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Recommendations for Weight Gain
during Pregnancy
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Pattern of Weight Gain during Pregnancy
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Weight gain recommendations during
pregnancy are based on
a)
weight at the time of
conception.
b)
c)
ethnicity.
waist-to-hip circumference
ratio at the time of
conception.
d)
ultrasound results (used to
size the infant) taken during
the first trimester of
pregnancy.
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Physical activity during pregnancy
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Physical Activity during Pregnancy
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Discomforts of Pregnancy

Physiological changes during pregnancy can
cause uncomfortable side effects for the
mother. These can include:

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Edema
Morning sickness
Heartburn
Constipation and hemorrhoids
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Complications of Pregnancy

Pregnancy can cause complications for the
mother and the child. These can include:


Pregnancy-induced hypertension, which includes
gestational hypertension, preeclampsia and
eclampsia
Gestational diabetes mellitus
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Gestational Diabetes:
Pregnant women who have never had diabetes before but who have high
blood sugar (glucose) levels during pregnancy are said to have
gestational diabetes. Gestational diabetes affects about 4% of all
pregnant women - about 135,000 cases of gestational diabetes in the
United States each year.
We don't know what causes gestational diabetes, but we have some
clues. The placenta supports the baby as it grows. Hormones from the
placenta help the baby develop. But these hormones also block the
action of the mother's insulin in her body. This problem is called insulin
resistance. Insulin resistance makes it hard for the mother's body to use
insulin. She may need up to three times as much insulin.
Gestational diabetes starts when your body is not able to make and use
all the insulin it needs for pregnancy. Without enough insulin, glucose
cannot leave the blood and be changed to energy. Glucose builds up in
the blood to high levels. This is called hyperglycemia.
http://www.diabetes.org/diabetes-basics/gestational/what-is-gestationaldiabetes.html
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Nutritional Needs
of Pregnancy
Energy Needs
1st trimester- same needs
2nd trimester- extra 340 calories/day
3rd trimester- extra 452 calories/day
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What is in a Prenatal Supplement?
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Factors that Increase Pregnancy Risk
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Factors that Increase Pregnancy Risk
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Micronutrient
Needs of
Pregnant Teens
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Which of the following is the correct sequence of
gestational events:
embryo; fetus; zygote
zygote; embryo; fetus
fetus; embryo; zygote
zygote; fetus; embryo
What’s the most common birth defect?
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Fetal Development
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Physiology of Lactation
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Lactation involves the synthesis of milk components,
including protein, lactose and lipids, and the movement
of the milk through the milk ducts to the nipple.
Colostrum is immature milk, secreted during the first
days after delivery. Colostrum is rich in protein and
immune factors.
The release of milk from the glands through the ducts is
referred to as let-down.
The let-down of milk is triggered by the hormone
oxytocin.
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Physiology of Lactation
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Maternal Nutrient Needs during
Lactation

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
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The need for nutrients is even greater during lactation
than during pregnancy.
Human milk contains about 160 kcalories per cup (240
ml).
The EER for lactation is estimated by adding the TEE
of nonlactating women and the energy in the milk and
then subtracting the energy supplied by maternal fat
sources.
Lactating women require approximately an additional
liter of fluid a day.
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Nutritional Needs of Infants
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Nutritional Needs of Infants
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Assessing
Infant Growth
failure to thrive: inability of a
child’s growth to keep up with
normal growth curves
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Comparing Breast Milk and Formula
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How long should breast feeding
continue?




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Physiologicaly, lactation can continue as long
as suckling is maintained
Breast feeding alone is sufficient to support
optimal growth for ~ 6 months
Currently, only 17% of infants are exclusively
breast fed for 6 months
After 12 months, the baby no longer needs
breast milk for nutritional needs
However, breast feeding can provude
nutrition, comfort, bonding.
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Breast Pumps Can Be Used for Bottle
Feedings
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Position of Bottle is Important
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Chapter 14
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