Question

Sarah is 28 years old and 7 months pregnant with her third child. Her other children are aged 2½ years and 1 ½ years. She had uncomplicated pregnancies and deliveries. Sarah is 5 ft 6 in tall; she weighed 142 pounds at the beginning of this pregnancy, which made her pre-pregnancy BMI 23. She has gained 24 pounds so far. Prior to her first pregnancy, her BMI was 20 (124 pounds). She is unhappy about her weight gain, but the stress of having two young children and being a stay-at-home mom made losing weight impossible. She went online for her MyPlate plan, which recommends she consume 2400 Kcal/day. She doesn't think she eats that much because she seems to have constant heartburn. She takes a prenatal supplement, so she feels pretty confident that even if her intake is not perfect, she is getting all the nutrients she needs through her supplement. A typical day's intake for her is shown below:

Breakfast: Cornflakes with whole milk (because the children drink whole milk), Orange juice

Snack: Bran muffin and whole milk

Lunch: Either a peanut butter and jelly sandwich or tuna fish sandwich with mayonnaise

Snack crackers, Whole milk, Pudding or cookies

Snack: Ice cream

Dinner: Macaroni and cheese, Green beans, Roll and butter, Whole milk, Cake or ice cream for dessert

Evening: Chips and salsa

• Does she have any risk factors for a high-risk pregnancy?

• Evaluate her pre-pregnancy weight and weight gain thus far. How much total weight should she gain?

• Based on the 2400-calorie meal pattern in Figure 11.1 (in your book), what does Sarah need to eat more of? What is she eating in more than the recommended amounts? How would you suggest she modify her intake to minimize heartburn?

• What would you tell her about weight gain during pregnancy? What strategies would you suggest to her after her baby is born that would help her regain her healthy weight?

• Is her attitude about supplements appropriate? What would you tell her about supplements?

Devise a 1-day menu for her that would provide all the food she needs in the recommended amounts and alleviate her heartburn.

Answer 1

Solution:

No. She doesn't have any risk factors for the pregnancy. But lack of intake essential nutrients leads to complications such as iron deficiency anemia, preterm delivery, increased vaginal bleeding.

During the pre-pregnancy state, she weighed 142 pounds and her BMI is 23. Presently, at the 7 months of pregnancy, she gained only 24 pounds. During the end of the second trimester, one should gain at least 25- 35 pounds. And in the third trimester, She should gain at least 1lb per week.

During the trimester of pregnancy, Sarah needs to eat more iron, protein, calcium, magnesium-rich food. Iron and folic acid are essential to prevent anemia and neural tube defects in the fetus. Vitamin C diet helps to increase the absorption of iron. Magnesium helps to relax muscles. But the Sarah diet menu has more amount of junk foods and a fatty diet. This increases the heartburn and taking off too much dessert is not recommended during pregnancy. Fried item increases the sodium level and leads to swelling.

Gradual weight gain is important during pregnancy which indicates the development of a healthy baby. During pregnancy, one should attain the recommended weight. Intake of essential nutrients is essential for the normal growth and development of the baby. It also helps you to lactate your baby after delivery. No need to stress about weight gain. There are many ways and exercises helps you to regain your normal weight after the delivery.

Prenatal supplements consist of most vitamins and minerals, and the folic acid that helps to meet the extra requirements during the pregnancy stage. Prenatal supplements itself not enough because most of the essential nutrients should gain from our daily foods. So prenatal supplements will only add support to the daily requirements.

1-day diet menu for Sarah

Breakfast	Porridge with low-fat milk and cinnamon. Apple juice
Morning snack	Muffin with peanut butter
Lunch	Wholemeal sandwich, egg salad with nuts
Evening snack	Banna bread or fruity flap.
Dinner	Spinach pasta with vegetable salad.