Question

Patty is a first-time mother who is newly pregnant. She and her husband, Sal, are excited about their new baby on the way. Patty is a small-framed woman who, based on her doctor's BMI charts, is categorized as "underweight." Patty is also an elite swimmer and runner. She has been working out for the majority of her adult life. Patty and Sal are both very aware of the importance of good nutrition and the role it plays in health and quality of life. However, they are both unsure of nutrition recommendations for pregnancy and want to provide the best nutrition possible for the new baby. 1. How much weight should Patty plan to gain during her pregnancy? 2. What specific nutrient is of particular importance pre-pregnancy and in the early stages of fetal development? 3. What should Patty do for exercise during her pregnancy? 4. Patty and Sal both follow a very healthy eating plan. Regardless of their good nutrition, what specific nutrient might Patty need to supplement during the second and third trimester? 5. Patty and Sal would like to maximize their baby's mental development. Which nutrients would best support that? 6. Patty is a coffee drinker and enjoys having two cups of coffee every morning. During pregnancy and breastfeeding, what should she do about her coffee drinking? 7. Patty typically drinks a glass of red wine with dinner. Now that she is pregnant, she knows that she should not drink alcohol. Patty's best friend, Betsy, said that it is fine to drink alcohol during the third trimester of pregnancy and encourages Patty to have her wine when that time comes to help her relax. What should Patty do and why? 8. After Patty and Sal's baby is born, how should they plan to feed the baby during the first year of life?

Answer 1

1. Since Patty is underweight, and her BMI is probably less than 18.5, she should gain 28-40 pounds during her pregnancy. Gaining the recommended amount of weight in pregnancy helps to prevent the complications in delivering the baby, and also helps in the normal development of the baby, as what the mother eats and drinks is the main source of nutrition for them.  

2. During the early stages of fetal development, Folic acid helps to prevent the neural tube defects, such as fetus's brain and spine. So, it is very important to take plenty of folic acid supplements before pregnancy and during the early weeks of pregnancy, especially for the first month.

3. Exercise for 30 minutes a day is recommended during pregnancy. These exercises can be gentle activities, such as walking and yoga, at least 4 days in a week for 30 minutes. Swimming is also great during pregnancy as it helps build new muscles.

4. During the second and third trimester, Patty should have more protein intake, since protein is key component in baby's growth. It helps maintain muscle and tissues.

During the third trimester, Patty's blood volume increases. So need for hemoglobin becomes higher to transport oxygen through blood. Intake of Iron, which is a component of hemoglobin helps in delivering oxygen to the baby, and helps in their immunity. A lack of iron in the diet could cause anemia, and also premature birth.

Calcium helps in the formation of baby's bones and teeth, which is essential in second and third trimester. It is also involved in development of muscles, nerves and circulatory system.

Vitamin D also helps in the development of baby's bones and teeth, and also in absorption of calcium. Since baby grows during second trimester, Vitamin D is essential.

Omega-3 fatty acid supports both the mother's and baby's immunity, heart, brain and eyes. DHA is essential in third trimester for the proper growth and development of baby's brain.

During delivery, Patty will lose plenty of blood. Vitamin K intake in third trimester helps in preventing clotting.

5. Nutrients such as protein, iron, zinc, vitamin A, copper, iodine, selenium, fatty acids, choline and folate have greater effects in mental development than others.  

Protein is required for neuron proliferation and differentiation. It also helps in growth factor synthesis.

Iron is needed for energy metabolism of neurons and glial cells.

Zinc and copper is required for neurotransmitter release.

Choline also helps in neurotransmitter release, and myeloma synthesis.

So, these nutrients help regulate brain development during fetal and postnatal stage.

6. Studies show that having more than 200mg of caffeine during pregnancy may not be healthy for the baby. So, more than 2 cups of coffee is not recommended for Patty, and she should limit it to 1 or 2 cups a day. High amount of caffeine during pregnancy may lead to low weight of baby, which would lead to diseases. Studies also show that high caffeine may also increase the risk of miscarriage, birth defects, premature birth and still birth.

Mostly, caffeine metabolize before it reaches breast milk, but it should also be considered that during breastfeeding, some amount of the caffeine may pass along to the baby. Caffeine level in breast milk increase after one or two hours after intake. So, less than 300 mg of caffeine a day is recommended.

7. During the third trimester, baby will be growing rapidly. Alcohol should not be consumed at this crucial developmental stage, as it can cause serious harm to baby. Alcohol can pass to the baby through placenta, and it takes long for it to be broken down compared to adults. So alcohol remains in baby's bloodstream and cause irreversible defects to their development.

8. Breastmilk provides new born baby with nutrients needed for their growth. Dry infant rice cereals can be given, followed by vegetables. Cereals containing zinc should also be included in baby's diet. Strained fruits, vegetables and meat can also be given.