Sarah is 28 years old and 7 months pregnant with her third child.
Sarah’s Case Study Discussion
Sarah does not have any risk factors for high-risk pregnancy. She is of appropriate age and in her reproductive years. Furthermore, her 2 previous pregnancies were uneventful. The case study also did not mention any history of smoking, alcohol intake, or any underlying comorbidities that could predispose her to a high-risk pregnancy. According to her normal pre-pregnancy BMI of 23, Sarah is expected to gain a total of 25 to 35 lb following the recommendations of The National Institute of Medicine (Davidson et al., 2021).
Based on the 2400-calorie meal pattern, Sarah being pregnant is expected to take more iron, protein, calcium, magnesium, and folic acid-rich foods (Davidson et al., 2021). The National Institute of Health recommends a minimum of 2450 calories/day, 71g of proteins/day, 54g of fats/ day, and 175g of carbohydrates per day for pregnant women in the 3rd trimester (Haas et al., 2017). Sarah is therefore eating a lot of calories and fats than the recommended amounts. To reduce her heartburn, Sarah needs to avoid spicy foods such as chips and salsa, tuna fish sandwiches with mayonnaise, macaroni with cheese, and orange juice.
I would inform her that weight gain during pregnancy is a normal physiological phenomenon keeping in mind that the weight of the placenta, growing fetus, and amniotic fluid contribute to the weight gain (Mousa et al., 2019). I would further advise her to adhere to a healthy diet and physical activity to regain and maintain her healthy weight. She has an appropriate attitude concerning supplements.
However, I will inform her that iron supplements are elemental to prevent anemia while folic acid supplementation is essential to prevent fetal neural tube defects (Mousa et al., 2019). Sarah can take cheerios, whole milk, and peanut butter- strawberry -kale smoothie for breakfast. Her lunch can be a combination of a medium banana, smashed white beans, cheese, and a whole-wheat English muffin. Her snack can be ice cream, baby carrots, or low-fat yogurt. Finally, her dinner can be summer vegetable chicken tortilla and spinach or green beans and roll and butter.
Davidson, K. W., Barry, M. J., Mangione, C. M., Cabana, M., Caughey, A. B., Davis, E. M., Donahue, K. E., Doubeni, C. A., Krist, A. H., Kubik, M., Li, L., Ogedegbe, G., Pbert, L., Silverstein, M., Simon, M., Stevermer, J., Tseng, C.-W., & Wong, J. B. (2021). Behavioral counseling interventions for healthy weight and weight gain in pregnancy: US preventive services task force recommendation statement: US preventive services task force recommendation statement. JAMA: The Journal of the American Medical Association, 325(20), 2087–2093. https://doi.org/10.1001/jama.2021.6949
Haas, S., R., D. N., & L., D. N. (2017, June 13). 1-day healthy-pregnancy meal plan: 2,200 calories. Eatingwell.Com; EatingWell. https://www.eatingwell.com/article/290318/1-day-healthy-pregnancy-meal-plan-2200-calories/
Mousa, A., Naqash, A., & Lim, S. (2019). Macronutrient and micronutrient intake during pregnancy: An overview of recent evidence. Nutrients, 11(2), 443. https://doi.org/10.3390/nu11020443
Sarah is 28 years old and 7 months pregnant with her third child. Her other children are aged 2½ years and 1 ½ years. She had uncomplicated pregnancies and deliveries. Sarah is 5 ft 6 in tall; she weighed 142 pounds at the beginning of this pregnancy, which made her prepregnancy BMI 23. She has gained 24 pounds so far. Prior to her first pregnancy, her BMI was 20 (124 pounds).
She is unhappy about her weight gain, but the stress of having two young children and being a stay-at-home mom made losing weight impossible. She went online for her MyPlate plan, which recommends she consume 2400 cal/day. She doesn\’t think she eats that much because she seems to have constant heartburn. She takes a prenatal supplement, so she feels pretty confident that even if her intake is not perfect, she is getting all the nutrients she needs through her supplement. A typical day\’s intake for her is shown below:
Breakfast: Cornflakes with whole milk (because the children drink whole milk), Orange juice Snack: Bran muffin and whole milk
Lunch: Either a peanut butter and jelly sandwich or tuna fish sandwich with mayonnaise, Snack crackers, Whole milk, Pudding or cookies
Snack: Ice cream
Dinner: Macaroni and cheese, Green beans, Roll and butter, Whole milk, Cake or ice cream for dessert Evening: Chips and salsa
1. Does she have any risk factors for a high-risk pregnancy?
2. Evaluate her prepregnancy weight and weight gain thus far. How much total weight should she gain?
3. Based on the 2400-calorie meal pattern in Figure 11.1, what does Sarah need to eat more of? What is she eating in more than the recommended amounts? How would you suggest she modify her intake to minimize heartburn?
4. What would you tell her about weight gain during pregnancy? What strategies would you suggest to her after her baby is born that would help her regain her healthy weight?
5. Is her attitude about supplements appropriate? What would you tell her about supplements? Devise a 1-day menu for her that would provide all the food she needs in the recommended amounts and alleviate her heartburn.