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listlengths 384
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is\tno\teffect\ton\tmaternal\tweight\tgain\t(\nDodd\tet\tal,\t2015\n).\nACOG\trecommends\tthat\tany\twoman\twho\tis\toverweight\tor\tobese\tbe\toffered\tnutrition\tassessment\nand\tcounseling,\tboth\tduring\tthe\tpreconception\tperiod\tand\tthe\tprenatal\tvisits\t(\nACOG,\t2014\n;\t\nACOG,\n2015d\n)\tand\tthis\tshould\tcontinue\tpostpartum\tto\tminimize\tpostpartum\tweight\tretention.\n\tRegarding
|
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] |
Regarding\nthe\teffectiveness\tof\tMNT\ton\tcurbing\texcessive\tmaternal\tweight\tgain,\tresults\tare\tmixed\tbut\ninterventions\tcan\tbe\teffective\t(\nElliott-Sale\tet\tal,\t2018\n)\tand\tstudies\tare\tongoing.\tThe\tintensity\tof\tthe\nintervention\tneeds\tto\tbe\tbalanced\twith\tcompliance\tlimitations,\tand\taddressing\tbarriers\tmust\tbe\nindividualized\t(\nDodd\tet\tal,\t2015
|
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] |
individualized\t(\nDodd\tet\tal,\t2015\n).\tIt\tappears\tthat\tdiet\tinterventions\tare\tmore\teffective\tthan\tthose\nfocusing\ton\tphysical\tactivity\tor\tboth\t(\nWalker\tet\tal,\t2018\n).\tHowever,\twhile\texercise\tprograms\talone\tdo\nnot\tappear\tto\taffect\tmaternal\tweight\tgain\tor\tbirthweight,\tthey\tdo\timprove\tmaternal\tfitness\n(\nSeneviratne\tet\tal,\t2015
|
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] |
(\nSeneviratne\tet\tal,\t2015\n)\tand\tmay\tprovide\tother\tlong-term\tbenefits.\tIt\tis\tunclear\twhether\ta\nparticular\texercise\tdose\tis\tcritical\tand\tit\tis\talso\tunclear\tif\tthe\teffect\tof\texercise\tvaries\tby\tmaternal\nprepregnant\n\tBMI\t(\nMcDonald\tet\tal,\t2016\n).\nAll\twomen\tshould\tbe\tgiven\tappropriate\tguidance\ton\tthe\tweight\tgain,\tas\twell\tas\tnutrient\tintakes,
|
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] |
that\tare\texpected,\tas\trecommended\tby\tthe\tWHO\t(\nWHO,\t2016b\n).\tAlthough\tenergy\tneeds\tincrease\nslightly,\tthe\tmother\tis\tnot\t“eating\tfor\ttwo”\tbecause\tof\tthe\thormonal\tand\tmetabolic\tchanges\tthat\noccur\tduring\tpregnancy,\tincluding\tlowering\tof\tmaternal\tnutrient\tstores\t(\nWakimoto\tet\tal,\t2015\n).
|
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] |
Wakimoto\tet\tal,\t2015\n).\nHelping\ta\tmother\tfind\tacceptable\tconcentrated\tsources\tof\tnutrients\tand\tminimizing\tthe\tintake\tof\nhigh-calorie,\tlow-nutrient\tfoods\tis\tlikely\tto\treassure\tthe\twoman\twho\tstarts\tthe\tpregnancy\toverweight\nor\tobese\tand/or\tis\tgaining\texcessively.\tJust\troutine\tweighing\tis\tnot\teffective\tin\treducing\tgestational
|
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] |
weight\tgain,\tat\tleast\tamong\twomen\twith\tobesity\t(\nHaby\tet\tal,\t2018\n).\tHowever,\tit\tis\tcertainly\thelpful\nwhen\tcombined\twith\tother\tinterventions\t(\nGoldstein\tet\tal,\t2016\n)\tand\tmothers\toften\twant\tguidance.\nAlthough\trepeated\tindividual\tface-to-face\tcontact\twith\tpersonalized\tadvice\tis\toften\tdone,\tit\tisn’t
|
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always\teffective.\tGroup\tmeetings\tare\tsometimes\thelpful\tbecause\tof\tthe\texpanded\tsupport\tthat\tthey\nprovide,\tbut\tin\tsome\tinstances\twomen\tgain\teven\tmore\tweight\twhen\tparticipating\tin\tgroup\teducation.\nWhile\n\tliterature\tmay\tbe\tuseful\tand\tsufficient\tfor\tsome,\tfor\tmany\tpeople\tjust\treceiving\tprinted
|
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] |
materials\tis\tlikely\tto\tnot\tbe\tbeneficial.\tAlthough\teHealth\t(electronic)\tand\tmHealth\t(mobile)\ninterventions\thave\tpotential,\tthey\thave\tnot\tbeen\tshown\tto\tbe\teffective.\tOverall,\tthere\tis\tno\tone\tbest\nintervention\twith\toptimal\tduration,\tintensity,\tor\tsetting.\tInterventions\tshould\tbe\tadapted\tto\tlocal\nconditions\tand
|
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] |
conditions\tand\n\tindividualized.\tEven\tlow\tlevels\tof\tintensity\tand\tfrequency\tcan\tbe\thelpful\tin\tgiving\ta\nclient\tsmall\t“nudges”\t(\nWalker\tet\tal,\t2018\n).\nMNT\tis\tknown\tto\tbe\thelpful\tduring\tpregnancy.\tHowever,\tto\tbe\tmost\teffective,\tdietitians\tand\nnutritionists\tmust\tconsider\tall\tcurrent\tissues.\tA\tpregnant\twoman\tmay\thave\tpoor\tweight\tgain\tand
|
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] |
also\tlow\tiron\tlevels.\tFoods\tthat\taddress\tboth\tissues\tat\tthe\tsame\ttime\tshould\tbe\n\tused.\tShe\tmay\thave\nlow\tcalcium\tintake\tbut\talso\thave\tGDM,\tthus\tmodifying\thow\tshe\tis\tcounseled.\tShe\tmay\thave\tcultural\npractices\tthat\tcould\taffect\ther\tnutritional\tstatus.\tFor\texample,\ta\twoman\twho\tis\tconsistently\tveiled
|
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] |
when\toutside\tof\ther\thouse\tmay\tbe\tat\tparticular\trisk\tof\tlow\tvitamin\tD\tlevels\tbecause\tof\tthe\tlack\tof\nsun\texposure\ton\ther\tskin.\tShe\tmay\thave\tpreexisting\tmedical\tconditions\tthat\tmust\tbe\tmanaged,\nincluding\tcarrying\tparasitic\tinfections\tcommon\tin\ther\thome\tcountry.\tShe\tmay\tdevelop\tissues\tduring
|
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] |
pregnancy\t(e.g.,\tanemia,\tgallstones,\tor\tGDM)\tbut\talso\tmay\thave\tmedical\tissues\tthat\tare\tnot\tdirectly\nrelated\tto\tthe\tpregnancy\t(e.g.,\tcancer\tor\ta\tCrohn’s\tdisease\tflare-up).\tShe\tmay\texperience\ttrauma\nfrom\ta\tmotor\tvehicle\taccident\tor\tphysical\tabuse\tthat\tcould\trequire\tan\tICU\tadmission.\tShe\tmay\tbe\nwilling
|
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] |
willing\n\tto\twalk\tmore\tbut\tbe\tafraid\tto\tdo\tso\tnear\ther\thome\tor\tafter\tdark.\tAll\tnutritional\tissues\tmust\tbe\nbalanced,\toften\twith\tlittle\tresearch\tdata\tto\tgive\tfirm\tguidance.\tOne\tshould\tgive\tthe\tbest\tadvice\nknown\tbut\tbe\topen\tto\tchanges\tas\tthe\tevidence\tbecomes\tavailable.\nIn\taddition,\tcultural\taspects\tof\tcounseling\talso\tmust\tbe\tkept\tin\tmind\t(see
|
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] |
Chapter\t10\n).\tThe\tbeliefs\nand\tcustoms\tof\tthe\thome\tculture\tof\tboth\n\tparents\tare\timportant\tin\tpredicting\thealth\tbehaviors\tand\nshould\tbe\taddressed,\tideally\tpreconceptually.\tAcculturation\tof\tboth\tis\timportant,\tbut\tthe\tdirection\tof\ninfluence\tcan’t\talways\tbe\tpredicted.\tFor\texample,\tnon-Hispanic\twhite\tmothers\tare\tmore\tlikely\tto
|
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] |
smoke\tthan\tnon-Hispanic\tblack\tor\tHispanic\twomen.\tHowever,\trates\tof\tsmoking\tare\thigher\tamong\nimmigrants\twith\thigher\tlevels\tof\tacculturation.\tA\n\tfather’s\tbeliefs\tand\tacculturation\tare\talso\nimportant,\tinfluencing\tmaternal\thealth\tbehaviors\t(\nCheng\tet\tal,\t2018\n).\tFor\tmany\thealth\tbehaviors,\nnativity\tappears\tto\tbe\tmore\timportant\tthan\tethnicity.
|
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A\twoman’s\tperceived\trisk\tof\tabnormal\tweight\tgain\tmay\tdiffer\tfrom\tthe\tU.S.\tnorm.\tChildrearing,\nincluding\tpregnancy\tand\tlactation,\tusually\thas\tstrong\tcultural\tcomponents,\tand\tit\tis\tadvisable\tto\nunderstand\n\tthe\tbeliefs\tand\tcustoms\tof\tthe\tpopulation\tgroups\tbeing\tserved.\tAlthough\teach\tindividual
|
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] |
does\tnot\tnecessarily\tfollow,\tor\tmay\tnot\teven\tbe\taware\tof,\tall\tthe\tbeliefs\theld\tin\tthe\tculture,\tthey\tmay\ninfluence\ta\tperson’s\tresponse\tto\tnutritional\tsuggestions.\tFor\texample,\ta\twoman\tcoming\tfrom\ta\nculture\tthat\tbelieves\tthat\tcleft\tlip\tand\tpalate\tare\tcaused\tby\tseeing\tan\teclipse\tmay\trely\ton\tthe\tsafety\npin\tover
|
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pin\tover\n\ther\tabdomen\tto\tprotect\ther\tand\tmay\ttherefore\tbe\tless\tconcerned\tabout\ttaking\ther\tfolic\tacid\nsupplements.\tIf\ta\twoman,\tor\ta\tfamily\tmember,\tis\tfearful\tthat\teating\tcrabs\tduring\tpregnancy\twill\ncause\ta\tmiscarriage,\tthat\tbelief\tshould\tbe\trespected\tand\tother\tsources\tof\tprotein\tcan\tbe\tchosen\n(\nMilman\tet\tal,\t2016
|
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] |
(\nMilman\tet\tal,\t2016\n).\tA\tVietnamese\twoman\twho\tis\tfearful\tof\tdrinking\tcold\torange\tjuice\timmediately\npostpartum\tbecause\n\tof\tthe\tnegative\teffect\tit\twill\thave\ton\tthe\tskin\tyears\tlater\tmay\tbe\twilling\tto\twarm\nthe\tjuice,\tput\tsugar\tin\tit,\tor\teat\tkiwis\tfor\tvitamin\tC\tinstead.\tA\twoman\tfrom\tMexico\twho\tbelieves\tthat
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you\tmust\tcomply\twith\ta\tcraving\tor\tsomething\twill\tbe\tmissing\tfrom\tthe\tbaby,\twill\tbe\tafraid\tto\tnot\teat\nthe\tdirt\tshe\tis\tcraving.\tHowever,\tshe\tmay\tbe\twilling\tto\tsmell\tthe\twet\tdirt\tand\teat\ta\tburned\ttortilla,\nthus\tcomplying\n\twith\tthe\tcraving\tbut\tingesting\tsomething\tthat\tis\tnot\tlikely\tto\tbe\tcontaminated.\tShe
|
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] |
may\tbelieve\tthat\t“vitamins\tmake\tyou\thungry”\tand\tso\twill\tstop\ttaking\ther\tprenatal\tsupplements\tif\tshe\nfeels,\tor\thas\tbeen\ttold,\tshe\tis\tgaining\ttoo\tmuch\tweight.\nFamilies\toften\tneed\tto\tbe\treassured\tthat\tlow-fat\tand\tnonfat\tmilks\tcontain\tthe\tsame\tlevels\tof\nprotein,\tcalcium,\tand\tvitamin\tD\tas\tthe\twhole\tmilk\t(i.e.,\tthey
|
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] |
protein,\tcalcium,\tand\tvitamin\tD\tas\tthe\twhole\tmilk\t(i.e.,\tthey\n\tare\tnot\twatered\tdown\tmilk\tand\ttherefore\ndangerous\tfor\tpregnancy).\tImmigrants\tfrom\tcountries\twhere\ttap\twater\tis\tnot\tpotable\tneed\tto\tbe\nreassured\tthat\tit\tis\ttreated\tin\tthe\tUnited\tStates\tand\tis\tsafe\tto\tdrink,\tand\tthat\tbottled\twater\tis\tnot
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only\tmore\texpensive\tbut\talso\toften\tdoes\tnot\tcontain\tfluoride.\tOn\tthe\tother\thand,\tan\timmigrant\tmay\nbe\tfearful\tof\tthe\tprenatal\tcare\tin\tthe\tUnited\tStates\twhen\tshe\tis\n\tnot\troutinely\tscreened\tfor\nToxoplasma\tgondii\n,\tas\tis\tthe\tstandard\tof\tcare\tat\thome.\nCultural\tdifferences\tare\tnot\tapparent\tjust\twith\timmigrants.\tWomen\twho\tfollow\ta\twell-balanced
|
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] |
vegetarian\tdiet\tcan\tcertainly\thave\ta\tsuccessful\tpregnancy,\tassuming\tfood\tavailability\tis\tnot\tlimited.\nHowever,\tthese\twomen\tmay\tneed\tnutritional\tguidance\tregarding\tprotein,\tiron,\tzinc,\tcalcium,\tomega-\n3\tfatty\tacids,\tand\tvitamin\n\tB\n12\n,\tespecially\tas\ttrying\tto\teat\tthe\trequired\tvolume\tof\tfood\tbecomes\tthe\nlimiting\tfactor\tlater\tin\tthe\tpregnancy\t(see
|
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] |
limiting\tfactor\tlater\tin\tthe\tpregnancy\t(see\t\nChapter\t10\n).\tFollowers\tof\tJehovah’s\tWitness,\tbecause\tthey\nchoose\tnot\tto\treceive\tblood\ttransfusions,\tmay\tneed\tboth\tearlier\tand\tmore\tconsistent\tadvice\ton\tthe\nconsumption\tof\thigh-iron\tfoods\tto\thelp\tkeep\ttheir\tiron\tlevels\tas\toptimal\tas\tpossible,\tlowering\ttheir\nrisk\tof\tsevere\tcomplications
|
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risk\tof\tsevere\tcomplications\n\teven\tif\tblood\tloss\tat\tdelivery\tis\thigh.\tThose\twho\tpractice\tdifferent\ndietary\tpatterns\tduring\tholidays,\tincluding\tfasting,\tmay\tneed\tguidance\ton\thow\tto\tminimize\tthe\nimpact\tof\tthat\tchange\ton\tthe\tdeveloping\tfetus.\tSomeone\tworking\tnights\tmay\tneed\tideas\ton\thow\tto\ndistribute\ther\tmeals\tto\toptimize\tglucose\tcontrol.
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distribute\ther\tmeals\tto\toptimize\tglucose\tcontrol.\nPregnant\twomen\tare\tadult\tlearners\tand\trelevant,\tsimple,\tconcrete\tmessages\tare\tmost\teffective,\nespecially\tif\tthey\tare\tmemorable\tand\tmotivational\t(\nGirard\tand\tOlude,\t2012\n).\tHaving\tmothers\tset\ntheir\town\tgoals\tis\thelpful\t(\nHaby\tet\tal,\t2018\n).\tBlaming\tparents\tfor\ttheir\tchoices\tis\tnot\thelpful\tand
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).\tBlaming\tparents\tfor\ttheir\tchoices\tis\tnot\thelpful\tand\ncare\tshould\tbe\ttaken\twhen\tdiscussing\tthe\tepigenetic\tconsequences\tof\tactions\tor\tinactions.\tAll\tpeople\nshould\tbe\tcounseled\twith\tsensitivity,\treinforcing\tthose\tpractices\tthat\tare\tparticularly\thelpful\tand
|
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modifying\tonly\tthose\tpractices\tthat\tmay\tbe\tharmful.\tOne\tmust\tinvestigate\tatypical\tdietary\tpatterns\nand\tfood\tsources\tto\tbest\tfit\tthe\tcustoms\tof\tthe\tpatient.\tCultural\tdifferences\tshould\tnot\tbe\tignored\tor\nrejected\toutright.\tIf\tthere\tare\tsome\tthat\tmust\tbe\tmodified\tnow,\tit\tis\tbest\tto\texplain\twhy,\thow,\tand\tfor
|
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] |
how\tlong.\tOtherwise,\tthe\tguidance\tof\tgrandmothers\tand\tcultural\thistory\twill\tlikely\tprevail.\nPregnancy\tis\ta\ttime\tof\tgreat\timpact.\tAlthough\thistorically\tthe\tgoal\thad\tjust\tbeen\ta\tfull-term,\tfull-\nsize\tnewborn,\tnow\tthe\tfocus\thas\texpanded\tto\tinclude\tensuring\tsomeone\tbiologically\tpredisposed\tto\nbe\thealthy\tfrom\tbirth\tto\told\tage\t(\nACOG,\t2013b
|
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] |
be\thealthy\tfrom\tbirth\tto\told\tage\t(\nACOG,\t2013b\n).\tIt\tis\toften\ta\ttime\twhen\ta\tmother\tis\tvery\treceptive\tto\ndoing\ther\tbest\tfor\ther\tchild.\tEating\tmore\tfruits\tand\tvegetables,\tlean\tmeats,\tlow-fat\tmilks,\tand\twhole\ngrains\twhile\tminimizing\texcess\tfat,\tsugar,\tand\tsalt\tintakes\twill\tlikely\timprove\tmaternal\thealth\tand
|
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birth\toutcomes\tin\tthe\tshort\tterm.\tAnimal\tresearch\tis\tshowing\thigh\tmaternal\tintakes\tof\tfats\tand\nsugars\tduring\tpregnancy\tand\tlactation\tresults\tin\taltered\tdevelopment\tof\tthe\tcentral\treward\tsystem\nin\toffspring,\tleading\tto\texcessive\tintakes\tof\tthese\tfoods\tpostnatally\t(\nMennella,\t2014\n).\tIn\taddition,\nresearch
|
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Mennella,\t2014\n).\tIn\taddition,\nresearch\n\thas\tdemonstrated\tthat\tflavors\tfamiliar\tto\tthe\tinfant,\tfrom\texposure\tthrough\tthe\tamniotic\nfluid\tand\tbreastmilk,\tare\tmore\tlikely\tto\tbe\taccepted\tby\tthat\tchild\twhen\tfirst\toffered,\tthus\tincreasing\nthe\tchance\tof\tconsumption.\tAlthough\tthis\tmay\tbe\timportant\tnutritionally,\texposure\tto\ta\tvariety\tof
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flavors\tearly\tin\tlife\twhen\tthe\tdeveloping\tbrain\thas\theightened\tsensitivity\tto\tenvironmental\tinfluences\nalso\tappears\tto\tfacilitate\tacceptance\tof\tnovel\tfoods\tlater.\tEating\tbetter\tduring\tpregnancy\thelps\ndevelop\tbetter\tfood\thabits\tfor\tthe\tmother\tand\tthe\trest\tof\ther\tfamily\tthat,\thopefully,\twill\tcarry\ton\tpast
|
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the\tcurrent\tpregnancy,\timproving\tthe\tentire\tfamily’s\thealth.\tIn\taddition,\tshe\tis\tlikely\tto\tbe\thaving\npositive\tepigenetic\teffects\tand\timproving\tthe\thealth\tof\tfuture\tgenerations,\tas\twell\tas\tlowering\thealth\ncare\tcosts\t(\nSimeoni\tet\tal,\t2018\n).\nPostpartum\tperiod\t=\tpreconceptual\tperiod
|
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] |
Simeoni\tet\tal,\t2018\n).\nPostpartum\tperiod\t=\tpreconceptual\tperiod\nReproductive\thealth\tconcerns\tdo\tnot\tend\tat\tdelivery\tand\tthe\tpostpartum\tperiod\tcan\tbe\tconsidered\nthe\t“fourth\ttrimester.”\tIn\taddition,\tfor\tmany\twomen,\tthe\tpostpartum\tperiod\tcan\tbe\tconsidered\ta\npreconceptual\tperiod.
|
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] |
preconceptual\tperiod.\nExcess\tpostpartum\tweight\tretention\tis\tassociated\twith\tincreased\trisk\tof\tGDM\tand\thypertension\nduring\ta\tsubsequent\n\tpregnancy,\teven\tin\tnormal-\tand\tunderweight\twomen\twho\tgain\tappropriately\tin\nthat\tsubsequent\tpregnancy.\tNutrition\tand\texercise\tcounseling\tshould\tcontinue\tpostpartum,\twith\tthe
|
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] |
goal\tof\treturning\tthe\tmother\tto\ther\tprepregnant\tweight\twithin\t6\tto\t12\tmonths\tand\tachieving\thealthy\nBMI\tbefore\tattempting\tanother\tpregnancy.\tHowever,\tbecause\tless\tthan\thalf\tof\tpostpartum\twomen\nachieve\ttheir\tprepregnant\n\tweight\tby\t1\tyear,\tand\tover\ta\tquarter\tof\twomen\tkeep\tat\tleast\t10\tpounds,
|
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all\twomen\twho\tare\toverweight\tor\tobese\tshould\tbe\toffered\tnutrition\tcounseling\tfor\tat\tleast\t12\tto\t18\nmonths\tafter\tdelivery\t(\nStang\tand\tHuffman,\t2016\n).\tIntensive\tdietary\tintervention,\talong\twith
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] |
objective\ttargets\tfor\texercise\tsuch\tas\tthe\tuse\tof\theart\trate\tmonitors\tor\tpedometers,\tappear\tmost\neffective\t(\nNascimento\tet\tal,\t2014\n).\nAppropriately\ttreating\tor\tresolving\tmedical\tissues\tsuch\tas\tGDM\tbefore\ta\tsubsequent\tpregnancy\nwill\thelp\tensure\ta\thealthy\toutcome\tfor\tboth\tmother\tand\tbaby.\tAdequate\tstress\tmanagement\twill
|
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] |
minimize\tthe\tadverse\teffects\tof\tstress\thormones\ton\toffspring\tneurodevelopment\t(\nHuberty\tet\tal,\n2017\n).\nNutrient\tstores\talso\tneed\tto\tbe\treplenished,\tand\tshort\tinterpregnancy\tintervals\t(less\tthan\t12\tto\t18\nmonths)\tare\n\tassociated\twith\tincreased\trisk\tof\tmiscarriage,\tpreterm\tdelivery,\tIUGR\tor\tLBW,\tstillbirth,\nand\tearly\tneonatal\tdeath\t(\nWu\tet\tal,\t2012a
|
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] |
and\tearly\tneonatal\tdeath\t(\nWu\tet\tal,\t2012a\n),\tas\twell\tas\tmaternal\tmorbidity\tand\tmortality\t(\nHuberty\tet\nal,\t2017\n).\tThe\tnutritional\tdemands\tof\tbreastfeeding\talso\tmust\tbe\tconsidered,\tand\tfor\tthose\tin\tareas\nwith\tlimited\tresources,\tit\tmay\ttake\tat\tleast\t1\tyear\tto\trecover.\tThe\tWHO\trecommends\twomen\tdelay\nconception
|
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] |
conception\n\tat\tleast\t24\tmonths\tafter\ta\tlive\tbirth\tto\treduce\tthe\trisk\tof\tadverse\tmaternal,\tperinatal,\tand\nneonatal\toutcomes,\tbut\tthe\tapplicability\tof\tthese\trecommendations\tto\twomen\tin\tthe\tUnited\tStates\tis\nquestioned\tand\tis\tbeing\tstudied\t(\nAhrens\tet\tal,\t2018\n).\tMaternal\tdepletion\tis\ttheorized\tto\toperate
|
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] |
interval\tis\tless\tthan\t6\tmonths,\tand\ta\tsignificant\tproportion\tof\tlow-income\twomen\tin\tthe\tUnited\tStates\nare\tstill\tiron\tdeficient\t2\tyears\tafter\tdelivery\t(\nBodnar\tet\tal,\t2002\n).\tOther\tnutrients\talso\tmay\tbe\ndepleted\tfor\tan\textended\tperiod,\tincluding\tfolate,\tvitamin\tA,\tand\tDHA,\tnegatively\taffecting\tthe\nsubsequent\tpregnancy\t(\nConde-Agudelo\tet\tal,\t2012
|
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] |
subsequent\tpregnancy\t(\nConde-Agudelo\tet\tal,\t2012\n).\tAn\tantioxidant-rich\tpreconceptual\tdiet\tmay\nlower\toxidative\tstress\tand\timprove\tpregnancy\toutcomes.\tInflammation\tis\talso\tthought\tto\tplay\ta\trole\nin\tincreased\trisk\twith\tshort\tinterconceptual\tperiods\t(\nWendt\tet\tal,\t2012\n),\tand\tthose\twomen\twho\thave
|
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] |
Wendt\tet\tal,\t2012\n),\tand\tthose\twomen\twho\thave\nno\tnonpregnant,\tnonlactating\ttime\tmay\tbe\tat\tparticular\trisk.\tWomen\twho\thave\tinterpregnancy\tfood\nsupplementation\thave\tbabies\twith\thigher\tbirthweights\tand\n\tlengths\tand\tmaternal\themoglobin\tvalues\nare\thigher\t(\nWakimoto\tet\tal,\t2015\n).
|
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0.08309962600469589,
0.034975502640008926,
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0.026000013574957848
] |
are\thigher\t(\nWakimoto\tet\tal,\t2015\n).\nIt\tis\ttheorized\tthat\tpreconceptual\tnutrition\tis\tas\tcritical\tas\tnutrition\tduring\tpregnancy\tand\tfor\nmany\tnutrients,\tlikely\tmore\tcritical\tbecause\tof\ttheir\trole\tin\tplacental\tformation\tand\torganogenesis\n(see\tPreconception\tand\tFertility).\nLactation\nExclusive
|
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0.016591276973485947
] |
(see\tPreconception\tand\tFertility).\nLactation\nExclusive\n\tbreastfeeding\tis\tunequivocally\tthe\tpreferred\tmethod\tof\tinfant\tfeeding\n\tfor\tthe\tfirst\t6\nmonths\tof\tlife.\tMany\tprofessional\thealth\torganizations\thave\tendorsed\tthis\trecommendation,\nincluding\tthe\tAcademy\tof\tNutrition\tand\tDietetics,\tthe\tAAP,\tACOG,\tthe\tAmerican\tAcademy\tof\tFamily
|
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] |
Practitioners,\tHealthy\tPeople\t2020,\tthe\tWIC\tprogram,\tthe\tU.S.\tSurgeon\tGeneral,\tand\tthe\tU.S.\nBreastfeeding\tCommittee.\tThese\torganizations\trecommend\tbreastfeeding\tthroughout\tthe\tfirst\tyear\nand\tbeyond,\n\tas\tlong\tas\tmutually\tdesired\tby\tmother\tand\tchild;\tthe\tWHO\tencourages\tbreastfeeding
|
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] |
throughout\tthe\tsecond\tyear\tof\tlife.\tBreastfeeding\toffers\tprotection\tfrom\tGI\tand\tother\tinfections\tand\nserves\tas\ta\tcritical\tsource\tof\tenergy\tand\tnutrients\tduring\tillness,\treducing\tmortality\tamong\nmalnourished\tchildren.\tThe\tdevelopment\tof\tstrong\timmune\tand\tdigestive\tsystems\tin\tbreastfed\nbabies\tis\tthought\tto\tbe\tdue
|
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babies\tis\tthought\tto\tbe\tdue\n\tto\tthe\tdevelopment\tof\tbeneficial\tbacteria\tin\tthe\tbaby’s\tgut,\tproviding\ta\nhealthy\tgut\tmicrobial\tpopulation.\nMothers\tshould\tbe\tencouraged\tto\tbreastfeed\tfor\tas\tlong\tas\tpossible,\teven\tif\tit\tis\tnot\tthe\tfull\tyear.\nNutrition\tfrom\tbreastmilk\tand\tthe\tprotection\tfrom\tillness\tit\tprovides\tare\tunmatched\tby\tany\tother
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] |
substitute.\tIn\t2016\tthe\tLancet\tBreastfeeding\tSeries\twas\treleased\tstating\tthat,\tif\toptimal\n\tduration\tof\na\tminimum\tof\t12\tmonths\twas\tachieved,\tglobal\thealth\tcare\tsavings\twould\tbe\t$300\tbillion\tdollars\tper\nyear.\tAdditionally,\t820,000\tlives\tper\tyear\twould\tbe\tsaved,\tand\t20,000\tdeaths\tfrom\tbreast\tand\tovarian\ncancers\tcould\tbe\tavoided\t(\nVictora\tet\tal,\t2016
|
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] |
cancers\tcould\tbe\tavoided\t(\nVictora\tet\tal,\t2016\n).\tWomen\tshould\tbe\tsupported\tin\ttheir\tdecision\tto\nbreastfeed\tfor\tany\tlength\tof\ttime,\twhether\tit\tis\tfor\tjust\t2\tweeks,\t2\tyears,\tor\tlonger.\tBreastmilk\ncontinues\tto\tprovide\tnutrition\tand\timmunities\tthroughout\tthe\ttime\tthe\tmother\tis\tlactating.\tMany
|
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] |
women\tface\tbarriers\tthat\tmay\tprevent\tthem\tfrom\tbreastfeeding\tfor\tas\tlong\tas\tthey\twould\tlike,\tso\nsupport\tfrom\tthe\thealth\tcare\tsystem\talong\twith\tfamily\tmembers\tand\tthe\tcommunity\tis\tnecessary\tfor\nmothers\tto\treach\ttheir\tgoals\t(\nFig.\t14.8\n).
|
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] |
FIG.\t14.8\nA\tnursing\tmother\tand\ther\tinfant\tenjoy\tthe\tclose\tphysical\tand\temotional\tcontact\tthat\taccompanies\nbreastfeeding.\n\tSource:\t(Courtesy\tRobert\tRaab.)\nThere\tare\tmany\thealth\tbenefits\tfor\tmother\tand\tchild,\tas\tshown\tin\t\nBox\t14.10\n.\tA\trecent\tstudy\nexamined\tthe\tracial\tand\tsocioeconomic\tdisparities\tin\tinfant\tfeeding,\tnoting\tthat\thigher\trates\tof
|
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] |
breastfeeding\tare\tseen\tin\tfamilies\tin\twhich\tthe\tmother\n\tis\tolder\tand\tmarried,\twith\ta\thigher\teducation\nand\tincome.\tLong-term\thealth\toutcomes\tof\tbreastfed\tinfants\tand\ttheir\tnonbreastfed\tsiblings\twere\ncompared\tand\tresearchers\tnoted\tthat\tmany\tof\tthese\tchildren\thad\tsimilar\tlong-term\tpositive
|
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] |
outcomes\tas\ttheir\tbreastfed\tsiblings\tor\tchildren\tin\ta\tcomparative\tgroup.\tThe\tauthors\tconcluded\tthat\na\tsupportive\tbreastfeeding\tenvironment\tand\tnot\tbreastfeeding\talone\n\tcontributes\tto\tlong-term\npositive\thealth\toutcomes\tof\tchildren\t(\nColen\tand\tRamey,\t2014\n).\tStudies\talso\thave\tshown\tthat\tlevels\tof
|
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] |
Colen\tand\tRamey,\t2014\n).\tStudies\talso\thave\tshown\tthat\tlevels\tof\nC-reactive\tprotein\t(CRP),\ta\tkey\tbiomarker\tof\tinflammation\tand\ta\tpredictor\tof\tincreased\ncardiovascular\tand\tmetabolic\tdisease\trisk\tin\tadulthood,\tare\tsignificantly\tlower\tamong\tindividuals\nwho\twere\tbreastfed.\tDecreased\tconcentrations\tcorresponded\tto\tthe\tduration\tof\tearlier
|
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] |
breastfeeding.\tResearchers\tconclude\tthat\tthe\tlonger\tthe\tduration\tof\tbreastfeeding,\tthe\tless\ninflammation\tand\tlower\trisk\tfor\theart\tand\tmetabolic\tdiseases\tlater\tin\tlife\t(\nMcDade\tet\tal,\t2014\n).\nBOX\t14.10\nBenefits\tof\tBreastfeeding\nFor\tinfant\nDecreases\tincidence\tand\tseverity\tof\tinfectious\tdiseases\nBacterial\tmeningitis\nBacteremia\nDiarrhea\nInfant\tbotulism
|
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] |
Bacterial\tmeningitis\nBacteremia\nDiarrhea\nInfant\tbotulism\nNecrotizing\tenterocolitis\nOtitis\n\tmedia\nRespiratory\ttract\tinfection\nSepticemia\nUrinary\ttract\tinfection\nDecreases\trates\tof\tother\tdiseases\nAsthma\nCeliac\tdisease\nCrohn’s\tdisease\nFood\tallergies\nHodgkin’s\tdisease
|
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] |
Hypercholesterolemia\nLeukemia\nLymphoma\nOverweight\tand\tobesity\nSudden\tinfant\tdeath\tsyndrome\nTypes\t1\tand\t2\tdiabetes\nOther\tbenefits\nPromotes\tanalgesia\tduring\tpainful\tprocedures\t(heel\tstick\tfor\tnewborns)\nPromotes\tenhanced\tperformance\ton\tcognitive\tdevelopment\ttests\nPromotes\tmother-child\tbonding\nPromotes\tready\tacceptance\tof\tsolid\tfoods\nFor\tmother
|
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Promotes\tready\tacceptance\tof\tsolid\tfoods\nFor\tmother\nDecreases\tmenstrual\tblood\tloss\nDecreases\tpostpartum\tbleeding\nDecreases\trisk\tof\thormonal\t(breast\tand\tovarian)\tcancers\nPromotes\tearlier\treturn\tto\tprepregnancy\tweight\nIncreases\tchild\tspacing\nPromotes\trapid\tuterine\tinvolution\nDecreases\tneed\tfor\n\tinsulin\tin\tmothers\twith\tdiabetes
|
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0.0886344164609909,
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0.07086663693189621,
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0.0448564812541008,
0.0011938730021938682,
0.07196866720914841,
0.15905515849590302,
0.0007637529633939266
] |
Decreases\tneed\tfor\n\tinsulin\tin\tmothers\twith\tdiabetes\nDecreases\trisk\tof\tpostmenopausal\thip\tfracture\tand\tosteoporosis\nFor\tsociety\nReduces\thealth\tcare\tcosts\nDecreases\tcosts\tto\tpublic\tprograms\t(i.e.,\tWIC)\nPrevents\texcess\tlost\twages\tresulting\tfrom\temployee\tabsenteeism\tfor\tsick\tchildren\nSupports\tgreener\tenvironment
|
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] |
Supports\tgreener\tenvironment\nReference:\tAmerican\tAcademy\tof\tPediatrics\tand\tAmerican\tCollege\tof\tObstetricians\tand\tGynecologists:\nBreastfeeding\thandbook\tfor\tphysicians\n,\tSecond\tEdition,\tElk\tGrove\tVillage,\tIll,\t2013,\tAmerican\tAcademy\tof\nPediatrics.\nIn\t1991,\tthe\tWHO\tand\tthe\tUnited\tNations\tChildren’s\tFund\tadopted\tthe\tBaby-Friendly\tHospital
|
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Initiative\t(BFHI),\ta\tglobal\teffort\tto\tincrease\tthe\tincidence\tand\tduration\tof\tbreastfeeding.\tTo\tbecome\n“baby-friendly,”\ta\thospital\tmust\tdemonstrate\tto\tan\toutside\treview\tboard\n\tthat\tit\timplements\tthe\t“Ten\nSteps\tto\tSuccessful\tBreastfeeding,”\t(Ten\tSteps)\ta\tguideline\tfor\tmother-baby\tmanagement\tin\tthe\nhospital\t(\nBox\t14.11
|
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] |
hospital\t(\nBox\t14.11\n).\tIn\tthe\tUnited\tStates\tthe\tnongovernmental\tagency\tthat\toversees\tthe\tdesignation\nprocess\tis\tBaby-Friendly\tUSA.\tIn\t2018\tthe\tWHO\treleased\ttheir\trevised\tImplementation\tGuidance\tfor\nthe\tBFHI\t(\nWHO,\t2018a\n).\tThe\toriginal\tTen\tSteps\thave\tbeen\tfurther\trefined\tto\tmeet\n\tthe\tcurrent
|
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] |
the\tcurrent\nevidence\tand\thave\tbeen\tcategorized\tinto\tfour\tfocus\tareas:\t(1)\tcritical\tmanagement\tprocedures\tto\nsupport\tbreastfeeding,\t(2)\tkey\tclinical\tpractices\tto\tsupport\tbreastfeeding,\t(3)\tcoordination,\tand\t(4)\nquality-improvement\tprocesses.\tBaby-Friendly\tUSA\twill\tbe\tmaking\tchanges\tto\tthe\tU.S.\tGuidelines\tin
|
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] |
Criteria\tto\tbe\tin\talignment\twith\tWHO\trecommendations.\tIn\ta\trecent\tsystematic\treview,\tthe\n\tAgency\nfor\tHealthcare\tResearch\tand\tQuality\t(AHRQ)\tfound\tthat\tthe\tBFHI\tis\tassociated\twith\timproved\trates\nof\tbreastfeeding\tinitiation\tand\tduration\t(\nFeltner\tet\tal,\t2018\n).\nBOX\t14.11\nBaby-Friendly\tHospital\tInitiative:\tTen\tSteps\tto\tSuccessful\nBreastfeeding\n1.
|
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] |
Breastfeeding\n1.\t\nHave\ta\twritten\tbreastfeeding\tpolicy\tthat\tis\troutinely\tcommunicated\tto\tall\thealth\tcare\tstaff.\n2.\t\nTrain\tall\thealth\tcare\tstaff\tin\tthe\n\tskills\tnecessary\tto\timplement\tthis\tpolicy.\n3.\t\nInform\tall\tpregnant\twomen\tabout\tthe\tbenefits\tand\tmanagement\tof\tbreastfeeding.\n4.\t\nHelp\tthe\tmother\tinitiate\tbreastfeeding\twithin\t1\thour\tof\tbirth.\n5.
|
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Help\tthe\tmother\tinitiate\tbreastfeeding\twithin\t1\thour\tof\tbirth.\n5.\t\nShow\tmothers\thow\tto\tbreastfeed\tand\thow\tto\tmaintain\tlactation,\teven\tif\tthey\tare\tseparated\nfrom\ttheir\tinfants.\n6.\t\nGive\tnewborn\tinfants\tno\tfood\tor\tdrink\tother\tthan\tbreastmilk\tunless\tmedically\tindicated.\n7.
|
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] |
7.\t\nPractice\trooming-in;\tallow\tmothers\tand\tinfants\tto\tremain\ttogether\t24\thours\ta\tday.\n8.\t\nEncourage\tbreastfeeding\ton\tdemand.\n9.\t\nGive\tno\tartificial\tteats\tor\tpacifiers\t(also\tcalled\tdummies\tor\tsoothers)\tto\tbreastfeeding\ninfants.\n10.\t\nFoster\tthe\testablishment\tof\tbreastfeeding\tsupport\tgroups\tand\trefer\tmothers\tto\tthem\ton
|
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] |
discharge\tfrom\tthe\thospital\tor\tclinic.\nAdapted\tfrom\tBaby-Friendly\tUSA\t\nThe\tTen\n\tSteps\tto\tSuccessful\tBreastfeeding\n\t(website):
|
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https://www.babyfriendlyusa.org/for-facilities/practice-guidelines/10-steps-and-international-code/\n,\t2018.\nThe\t\nSurgeon\tGeneral’s\tCall\tto\tAction\tto\tSupport\tBreastfeeding\n\t2011\treport\tstates\tthat\nbreastfeeding\tshould\tbe\tpromoted\tto\tall\twomen\tin\tthe\tUnited\tStates\tand\tsupported\tby\tclinicians,
|
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employers,\tcommunities,\tresearchers,\tand\tgovernment\tleaders.\n\tAll\tare\tencouraged\tto\tcommit\tto\nenabling\tmothers\tto\tmeet\ttheir\tpersonal\tgoals\tfor\tbreastfeeding.\tHowever,\ttoo\tmany\tmothers\tare\nstill\tnot\table\tto\treach\tthese\tgoals.\tImprovement\tof\tsupport\tsystems\tis\tneeded\tfor\tmothers\tto
|
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] |
overcome\tchallenges\tand\tbarriers\tso\toften\tin\tthe\tway\tof\tsuccessful\tbreastfeeding.\tExcess\thealth\nrisks\tassociated\twith\tnot\tbreastfeeding\tcan\tbe\tfound\tin\t\nBox\t14.12\n.\nBOX\t14.12\nExcess\tHealth\tRisks\tAssociated\twith\tNot\tBreastfeeding\nOutcome\nExcess\nRisk\n*\n\t\n(%)\nComparison\tGroups\nAmong\tfull-term\tinfants\nAcute\tear\tinfections\t(otitis\tmedia)\n100
|
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] |
Among\tfull-term\tinfants\nAcute\tear\tinfections\t(otitis\tmedia)\n100\nEFF\tvs.\tEBF\tfor\t3\tor\t6\tmonths\nEczema\t(atopic\tdermatitis)\n47\nEBF\t<3\tmonths\tvs.\tEBF\t≥3\tmonths\nDiarrhea\tand\tvomiting\t(gastrointestinal\tinfection)\n178\nNever\tBF\tvs.\tever\tBF\nHospitalization\tfor\tlower\trespiratory\ttract\tdiseases\nin\tthe\tfirst\tyear\n257\nNever\tBF\tvs.\tEBF\t≥4\tmonths
|
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] |
in\tthe\tfirst\tyear\n257\nNever\tBF\tvs.\tEBF\t≥4\tmonths\nAsthma,\twith\tfamily\thistory\n67\nBF,\t3\tmonths\tvs.\t≥3\tmonths\nAsthma,\tno\tfamily\thistory\n35\nBF,\t3\tmonths\tvs.\t≥3\tmonths\nChildhood\tobesity\n32\nNever\tBF\tvs.\tever\tBF\nType\t2\tdiabetes\tmellitus\n64\nNever\tBF\tvs.\tever\tBF\nAcute\tlymphocytic\tleukemia\n23\nNever\tBF\tvs.\t6\tmonths\nAcute\tmyelogenous\tleukemia\n18
|
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23\nNever\tBF\tvs.\t6\tmonths\nAcute\tmyelogenous\tleukemia\n18\nNever\tBF\tvs.\t6\tmonths\nSudden\tinfant\tdeath\tsyndrome\n56\nNever\tBF\tvs.\tever\tBF\nAmong\tpreterm\tinfants\nNecrotizing\tenterocolitis\n138\nNever\tBF\tvs.\tever\tBF\nAmong\tmothers\nBreast\tcancer\n4\nNever\tBF\tvs.\tever\tBF\t(per\tyear\tof\nbreastfeeding)\nOvarian\tcancer\n27\nNever\tBF\tvs.\tever\tBF
|
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] |
breastfeeding)\nOvarian\tcancer\n27\nNever\tBF\tvs.\tever\tBF\n*The\texcess\trisk\tis\tapproximated\tby\tusing\tthe\todds\tratios\treported\tin\tthe\treferenced\tstudies.\nEFF\n,\tExclusive\tformula\tfeeding.\nEBF\n,\tExclusive\tbreastfeeding.\nBF\n,\tBreastfeeding.\nAdapted\tfrom\tU.S.\tDepartment\tof\tHealth\tand\tHuman\tServices
|
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] |
Adapted\tfrom\tU.S.\tDepartment\tof\tHealth\tand\tHuman\tServices\n:\tThe\tSurgeon\tGeneral’s\tCall\tto\tAction\tto\tSupport\tBreastfeeding\n,\tWashington,\tDC,\n2011,\tOffice\tof\tthe\tSurgeon\tGeneral.\nContraindications\nContraindications\tto\tbreastfeeding\tare\trare,\tbut\ta\tfew\tconditions\twarrant\tat\tleast\ta\ttemporary
|
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interruption\tfrom\teither\tdirect\tfeeding\tfrom\tthe\tbreast\tor\tfrom\tfeeding\tbreastmilk.\tBreastfeeding\tis\ncontraindicated\tfor\tinfants\twith\tclassic\tgalactosemia,\tand\tfor\tmothers\twho\thave\tactive\tuntreated\ntuberculosis,\tare\tpositive\tfor\thuman\tT-cell\tlymphotropic\tvirus\ttype\t1\tor\t2,\thave\tbrucellosis,\tuse\tdrugs
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0.009700813330709934,
0.09758980572223663,
0.058310192078351974,
0.02833184413611889,
0.034785401076078415
] |
of\tabuse\t(without\tmedical\tsupervision),\thave\tHIV\t(in\tthe\tUnited\tStates)\t(\nUSDHHS,\t2018a\n),\tor\twho\ntake\tcertain\tmedications\t(i.e.,\tantimetabolites\tand\tchemotherapeutic\tagents).\tExclusive\nbreastfeeding\n\tin\tHIV\tpositive\tmothers\ton\tantiretroviral\ttherapy\tis\thighly\trecommended\tthroughout\nthe\tworld\t(\nWHO,\t2016a
|
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] |
the\tworld\t(\nWHO,\t2016a\n).\tA\tmother\tshould\tnot\tbreastfeed\twith\tactive\therpes\tsimplex\tlesions\ton\ther\nbreast;\thowever,\texpressed\tmilk\tcan\tbe\tused\twithout\tconcern.\tIf\ta\tmother\tdevelops\tvaricella\t5\tdays\nbefore\tthrough\t2\tdays\tafter\tdelivery,\tshe\tshould\tbe\tseparated\tfrom\ther\tinfant\tbut\tcan\tprovide\ther\nexpressed\tmilk\tto\tthe
|
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] |
expressed\tmilk\tto\tthe\n\tinfant.\tMothers\twho\thave\tinfluenza\tshould\tbe\tencouraged\tto\tcontinue\tto\nbreastfeed\t(\nCDC,\t2018b\n).\tMothers\tacutely\tinfected\twith\tH1N1\tinfluenza\tshould\tseparate\tthemselves\nfrom\ttheir\tinfants\twhile\tfebrile,\tbut\tagain,\tcan\tprovide\ttheir\texpressed\tmilk\tfor\tfeedings\t(\nAAP,\t2012\n).
|
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] |
AAP,\t2012\n).\nThe\tuse\tof\tmost\tradioactive\tisotopes\trequires\ttemporary\tcessation\tof\tbreastfeeding,\tranging\tfrom\t6\nhours\tto\tup\tto\t1\tmonth\t(\nHale,\t2019\n).\tWomen\tundergoing\tprocedures\tusing\tthese\ttypes\tof\nmedications\tshould\tconsult\twith\ttheir\thealth\tcare\tprovider\tto\tdetermine\tthe\tspecific\tdrug\tused\tso
|
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that\tadequate\ttime\tis\tallowed\tfor\tclearance,\tbut\tno\tmore\ttime\tthan\tis\tnecessary\tso\tthat\nbreastfeeding\tcan\tbe\tresumed.\tClearance\ttime\tvaries\tbetween\tdrugs;\texpressing\tand\tdiscarding\nbreastmilk\tcan\thelp\tpreserve\tmilk\tproduction\tif\textended\tcessation\n\tis\tnecessary.
|
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is\tnecessary.\nThe\tCDC\tadvises\twomen\tin\tthe\tUnited\tStates\twho\thave\tHIV\tto\trefrain\tfrom\tbreastfeeding\tto\tavoid\npostnatal\ttransmission\tto\ttheir\tinfants\tthrough\ttheir\tbreastmilk.\tBecause\tsanitary\tconditions\tfor\tsafe
|
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use\tof\tinfant\tformula\tare\tavailable\tin\tthe\tUnited\tStates,\texperts\tbelieve\tthe\tmorbidity\trisk\tcan\tbe\nkept\tto\ta\tminimum.\tHowever,\tin\tdeveloping\tcountries\twhere\tsanitary\tconditions\tare\tnot\n\tas\tprevalent,\nand\tthe\trate\tof\tmortality\tin\tthe\tinfant\tfrom\tinfectious\tdiseases\tand\tmalnutrition\tare\thigh,\tthe\thealth
|
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risks\tof\tnot\tbreastfeeding\tmust\tbe\tconsidered.\tIn\taddition,\tin\tareas\twhere\tHIV\tis\tprevalent,\nexclusively\tbreastfeeding\tfor\tthe\tfirst\t3\tmonths\thas\tbeen\tshown\tto\treduce\tthe\trisk\tof\tinfants\nacquiring\tHIV\tcompared\twith\tinfants\twho\treceive\ta\tmixed\tdiet\tof\thuman\tmilk\tand\tother\tfoods,\nincluding
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including\n\tinfant\tformula.\tSix\tmonths\tof\texclusive\tbreastfeeding\twhile\tthe\tmother\treceives\nantiretroviral\ttherapy\thas\tbeen\tshown\tto\tsignificantly\treduce\tthe\tpostnatal\tacquisition\tof\tHIV\t(\nAAP,\n2012\n).\nNutritional\trequirements\tof\tlactation\nDespite\tthe\tfact\tthat\tbreastfeeding\tincreases\tthe\tneed\tfor\tenergy\tand\tsome\tnutrients,\thuman\tmilk\tis
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made\tfrom\tmaternal\tnutrient\tstores,\tso\twell-nourished\tmothers\tneed\n\tnot\tworry\tthat\tthe\tquality\tof\ntheir\tbreastmilk\twill\tsuffer\tfrom\tan\timperfect\tdiet.\tBreastmilk\tremains\tperfect\tfor\tthe\tinfant\teven\tin\ncases\tof\thardship\tand\tfamine.\tOnly\tin\trare\tcases\twhen\tmothers\texperience\tlong-term,\tsevere
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nutritional\tdeficiency\tis\ttheir\tbreastmilk\taffected.\tAn\texcuse\tto\tnot\tchoose\tbreastfeeding\tbased\ton\nthe\tfact\tthat\ta\twoman\tenjoys\tdrinking\tcoffee\tor\ttea,\tor\tan\toccasional\talcoholic\n\tbeverage,\tis\nunwarranted.\nUnless\ta\tvitamin-mineral\tdeficiency\tis\tidentified,\tor\tthe\tmother\thas\ta\trestricted\tdiet\tor\tan\tissue
|
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] |
with\tmalabsorption,\tdietary\tsupplements\tare\tusually\tnot\tnecessary.\tA\tdiet\tincluding\ta\tvariety\tof\nwhole\tfoods,\tadequate\tin\tcalories,\tshould\tprovide\tthe\twoman\twith\tall\tthe\tnutrients\tshe\tneeds.\nDespite\tthis\tfact,\tmany\tclinicians\trecommend\tthe\tcontinued\tuse\tof\ta\tprenatal\tvitamin/mineral
|
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] |
supplement\tfor\tthe\tduration\tof\tlactation,\tespecially\tif\tthe\tmother\tremains\tiron\tdeficient\tafter\tbirth.\nIncreased\t\nprolactin\n\treceptors\tin\tthe\tbreast\tand\ttherefore\thigher\tmaternal\tprolactin\tlevels\tdevelop\nwith\tearly\tsuckling\tstimulation\tand\tmilk\tremoval,\ta\tprocess\tenhanced\twith\tincreased\tfrequency\tof
|
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breastfeeding\tin\tthe\tearly\tneonatal\tperiod.\tThe\tmaternal\tresponse\tto\ther\tinfant’s\thunger\tcues\twill\nstimulate\ther\tmilk\tsupply,\taveraging\tabout\t8\tto\t12\tbreastfeeds\tover\t24\thours\tin\tthe\tfirst\t2\tto\t3\nweeks.\tEncouraging\tthe\tmother\tto\tfocus\ton\trecognizing\thunger\tcues\tversus\twatching\tthe\tclock\tis
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highly\trecommended.\tThe\tbelief\tthat\tmore\tmilk\tis\tmade\twith\tincreased\tfluid\tconsumption\tis\nmisguided\tbecause\tthe\tbody\twill\texcrete\texcessive\tfluid\tto\tmaintain\telectrolyte\tbalance.\tThis\tactually\nmay\tresult\tin\n\ta\tdecrease\tof\tmilk\tproduction.\tConcern\tfor\tthe\tmother’s\thydration\tand\ther\tability\tto
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0.022147003561258316,
0.06240374967455864,
0.04475424066185951,
0.08043825626373291,
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] |
maternal\tnutrition\n\tmay\taffect\tthe\tquantity,\tbut\tnot\tquality,\tof\tmothers’\tmilk\t(\nLawrence\tand\nLawrence,\t2016\n).\tAlthough\ta\tmother’s\tmilk\tmaintains\tits\tquality\teven\twhen\tnutrient\tintake\tis\nsuboptimal,\tthe\twoman\tfeels\tthe\teffects\tof\teating\tpoorly,\tpossibly\taffecting\ther\timmune\tsystem,\tand
|
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] |
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