Nutrition in Pregnancy and Lactation A Report to the Children's Bureau (1967) / Chapter Skim
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SPECIAL PROBLEMS
SPECIAL PROBLEMS
Pages 34-49
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From page 35... ...
(15) Planning a weight control program aimed at limiting gain to less than 24 pounds assumes knowledge of a woman's body stores and dietary intake which is generally not available, The danger exists of interfering with the normal physiological processes of both the mother and the fetus.
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From page 36... ...
i Furthermore, every effort must be made to distinguish between the normal steady gain in weight of 0.5 to 0.8 pounds per week and that due to edema, usually evidenced by the sudden gains characteristic of water retention. The Underweight Pregnant Woman: Although it was pointed out by Tompkins, et.
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From page 37... ...
(17) In the management of the obese pregnant woman, it is necessary to bear in mind that the existing body-weight usually represents a weight accumulation of many years and does not necessarily reflect her current caloric intake.
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From page 38... ...
commented: The incidence of pre-eclampsia and eclampsia is so intimately affected by standards of antenatal care that it is difficult on the evidence available to define the precise role of nutrition in toxemia, except to state the nutritional status of the patient may possibly modify the course of the disease. On the other hand, many authorities believe that nutritional factors are of prime importance, although the mechanisms through which poor nutrition operates in the development of pregnancy toxemia remain obscure.
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From page 39... ...
accounting for about one-sixth of all maternal deaths, and is undoubtedly responsible for large number of stillbirths and neonatal deaths each year in the United States. The harmful effects of pregnancy toxemia on the fetus and on the later development of the child appear to be closely related to the deleterious effects of the disease on the fetus in utero.
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From page 40... ...
In these clinics routine management often includes salt restriction, activity restriction, and the liberal use of diuretics, particularly for patients who show any suggestive increase in rate of gain in weight. Such management makes it difficult to even approximate the true incidence of toxemia.
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From page 41... ...
Tompkins and associates (31) , under carefully controlled circumstances, found that in clinic patients receiving adequate protein and vitamin supplementation the incidence of diagnosable toxemia could be reduced to 0.6 per cent in contrast to an incidence of 4.7 per cent in a non-supplemented control group.
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From page 42... ...
The basic dietary principles employed in prevention apply here and consist of a nutritionally adequate diet including a high level of protein (100 g) , avoidance of excessive salt, and sufficient calories to meet energy requirements.
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From page 43... ...
Muscle cramps have been attributed to sodium depletion, peripheral vascular insufficiency, or lowered serum calcium levels, (18) but available evidence is insufficient to permit any firm conclusion about either etiology or treatment.
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From page 44... ...
(20) However, some expectant mothers, especially those who entered pregnancy in poor nutritive status, or are still growing, or are unable to obtain or tolerate all foods recommended may require additional nutrients beyond those normally furnished by the diet.
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From page 45... ...
When prescribing vitamin and mineral supplements it is essential to guard against the possibility that some women because of their expenditures for supplements, raay be forced to deprive themselves of the other essential nutrients found only in foods. Anemia in Pregnancy Iron deficiency anemia is considered to be the most common complication of pregnancy in American women.
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From page 46... ...
The total circulating hemoglobin and serum iron may be little changed, however, because of the physiologic increase in total blood volume which accompanies pregnancy. Relatively little information is available concerning the changes which occur in iron stores in bone marrow.
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From page 47... ...
An iron supplement affording 100 to 150 mgs daily of elemental iron may be recommended, with the iron provided in the ferrous form and in divided doses three to four times a day. Hyperemesis Nausea and to a lesser extent vomiting occur frequently in association with pregnancy.
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From page 48... ...
Weight recorded during this period of fluctuation is apt to be misleading and may result in the design of a weight control program which seriously underestimates the total desirable gain in weight during.pregnancy. Therefore, when designing a weight control program, the patient's prepregnant and/or desirable weight should be used, rather than weight recorded during the period of nausea.
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From page 49... ...
49 eating habits. It is customary to add vitamin B complex and vitamin C to the intravenous solutions.
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