NursingABC - Module 8/6/19, 11(06 PM
Pregnancy & Newborns
From conception to death nutrition has a lasting impact on our growth and development. This module will
explore the role of nutrition in pregnancy, lactation, infancy, childhood, adolescence and adulthood.
A healthy baby is the desire of every pregnant mother. Wise choices related to social, health, environmental
and nutritional factors during pregnancy can all affect the outcome. A healthy pregnancy with a successful
outcome begins prior to conception. Studies have shown that an adequate intake of vitamins and minerals
several months prior to conception, as well as throughout the pregnancy, a healthy body weight, control of
existing health conditions, and avoidance of teratogens (agents that may cause birth defects - details
provided later in the module) will improve the odds of a healthy pregnancy for both mom and the baby. In a
country like the United States one would expect a low mortality rate for both mom and baby. Unfortunately
this is not the case. Despite the availability of health care, either through a private company or programs that
are available for low income and needy moms, the rate of infant mortality is among the highest in the world.
Teen moms are especially at high risk as they are more likely to not seek care during their pregnancy.
The length of a normal pregnancy is 40 weeks, divided into 3 trimesters. At conception an egg and sperm
unite and produce a zygote. Over the next 14 days cell division occurs rapidly, this is the blastogenic stage
of the pregnancy, and by day 14 an embryo is formed. Weeks 2 through 8 are called the embryonic stage
as the organ system develops. At week 5 of the pregnancy the heart is beating and by week 8 the embryo is
known as a fetus. By the end of the first trimester most organs are formed and the fetus has the ability to
move. Weeks 9 through the remainder of the pregnancy are called the fetal stage and are a period of
https://student.nursingabc.com/modules/print_view/197/39038 Page 1 of 25
,NursingABC - Module 8/6/19, 11(06 PM
growth. A full term pregnancy typically takes 40 weeks. The first trimester is an extremely important time for
development and growth of the fetus. Unfortunately many women do not realize they are pregnant until the
second month of the pregnancy. By this point cell division and crucial periods of growth have already
occurred. During crucial periods of development exposure to toxins and inadequate nutrient intake can have
an adverse effect on the fetus. It is important that mom eliminate harmful substances from her diet and
lifestyle prior to conception to improve her chances of having a healthy baby. In terms of diet, the quality of
the mother’s diet is more important than the quantity to ensure adequate nutrients for the fetal development.
During the second trimester, development of the hands, feet, arms and legs occurs and the fetus resembles
a baby. Mom is also experiencing physiological changes to support the pregnancy and prepare for birth. The
third trimester of pregnancy is a critical period of growth as the fetus will double in length and will increase
weight to approximately 7 to 9 pounds.
During the pregnancy the placenta provides oxygen and nutrients from the mother’s blood to the fetus and
transfers fetal waste to mom for excretion. An infant born after 37 weeks of gestation, which is the period of
intrauterine growth, and weighing greater than 5.5 pounds has a chance for a more positive outcomes, less
chance of medical issues and a better quality of life. Infants weighing less than 5.5 pounds at birth are
considered low birth weight infants, those born prior to 37 weeks are preterm and an infant who is full term
but less than 5.5 pounds is considered small for gestational age. All of these infants are more likely to have
increased medical conditions and delayed growth in their early months of life. Although many factors affect
the health of a baby, an adequate diet, education and proper prenatal care can increase the chances of a
successful pregnancy.
Nutrient needs during pregnancy
1. Calories - during the first trimester increased calories are required to support the growth and
development of the fetus. The idea of eating for two is a misconception in that the calorie needs are not
doubled but the need for certain nutrients increase by 50% during pregnancy. Calorie needs during the
https://student.nursingabc.com/modules/print_view/197/39038 Page 2 of 25
, NursingABC - Module 8/6/19, 11(06 PM
second and third trimester are increased by approximately 20%.
2. Adequate weight gain - a healthy weight gain of 25-35 pounds during pregnancy is a good predictor
of a healthy pregnancy. Weight gain should be monitored during the course of the pregnancy with the
following pattern being the norm, 2 -4 pounds during the first trimester and approximately 1 pound
weekly during the remainder of the pregnancy. The chance for complications during pregnancy and
delivery increase when a pregnant mom is overweight or obese or if the baby is larger than normal. The
weight gain for overweight/obese moms to be is less than 25 pounds. Likewise, underweight or
pregnant teens require a higher weight gain to support the pregnancy. The figures given are typical
guidelines, but because every individual has a unique medical history and nutritional needs, women
should consult their physicians for dietary advice and recommended weight gain during their pregnancy.
3. Increased protein and carbohydrate needs - most women eat adequate amounts of protein in their
normal diet. Pregnant moms require an additional 25 grams per day above the RDA, but this is easily
met without dietary changes. Adequate carbohydrates and protein are required to meet energy needs
and for growth. If inadequate carbohydrates are ingested the body will turn to fat for energy needs and
ketones will be produced. Ketones will inhibit brain development of the fetus.
4. Vitamin needs - needs for vitamins increase during pregnancy, especially the B vitamins. The extra
need for these vitamins is easily met through a normal diet, but one exception is Folate. Folate is
needed for cell development and the synthesis of DNA, as well as red blood cell development. Without
adequate folate the pregnant mom may develop anemia. In addition, there is a well-established link
between higher incidents of neural tube defects with inadequate folate intake prior to conception and
early in the pregnancy. To ensure adequate intake, careful menu planning and in some instances a
supplement are recommended. All grain products are now fortified with folate as a precautionary
measure to lower the risk of neural tube defects.
5. Increased mineral needs - especially iodide, zinc and iron. Intakes of animal products, iodized salt
and fortified breakfast cereals will help to meet the iodide and zinc requirements. Remember that iron is
required to make hemoglobin for red blood cells. Women in general have a higher need than males due
to loss during menstruation. During pregnancy extra iron is required because of increased blood
volume and to provide iron stores to the fetus. Iron deficiency anemia can lead to preterm delivery, low
birth weight infants, and increased risk for fetal death. Animal products are a good source of iron as are
fortified breakfast cereals. By combining plant sources of iron with a rich source of vitamin C, the
absorption of the iron will be enhanced.
6. Fitness and Teratogens - moderate levels of physical activity are encouraged daily as well as
avoidance of alcohol and other known teratogens. Known teratogens include: caffeine, drugs, alcohol
and tobacco. Tobacco use can increase the risk for miscarriage, stillbirth, preterm delivery and low birth
weight infants. Alcohol is linked to a risk for fetal alcohol syndrome which results in physical and mental
disabilities and growth retardation. Drugs increase the risk for low birth weight, preterm delivery,
https://student.nursingabc.com/modules/print_view/197/39038 Page 3 of 25
Pregnancy & Newborns
From conception to death nutrition has a lasting impact on our growth and development. This module will
explore the role of nutrition in pregnancy, lactation, infancy, childhood, adolescence and adulthood.
A healthy baby is the desire of every pregnant mother. Wise choices related to social, health, environmental
and nutritional factors during pregnancy can all affect the outcome. A healthy pregnancy with a successful
outcome begins prior to conception. Studies have shown that an adequate intake of vitamins and minerals
several months prior to conception, as well as throughout the pregnancy, a healthy body weight, control of
existing health conditions, and avoidance of teratogens (agents that may cause birth defects - details
provided later in the module) will improve the odds of a healthy pregnancy for both mom and the baby. In a
country like the United States one would expect a low mortality rate for both mom and baby. Unfortunately
this is not the case. Despite the availability of health care, either through a private company or programs that
are available for low income and needy moms, the rate of infant mortality is among the highest in the world.
Teen moms are especially at high risk as they are more likely to not seek care during their pregnancy.
The length of a normal pregnancy is 40 weeks, divided into 3 trimesters. At conception an egg and sperm
unite and produce a zygote. Over the next 14 days cell division occurs rapidly, this is the blastogenic stage
of the pregnancy, and by day 14 an embryo is formed. Weeks 2 through 8 are called the embryonic stage
as the organ system develops. At week 5 of the pregnancy the heart is beating and by week 8 the embryo is
known as a fetus. By the end of the first trimester most organs are formed and the fetus has the ability to
move. Weeks 9 through the remainder of the pregnancy are called the fetal stage and are a period of
https://student.nursingabc.com/modules/print_view/197/39038 Page 1 of 25
,NursingABC - Module 8/6/19, 11(06 PM
growth. A full term pregnancy typically takes 40 weeks. The first trimester is an extremely important time for
development and growth of the fetus. Unfortunately many women do not realize they are pregnant until the
second month of the pregnancy. By this point cell division and crucial periods of growth have already
occurred. During crucial periods of development exposure to toxins and inadequate nutrient intake can have
an adverse effect on the fetus. It is important that mom eliminate harmful substances from her diet and
lifestyle prior to conception to improve her chances of having a healthy baby. In terms of diet, the quality of
the mother’s diet is more important than the quantity to ensure adequate nutrients for the fetal development.
During the second trimester, development of the hands, feet, arms and legs occurs and the fetus resembles
a baby. Mom is also experiencing physiological changes to support the pregnancy and prepare for birth. The
third trimester of pregnancy is a critical period of growth as the fetus will double in length and will increase
weight to approximately 7 to 9 pounds.
During the pregnancy the placenta provides oxygen and nutrients from the mother’s blood to the fetus and
transfers fetal waste to mom for excretion. An infant born after 37 weeks of gestation, which is the period of
intrauterine growth, and weighing greater than 5.5 pounds has a chance for a more positive outcomes, less
chance of medical issues and a better quality of life. Infants weighing less than 5.5 pounds at birth are
considered low birth weight infants, those born prior to 37 weeks are preterm and an infant who is full term
but less than 5.5 pounds is considered small for gestational age. All of these infants are more likely to have
increased medical conditions and delayed growth in their early months of life. Although many factors affect
the health of a baby, an adequate diet, education and proper prenatal care can increase the chances of a
successful pregnancy.
Nutrient needs during pregnancy
1. Calories - during the first trimester increased calories are required to support the growth and
development of the fetus. The idea of eating for two is a misconception in that the calorie needs are not
doubled but the need for certain nutrients increase by 50% during pregnancy. Calorie needs during the
https://student.nursingabc.com/modules/print_view/197/39038 Page 2 of 25
, NursingABC - Module 8/6/19, 11(06 PM
second and third trimester are increased by approximately 20%.
2. Adequate weight gain - a healthy weight gain of 25-35 pounds during pregnancy is a good predictor
of a healthy pregnancy. Weight gain should be monitored during the course of the pregnancy with the
following pattern being the norm, 2 -4 pounds during the first trimester and approximately 1 pound
weekly during the remainder of the pregnancy. The chance for complications during pregnancy and
delivery increase when a pregnant mom is overweight or obese or if the baby is larger than normal. The
weight gain for overweight/obese moms to be is less than 25 pounds. Likewise, underweight or
pregnant teens require a higher weight gain to support the pregnancy. The figures given are typical
guidelines, but because every individual has a unique medical history and nutritional needs, women
should consult their physicians for dietary advice and recommended weight gain during their pregnancy.
3. Increased protein and carbohydrate needs - most women eat adequate amounts of protein in their
normal diet. Pregnant moms require an additional 25 grams per day above the RDA, but this is easily
met without dietary changes. Adequate carbohydrates and protein are required to meet energy needs
and for growth. If inadequate carbohydrates are ingested the body will turn to fat for energy needs and
ketones will be produced. Ketones will inhibit brain development of the fetus.
4. Vitamin needs - needs for vitamins increase during pregnancy, especially the B vitamins. The extra
need for these vitamins is easily met through a normal diet, but one exception is Folate. Folate is
needed for cell development and the synthesis of DNA, as well as red blood cell development. Without
adequate folate the pregnant mom may develop anemia. In addition, there is a well-established link
between higher incidents of neural tube defects with inadequate folate intake prior to conception and
early in the pregnancy. To ensure adequate intake, careful menu planning and in some instances a
supplement are recommended. All grain products are now fortified with folate as a precautionary
measure to lower the risk of neural tube defects.
5. Increased mineral needs - especially iodide, zinc and iron. Intakes of animal products, iodized salt
and fortified breakfast cereals will help to meet the iodide and zinc requirements. Remember that iron is
required to make hemoglobin for red blood cells. Women in general have a higher need than males due
to loss during menstruation. During pregnancy extra iron is required because of increased blood
volume and to provide iron stores to the fetus. Iron deficiency anemia can lead to preterm delivery, low
birth weight infants, and increased risk for fetal death. Animal products are a good source of iron as are
fortified breakfast cereals. By combining plant sources of iron with a rich source of vitamin C, the
absorption of the iron will be enhanced.
6. Fitness and Teratogens - moderate levels of physical activity are encouraged daily as well as
avoidance of alcohol and other known teratogens. Known teratogens include: caffeine, drugs, alcohol
and tobacco. Tobacco use can increase the risk for miscarriage, stillbirth, preterm delivery and low birth
weight infants. Alcohol is linked to a risk for fetal alcohol syndrome which results in physical and mental
disabilities and growth retardation. Drugs increase the risk for low birth weight, preterm delivery,
https://student.nursingabc.com/modules/print_view/197/39038 Page 3 of 25
