LB2882MaternalNutriti+ - Mead Johnson Nutrition

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ALCOHOL, CAFFEINE, AND OTHER FOOD SAFETY ISSUES IN WOMEN OF CHILDbEARING AGE Alcohol Prenatal alcohol use is a preventable cause of birth defects. The term Fetal Alcohol Spectrum Disorders (FASDs) refers to the problems that arise in infants from mothers who consumed alcohol during pregnancy including facial abnormalities, intellectual disabilities, heart defects, and learning and emotional problems. The most severe effect attributed to prenatal alcohol intake is Fetal Alcohol Syndrome, a combination of physical and mental birth defects. 29,30 The effects of gestational alcohol intake are more pronounced in the offspring of heavy drinkers, but lesser amounts of alcohol intake during pregnancy have also proven to be problematic. 127-129 Pregnant women should be counseled to avoid all alcohol during pregnancy since there is no known safe intake. 29,30 The effects of alcohol on the breastfeeding infant are directly related to maternal consumption. Moderate to heavy drinking (2 or more alcoholic drinks per day) can interfere with let-down and milk ejection. 130 Alcohol is transferred into breast milk and is capable of slowing infant growth. 130 An occasional drink when lactating probably presents little risk to a nursing child but mothers should discuss alcohol consumption with their health care provider. 131 Caffeine Caffeine is present in a variety of beverages and foods (Table 11). Studies evaluating the risk of caffeine consumption and pregnancy complications have been confl icting in their fi ndings. 31-33 Some authors of observational studies have concluded that caffeine contributes to miscarriage, growth restriction, reduced birth-weight, preterm birth or stillbirth but authors of a 2009 review concluded that there is insuffi cient evidence “from randomized controlled trials to support any benefi ts from avoiding caffeine during pregnancy.” 33 Given the potential for pregnancy complications seen in observational studies, it is prudent to advise women to limit caffeine intake to 200 mg/day or less when trying to conceive a child and during pregnancy. 34 A small amount of caffeine is transferred into breast milk, but the American Academy of Pediatrics considers caffeine consumption safe for breastfeeding women. 130 Women who consume more than 2-3 cups of coffee per day, however, may fi nd that their babies become irritable or have diffi culty sleeping. 34,130 TAbLE 11. SELECTED SOURCES OF CAFFEINE beverage or Food Amount Caffeine (mg) Coffee, drip brewed 12 ounces 98-180 Energy drinks 8 ounces Varies. Several contain ~80 Cappuccino 12 ounces 113 Energy mints 1 piece 100 Espresso 1 ounce 75 Cola soft drinks 12 ounces 36-69 Tea, Black, brewed 8 ounces 38-58 Tea, green, brewed 8 ounces 23-35 Bottled iced tea 12 ounces 25-45 Sources: www.pepsiproductfacts.com/caffeine.php; www.starbucks.com; www.redbull.com.; www.vroomfoods.com; http://www.cspinet.org/ new/cafchart.htm. Accessed 9/12 and 10/12. MATERNAL NUTRITION 24
FOOD SAFETY ISSUES Fish and Seafood Seafood is an easy-to-prepare food that is rich in protein, vitamins, and minerals, and relatively low in total and saturated fat. Fish and shellfish also supply LCPUFA, most notably DHA, that play a role in the development of the fetal and infant brain and retina. Fish and shellfish, however, are also potential sources of methyl mercury and other neurotoxic contaminants. 35 Exposure to high levels of such contaminants during gestation increases the risk for suboptimal neurodevelopment of children. Levels of neurotoxic contaminants in fish vary widely among regions of the world. Therefore, it is important to check with national and regional authorities for information on the levels of contaminants found in fish consumed in that region and for recommendations on fish consumption. 35 According to the US Food and Drug Administration (FDA) and the US Dietary Guidelines for Americans 2010, women in their childbearing years should avoid swordfish, tilefish, king mackerel, and shark because of their high methyl mercury content. In addition, women should eat no more than 12 ounces (about 340 grams) of low-mercury fish and shellfish weekly, such as trout, salmon, pollock, catfish, canned light tuna, canned sardines, shrimp, crab, scallops, and herring, and limit albacore (“white”) tuna intake to 6 ounces weekly as part of the 12-ounce limit. 36,37 Women who eat fish caught for sport should first check the safety of the rivers, lakes, and streams where the fish has been caught with local or state health authorities. Even with all the caveats, it is likely that the benefits of consuming low-risk seafood outweigh the potential harm to a developing fetus and to maternal health. 132 Maternal intake of low-risk seafood during pregnancy helps to optimize neurodevelopment in children. 132-134 Foodborne Pathogens Pregnant women run a greater risk for foodborne illness from pathogens that can threaten maternal and fetal health. 38 For example, pregnant women are more likely to develop listeriosis if exposed to Listeria monocytogenes. 135 Infection with Toxoplasma gondii from eating undercooked, contaminated meat and/or from contact with contaminated cat feces can be transmitted to a fetus and can cause severe illness. 136 Table 12 summarizes common foodborne pathogens that may harm a pregnant woman or her fetus. Adequate hand washing and proper food handling can significantly reduce the risk of foodborne illness. 38 There is no evidence to suggest that organic foods, which are produced with no synthetic pesticides, synthetic fertilizers, antibiotics, growth hormones and other drugs, offer complete protection from foodborne pathogens. 25
Page 1 and 2: MATERNAL NUTRITION bY Elizabeth M.
Page 3 and 4: TAbLE OF CONTENTS EXECUTIVE SUMMARY
Page 5 and 6: EXECUTIVE SUMMARY A mother’s nutr
Page 7 and 8: INTRODUCTION A mother’s nutrition
Page 9 and 10: Preconception Care In 2005, the WHO
Page 11 and 12: Nutrient Needs during Pregnancy and
Page 13 and 14: During lactation, the U.S. Dietary
Page 15 and 16: The United States has not establish
Page 17 and 18: Folate and Folic Acid Folate is a g
Page 19 and 20: Vitamin D Vitamin D’s principal r
Page 21 and 22: Iron Iron is vital to the productio
Page 23 and 24: Table 10. WHO Recommended Nutrient
Page 25: Guidelines for Physical Activity du
Page 29 and 30: the recommendations, summarized bel
Page 31 and 32: Women are encouraged to enter pregn
Page 33 and 34: 53. Viswanathan M, Siega-Riz AM, Mo
Page 36: XXXXXX NEW 12/12 ©2012 Mead Johnso

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