Nutrition Acroos LifeSpan - Pregnancy to Pre-schooler

• Nutrition and Pregnancy

  Ensures optimum nutrition before, during and after pregnancy and during lactation
• Characteristics of Pregnancy

  • Fertilized ovum implants itself to the uterus
  • Human pregnancy lasts for 266 to 280 days (37-40 weeks)
  • Consists of three trimesters
  • Has three main phases - implantation, organogenesis, growth
• Nutrition in Pregnancy

  1. Always start with diet history when giving nutritional instruction to the mother

  2. PICA - persistent ingestion of inedible substances of little nutritional value

  3. Vegetarians lack essential protein and minerals, need Vitamin B12 supplement
• Calorie Allowances

  Non-pregnant requirements - 1,800 to 2,200 Kcal/day<|>Additional caloric requirement per day - 300 Kcal/day<|>Usual daily caloric need in pregnancy - 2,100 to 2,500; never less than 1,800 Kcal/day
• Maternal weight gain

  25 to 35 lbs
• Maternal under weight

  High risk of low birth weight, preterm and infant deaths
• Maternal over weight

  Risk of complications in labor and delivery, hypertension, gestational DM, post partum infections
• Protein allowances

  Additional 30 g/day to ensure 74 to 76 g/day<|>Rich food sources include milk, meat, fish, poultry and eggs<|>Provides for the storage of nitrogen<|>Protects the mother from any complications<|>Growth for maternal uterus, mammary tissues and placenta<|>Needs for fetal growth and repair<|>Hormonal preparation for lactation
• Carbohydrates

  Sufficient intake is necessary for added energy<|>Avoid "empty" calories like soft drinks
• Fats

  High energy foods for absorption of vitamins ADEK<|>Avoid too much fats to prevent vomiting and heartburn
• Iron

  Most important mineral that must be taken in supplementary amount<|>Supplementary in pregnancy is 30-60mg per day<|>Needed to increase maternal RBC and for fetal liver storage in the third trimester
• Calcium

  Needed for maternal calcium and phosphorous metabolism and fetal bone and skeletal growth<|>1,200 mg/day, equivalent to 1 quart of milk a day (4 glasses)
• Sodium

  Most abundant cation in extracellular fluid<|>Needed for tissue growth and development<|>Should not be restricted without serious indications
• Iodine

  Needs for fetal development and avoid cretinism
• Vitamins

  • Water soluble
  • Fat soluble
• Weight Gain

  Recommended as an average of 11.2 - 16 kg (25 - 35 lb)<|>1 lb per month during FIRST trimester<|>1 lb per week during 2nd and 3rd trimester<|>3 - 12 - 12
• Calorie Needs

  2,200 for women in childbearing age<|>+300 in pregnancy = 2,500 calories
• CHO intake

  • Mother - Ketoacidosis
  • Fetus - Neurologic defects, Death
• Even an OBESE pregnant should never consume LESS than 1,500 calories per day
• Weight is the most accurate indicator if the woman has adequate caloric intake
• Protein Needs

  44g - 46g for women in childbearing age<|>60g in pregnancy
• Nutrients needed in pregnancy

  • Iron
  • B complex especially B12
  • Calcium
  • Phosphorus
  • Cholesterol
• Vitamin A Needs

  Pregnant Women - 10,000 IU twice a week from 4th month until delivery<|>Post-partum Women - 200,000 IU single dose within 4 weeks after delivery<|>Pregnant women with Nightblindness - 10,000 IU once a day for 4 weeks
• Vitamin B9 Needs

  Pregnant Women - 60mg iron/400mcg folic acid once a day for 6 months<|>Lactating Women - 60mg iron/400mcg folic acid once a day for 3 months
• Mineral Needs

  Calcium - 1,200 - 1,500 mg<|>Phosphorus - eat high CHO<|>Iodine - 175 ug daily<|>Iron - 30 mg OB, 60 mg CHN<|>Zinc - 15 mg
• Discomforts

  1. Nausea and Vomiting - Eat dry crackers before rising, high CHO low fat diet, small frequent feedings

  2. Heartburn - Small frequent meals, don't lie down immediately after eating, Amphojel or Maalox may be prescribed
• Complications of Pregnancy and Dietary Modifications

  • Morning Sickness
  • Rapid weight gain or loss
  • Toxemia of Pregnancy
  • Anemia
  • Gestational DM
  • Constipation
  • Socio-economic and cultural factors
  • Alcohol, caffeine and nicotine
• Nutritional Requirements for Lactating Mothers


  Greater than in pregnancy to ensure enough supply of milk for the baby
• Mother's milk is the best food for baby (Executive Order 51)
• Breastfeeding

  1. If vaginal delivery - may start within 30 minutes after birth

  2. If CS delivery - may start 4 hours after delivery

  3. Demand feeding is the best rule to observe

  4. Provide a relaxed, warm and supportive environment as the letdown reflex is affected by negative emotions of the mother

  5. Provide reinforcement for positive behavior or successful actions
• Breastfeeding benefits to the mother

  • Promotes maternal-infant bonding
  • Promotes uterine contraction and provided less incidence of thrombophlebitis
  • Reduces rate of ovarian cancer and premenopausal breast cancer
  • Decreases maternal morbidity and mortality
  • Save time, money, effort and economical
  • Delays fertility
  • Provide social and economic benefits
• Breastfeeding benefits for the baby

  • Promote attachment
  • Provide perfect food that contains all necessary nutrients
  • Easily digested, has the right temperature and free from harmful bacteria
  • Provides passive antibody transfer to the newborn
  • It has colostrums, high protein content contains antibodies which help resist infection
  • Causes fewer incidences of allergies, vomiting, diarrhea, constipation and aspiration
  • Enhances brain development because of taurine content
  • Decreases infant morbidity and mortality
• Advantages of Breast milk than Cow's milk

  Breast milk is higher in CHO, fat and water content but lower in protein, vitamins and minerals<|>It has lactalbumin - human milk protein - easy to digest and hypoallergenic and cow's milk protein called casein causes allergy<|>Breast milk is higher in lactose than cow's milk
• Breastfeeding Misconceptions

  • A mother sick with PTB cannot breastfeed
  • Breast milk is not good if the mother has stayed long under the sun
  • A mother cannot breastfeed during pregnancy
  • A mother cannot breastfeed with only one breast if the other breast is painful
  • A mother cannot breastfeed if she has a cold, flu or diarrhea
  • Breast milk is not good if the mother has been caught in a sudden shower
• Breastfeeding Contraindications

  • Syphilis, AIDS, DM or any severe infections
  • Emotional and mental stress
  • Mother who smokes
  • Mother who takes contraceptive pills or drugs
  • Metabolic abnormalities or severe prematurity of the newborn which require the use of special therapeutic formulas
• Factors affecting milk secretion

  • Diet
  • Nutritional State of mothers
  • Emotional and Physical State
  • Suckling
  • Use of contraceptives and drugs
• Child Health Programs

  • Newborns, Infants, Children
  • Infant and Young Child Feeding
  • Newborn Screening
  • EPI
  • IMCI
  • Micronutrient Supplementation
  • Dental Health
  • Early Child Development
  • Child Health Injuries
• Infant and Young Child Feeding

  1. Initiate breastfeeding within 1 hour after birth

  2. Exclusive breastfeeding for the first 6 months

  3. Complementary feeding for age 6 months up to 2 years or beyond

  4. Timely

  5. Adequate

  6. Safe

  7. Properly fed
• Diet

  Breastfeeding/breast milk is best given until 18 months to 2 years of age<|>Bottle feeding - artificial feeding with cow's milk, costly, associated with infantile obesity or "protein-calorie malnutrition plus"<|>Mixed feeding - complemented (insufficient supply of breast milk), supplemented (mother is away from home for feeding)
• Formula Preparation

  1. Aseptic method - equipments and ingredient are sterilized separately

  2. Terminal method - formulas are poured into clean but unsterilized bottles and are sterilized together