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38-42 weeks to deliver full term infant |
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fertilized ovum- terms for cells as they divide until 14 days |
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term for cells from 14 days to 8 weeks |
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embryo is termed this at 8 weeks through the end of the pregancy |
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fluid in the placenta surrounding the fetus |
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supplies nutrients and oxygen from maternal circulation |
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what is the role of the placenta? |
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to get full nutrients from fats, carbs, antioxidant nutrients, B vitamins, zinc, and iron |
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What are best practices to improve fertility nutritionally? (what 6 nutrients are especially important?) |
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-Adipose tissue produces estrogen -Low body fat decreases fertility in both men and women -women: lower estrogen production (poverty, eating disorder, excessive exercise; amenorrheic, birthrate declines 50%; BMI above 20 is needed) -men: decrease sex drive, sperm count -High body fat decreases fertility in both men and women -excess body fat decreases fertility-losing 5% to 20% body fat increases conception chance |
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Definition
how is body fat related to fertility? |
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tiny cysts that surround the ovaries (a cause of female infertility) |
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what is polycystic ovary syndrome? |
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two hormonal alterations: increased testosterone and increased insulin levels -all women secrete some testosterone; high levels cause symptoms (excess hair growth on face, acne, and a tendency to deposit fat around waist) -insulin resistance (body cannot use its insulin well) and chance of type 2 diabetes |
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Definition
How do hormonal changes involved in Polycystic Ovary Syndrome (PCOS) affect fertility? |
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folate is important for women and men -role in DNA synthesis (significant for egg and sperm), metabolism of homocysteine -natural sources: leafy green vegetables, strawberries, orange juice -synthetic form: supplement or fortified foods (ready-to-eat breakfast cereals) |
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Definition
what are the best practices to improve fertility nutritionally regarding folate? |
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Diets rich in antioxidant nutrients can limit activity of free radicals and damage to DNA and cell membranes: -Vitamin E, vitamin C, zinc, beta-carotene, some plant pigments linked to improved fertility for both men and women -brightly colored fruits and vegetables, whole grains, and plant oils, rich sources |
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Definition
what are the best practices to improve fertility nutritionally regarding antioxidants? |
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Iron and Zinc linked to fertility -zinc linked to male fertility: protects sperm from oxidative damage and required for normal sexual maturation -in women, iron and zinc needed for normal ovulation |
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Definition
what are the best practices to improve fertility nutritionally regarding 2 certain minerals? |
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-limit sources of saturated and trans fats -choose plant oils and fish oils -women: promotes insulin resistance, impairs ovulation men: high intakes linked to poor sperm quality men: omega-3 fatty acids in fish oil, walnuts improve sperm quality |
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Definition
what are the best practices to improve fertility nutritionally regarding dietary fat? |
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-avoid alcohol when trying to conceive -some studies show reduced fertility with higher alcohol consumption -alcohol decreases level of estrogen, testosterone and can disrupt normal cycles of ovulation and sperm production |
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Definition
what are the best practices to improve fertility regarding alcohol? |
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1) adverse reactions to medications 2) high intakes of vitamin A 3) exposure to radiation 4) trauma 5) smoking 6) alcohol abuse 7) use of aspirins and NSAIDs 8) illicit drug use |
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Definition
what 8 practives (nutrition, social, environmental) or pre-existing health conditions couuld lead to poor pregnancy outcomes? |
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1) low or high BMI increases risks 2) deficient intake of folate can lead to birth defects (neural tube defects) 3) deficient intake of calcium and iron can increase risks 4) excessive intake of Vitamin A can increase risks of birth defects |
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Definition
what 4 nutritional practices can lead to poor pregnancy outcomes? |
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first trimester (there is a rapid increase in cell number and size; half of all pregnancies miscarry during the first trimester) |
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in which trimester does the mother's nutritional status and intake have the greatest impact on fetal development? |
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a nutritional deficiency in this trimester affects the mother's ability to breastfeed |
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1) FAT 2) CALCIUM 3) IRON (fetus may deplete mother's store of iron if intake is low) |
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Which 3 nutrients are transferred to the infant in the 3rd trimester? |
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mother's physical and emotional health is protected so she can return to pre-pregnancy health |
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what is defined as a successful pregnancy for the mother? |
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1) greater than 37 weeks gestation 2) birth weight greater than 5.5 pounds 3) sufficient lung development also imp. 4) the longer the gestation, the less the health risk |
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what is defined as a successful pregnancy for the infant? |
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less than 5.5 pounds at birth |
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what is characterized as low birth weight (LBW) for infants? |
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what is characterized as a preterm infant? |
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full-term and preterm infants weighing LESS THAN THE EXPECTED WEIGHT FOR GESTATION; more likely to have medical complications |
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Definition
what is the definition for "Small for gestational age" (SGA) |
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1) prenatal care, primary determinant of success 2) untreated health conditions, anemia, AIDS, hypertension, or diabetes must be addressed 3) maternal age 4) closely spaced and multiple births 5) smoking, medication, and drug abuse 6) food safety 7) nutritional status |
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Definition
what 7 factors plays a role in the success of pregnancy? |
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Ideal age for pregnancy, between 20 and 35 years Teen pregnancy increases risk for negative outcomes both mother and child |
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Definition
how is maternal age related to the outcome of a pregnancy? |
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siblings born in succession to a mother with less than a year between birth and subsequent conception are more likely to be born with low birth weights than are those farther apart in age |
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Definition
how is closely spaced and multiple births related to the outcome of a pregnancy? |
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Found in UNPASTEURIZED MILK, SOFT CHEESES MADE FROM RAW MILK, RAW CABBAGE |
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Definition
what food expose a risk of listeria monocytogenes? |
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Recommend PASTEURIZED MILK, THOROUGHLY COOKED MEATS (INCLUDING DELI MEATS), FISH, AND POULTRY |
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Definition
What are food safety recommendations during pregnancy to reduce risk of Listeria exposure? |
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1) infants to over/underweight women more likely to have problems 2) Obese women: infants more likely for birth defects, death early in life, obesity in childhood 3) BMI under 18.5: infants more likely low birth weight, premature -lower nutrients stores, specifically iron -improve by gaining weight before, during pregnancy |
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Definition
How does pre-pregnancy BMI affect pregnancy outcome? |
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1) supports fetal growth 2) supports maternal changes -to support pregnancy and lactation Inadequate calories -can retard fetal growth (especially if <1000 kcal per day) -higher risk for maternal and fetal death in famine areas) The poorer the nutritional status of the mother, the poorer the pregnancy outcome |
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Definition
How does nutrition during pregnancy affect pregnancy outcome? |
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1st trimester: balanced and adequate diet--no increase in kcal 2nd trimester: 350-450 extra kcal per day |
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Definition
What are energy demands during pregnancy during the first, second, and third trimesters? |
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adequate maternal weight gain |
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Definition
What is the best predictor of pregnancy outcome? |
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healthy women should get 150 minutes/week of moderate-intensity aerobic activity |
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Definition
what is the activity recommendation for a healthy woman during pregnancy? |
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those that inherent risk of falls and abdominal trauma Especially during 2nd and 3rd trimester: downhill skiing, weightlifting, soccer, basketball, horseback riding, certain calisthenics (deep knee bends), and y contact sports (hockey), and SCUBA diving |
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What types of activities should be avoided during pregnancy? |
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Benefits for Mother: -prevents excessive weight gain during pregnancy -improved cardiovascular function -lower risk for gestational diabetes -lower risk for gestational hypertension -reduced bone loss associated with pregnancy -less edema in the legs and feet -better sleep -decreased back pain -improved satisfaction with body image Benefits for Baby: -During Gestation: -decreased resting heart rate -healthier placenta -increased amniotic fluid -possible improvements in brain development -larger gestation -After Gestation: -lower birth weight -leaner BMI during childhood |
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Definition
What are benefits of exercising during pregnancy? |
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first trimester: 2-4 lb Second and third trimester: 0.75-1lb weekly weight gain; in all- 25-35 lb weight gain |
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what is the optimal weight gain during pregnancy for a woman who begins pregnancy at a healthy BMI during the 3 trimesters? |
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What is the optimal weight gain during pregnancy for a woman who begins pregnancy at a low (>18.5) BMI? |
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What is the optimal weight gain during pregnancy for a woman who begins pregnancy at an overweight (25.0-29.9) BMI? |
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What is the optimal weight gain during pregnancy for a woman who begins pregnancy at an obese (<30.0) BMI? |
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ADDITIONAL 25G/DAY BEYOND THE 0.8G/KG (many (non-pregnant women already consume recommended amount of protein for pregnancy) |
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Definition
What is the RDA for Protein during pregnancy? |
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Term
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what is the RDA for protein for non-pregnant women? |
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175gm/day (130 grams/day for non-pregnant women) |
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Definition
what is the RDA for carbs during pregnancy? |
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Definition
what is the RDA for carbs for non-pregnant women? |
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MAINTAIN 20-30% OF TOTAL CALORIES FROM FAT(AVOID LOW FAT DIET) (20-30% of diet also for non-pregnant women) |
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What is the lipid intake recommendation during pregnancy? |
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Term
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what is the recommended fat intake for non-pregnant women? |
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RDAs/AIs up 30% for most B vitamins and even greater for vitamin B-6 (45%) and folate (50%) Vitamin needs increase by 10%; most needs easily met through diet, except for folate (vitamin D intake often insufficient) |
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Definition
What are the general recommendations for vitamins during pregnancy? Can needs be met by diet mostly? |
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Vitamin D (RDA=15mcg/day; 600 IU) -decreased Vitamin D has a risk for rickets, serious complications of pregnancy--higher rates of diabetes and hypertension and Cesarean section; diseases that develop later in childhood or adulthood, such as type 1 diabetes, multiple sclerosis, asthma, schizophrenia, and certain types of cancer are assocated with low vimtain D |
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what is the recommendation regarding Vitamin D and why? |
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folate (600mcg/day) for synthesis of DNA (egg and sperm house genetic material); fetal and maternal growth; increased RBC formation; prevent neural tube defects! |
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Definition
What is the recommendation regarding folate and why during pregnancy? |
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IRON (27mg/day) -increased hemoglobin -iron stores for fetus (remember when the mother will transfer the iron?) -many women need a supplement |
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Definition
what are the recommendations for iron during pregnancy and why? |
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Higher IRON needs (27mg/day) Higher FOLATE needs (600mcg/day) (easier than changing diet (morning sickness too!) vitamin A -should NOT EXCEED 3000 ug RAE/day |
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Definition
For which vitamins is the UL especially important during pregnancy and why? |
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folate, iron, and vitamin D |
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Definition
what vitamin and mineral supplements are routinely prescribed for pregnancy? |
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Active 24 year old, 1st trimester-->2200 kcal/day active 24 year old, 2+3rd trimester-->2600 kcal/day |
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Definition
what is a good kcal for an active 24 year old in the all 3 trimesters? |
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Lacto-ovo or Lacto-vegetarian can usually meet nutritional needs Vegans: -requires sufficient protein -focus on vitamins D, B-6, and B-12; iron, calcium, and zinc Prenatal supplements may be necessary |
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Definition
What nutrients are of special concern for a pregnant woman who practices a vegan lifestyle (6 micronutrients and one macronutrient)? |
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Heartburn -Hormone relaxes muscles in uterus and intestine -stomach acid refluxes into esophagus 1) avoid lying down after eating 2) avoid spicy foods 3) check with physician regarding use of antacids (antacids can prevent absorption of some nutrients) |
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Definition
What diet and lifestyle strategies would you suggest to a pregnant woman who complains of frequent heartburn? |
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Constipation -relaxation of the intestinal muscle -fetus competes with the GI for space Recommendations: -regular exercise -fluid (10 cups/day) and fiber (28gm/day) |
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what diet and lifestyle strategies would you suggest to a pregnant woman who complains of frequent constipation? |
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what is morning sickness? |
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70-80% will experience morning sickness in the first trimester may be due to heightened sense of smell can occur any time of the day |
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When do you usually get morning sickness? |
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1) avoid nauseating foods or smells 2) eat small, frequent bland meals 3) consider changing prenatal supplement 4) megadose of vitamin B-6 |
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what are 4 ways that you can treat morning sickness? |
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a high blood glucose concentration that develops during pregnancy and returns to normal after birth; one cause is the placental production of hormones that antagonize the regulation of blood glucose by insulin |
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routine screening at 24-28 weeks gestation |
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Definition
when are women screen for gestational diabetes? |
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hormones synthesized by the placenta decrease action of insulin |
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Definition
what causes gestational diabetes? |
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controlling carbs in diet may be recommended Insulin may be needed in some cases |
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Definition
how can gestational diabetes be treated? |
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1) increased birth weight 2) low infant blood glucose after birth 3) trauma 4) malformations 5) usually disappears after birth but is linked to diabetes later in life for mother |
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Definition
What are complications of unmanaged gestational diabetes? |
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blood pressure greater than 140/90 mmHg that is first diagnosed after 20 weeks of gestation. This may evolve into preeclampsia or eclampsia |
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gestational hypertension (pregnancy-induced hypertension) |
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1) elevated blood pressure 2) protein in the urine 3) edema 4) change in blood clotting 5)convulsions in 3rd trimester 6) liver and kidney damage, leading to death |
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what are complications of Pregnancy-induced hypertension? |
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AAP and AND recommend breastfeeding exclusively for the first 6 months, with the continued combination of breastfeeding and infant foods (solid food) until 1 year |
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Definition
What are the AND and AAP recommendations regarding breastfeeding? |
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Advantages: For Infant: -bacteriologically safe -always fresh and ready to go -provides antibodies and substances that contribute to maturation of the immune system -contributes to maturation of GI tract via Lactobacillus bifidus fator -decreases risk of infections -reduces risk of food allergies and intolerances -reduces risk of celiac disease and inflammatory bowel disease -est. habit of eating in moderation -contributes to proper development of jaws and teeth for better speech -may enhance nervous system development and eventual learning ability -decreases risk of childhood leukemia and lymphoma For mother: -contributes to earlier recovery from pregnancy -decreases risk of several chronic diseases later in life (HPT, CVD, Diabetes -decreases risk of ovarian and premenopausal breast cancer -potential for quicker return to prepregnancy weight -potential for delayed ovulation, thus reducing chances of pregnancy in short term |
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Definition
what are some advantages of breastfeeding? |
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-widespread misinformation -mother needs to return to a job -embarrassment and modesty -lack of support -inexperienced mother -medical conditions (infant with galactosemia, infant with PKU, mothers on meds., mothers with TB, AIDS, HIV+ and chemotherapy) |
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Definition
what are barriers to breastfeeding? |
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1) infant has 6+ wet diapers a day 2) shows normal weight gain 3) passes 1+ stool per day 4) softening of breast tissue |
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Definition
what are 4 ways a mother can tell if her baby is well-nourished |
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thick, yellow fluid produced during late pregnancy and few days after birth |
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contains antibodies, immune-system cells and lactobacillus Bifidus factor; provides protection to infant against infections; facilitates the passage of 1st stool (meconium) |
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Definition
Why is colostrum important for an infant? |
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Human milk provides adequate hydration for the baby; additional fluid are needed when the infant is an a hot climate, diarrhea, or vomiting Too much water can lead to brain disorders and causes low blood sodium |
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Definition
Does an infant need additional fluid beyond breastmilk? |
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Energy RDA is ADDITIONAL 400-500 KCAL/DAY (milk production requires ~800kcal/day but the difference will contribute to mother's gradual weight loss) |
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Definition
How many extra kcal does a breastfeeding mother need? |
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Increased need for Vitamina A, E, C, riboflavin, copper, chromium, iodide, manganese, selenium, and zinc- FOLLOW DIET PLAN FOR PREGNANCY |
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Definition
What diet should a breastfeeding mother follow and why? |
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1) balanced variety of foods 2) moderate fat intake 3) adequate fluids 4) reduction of milk supply caused by: restricting kcal, ingestion of alcohol, smoking 5) limit high mercury fish and intake of peanutts (allergens) |
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Definition
What are the 5 general guidelines for nutrition for lactating mother? |
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prevents neural tube defects |
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Definition
prevents cretinism (congenital hypothyroidism) |
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Definition
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prevent toxicity of this vitamin to avoid birth defects |
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moderate use to avoid decreased iron absorption and harm to fetus |
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obesity and chronic health conditions |
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manage health and pre-existing conditions |
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avoid to prevent birth defects and fetal alcohol spectrum disorders and Alcohol Related Birth Defects |
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environmental contaminants |
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mercury (avoid swordfish, shark, kind mackerel, and tile fish and consume < 6oz tune per week) |
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large amounts of alcohol during pregnancy; excess of this reaches the embryo/fetus and it cannot metabolize this; results in poor fetal and infant growth; physical deformities, mental retardation, and irritability and hyperactivity |
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