NUTRITION AND DIET THERAPY

REPORTING

GROUP II

BALILI, JOLCE KRISKA BAROLA, TRIXIA CABALES, MICO VECRIS

MONIQUE
DIET DURING
PREGNANCY AND
LACTATION
 CONTENTS
1. Weight Gain during Pregnancy (CABALES)

2. Nutritional Needs during Pregnancy (CABALES)

Fulfillment of Nutritional Needs during Pregnancy (CABALES)

3.
4. Concerns during Pregnancy (BALILI)

5. Diet for the Pregnant Woman with Diabetes (BALILI)

6. Pregnancy during Adolescence (BAROLA)

7. Lactation (BAROLA)
 OBJECTIVES
After studying this
chapter, you should
be able to:
first second third

Identify nutritional Describe Modify the normal

needs during nutritional needs diet to meet the
pregnancy and of pregnant needs of pregnant
lactation adolescents and lactating
women
 WEIGHT GAIN DURING PREGNANCY
Weight gain during pregnancy is natural and necessary for the
infant to develop normally and the mother to retain her health.
• 25 to 35 pounds - average weight gain during pregnancy
• 2 to 4 pounds - average weight gain during the first trimester of pregnancy
• 1 pound a week - average weight gain occurs during the second and third
trimesters of pregnancy
RECOMMENDED WEIGHT GAIN:
• 28 to 40 pounds - underweight women should gain
• 25- to 35 pound - women of average weight (stay within average weight gain)
• 35 to 45 pounds - women pregnant with twins
• Overweight women can afford to gain less than the average woman, but not less
than 15 pounds.
Components of Weight Gain during Pregnancy,
with Approximate Amounts of Gain
COMPONENT AMOUNT OF GAIN
Fetus 7.5 pounds
Placenta 1 pound
Amniotic Fluid 2 pounds
Uterus 2 pounds
Breasts 1-3 pounds
Blood Volume 4 pounds
Maternal Fat 4+ pounds
 NUTRITIONAL NEEDS DURING PREPREGNANCY
Some specific nutrient requirements are increased
dramatically during pregnancy.
PROTEIN REQUIREMENT:
• Increased by 20% for the pregnant woman over 25 and by 25%
for the pregnant adolescent.

• Proteins are essential for tissue building, and protein-rich foods

are excellent sources of many other essential nutrients,
especially iron, copper, zinc, and the B vitamins.
FAT-SOLUBLE VITAMINS:
• Vitamin A - no need for increased vitamin A during pregnancy.
- excess vitamin A (more than 3,000 RE) cause birth defects
such as:
• hydrocephaly (enlargement of the fluid-filled spaces of
the brain)
• microcephaly (small head)
• mental retardation
• ear and eye abnormalities
• cleft lip and palate
• heart defects
• Vitamin D - required amount is 10 μg
• Vitamin E - 15 mg αTE
• Vitamin K - given as AI of 75 to 90 μg depending upon age
WATER-SOLUBLE VITAMINS: are increased during pregnancy
• Vitamin C - additional is needed to develop collagen and to increase
the absorption of iron
• B Vitamins - are needed in greater amounts because of their roles in
metabolism and the development of red blood cells.

MINERALS: are all increased during pregnancy

• Calcium
• Iron
• Zinc
• Iodine
• Selenium
 FULFILLMENT OF NUTRITIONAL NEEDS DURING PREGNANCY
To meet the nutritional requirements of pregnancy, the woman should base her diet
on MyPyramid. Special care should be taken in the selection of food so that the
necessary calories are provided by nutrient-dense foods.

DRINKING ADDITIONAL MILK

- one of the best ways of providing these nutrients
- extra milk will provide protein, calcium, phosphorus, thiamine, riboflavin,
and niacin
** If whole milk is used, it will also contribute saturated fat and cholesterol and
provide 150 calories per 8 ounces of milk.
** Fat-free milk contributes no fat and provides 90 calories per 8-ounce serving and
thus is the better choice.
CONCERNS DURING PREGNANCY
NAUSEA PICA

CONSTIPATION ANEMIA

HEART BURN ALCOHOL,

CAFFEINE,
EXCESSIVE DRUGS, and
WEIGHT GAIN TOBACCO
 NAUSEA

(the feeling of a need to vomit) The following suggestions can help relieve
• occurs during the first trimester of morning sickness:
pregnancy. • Eat dry crackers or dry toast before rising.
• this type of nausea is commonly • Eat small, frequent meals.
known as morning sickness • Avoid foods with offensive odors.
• it typically passes as the pregnancy • Avoid liquids at mealtime.
proceeds to the second trimester
hyperemesis gravidarum - nausea persists
and becomes so severe that it is life-
threatening. The mother may be hospitalized
and given parenteral nutrition (patient is
given nutrients via a vein)
 CONSTIPATION HEART BURN
Constipation and hemorrhoids can be - can result from relaxation of the cardiac
relieved by eating high-fiber foods: sphincter and smooth muscles related to
• getting daily exercise progesterone
- As the fetus grows, it pushes on the mother’s
• drinking at least 8 glasses of liquid each
stomach, which may cause stomach acid to
day
move into the lower esophagus and create a
• responding immediately to the urge to burning sensation there.
defecate. MAY RELIEVED BY:
• eating small, frequent meals
• avoiding spicy or greasy foods
• avoiding liquids with meals
• waiting at least an hour after eating before
lying down
• waiting at least 2 hours before exercising
 EXCESSIVE WEIGHT GAIN
the pregnant woman should reevaluate her diet and eliminate foods (except for the
extra pint of milk) that do not fit within MyPyramid.
• Drink Fat-free Milk - which would reduce her calories but not her intake of
proteins, vitamins, and minerals.
• Lactose Intolerance - cannot tolerate lactose (the sugar in milk), it is not advisable
to substitute calcium pills for milk because the substitution reduces the protein,
vitamin, and mineral content of the diet.

A bowl of clean, crisp, raw vegetables such

as broccoli or cauliflower tips, carrots,
celery, cucumber, zucchini sticks, or
radishes dipped in a fat-free salad dressing
or salsa can provide interesting snacks that
are nutritious, filling, satisfying, and low in
Broiling, baking, or boiling foods
calories.
instead of frying can further
reduce the caloric intake.
 PREGNANCY-INDUCED
HYPERTENSION

If the condition persists

was formerly called toxemia It is characterized by high and reaches the
or preeclampsia. It is a blood pressure, the eclamptic (convulsive)
condition that sometimes presence of albumin in the stage, convulsions,
occurs during the third urine (proteinuria), and coma, and death of
trimester. edema. mother and child may
occur.

Pregnant Adolescents The cause of this Multifetal Pregnancies

have a higher rate of condition is not known, -in those women with
PIH than do pregnant but it occurs more morbid obesity,
adults. frequently in first-time inadequate diets, and
pregnancies. protein-deficient diets.
• Take a balanced diet with optimal calories.
• Eat a healthy more whole grains and potassium-rich foods.
-potassium helps lower blood pressure
 PICA
is the craving for nonfood substances such as
starch, clay (soil), or ice. Some believe it
relieves nausea. Others think the practice is
based on cultural heritage.
**The consumption of soil should be
highly discouraged.
• Ingesting soil can lead to an
intestinal blockage.
• Substances in the soil would
bind with minerals, leads to
nutrient deficiencies.
• nonfood substances replaces
nutrient-rich foods in the diet,
results in multiple nutrient
deficiencies.
 ANEMIA
a is a condition caused by an insufficiency of red
blood cells, hemoglobin, or blood volume.
** Iron deficiency - is its most common form
**Folate deficiency - can result in a form of
megaloblastic anemia that can
occur during pregnancy.
• Folate Supplement of 400 to 600 μg a
day during pregnancy.
 ALCOHOL, CAFFEINE, DRUGS, and TOBACCO

ALCOHOL
Alcohol consumption is associated with
subnormal physical and mental development of
the fetus. This is called fetal alcohol syndrome
(FAS).
• growth deficiency (height, weight)
• central nervous system dysfunction
including hyperactivity, seizures,
attention deficits, and microcephaly
(small head).
Fetal Alcohol Effect (FAE) - children are born with less dramatic or
no physical defects but with many of the behavioral and
psychosocial problems associated with FAS.
 CAFFEINE DRUGS

Caffeine is known to cross the Drugs vary in their effects, but

placenta, and it enters the fetal self-prescribed drugs, including
bloodstream. vitamins and mineral
• caffeine intake to 2 cups supplements and dangerous
of caffeine-containing illegal drugs, can all damage the
beverages each day, or fetus.
less than 300 mg/day. • Drugs derived from
vitamin A- fetal
malformations and
spontaneous abortion
• Illegal drugs - infant will
be born addicted
 TOBACCO

Tobacco smoking by pregnant women has for some time been

associated with babies of reduced birth weight.

**The more the mother smokes, the smaller her baby will be.
(reduces the oxygen and nutrients carried by the blood)

Risk Associated with Smoking Include:

• SIDS (sudden infant death syndrome)
• Fetal Death
• Spontaneous Abortion
• Complications at birth
• Affect the Intellectual and
Behavioral Development
 DIET FOR THE PREGNANT WOMAN WITH DIABETES
• Some women have
DIABETES diabetes when they
become pregnant.
Diabetes mellitus is a
• Others may develop
group of diseases in
gestational diabetes
which one cannot use during pregnancy
or store glucose **disappears after the
normally because of infant is born
inadequate production **40% chance (2 diabetes
or use of insulin. later in life)

• Either type increases the risks of physical or mental defects in the infant, stillbirth, and macrosomia (birth weight
over 9 pounds) unless blood glucose levels are carefully monitored and maintained within normal limits.
• Every pregnant woman should be tested for diabetes (16 and 28 weeks).
• The diet should be planned with a registered dietitian or a certified diabetes educator.
• Clients with gestational diabetes - require insulin to control blood glucose levels.
• Oral hypoglycemic agents and artificial sweeteners - found to be safe for use during pregnancy.
FOODS TO EAT:
• Plenty of whole fruits and vegetables.
• Moderate amounts of lean proteins and healthy fats.
• Moderate amounts of whole grains, such as bread, cereal, pasta, and rice, plus starchy
vegetables, such as corn and peas.
• Fewer foods that have a lot of sugar, such as soft drinks, fruit juices, and pastries.

Diabetes During Pregnancy: Diet Tips

• Eat 3 meals and 2–3 snacks per day.
• Measure your servings of starchy foods.
• One 8-ounce cup of milk at a time.
• One small portion of fruit at a time.
• Eat more fiber.
• Strictly limit sweets and desserts.
 PREGNANCY DURING ADOLESCENCE
Teenage pregnancy is an increasing concern. The young woman may need prenatal health
care, infant care, and psychological, nutritional, and economic counseling, as well as help
in locating appropriate housing.

**Nutritional Habits – primary importance to fulfill the nutritional needs of her own
growing body.
Adolescents are vulnerable to:
• Pregnancy-Induced Hypertension - can cause cardiovascular and kidney problems later
• Premature Delivery - is a leading cause of death among newborns.
• Inadequate Nutrition - is related to both mental and physical birth defects

• WIC (Women, Infants, and Children) – government funded program can help with prenatal care,
nutrition education, and adequate food for the best outcome possible.
• Pregnant teenagers will need much counseling and emotional support from caring, experienced
people before nutritional improvements can be suggested.
 LACTATION
the production and secretion of
breast milk for the purpose of
nourishing an infant, is facilitated
by an interplay of various hormones
after delivery of the infant.

Oxytocin and Prolactin- instigate the lactation 2 to 3 weeks -fully establish a feeding routine
process -recommended that no supplemental
• Prolactin is responsible for milk production feedings be given during this time.
• Oxytocin is involved in milk ejection from the breast. Human milk - is formulated to meet the nutrient needs
**the infant’s sucking initiates the release of oxytocin, of infants for the first 6 months of life.
which causes the ejection of milk into the infant’s mouth. Iron content in breast milk is very low, but it is very well
(called the let-down reflex, a supply-and-demand absorbed (no iron supplement is needed for breastfed
mechanism) babies)
 LACTATION SPECIALIST

A lactation specialist is an expert on

breastfeeding and helps new mothers who
may be having problems.
• baby not latching on properly - cause
the breast to become sore and could be
discouraging to first-time mothers.
• best first food for babies is breast milk
 BENEFITS OF BREASTFEEDING
Breastfed babies have a
lower incidence of ear
Breast milk (human milk) infections, diarrhea,
allergies, and hospital
- primary benefit is nutrition Breastfeeding
admissions.

- contains just the right amount of: facilitates bonding

between mother Sucking at the
• lactose and child. breast promotes
(skin-to-skin good jaw
• water contact) development.

• essential fatty acids “kangaroo

care”
• amino acids for brain
development, growth, and help in losing the
Breast milk will keep:
• 8 to 10 hrs at room
digestion pounds gained temperature (66°–72°F)
during • 8 days (refrigerator)
- contains at least 100 ingredients pregnancy and • 3 to 4 months
stimulating the (refrigerator freezer)
not found in formula uterus to contract to • 12 months (deep
its original size. freezer)
 CALORIE REQUIREMENTS DURING
LACTATION
The mother’s calorie requirement increases during lactation.
The caloric requirement depends on the amount of milk produced.

• 85 calories - required to produce 100 ml (3 1/3 ounces) of milk.

• First 6 months - average daily milk production is 750 ml (25 ounces), and extra 640
calories a day.
• Second 6 months - average daily milk production slows to 600 ml (20 ounces), and
510 extra calories a day.

**The Food and Nutrition Board suggests an increase of 500 calories a day during
lactation.
**Each ounce of human milk contains 20 calories.
 NUTRIENT REQUIREMENTS DURING
LACTATION
Most nutrient requirements are increased during lactation. The
amounts depend on the age of the mother.
Protein - is important because it is estimated that 10 grams of protein are secreted in
the milk each day.
MyPyramid - will be helpful in meal planning for the lactating mother
• sufficient fruits and vegetables
• extra fat-free milk
**Vegetarians will need to be sure they have sufficient:
• Calories
• Iron
• Zinc
• Copper
• Protein
• Calcium
• Vitamin D
 MEDICINES, CAFFEINE, ALCOHOL, AND
TOBACCO
Most chemicals enter the mother’s milk, so it is essential that the
mother check with her obstetrician before using any medicines or
nutritional supplements.
• Caffeine - can cause the infant to be irritable
• Alcohol in excess, tobacco, and illegal drugs - can be very harmful.
• Both illegal drugs (marijuana or heroin) and prescription medication (methadone
and oxycodone) - can cause the baby to be excessively drowsy and to feed poorly.
• Stimulant drugs - can cause the baby to be irritable.

**The biggest concern is addiction of the mother and baby.