Narrated Maternal Nutrition Presentation

Maternal & Child Nursing CareSecond Edition : 

Maternal & Child Nursing CareSecond Edition Lecture NotesChapter 12Maternal Nutrition Marcia L. London Patricia W. Ladewig Jane W. Ball Ruth C. Bindler

INTRODUCTION : 

INTRODUCTION NUTRITION PLAYS A KEY ROLE IN THE OUTCOME OF PREGNANCY A CLIENT’S NUTRITIONAL STATUS AT CONCEPTION AND THE QUALITY OF THE DIET SHE EATS DURING PREGNANCY HELPS DETERMINE HER HEALTH AND THE WELL-BEING OF HER CHILD

Weight Gain Recommendations : 

Weight Gain Recommendations Optimal weight gain Depends on the woman’s weight for height Prepregnant nutritional state Underweight: 28 to 40 lb Normal weight: 25 to 35 lb Overweight: 15 to 25 lb Obese: Approximately 15 lb

Weight Gain Recommendations : 

Weight Gain Recommendations Pattern of weight gain is important First trimester: 3.5 to 5 lb Second and third trimester: About 1lb weekly Twins: Second and third trimesters: 1.5 lbs per week Dieting during pregnancy can result in maternal ketosis

Role of Nutrients : 

Role of Nutrients Carbohydrates Main source of energy as well as fiber Promotes maternal, fetal, and placenta weight gain Protein: Supplies needed amino acids for growth of uterus and breast tissue Magnesium: Promotes cellular metabolism Iron: Prevents maternal anemia Maintains fetal and infant stores of iron

Role of Nutrients : 

Role of Nutrients Fat: Promotes fetal fat deposits Calcium and phosphorus: Promotes mineralization of fetal bones and teeth Iodine: Promotes fetal thyroid gland function Sodium: Regulates fluid balance and metabolism in the mother

Role of Nutrients : 

Role of Nutrients Zinc: Promotes growth of fetus and sufficient lactation Vitamins: Maintain good maternal health Folic acid: May prevent neural tube defects in the fetus

Folate Supplementation in Pregnancy : 

Folate Supplementation in Pregnancy

FLUIDS : 

FLUIDS NEED 6-8 GLASSES A DAY WOMEN WHO CONSUME MORE THAN 300 MG OF CAFFEINE/DAY ARE AT INCREASED RISK OF MISCARRIAGE AND OF DELIVERING INFANTS WITH IUGR.

Vegetarian Diets During Pregnancy : 

Vegetarian Diets During Pregnancy There are different types of vegetarian diets Lacto-ovovegetarians: Dairy and egg products Lactovegetarians: Dairy products but no eggs Vegans: No foods from animal sources Most vegans need additional supplementation - vitamins B12, D, and calcium

Vegetarian Diets During Pregnancy : 

Vegetarian Diets During Pregnancy Vegetarians’ daily food requirements are: 6 to 11 servings of whole grains, cereal, pasta, and rice 2 to 4 servings of fruit 3 to 5 servings of vegetables 2 to 3 servings of legumes, nuts, seeds, and meat alternatives 2 to 3 servings of milk products (unless vegan)

Factors Affecting Nutritional Intake : 

Factors Affecting Nutritional Intake Nausea, vomiting, and heartburn Lactose intolerance may cause diarrhea or bloating after dietary intake Cultural, ethnic, and religious influences may prohibit use of foods needed for adequate nutrition

Factors Affecting Nutritional Intake : 

Factors Affecting Nutritional Intake Socioeconomic level may limit availability of nutritious foods Lack of knowledge about proper nutrition may limit woman’s ability to prepare nutritional foods Clients with eating disorders may have nutritional and electrolyte imbalances Pica may result in iron deficiency anemia

PICA AND FOOD CRAVINGS : 

PICA AND FOOD CRAVINGS PICA -PRACTICE OF EATING SUBSTANCES NOT NORMALLY THOUGHT OF AS FOOD THE MAIN CONCERN IS THAT EATING NON-FOOD SUBSTANCES DECREASES THE INTAKE OF NUTRITIONAL FOODS

Nutritional Requirements : 

Nutritional Requirements Calories in second and third trimester Increase by 300 kcal/day During lactation: Increase by another 200 kcal/day Protein increases by 14 mg to 60 mg/day

Developing Cultural Competence : 

Developing Cultural Competence

Factors to Assess : 

Factors to Assess Factors to assess in pregnant adolescents Low prepregnant weight and anemia Low weight gain during pregnancy and eating disorders Young age at menarche Unhealthy lifestyle: Smoking, alcohol, and illicit drug use Excessive prepregnant weight Chronic disease

Weight Gain and Nutrient Intake : 

Weight Gain and Nutrient Intake Weight gain: Recommended weight gain of the adult pregnancy plus the expected gain of the adolescent Nutrient needs - adolescent needs more iron, calcium, and folic acid than adult pregnant woman Caloric needs Vary widely Figures as high as 50 kcal/kg have been suggested Satisfactory weight gain usually confirms an adequate caloric intake

Nutritional Counseling : 

Nutritional Counseling Basic factors to consider Number of years since adolescent reached menarche Whether growth has been completed Most adolescents have irregular eating patterns Adolescent may not be the one who regularly prepares meals Individual who prepares meals should be included in nutritional counseling Teens are present, not future, oriented, which impacts nutritional counseling

Nutritional Counseling : 

Nutritional Counseling May be helpful to involve the expectant father Clinics and schools often offer classes Provides focused activities designed to address this topic Pregnant teenager will soon become a parent - her understanding of nutrition may influence her well-being but also that of her child Counseling may be individualized May involve other teens May provide a combination of both approaches

Formula-Feeding Mothers : 

Formula-Feeding Mothers Eat a well-balanced diet Dietary requirements are the same as before pregnancy Weight loss of 1 to 2 pounds/week is acceptable Advise her to reduce her daily caloric intake by about 300 kcal Excessive weight gain: Refer to dietician The dietitian can design healthy weight-reduction diets

Breastfeeding Mothers : 

Breastfeeding Mothers Calorie requirements increase by 200 kcal/day over needs during pregnancy Need 2500 to 2700 kcal/day Need 65 g/day of protein. Need 1000 mg/day of calcium Should avoid foods that irritate the infant