Question

haleen: Pregnancy & Lactation Case Study (10 pts.) Instructions: This case study assignment should be treated as a short paper, including a cover page, a heading, and page numbers. Set up the paper with one-inch margins, double-spacing, with the font set at 12-point Times New Roman. The introduction to the paper should summarize the case you have chosen to discuss. Responses to the case study questions should be written in paragraph form. Each paragraph in the case study should begin with an introductory statement that lets the reader know what topic you will be addressing in the paragraph. For example, if the case study question asks, “What nutrients are deficient in Shaleen’s diet, based on her current diet history?” You might start the discussion in this paragraph by indicating: “Shaleen has X nutritional deficiencies, based on her diet history. Her current diet consists of XXXXX. She is deficient in XXXXX.” The paragraph would continue with the explanation (or rationale) for your response: “According to Rolfe et al. (2012), a 16-year-old requires XXXXX. Because she is pregnant, she also XXXXX and so on. Scenario: Shaleen is a 16-year-old inner-city youth and high school student. She requests a pregnancy test at the Public Health Clinic. The pregnancy test is positive and she informs the clinic that her last menstrual period was 8 weeks ago. Previous History: Shaleen has had two previous pregnancies, one a stillbirth in which she gained 15 pounds and the baby weighed 4 pounds at term. The other ended due to a miscarriage at 9 weeks gestation and occurred 6 months ago. Her first pregnancy was at the age of 13. Social History: Lives at home with her mother and 5 siblings. Her mother provides the only income as a third shift waitress at a local 24-hour restaurant. The family receives $200 per month in food stamps. You speak with Shaleen at the Public Health Clinic after she receives the positive results of her pregnancy test. A brief diet and health history indicates the following information. She is a three-year smoker and is constantly concerned about her weight. Her diet consists mainly of diet cola, pizza, burgers, hot dogs, and convenience pasta dishes like Spaghetti-Os. She does get school lunch for free because of her family income level but rarely eats the fruits and vegetables or drinks the milk. Since Shaleen is the eldest sibling, she prepares meals for her younger siblings and sometimes does not have time herself to eat what has been prepared. Physical Exam: Ht = 5’6” Usual Wt = 108 lbs. Present Wt = 110 lbs. BMI = BP = 118/76 Blood glucose = 100 Shaleen’s pregnancy progresses without any problems until at 30 weeks her physician becomes concerned because her blood pressure has risen to 140/95, her blood glucose is 180, and she has gained 7 lbs. in two weeks. She is showing signs of generalized edema and she has protein and ketones in her urine. Her weight at this time is 118 lbs. Questions:

How would her caloric and nutrient needs change if she decided to breastfeed? What general dietary recommendations should be given to ensure that these nutrient changes are met?

If she decides to formula feed, how much should she offer and are there any cautionary points that she should be concerned about with this method of feeding? How does this food choice differ from breast milk?

Answer 1

Height: 5 feet, 6 inch

Weight: Usual 108 lbs

              Present 118 lbs

Age: 16 Years

Gender: Female

Calculation:

Shaleen's is just 16year old and is not actually not a proper age for child birth. She seems to be gaining weight which is also not a good sign as overweight can also leads to hypertension and that will be a big concern in case of child birth . For pregnant women, it is important that they gain just the right amount of weight during the pregnancy by eating a healthy diet to provide everything the developing baby needs to be healthy.

It is recommended that women gain 25 – 35 pounds during pregnancy. Her current weight gain indicates of developing pre-eclampsia. Due to indication of pre-eclampsia, with the remainder pregnancy she can gradually gain 5 lbs.

Protein intake should be 0.66 gm per kg body weight (118 lbs= 53 kg) and an additional 31.2 gm in third trimester. so toal protein intake of Shaleen should be 66.18 gms.

Based on the healthy BMI recommendation woman at the age of 16 years old recommended weight is 104.1 lbs - 153.0 lbs

Shaleen's present weight is 118 lbs

Shaleen need 1,610 Calories/day to maintain her weight

According to the CDC for a breastfeed women need additional 500 Calories/day

So the shaleen need 1610 + 500 = 2100 Calories/day

Shaleen is a smoker.It does place a risk for smoker which can affect the child during breastfeed.. Her diet mostly consists of junk food that will deprive her of essential vitamins and minerals which is of utmost importance for the shaleen calories need.

Shaleen's is deprived of essential vitamins and minerals and her maximum portion of food contains junk which will not give her any nutrition.Instead it will add to her weight.

Looking at the diet chart,its should be very clear that during breakfast and dinner, Shaleen should take mostly carbcarbohydrates,proteins and less fats. Because she is having some inadequate amount of proteins.

She definitely needs to take vitamin supplements provided she also needs to have ample amount of fruits and vegetables in her diet.

A day's sample diet is listed here for Shaleen:
Breakfast:
1 serving Pastry
6 oz. fruit punch
Lunch:
1 serving Hamburger on bun
1/2 cup canned peaches
12 oz diet cola
Snack:
1 serving ice cream cone
Dinner:
1 chicken drumstick
1 cup rice
1/2 cup refried beans
3 tortillas
12 oz fruit punch