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
24 to 35 lbs (11.2 - 16 kg)<|>1 lb per month during the FIRST trimester<|>1 lb per week during the 2ND and 3RD trimester<|>3 - 12 - 12
Maternal underweight
High risk of low birthweight, preterm and infant deaths
Maternal overweight
High risk of complications in labor and delivery, hypertension, gestational DM, and postpartum 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, growth for maternal uterus/mammary tissues/placenta, fetal growth and repair, hormonal preparation for lactation
Carbohydrates
Sufficient intake is necessary for added energy<|>Avoid "empty" calories like soft drinks
Fiber
Taken from fruits and vegetables to prevent constipation
Topics
Supplementation
Dental Health
Early Child Development
Child Health Injuries
DIET
Breastfeeding/breast milk
Best to be 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
TWO METHODS OF FORMULA PREPARATION
Aseptic Method - Equipment and ingredients are sterilized separately
Terminal Method - Formulas are poured into clean but unsterilized bottles and are sterilized together
FEEDING TIME
A 5 to 2.7 kg baby usually feeds every 3 hours (8 feedings)
A 6 to 4 kg baby usually feeds every 4 hours (6 feedings)
2 to 3 months old, the baby is on 4 to 5 feedings, the baby sleeps through the night after 10 pm feeding
WEANING
6 months: Breast to bottle
12 months: Bottle to cup
SUPPLEMENTARY FOODS
2 months: Liquids like rice water, calamansi juice may be introduced depending upon the infant's tolerance and acceptance
4 months: First solid foods (rice cereals)
5-6 months: Teething foods; full diet consisting of pureed meat, egg, strained fruits and vegetables and chewy foods be given not only to soothe the sensitive gums, but also to teach the baby the art of self-feeding
7-8 months: Foods are mashed or chopped finely, not strained to teach mastication, soft cooked egg with rice porridge, boiled fish, banana and camote mash and the like
9-12 months: Whole tender foods or foods chopped coarsely are given, finger foods like cottage cheese, crackers, plain meats and egg yolks
Choking Hazards - Hotdogs, grapes, hard candies, raw carrots, popcorns, nuts, peanut butter
Insufficient Calories - Skim milk
Potential Allergen - Cow's milk, egg whites
CUES TO READINESS TO SOLIDS
Sucking reflexes are intact
Ability to sit with support
Avoid feeding an infant lying supine to prevent aspiration
Present salivary glands and intestinal enzymes that aids in digestion
Fetal iron reserves in the liver are usually consumed by 4-6 months
RULES TO FOLLOW WHEN INTRODUCING SUPPLEMENTAL FOODS
Introduce one food at a time
Show pleasure when giving new food at the same time, make gestures
Give a small amount (1 tsp.) at a time
Offer bland foods to the baby (not too salty, not too sweets)
Do NOT mix with formula
Feed when the newborn is hungry after a few sucks of milk to increase his patience for new food
Never start two new foods at the same time
Allow an interval of 4-7 days between new foods
Feed the baby only with freshly-cooked foods or fruits freshly-peeled. Avoid giving left-over foods to babies
Do not bribe, plead, threaten or force the infant
COMMON DISORDERS
Diarrhea: Most frequently caused by bacteria and viruses
Vomiting
Allergy: Milk intolerance
Constipation
Colic: Most common
HEALTH PROBLEMS WITH INFANCY
Galactosemia
Phenylketonuria (PKU)
Maple Syrup Urine Disease (MSUD)
Congenital Hypothyroidism
FLUID NEEDS OF THE YOUNG CHILD
WATER is good for thirst
Too much FRUIT JUICE may cause diarrhea and may reduce the child's appetite for foods
SODAS are not suitable
TEAS AND COFFEE reduce iron absorption
A non-breastfed child (6-24 mons.) needs 2-3 cups of water on a temperate day or 4-6 cups in a hot climate
FEEDING THE CHILD WHO IS ILL
Encourage the ill child to eat and drink with lots of patience
Feed small amounts frequently
Give food that the child likes
Give a variety of nutrient-rich foods
Continue to breastfeed
NUTRITION PROGRAM
Common nutritional deficiencies are Vitamin A, Iron, and Iodine
MICRONUTRIENT SUPPLEMENTATION - Araw ng Sangkap Pinoy/Garantisadong Pambata Child Health Week: Twice a year distribution of Vitamin A capsule
FOOD FORTIFICATION (RA 8976) - Mandatory fortification of staples (flour, cooking oil, refined sugar, rice and processed foods) through Sangkap Pinoy Seal
VITAMIN A
Infants (6-11 months): 100,000 IU, 1 dose usually given with measles at 9 months
Children (21-71 months): 200,000 IU, 1 capsule every 6 months
IRON
Infants (6-11 months): Drops: 15 mg iron/0.6 mL, 0.6 mL once a day for 3 months
Children (1-5 years): Syrup: 30 mg iron/5 mL, 1 tbsp. once a day for 3 months
Adolescent Girls: Tablet: 30 mg iron with 400 mcg folic acid, One tablet a day
IODINE
Children of School Age: Iodized oil capsule with 200 mg iodine, 1 capsule for 1 year
Adult: Iodized oil capsule with 200 mg iodine, 1 capsule for 1 year
Gluconeogenesis
Converting protein (glucogenic amino acids) to carbohydrates releases cortisol, the so-called "stress" hormone
Glycogenesis
Formation of glycogen to glucose
Glycogenolysis
Breakdown of glycogen to glucose; the process is caused by the hormones glucagon and epinephrine which stimulate glycogenolysis and which are produced in response to low blood glucose levels. It takes place in the muscle and liver tissue which is where glycogen is stored
TOTAL ENERGY REQUIREMENT
CARBOHYDRATES (CHO): 50 to 70%
PROTEIN (CHON): 10 to 15%
FATS (CHO with Glycerol base): 20 to 30%
NUTRITION IN TODDLER
Period of life from 1-3 years old
DAILY CALORIC REQUIREMENT
1,300 to 1,400 kcal/day or 100 cal/kg/day
Physiologic anorexia
Decrease in appetite because the toddler is busy at play
Weight quadruples at 2 years old
TODDS NEEDS A PRAISE
Temper tantrums
Offer choices
Diet preference is unpredictable, able to feed self
Dental examination at 2-3 years (2y/o: 16, 3y/o: 30)
Safety is a priority
No-no-no Attitude
Ensure increase of Ca, P and Fe
Elimination training (bladder training and bowel training)