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Maternal and Child Nursing
NUR 362
Lecture 4
Why is nutrition so important?
Meet increased nutrient demands
Provide needed energy
Prevent or minimize common
pregnancy-related problems
Reduce risk of birth defects
Supply needed nutrients for baby’s
growth
Ensure healthy birth weight
Maintain a healthy weight
Key Components of a Healthy
Pregnancy
Appropriate weight gain
Consumption of a variety of foods
Vitamin and mineral supplementation
Avoidance of alcohol, tobacco and
other harmful substances
Safe food handling
Recommended Weight Gain
Underweight
28-40 lbs
Normal weight
25-35 lbs
Overweight
15-25 lbs
Obese
~ 15 lbs
Twins
35-45 lbs
Triplets
50 lbs
1 pound = about 0.45 kilograms
Normal Pregnancy Weight
Gain
Breast
Blood
Extra water
Uterus
Placenta/amniotic
fluid
Baby
Fat stores
Total
1-1.5 lbs
3-4.5 lbs
4-6 lbs
2.5-3.0 lbs
3.5-5.5 lbs
7-8 lbs
4-6.5 lbs
25-35 lbs
Risks of Low Weight Gain
Low weight gain in second or third
trimester increases risk of intrauterine
growth retardation
Low weight gain in third trimester
increases risk of preterm delivery
Guidelines for teenagers
Higher weight gains and greater
postpartum weight retention is
common if mother is still growing
Maternal growth in multiparous
teenagers is associated with lower
birth weights
Proper nutrition
Major Nutrients
Carbohydrates
Protein
Fat
Vitamins
Minerals
Water
Special Interest
Nutrients
Vitamin B12
Generally adequate amounts are obtained
through animal products
Fish, eggs, milk, meats, etc.
Vegans that do not have any animal
products in their diet need
supplementation
Works with folic acid in cell growth and is
essential to the normal development of
the infant
Folic Acid
A supplement taken 1-3 months prior to conception
and during first 6 weeks gestation reduces the risk
of neural tube defects, cleft palate/lip
400 micrograms per day of synthetic folic acid
needed per day (pregnant women and those of
childbearing age)
Needed for rapidly dividing cells, protein
metabolism, and formation of red blood cells
Iron
Needed for the formation of red blood cells
15 milligrams a day for woman during
childbearing years recommended
Iron supplement (30 mg/d) recommended
for pregnant women
Calcium
Calcium absorption doubles early in
pregnancy
Is used in the formation of fetal bones
Will be absorbed from maternal bones if
not enough calcium in diet
Calcium absorption increases with
Vitamin D
Calcium and vitamin D supplements
sometimes needed
Recommended amounts of calcium during
Pregnancy 1200-1500 mg per day
Multivitamin and Mineral
Supplements
Recommended for:
Women who smoke
Women with iron deficiency anemia or poor
quality diets
Women who eat animal products rarely or not
at all (such as vegans)
Vitamin B 12 supplement important for vegans
Foods to Avoid
Fish containing high levels of mercury
Undercooked fish
Partially cooked eggs
undercooked meat and poultry
Things to Avoid During
Pregnancy
Cigarettes
Over-The-Counter Medications or
Herbal Supplements
Consult health care provider
Caffeine
Consult health care provider
Smoking during Pregnancy
Limits oxygen supplied to the fetus
Reduces birth weight of the infant
Increases the risk of pre-term delivery
Increases the risk of perinatal mortality
Passive exposure to tobacco smoke may also
reduce infant growth
Associated with mental retardation and
nicotine addiction in the fetus
Common Pregnancy
Problems
Nausea and Vomiting
Avoid strong odors
Eat before getting out of bed
Avoid an empty stomach
Eat easy-to-digest foods
Eat slowly
Snack before bed
Constipation
Hormonal changes slow down the
intestine
Drink 8-12 glasses of water everyday
Eat high-fiber foods
Be as physically active as possible
Do not use laxatives unless
prescribed by health care provider
Heartburn
Eat small meals frequently
Cut down on caffeinated and
carbonated beverages
Eat slowly in a relaxed environment
Do not lie down after eating
Prop head of bed up
Wear loose-fitting comfortable clothes
Avoid gaining too much weight
Talk to doctor before taking antacids
Swelling
As blood supply increases, legs, feet,
and arms may swell
Drink plenty of fluids, especially water
Avoid diuretics, unless prescribed by
health care provider
Elevate your feet whenever possible
Wear loose-fitting shoes and clothes
Pica (nonfood cravings)
Some pregnant women develop cravings
for nonfood substances like clay, dirt, or
ice
This does not reflect a physiological need
for a particular nutrient
Pica is especially common in African
American women
Pica may lead to iron-deficiency anemia,
malnutrition and lead exposure (brain
damage)
Respiratory distress
In many women respiratory distress
occurs because of the growing uterus
as the pregnancy advances .
Fatigue and insomnia
Fatigue is very common in early pregnancy and
reaches a peak at the end of the first trimester .
Rest, lifestyle adjustment and reassurance are
usually all that is required .
Fatigue also occurs in late pregnancy, when
anemia should be excluded .
Insomnia is also very common and due to a
combination of anxiety, hormonal changes and
physical discomfort .
Varicose veins
Feet and ankles can also become
swollen .
Treatment is by elevation of legs when
sitting, support, encourage walking
and avoid standing still .
Backache
Many women develop backache during
pregnancy and it often first develops during
the 5th to 7th months of pregnancy .
Encourage light exercise and simple
analgesia, and consider physiotherapy
referral .
Exercising in water, massage therapy and
group or individual back care classes have
been shown to be effective interventions .