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:

At what point should her infant be introduced to solid foods? Outline a timeline for the introduction of these foods with appropriate suggestions for each new food.

Answer 1

HEADING: Pregnancy and lactation

The infant should be exclusively breast feed till the age of 6 months following which introduction of semi solid to solid diet should be introduced gradually.In the above scenario the mother presents with high risk pregnancy which threatens the life of both the mother and fetus.

Speaking about the fetus following delivery as per the protocol of the institution the general assessement needs to be done to identify any risk involved thereby adhering to the specific treatment as needed,mentioning the above scenario the mother had presented with malnutrition and signs of pre-eclampsia at 30 weeks of gestational age therefore the possibilities of the fetus being preterm and prematurity is taken to consideration and for which the mothers milk which contains all the requirements of the baby as newborn and infant should be considered ,initiated and explained to the caregiver and the mother.

Regarding introduction of solid food the introduction can be done at beginning of 4-6 months by single grain cereals because the level of iron stored up while in utero drops after birth, the cereals are fortified with suplements it .The cereals is to be mixed with breast milk of formula feeds gradually introduction of smashed bananas or carrots, or pureed chicken can be done.The food should be soft and smashed which is easily digestable and tolerated. Avoid raw slice as it can lead to choking

Chopped, ground, or mashed foods Can be introduced by 9 months of age Incorporate more finger foods and make sure there's texture in any mash the infant can be feed on soft rice and casseroles .Small amount of protein can be introduced gradually in the form of eggs,cheese,lentils,tofu,yogurt and meat as baby tolerates.

POINTS TO KEEP IN MIND:

• The parent can also try giving need foods if the baby turns away from a particular feeds,foods like sweet potatoes can be introduced.
• Watch for constipation as solid foods can some times cause change in stool patterns,in such cases introduce a high-fibre fruits like pears,prunes and peaches to infants diet or a few ounces of pear,apple or prune juice daily until bowel movement are back to normal.
• Babies are born with preference for sweet hence sweet or savories can be introduced as well.
• Certain foods to be avoided in infants includes Honey as it causes botulism in infants ,cow mlik or soy milk should be introduced preferrably after their first birthday.