Maternal and infant nutrition Flashcards
What are the boundaries of the different trimesters in pregnancy
1st trimester: 0-13wks
2nd trimester= 14-26wks
3rd trimester=27-40wks
Define the term preconceptual
1-3 months prior to conception
Define the term periconceptual
Immediately prior to conception& early gestational phase
What risks are associated with maternal obesity?
- Gestational diabetes mellitus
- Pre-eclampsia
- Thromboembolism
- C-section
- Still birth
- Congenital malformation
- Miscarriage
- Haemorrhage
- Infection
Outline the oral folate recommendations
- Folic acid is critical in early pregnancy to pretect against NTDs in developing fetus
- All women planning pregnancy should have 400ug/day until 12 weeks postconceptually
- Prior NTD supplement 5mg folic acid/day
- Choose foods fortified with folic acid ( some breakfast cereals) & folate-rich foods
- Remainder of pregnancy, RNI= non pregnant (200)+100ug/day—> to prevent megaloblastic anaemia
Outline vitamin A intake during pregnancy
- Deficiency and excess lead to poor outcomes
- Increased requirements: RNI=600+100 retinol equivalents per day
- high intakes are teratogenic in the preconceptual period
- Avoid liver& liver products (pate), supplements containing vitamin A, fish liver oil supplements
- Good dietary sources suitable during pregnancy: milk/milk products, eggs, leafy greens,carrots
- Its the retinol form that can be teratogenic
- You can eat as many of the vegetable form (Beta-carotene) in pregnancy as you want as its converted to retiol and stops when sufficient
Outline vitamin D intake during pregnancy
- Requirements primarily met via sun exposure
- Deficiency associated with congenital rickets in newborn and impaired fetal/infant skeletal growth in absence of rickets
- 10ug/day supplement when pregnant& breastfeeding
Outline calcium during pregnancy
-Required for calcification of fetal skeleton
Maternal adaptations to meet increased calcium requirements:
-increased intestinal absorption of dietary calcium
-increased reabsorption of calcium by the kidneys leads to enhanced retention
-increased bone turnover to release calcium
Outline iron during pregnancy
-Requirements increase as pregnancy progresses; majority of Fe accumulated by fetus in 3rd trimester
Maternal adaptation:
-amenorrhoes, increased absorption of dietary non-heme Fe, mobilisation of maternal stores
-Fetus acts as parasite drawing on maternal stores( increased risk of anemia)
-Infant Fe deficiency anaemia rarely due to maternal Fe deficiency anaemia; most commonly due to short gestation
Define the term exclusive breastfeeding
No food or drink( inc water) except breast milk ( with exception of vitamin/mineral supplements & medicines)
Define the term weaning
The process of expanding diet to include food& drinks other than breast milk or infant formula
Define the complementary feeding
Giving foods& liquids in addition to breastmilk ( or infant formula) when these are no longer sufficient to meet the nutritional needs of infants
Outline the composition of human breast milk
Optimal nutrition composition to meet nutritional requirements if mother not deficient
-BUT low in vit D—> breastfeeding mothers should take 10ug/d
-Fe conc low but bioavilability/absorption high
Contains bioactive factors—> confer immunological protection
-Cellular factors: macrophages, neutrophils, lymphocytes
-Humoral factors: immunoglubulins (IgA, IgG), lysozymes, lactoferrin, bifidus factor, complement, interferon
-Particularly high conc, in the colostrum
Composition is variable
-Within feed—> ‘Foremilk’ & ‘hindmilk’
-With stage of lactation—> colostrum vs mature milk
-May vary with maternal diet eg fat composition
How does infant formula differ from breast milk?
- Lack non-nutritional bioactive components of breast milk
- Quantity and quality of macronutrients
