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Copy of Nutrition

Pregnancy and
by

Vincent Ngai

on 31 October 2013

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Transcript of Copy of Nutrition

Other Relevant Infos
Past versus Present: Prenatal care approach

o Several cases of Eclampsia and Convulsions for pregnant women
o Focused mainly on managing patients with symptoms
o Infection and poor sanitation led to several complications


o Nurse played a critical role in providing care and information
o Creation of midwives
o Poor resource accessibility
o “Culturally focused”

Childbirth occurred at home
History of Prenatal Care: Early 1800's
Pregnant women beliefs
o Associates childbirth with fear due to high possibility of death for mother and baby
o Poor pain management which also increased anxiety during the childbearing period
o Pregnancy associated with taboo and fear which decrease the desire of having a baby

Improvements in health care
and technology

o Increased tremendously the success rate of delivering a healthy baby
o Provided reassurance for mothers regarding the taboo of having a baby
o Created prevention methods to complications and increased monitoring throughout pregnancy


Beliefs in the present
o Young mothers may now plan ahead their pregnancies
o High expectation of a healthy journey for both baby and mother
o Better pain management, feel more at ease to giving birth

Childbirth shifted from home-care to hospital
o Improved health
o Decreased complications and infections
o Physician play a more active role in the care (obstetrician created)

Outline
Introduction of pregnancy in young population
Past beliefs versus present practices
Video discussion
Exercise and nutrition
Other related information
Resources
Young Pregnant Women
Adriane Pepin
Brian Landry
Jessica Porfilio
Sarah Bowden
Stephanie Cabrera
Vincent Da Hung Ngai

Introduction
Most pregnancies occur at age 25 - 34 years old
Should women exercise during pregnancy?
Query
Birth rates highest among Quebec and Ontario provinces
Increasing trend of birth rates between 2006 - 2008 in Quebec

Exercise
Food and Pregnancy
Discussion
What Information are Pregnant Women Receiving?
Questions?
References
Thank You For Listening
How do young women perceive and maintain their health?
Stable trend of Infant mortality rate within the last decade
Should pregnant women vastly change their caloric intake?
Past
Present
Don’t exercise in hot and humid environments
Drink water to help prevent overheating and dehydration
Wear comfortable clothes that don’t restrict your rib cage and material that enables you to dissipate heat.
Wear a supportive bra.
Don’t overstretch
Listen to your body
Keep heart rate below 140 beats/minute
Adjust your expectations
Focus on posture and alignment
Get adequate rest



Exercise Recommendations

STATE ONE BENEFIT OF EXERCISING DURING PREGNANCY FOR THE MOTHER

POP QUIZ QUESTION #1

Fetal responses post exercise include a decrease in vascular resistance and an increase in umbilical blood flow
Improve the baby's tolerance to stress before and during labor
Babies tend to be more alert and readily self-quieted following birth
After submaximal exercise specifically, fetal aortic blood flow resistance decreases
No difference in birth weight
Decrease in fetal heat dissipation to the mother

Maternal Exercise Effects on the Fetus/Baby
Purpose: To explore health care providers knowledge, beliefs, and practices about exercising throughout pregnancy.
Methods: 93 practicing health care providers participated in a 31 question pen and paper survey.
Results: 99% of respondents believed that exercise during pregnancy is beneficial. 60% of M.D.s and 86% of D.O.s were not familiar with the ACOG guidelines for exercise and pregnancy.
Conclusion: Health care providers’ beliefs about exercise during pregnancy were positive, but not all were aware of or followed current ACOG recommendations. Different strategies for dissemination of current research should be conducted.




Study: Exercise and Pregnancy Knowledge Among Healthcare Providers

NAME ONE SAFE PHYSICAL ACTIVITY FOR MOTHERS DURING PREGNANCY

POP QUIZ QUESTION #2

Exercise Contraindications

Relative Contraindications

Absolute Contraindications

Serious cardiovascular or respiratory disorders
Placenta previa
Hypertension or pre-eclampsia
Preterm labor
Incompetent cervix
High order multiple gestation
Ruptured membranes
Persistent vaginal bleeding








Activities to Avoid

Safe Activities

Risks

Benefits

Benefits and Risks of Exercising For Mothers

Decrease backache, constipation, bloating, and swelling
Prevent and treat gestational diabetes mellitus
Improve energy, posture, and mood
Promote muscle tone, strength, and endurance
Improve sleep
Return to pre-pregnancy weight more easily
Walking
Swimming
Cycling on a stationary bike
Low impact and water aerobics
Jogging*






OLO Program in Quebec
Goal: to improve the nutrition, health and well-being of low-income pregnant women and contribute to the birth of healthy babies
Everyday they receive: 1 egg, 1 litre of milk and 150 ml of orange juice; plus vitamins and mineral supplements
Pre-natal nutrition
CLSC
Private sector at your own expense
Pre-natal health education/ Health promotion classes
Walking/Parks
Public Pools
Lululemon - Yoga classes
Pre-natal exercise classes for low income families
Studio Bump
B Fit Studio
Studio Vie
Olympic pool
YMCA
Pre-natal exercise classes

Tiny Tots
Health care workers
Tiny tots to Toddlers
CLSC

CSSS Resources
Contact sports (soccer, hockey, basketball)
Sports involving balance and risk of falling (downhill skiing, horseback riding)
Jumping, jarring movements or quick changes in direction
Scuba diving
Light headedness, dizziness
Painful uterine contractions
Excessive shortness of breath
Leakage of amniotic fluid
Chest pain
Moderate cardiovascular or respiratory problems
Purpose: Assess the knowledge and behavior of a sample of pregnant women regarding exercise, diet, and weight management during pregnancy
Methods: 83 pregnant women receiving prenatal care at 2 clinics answered survey while waiting for regular prenatal visit
Results: Participants knew the most about exercise and weight management but had less knowledge regarding nutrition
Conclusion: Pregnancy education is a first step to healthful pregnancy behaviors, but promotion of healthful behaviors during pregnancy needs to e expanded/improved


Study: Exercise, Nutrition, and Weight Management during Pregnancy

Normal Neural Tube

- Recommended: 400 mcg of folic acid/day – beginning at least one month before trying to get pregnant
- Decreases Neural Tube Defects by 50-70%
- Neural tube formation: 3rd – 4th weeks of pregnancy
- NTDs: failure of neural tube to close
- Result: abnormalities of brain, skull, spine  stillbirth or lifelong disability
- Most common NTD: spina bifida
Folic Acid and Neural Tube Defects

POP QUIZ QUESTION #4

WHY IS IT IMPORTANT TO TAKE FOLIC ACID DURING PREGNANCY?
HOW MANY SERVINGS OF FRUITS AND VEGETABLES ARE RECOMMENDED DURING PREGNANCY?

POP QUIZ QUESTION #3
Include an extra 2 to 3 food guide servings from any of the Four Food Groups each day
e.g Fruit and yogurt for a snack

Extra food servings
Food and Pregnancy

“More for me please, I’m eating for two!”

Doré, N., Le Hénaff, D. (2013). From Tiny Tot to Toddler: A practical guide for parents from
pregnancy to age two. Québec, Institut national de santé publique du Québec.

Injuries
Diastasis
Overstretching (hormone relaxin)
Falls
Shift in center of gravity
Overheating
Challenges thermoregulation
Teratogenic potential
Pregnant woman article:
http://espn.go.com/chicago/story/_/id/7084374/oh-baby-woman-runs-chicago-marathon-gives-birth
http://espn.go.com/video/clip?id=9793276
Would you consider exercising during pregnancy?
What is now your belief on "eating for two"?
What is thalidomide and what effect does it have on babies?
(The subjects covered in prenatal classes include:becoming parents; information on the course of pregnancy;lifestyle considerations; nutrition of the mother and the newborn;preparing for delivery;labour and delivery;caring for the newborn;breastfeeding; andreturning home after delivery. )
Aquatic prenatal fitness. Parc olympique de Montréal. (n.d.). Parc olympique de Montréal. Retrieved October 23, 2013, from http://parcolympique.qc.ca/en/the- park/sports-centre/aquatic-activities/aquatic-prenatal-fitness/

Azaïs-Braesco, V. & Pascal, G. (2000). Vitamin A in pregnancy: Requirements and safety limits. The American Journal of Clinical Nutrition, 71 (5), 1325-1333.

Bauer, P. Broman, C. & Pivarnik, J. (2010). Exercise and pregnancy knowledge among healthcare providers. Journal of Women’s Health, 19, 335-341.

Bernstein, P. Farrugia, M. & Thomas, J. (2009). Canada’s Pregnancy Care Book. Toronto, Ontario: Robert Rose.

Boatwright, D. Hernandez, B. Martens, D. & Strickland, G. (2006). Pregnancy and exercise: Physiological changes and effects on the mother and fetus. Strength and Conditioning Journal, 28 (1), 78-82.

Centres de santé et de services sociaux (CSSS). (n.d.). : Portail Santé Montréal. Retrieved October 23, 2013, from http://www.santemontreal.qc.ca/ou-aller/centres-de-sante- et-de-services-sociaux-csss/

Derbyshire, E. (2011). Nutrition in the Childbearing Years. Blackwell Publishing. Retrieved from: http://onlinelibrary.wiley.com/store/10.1002/9781444344790.ch9/asset/ ch9.pdf?v=1&t=hn3gosxk&s=cb8bbdff01e0cdefb6841f486040d8750f21b076

Dietary Supplement Fact Sheet: Folate. (2012). In Office of Dietary Supplements: National Institutes of Health. Retrieved October 25, 2013, from http://ods.od.nih.gov/factsheets/Folate-HealthProfessional/

Doré, N., Le Hénaff, D. (2013). From Tiny Tot to Toddler: A practical guide for parents from pregnancy to age two. Québec, Institut national de santé publique du Québec.

Food to Avoid during Pregnancy. (2013). American Pregnancy Association: Promoting Pregnancy Wellness. Retrieved October 23, 2013, from http://americanpregnancy.org/pregnancyhealth/foodstoavoid.html

Foods to Avoid during Pregnancy. (n.d.) In The Dairy Council. Retrieved October 25, 2013, from http://www.milk.co.uk/page.aspx?intPageID=102

H.E.R. Foundation. (2013). About Hyperemesis Gravidarum. Retrieved from: http://www.helpher.org/hyperemesis-gravidarum/

Herer, E. (2009). Pregnancy Day by Day (Canadian Edition). Toronto, Ontario: Dorling Kindersley.

Housman, J., & Jones, J., & McAleese, W. (2010). Exercise, Nutrition, and Weight Management During Pregnancy. American Journal of Health Studies, 25. Retrieved from: http://www.sirc.ca/newsletters/may12/documents/Free/nutrition.pdf

Infant mortality rates, by province and territory (Both sexes). (n.d.). Government of Canada, Statistics Canada. Retrieved October 15, 2013, from http://www.statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/health21a-eng.htm

Kim, J. H., Schialli, A. R. (2011). Thalidomide: the Tragedy of Birth Defects and the Effective Treatment of Disease. Toxicological Sciences. 122(1). (pp. 1-6). Retrieved from: http://toxsci.oxfordjournals.org/content/122/1/1.full

Maloni, J. A., Cheng, C. Y., Liebl, G. P., & Maier, J. S. (2004). Transforming Prenatal Care: Reflections on the Past and Present With Implications for the Future. Journal of Obsteric, Gynecologic, & Neontal Nursing, 25, 17-23.

Montreal's B-Fit Studio prenatal and postnatal fitness | b-fitstudio.com. (n.d.). bfitstudiocom RSS. Retrieved October 23, 2013, from http://b- fitstudio.com/personal-training/prepostnatal/

My Food Guides Servings Tracker: Pregnant female aged 19 to 50. (2011). In Health Canada. Retrived October 21, 2013, from http://www.hc-sc.gc.ca/fn-an/food- guide-aliment/track-suivi/table_female-femme_preg-ence_age19-50-eng.php

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Perry, S. E., Hackenberry, M. J., Lowdermilk, D. L., Wilson, D. (2010). Maternal and Child Nursing Care (4th ed.) (pp. 254-255). Mosby, Inc., an affiliate of Elsevier Inc.

Personal Training. (n.d.). Studio Vie Montreal. Retrieved October 23, 2013, from http://www.lestudiovie.com/services/training/personal-training

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