Unit 5: Nutrition Through the Lifecycle (Cohort 3 Video)
Reading: Chapter 9: "Growing a Healthier Nation: Maternal, Infant, Child, and Adolescent Nutrition
with an Emphasis on Childhood Overweight"
What is the recommended weight gain - based on the BMI of the woman when she became
pregnant - for underweight, normal weight, overweight and obese women?
Underweight women (BMI < 18.5) should gain between 28 and 40 pounds
BMI 18.5–24.9 should gain between 25 and 35 pounds during pregnancy
Overweight women (BMI 25–29.9) should gain between 15 and 20 pounds
obese women (BMI ≥ 30) should gain 11 to 20 pounds
If a woman is carrying twins, she should gain 37 to 42 pounds depending on her pre-pregnancy
weight status
Identify risk factors for preterm delivery.
How much additional energy (kcal/day) does a woman require in the first, second and third
trimesters?
Pregnant woman needs an additional:
340 kcal/day in the second trimester
452 kcal/day in the third trimester
Goals may need to be adjusted for women who are in the underweight or overweight/obese weight
categories
How much additional protein (g/day) does a woman require while pregnant?
DRI for protein in pregnancy is an additional 25 g/day for all three trimesters
What are the recommendations surrounding smoking and alcohol consumption by pregnant
women?
Smoking is totally contraindicated during pregnancy due to the profound impact it has on
development of the fetus. Less oxygen is available to the fetus of a mother who smokes, so the baby
is likely to be small for gestational age (SGA). SGA babies are at higher risk of complications of birth
and have higher rates of problems during the first year of life
Alcohol is known to cause birth defects and is linked to fetal alcohol syndrome (FAS). Infants born
with FAS exhibit numerous permanent developmental problems, including mental retardation
What is the connection between breastfeeding and childhood obesity?
, Breast milk may contribute to breast-feeding being protective against overweight;
Breast milk nutritional content changes over time, containing less protein after the first few months
when the infant’s need for protein is less. It is thought that the more rapid gains in weight and
length from about 2 months of age to the end of the first year of life of formula-fed infants may be
due to the higher protein content of formula, which exceeds the infant’s needs after about 1 to 2
months of age. Differences in adiposity appear only at about 12 months when evidence suggests
that breast-fed infants are leaner than formula-fed infants
What are the AAP recommendations regarding juice consumption by infants and children up to 6
years of age?
The AAP has concluded that fruit juice offers no nutritional benefit for infants younger than 6
months and no benefit over whole fruits for infants older than 6 months. They recommend that
juice not be introduced to infants before 6 months, should not be given in a bottle or easily
transported covered cup, should not be given at nap or bedtime, and should be limited to 4 to 6
ounces daily for infants and children up to 6 years old
Why is the glucose tolerance test given to pregnant women?
Gestational diabetes is a form of diabetes that develops in some women when they become
pregnant, but resolves once the pregnancy ends. Many of these women will go on to have type 2
diabetes later in life, particularly if they become obese. Gestational diabetes can have harmful
effects on both mother and infant. The mother has an increased risk of preeclampsia and delivering
by Cesarean section. Infants born to women with all types of diabetes have a higher risk of
becoming too large in utero (macrosomia: weighing more than 10 pounds). The infant also is at
higher risk to be stillborn, to have hypoglycemia at birth, and to develop hypertension, diabetes, and
obesity as an adult.
Women in moderate to high-risk categories need to be screened for gestational diabetes using a
glucose tolerance test. This is usually done by weeks 24 to 27 of pregnancy. Once diagnosed, an
intervention plan is developed to bring the diabetes under control. Interventions generally start with
diet and exercise and move to include medications as necessary to control blood glucose levels.
Women with gestational diabetes need to be counseled and monitored by a dietitian/public health
nutritionist.
When counseling a patient with an eating disorder, what recommendations should be made to
promote healthy eating habits and what long term consequences of eating disorders should be
considered?
Women identified as high risk should be referred to the dietitian/public health nutritionist for more
intensive nutrition counseling. High-risk women may include those who are not gaining sufficient
weight; those who are gaining excessive amounts of weight; women with preexisting health
conditions, such as diabetes, that require dietary intervention; and women who develop diseases
requiring nutrition advice
Maintaining a healthy weight gain as appropriate for her BMI category. Weight should be plotted at
every prenatal visit to monitor growth.
Reading: Chapter 9: "Growing a Healthier Nation: Maternal, Infant, Child, and Adolescent Nutrition
with an Emphasis on Childhood Overweight"
What is the recommended weight gain - based on the BMI of the woman when she became
pregnant - for underweight, normal weight, overweight and obese women?
Underweight women (BMI < 18.5) should gain between 28 and 40 pounds
BMI 18.5–24.9 should gain between 25 and 35 pounds during pregnancy
Overweight women (BMI 25–29.9) should gain between 15 and 20 pounds
obese women (BMI ≥ 30) should gain 11 to 20 pounds
If a woman is carrying twins, she should gain 37 to 42 pounds depending on her pre-pregnancy
weight status
Identify risk factors for preterm delivery.
How much additional energy (kcal/day) does a woman require in the first, second and third
trimesters?
Pregnant woman needs an additional:
340 kcal/day in the second trimester
452 kcal/day in the third trimester
Goals may need to be adjusted for women who are in the underweight or overweight/obese weight
categories
How much additional protein (g/day) does a woman require while pregnant?
DRI for protein in pregnancy is an additional 25 g/day for all three trimesters
What are the recommendations surrounding smoking and alcohol consumption by pregnant
women?
Smoking is totally contraindicated during pregnancy due to the profound impact it has on
development of the fetus. Less oxygen is available to the fetus of a mother who smokes, so the baby
is likely to be small for gestational age (SGA). SGA babies are at higher risk of complications of birth
and have higher rates of problems during the first year of life
Alcohol is known to cause birth defects and is linked to fetal alcohol syndrome (FAS). Infants born
with FAS exhibit numerous permanent developmental problems, including mental retardation
What is the connection between breastfeeding and childhood obesity?
, Breast milk may contribute to breast-feeding being protective against overweight;
Breast milk nutritional content changes over time, containing less protein after the first few months
when the infant’s need for protein is less. It is thought that the more rapid gains in weight and
length from about 2 months of age to the end of the first year of life of formula-fed infants may be
due to the higher protein content of formula, which exceeds the infant’s needs after about 1 to 2
months of age. Differences in adiposity appear only at about 12 months when evidence suggests
that breast-fed infants are leaner than formula-fed infants
What are the AAP recommendations regarding juice consumption by infants and children up to 6
years of age?
The AAP has concluded that fruit juice offers no nutritional benefit for infants younger than 6
months and no benefit over whole fruits for infants older than 6 months. They recommend that
juice not be introduced to infants before 6 months, should not be given in a bottle or easily
transported covered cup, should not be given at nap or bedtime, and should be limited to 4 to 6
ounces daily for infants and children up to 6 years old
Why is the glucose tolerance test given to pregnant women?
Gestational diabetes is a form of diabetes that develops in some women when they become
pregnant, but resolves once the pregnancy ends. Many of these women will go on to have type 2
diabetes later in life, particularly if they become obese. Gestational diabetes can have harmful
effects on both mother and infant. The mother has an increased risk of preeclampsia and delivering
by Cesarean section. Infants born to women with all types of diabetes have a higher risk of
becoming too large in utero (macrosomia: weighing more than 10 pounds). The infant also is at
higher risk to be stillborn, to have hypoglycemia at birth, and to develop hypertension, diabetes, and
obesity as an adult.
Women in moderate to high-risk categories need to be screened for gestational diabetes using a
glucose tolerance test. This is usually done by weeks 24 to 27 of pregnancy. Once diagnosed, an
intervention plan is developed to bring the diabetes under control. Interventions generally start with
diet and exercise and move to include medications as necessary to control blood glucose levels.
Women with gestational diabetes need to be counseled and monitored by a dietitian/public health
nutritionist.
When counseling a patient with an eating disorder, what recommendations should be made to
promote healthy eating habits and what long term consequences of eating disorders should be
considered?
Women identified as high risk should be referred to the dietitian/public health nutritionist for more
intensive nutrition counseling. High-risk women may include those who are not gaining sufficient
weight; those who are gaining excessive amounts of weight; women with preexisting health
conditions, such as diabetes, that require dietary intervention; and women who develop diseases
requiring nutrition advice
Maintaining a healthy weight gain as appropriate for her BMI category. Weight should be plotted at
every prenatal visit to monitor growth.
