13.2 Nutrition During Pregnancy: Nutrients

13.2 Nutrition During Pregnancy: Nutrients


– WELCOME TO THE SECOND SECTION ON NUTRITION DURING PREGNANCY
AND INFANCY. IN THIS SECTION, I’M GOING TO BE
COVERING THE IMPORTANT NUTRIENTS TO HAVE EITHER PRIOR TO
PREGNANCY OR DURING PREGNANCY. I’M NOT GOING TO COVER
EVERY SINGLE NUTRIENT BUT JUST THE IMPORTANT ONES THAT I THINK WOMEN NEED
TO BE AWARE OF. WE’RE GOING TO START
WITH FOLATE, WHICH WE COVERED EARLIER
THIS SEMESTER. AND I WANT TO DRAW
YOUR ATTENTION TO THIS CHART. AND THE GREENE REPRESENTS WOMEN
AND THEIR NEEDS, SO THIS IS 100 PERCENT
OF THE RDA. YELLOW REPRESENTS
PREGNANCY WOMEN. SO YOU CAN SEE THAT
THE RECOMMENDATION FOR INTAKE
DURING PREGNANCY INCREASES. DURING LACTATION, SO AFTER BIRTH
WHEN THE BABY IS BREASTFEEDING, PURPLE REPRESENTS MORE
THAN THE RDA COMPARED TO A WOMAN WHO IS NON-PREGNANCY
BUT LESS THAN SOMEONE WHO IS ACTUALLY PREGNANT,
A WOMAN WHO IS PREGNANT. I WANT TO SPECIFICALLY
POINT OUT, WE WENT OVER THIS EARLIER, THAT THE KEY IS ACTUALLY
HAVING THE FOLATE WHEN TRYING TO CONCEIVE; SO WHEN SOMEONE IS
TRYING TO BECOME PREGNANT, BECAUSE FOLATE IS SO IMPORTANT
FOR NEURAL TUBE DEVELOPMENT, WHICH OCCURS IN THOSE FIRST
FEW WEEKS OF PREGNANCY AND MANY WOMEN DON’T EVEN
KNOW THEY’RE PREGNANT. SO STARTING TO SUPPLEMENT
OR INCREASE CONSUMPTION, YOU KNOW, TWO MONTHS INTO
THE PREGNANCY IS NOT GOING– ALTHOUGH BENEFICIAL, IT’S NOT GOING TO BE AS
IMPORTANT AS DOING IT RIGHT AT, ESSENTIALLY CONCEPTION. SO THE SUPPLEMENTATION
IS RECOMMENDED AND IT’S FOR PREVENTING
NEURAL TUBE DEFECTS, WHICH I’LL GET TO
ON THE NEXT SLIDE, OF 400 MICROGRAMS OF FOLIC ACID. BUT KEEP IN MIND THAT
EVEN THOUGH WE SAY IT’S FOR DURING PREGNANCY,
IT’S REALLY FOR WOMEN WHO ARE TRYING TO GET PREGNANT,
VERY IMPORTANT. NOW, WE TALKED ABOUT HIS
BEFORE BUT THE FOLATE IS EXTREMELY IMPORTANT IN
DEVELOPMENT OF THE NEURAL TUBE. SO IF THIS TUBE
HERE ESSENTIALLY, WHICH CARRIES THE SPINAL CORD, ENDS UP NOT DEVELOPING PROPERLY,
IT CAN END UP BULGING OUT, YOU CAN SEE THAT HERE,
FROM THE BACK. SO THEN YOU HAVE THIS SPINAL
CORD ESSENTIALLY WRAPPED AROUND, LIKE THIS, IS NOT GOING TO
FUNCTION PROPERLY. NOW, IN MY PRACTICE, I ACTUALLY DO SEE INDIVIDUALS
WITH SPINA BIFIDA. AND THEY CAN HAVE
A VERY PRODUCTIVE LIFE BUT THEY ARE LIMITED. AND TYPICALLY IT’S
EITHER A PARTIAL PARALYSIS OF ONE LEG OR BOTH. AND GENERALLY THEY WALK
WITH A LIMP OR A CANE, OR SOME SORT OF
ASSISTIVE DEVICE. AND SO, I TYPICALLY SEE THEM
WHEN THEY COME IN REGARDING FOOT PROBLEMS OR MAYBE THEIR
FOOT ISN’T PROPPING UP PROPERLY, SUCH AS A FOOT DROP
OR PROBLEMS WITH GAIT THAT MEANS WITH
AMBULATION OR WALKING. AND USUALLY I’M NOT
TREATING THE PROBLEM BECAUSE I DON’T TREAT
THESE TYPES OF PROBLEMS, BUT MORE WITH BRACING
BECAUSE OF THE DEFORMITIES THAT DEVELOP IN THEIR
FEET LATER ON IN LIFE. SO AGAIN, FOLATE DEFICIENCY,
IF YOU’RE NOT OBTAINING ENOUGH FOLATE PARTICULARLY RIGHT AT
THE BEGINNING OF PREGNANCY, THERE’S AN ABNORMAL SPINAL
CORD DEVELOPMENT AND THAT LEADS TO A NEURAL TUBE DEFECT,
MOST COMMONLY SPINA BIFIDA. NOW CALCIUM, CALCIUM IS
INTERESTING BECAUSE IT ACTUALLY IS TRUE THAT THE BABY
BEST NEED INCLUDES CALCIUM. AND CALCIUM WILL BE DRAWN
FROM THE MOTHER’S STORES. NOW THINK ABOUT WHERE
DO WE STORE CALCIUM. WE HAVE ABUNDANT
STORES OF CALCIUM. WHERE IS THAT IN OUR BODY? IT’S IN THE BONES. WE HAVE A LOT OF CALCIUM
THAT WE CAN TAKE. SO IN GENERAL THE
RECOMMENDATIONS DON’T CHANGE AND IT’S BECAUSE CALCIUM ABSORPTION
INCREASES DURING PREGNANCY. SO LET’S TAKE A LOOK AT THIS. WE HAVE OUR NON
PREGNANT WOMAN WHO NEEDS 100 PERCENT OF THE RDA. AND WHEN WE GO TO
THE PREGNANT WOMAN, SHE DOESN’T NEED ANY MORE
THAN THE NON PREGNANT WOMAN, AND DURING LACTATION
THE SAME THING. SO CALCIUM RECOMMENDATIONS,
SO THE– WHICH MEANS THE INTAKE
FOR CALCIUM DURING PREGNANCY AND LACTATION
DOES NOT CHANGE. IT’S BECAUSE CALCIUM ABSORPTION
INCREASES TO COMPENSATE FOR THE INCREASED NEEDS OF
THE FETUS. OKAY? SO THE RECOMMENDATION
DOESN’T CHANGE BECAUSE THE BODY NATURALLY
COMPENSATES FOR THIS. SO CALCIUM ABSORPTION
DOUBLES DURING PREGNANCY, THAT’S IMPORTANT. AND WHAT’S AN INTERESTING
FACT IS THAT YOU WOULD THINK IF WE ARE DRAWING
CALCIUM FROM OUR BONES, FOR THIS DEVELOPING BABY,
THAT PERHAPS WOMEN WHO HAVE MULTIPLE PREGNANCIES END UP WITH
OSTEOPOROSIS LATER ON IN LIFE, AND THAT ACTUALLY ISN’T TRUE. SO IMMEDIATELY AFTER BIRTH,
THE MOTHER– THERE’S JUST A
NATURAL COMPENSATION FOR CONTINUING THAT ABSORPTION; INCREASED ABSORPTION OF CALCIUM, AND THEN RE-SUPPLYING THE
BONES TO BUILD BACK UP ANY LOST CALCIUM OR ANY
LOSS OF BONES STRENGTH. SO MULTIPLE PREGNANCIES IS NOT
A RISK FOR LATER OSTEOPOROSIS. IRON, SO I’M GOING TO
FINISH ON IRON AND THESE ARE KIND OF OUR BIG
THREE WITH ARE NUTRIENTS. AND I REALLY WANT
TO POINT OUT THAT IN PREGNANCY HOW MUCH
THE NEED INCREASES. SO AGAIN, THIS IS OUR IN GREEN,
OUR NON PREGNANT WOMAN, PROBABLY SAY 100
PERCENT OF THE RDA. AND THEN, LOOK AT THIS INCREASE
NEED DURING PREGNANCY, SUBSTANTIAL INCREASE
NEED DURING PREGNANCY. NOW, THIS IS BECAUSE
THE INFANT– ACTUALLY IT’S NOT THE INFANT, BUT FETUS IS ACTUALLY PULLING
THAT IRON FROM THE MOTHER. AND THE MOTHER WILL GIVE UP
ANY OF HER NUTRIENTS FOR THIS DEVELOPING NEWBORN
BABY. OKAY? SO THAT’S JUST THE
NATURAL PROGRESSION IS IF THE MOTHER HAS IRON
IT’S GOING TO GO TO THE BABY BEFORE REALLY
BEFORE THE MOTHER. SO IN ORDER FOR THE
MOTHER TO BE HEALTHY, THE MOTHER HAS TO HAVE
AN INCREASED IRON INTAKE. BUT THE BABY IS
TRYING TO ACTUALLY GET THIS STORE OF IRON
FOR FOUR TO SIX MONTHS. NOW REMEMBER IRON IS
PART OF HEMOGLOBIN, HEMOGLOBIN CARRIES OXYGEN. VERY IMPORTANT TO HAVE
ENOUGH IRON ESPECIALLY IN THOSE FIRST FEW
MONTHS OF LIFE, OR THE BABY IS EITHER
GOING TO NOT LIVE. OR THE BABY WILL LIKELY
SUFFER SOME SORT OF, YOU KNOW, DEFECT OR
DEVELOP SOME SORT OF CONDITION DUE TO IRON
DEFICIENCY AND/OR ANEMIA. IT’S VERY IMPORTANT. SO THE BABY, THIS
IS JUST A NATURAL– SOMETHING THAT HAPPENS
NATURALLY IS THAT BABY IS GOING TO STOCK
UP ON THAT IRON. SO NOT ONLY A NEED WHILE
ITS DEVELOPING IN FETUS– AS A FETUS, SO IN THE WOMB,
BUT ALSO FOR THOSE FIRST SIX MONTHS OF LIFE SO THE BABY CAN
LIVE AND THAT NEWBORN CAN LIVE. BUT THAT ENDS UP
THAT THE MOTHER NEEDS TO HAVE SUBSTANTIALLY MORE IRON. SO THIS IS ACTUALLY WHEN
SUPPLEMENTATION IS RECOMMENDED. SO WE TALKED ABOUT
IT’S ALWAYS BEST TO GET YOUR NUTRIENTS FROM FOOD. BUT TO BE ABSOLUTELY SURE
THAT YOUR BABY HAS ENOUGH IRON AFTER THEY’RE BORN FOR
THAT FOUR TO SIX MONTHS, MOST– THEY GENERALLY ALMOST ALWAYS
RECOMMEND IRON SUPPLEMENTATION. SO THIS RECOMMENDATION
SHOULD COME FROM YOUR DOCTOR, IF YOU ARE PREGNANT. NOW, DURING LACTATION, SO DURING BREASTFEEDING
NOTICE HOW IT DROPS. SO EVEN THOUGH, AND WE’LL GO OVER BREAST
MILK IN A FEW LECTURES, BUT EVEN THOUGH BREAST MILK WILL SUPPLY IRON THE NEED
IS NOT AS GREAT. WELL, WHY IS THAT? WELL, THE BABY STOCKED UP
FOR FOUR TO SIX MONTHS. SO THE BABY– IF THE MOTHER HAS ADEQUATE
NUTRITION DURING PREGNANCY, THE BABY WILL BE HEALTHY
ENOUGH TO NOT REALLY NEED A LOT OF IRON FOR THAT
FIRS T FOUR TO SIX MONTHS. BECAUSE THE BABY, ESSENTIALLY
THE NEWBORN HAS PREPARED. AFTER BIRTH THAT
NEWBORN IS PREPARED. BUT THE KEY IS ADEQUATE
NUTRITION DURING PREGNANCY. AND THIS IS THE END OF
OUR SECTION ON NUTRIENTS.

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