Chapter 12
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Chapter 12. Maternal and Fetal Nutrition Debbie Hogan RN. Maternal and Fetal Nutrition. Good nutrition before and during pregnancy an important preventive measure Low-birth-weight (LBW) infants Preterm infants Neonatal death rates for moderate LBW are five times higher than babies >2500 g

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Chapter 12

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Chapter 12

Chapter 12

Maternal and Fetal Nutrition

Debbie Hogan RN


Maternal and fetal nutrition

Maternal and Fetal Nutrition

  • Good nutrition before and during pregnancy an important preventive measure

    • Low-birth-weight (LBW) infants

    • Preterm infants

    • Neonatal death rates for moderate LBW are five times higher than babies >2500 g

    • The risk for VLBW is 100 times higher


Nutrient needs before conception

Nutrient Needs Before Conception

  • First trimester crucial for embryonic and fetal organ development

  • Healthful diet before conception ensures that adequate nutrients are available for developing fetus

  • Folic acid intake important in periconceptual period

    • Neural tube defects are more common in infants of women with poor folic acid intake


Chapter 12

Fig. 12-1. Factors that influence the outcome of pregnancy.


Nutrient needs during pregnancy

Nutrient Needs During Pregnancy

  • Energy needs

    • Weight gain

      • Body mass index (BMI) = weight/height2

    • Pattern for weight gain

    • Hazards of restricting adequate weight gain

  • Protein

  • Fluids


Nutrient needs during pregnancy cont d

Nutrient Needs During Pregnancy—cont’d

  • Minerals and vitamins

    • Iron

    • Calcium

  • Other minerals and electrolytes

    • Magnesium

    • Sodium

    • Potassium

    • Zinc

    • Fluoride


Nutrient needs during pregnancy cont d1

Nutrient Needs During Pregnancy—cont’d

  • Minerals and vitamins

    • Fat-soluble vitamins

      • Vitamins A, D, E, and K

    • Water-soluble vitamins

      • Folate or folic acid

      • Pyridoxine

      • Vitamin C

    • Multivitamin-multimineral supplements


Nutrient needs during pregnancy cont d2

Nutrient Needs During Pregnancy—cont’d

  • Other nutrition issues during pregnancy

    • Pica and food cravings

    • Adolescent pregnancy needs

      • Improve nutritional health of pregnant adolescents by focusing on knowledge and planning of meals

      • Nutrition interventions and educational programs effective with adolescents

      • Understanding factors that create barriers to change in adolescent population

      • Promote access to prenatal care


Nutrient needs during pregnancy cont d3

Nutrient Needs During Pregnancy—cont’d

  • Physical activity during pregnancy

    • Moderate exercise yields many benefits, including improving muscle tone, shortening course of labor, and sense of well-being

      • Liberal amounts of fluid should be consumed before, during, and after exercise

      • Calorie intake sufficient to meet increased needs of pregnancy and exercise


Nutrient needs during lactation

Nutrient Needs During Lactation

  • Nutrition needs during lactation similar to those during pregnancy

  • Needs for energy (calories), protein, calcium, iodine, zinc, the B vitamins, and vitamin C greater than nonpregnant needs


Nutrient needs during lactation cont d

Nutrient Needs During Lactation—cont’d

  • Energy intake increase of 500 kcal more than woman’s nonpregnant intake recommended

  • Smoking, alcohol intake, and excessive caffeine intake should be avoided during lactation


Nursing care management

Nursing Care Management

  • Assessment

    • Diet history

      • Obstetric and gynecologic effects on nutrition

    • Medical history

    • Usual maternal diet

    • Physical examination

    • Laboratory testing


Nursing care management cont d

Nursing Care Management—cont’d

  • Plan of care and implementation

    • Adequate dietary intake

      • Pregnancy

      • Postpartum

      • Daily food guide and menu planning

      • Medical nutrition therapy

      • Counseling about iron supplementation


Nursing care management cont d1

Nursing Care Management—cont’d

  • Plan of care and implementation

    • Adequate dietary intake

      • Coping with nutrition-related discomforts of pregnancy

        • Nausea and vomiting

        • Constipation

        • Pyrosis (heartburn)

        • Cultural influences

        • Vegetarian diets


Nutrition adolescent pregnancy

Nutrition & Adolescent Pregnancy

  • Adolescent attempting to meet needs of her growing body

  • Now needs nutrients for fetus

  • Weight restriction/mask the pregnancy

  • Insufficient dietary intake=SGA


Key points

Key Points

  • Woman’s nutritional status before, during, and after pregnancy contributes to her well-being and that of her infant

  • Physiologic changes during pregnancy influence need for additional nutrients and efficiency with which the body uses them

  • Total maternal weight gain and pattern of weight gain are important determinants of outcome of pregnancy


Key points cont d

Key Points—cont’d

  • Appropriateness of mother’s prepregnancy weight for height (BMI) is major determinant of recommended weight gain during pregnancy

  • Nutritional risk factors include adolescent pregnancy; bizarre or faddish food habits; abuse of nicotine, alcohol, or drugs; low weight for height; and frequent pregnancies


Key points cont d1

Key Points—cont’d

  • Iron supplementation is recommended routinely during pregnancy

  • Other supplements recommended when nutritional risk factors present

  • Nurse and woman influenced by cultural and personal values and beliefs during nutrition counseling


Key points cont d2

Key Points—cont’d

  • Pregnancy complications that may be nutrition related include:

    • Anemia

    • Gestational hypertension

    • Gestational diabetes

    • Intrauterine growth restriction

  • Dietary adaptations can be effective interventions for some common discomforts of pregnancy, including nausea and vomiting, constipation, and heartburn


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