Kathryn H. Thompson, Ph.D.

April 11, 2001

Prenatal Nutrition and Lactation

Objectives

 

Prenatal Nutrition

  1. Questions with nutritional implications for the obstetric history and physical exam
    1. Present illness
      1. General: recent weight change, poor weight gain, edema, dehydration
      2. G.I. complaints: Diarrhea, nausea, vomiting, heartburn, constipation
    2. Medical History
      1. Prenatal vitamins, nutritional supplements, herbs, remedies?
      2. Iron supplements/
      3. Food allergies
      4. Non-food cravings
      5. Obstetric history
    3. Social History
      1. Alcohol?
      2. Special Diet?
      3. How many meals and snacks daily?
      4. Avoid any specific foods?
      5. Milk: how much, type?
      6. Lactose intolerance
    4. Family History
      1. Familial occurrence of dx
      2. History of children with fetal anomalies
    5. Review of symptoms
      1. General: Fatigue, weight change
      2. Month: teeth, gums, lips, tongue
      3. GI/abdomen: Appetite, food intolerance, nausea, constipation, diarrhea
    6. Physical Exam
      1. Anthropometric data
        1. Height
        2. Current weight
        3. Prepregnancy weight
        4. Prepregnancy BMI
        5. Weight gain during pregnancy so far
    7. Laboratory Evaluation
      1. Glucose
      2. Hematocrit
      3. Hemoglobin
  2. Maternal weight gain
    1. Underweight
      1. BMI < 19.8
      2. Total weight gain 28 - 40 lbs.
      3. 5 lbs./ 4 weeks
    2. Normal
      1. BMI = 19.8 - 26
      2. Total weight gain 25 - 35 lbs.
      3. 4 lbs./ 4 weeks
    3. Overweight
      1. BMI = 26.1 -29
      2. Total weight gain 15 - 25 lbs.
      3. 2.6 lbs./ 4 weeks
  3. Nutritional requirements
    1. Energy: + 300 kcal in 2nd and 3rd trimester
    2. Protein: RDA = 60 g
    3. Calcium
    4. Folate
    5. Iron
  4. Nutritional Problems
    1. Nausea and vomiting
    2. Constipation
    3. Heartburn