Simply Good Eating For Moms & Kids

Baby and Me: The How-To’s for a Healthy Pregnancy

The goal of this lesson is to address issues important to the health and well-being of pregnant women.

Basics of Having a Healthy Pregnancy

• Weight gain during pregnancy is normal and healthy for mother and baby.
• With a little planning, a pregnant woman can meet the nutritional needs of herself and her baby.
• Pregnant women should ask their health care provider before taking any medications or dietary supplements.
• Drugs, alcohol, and tobacco can have serious negative effects on pregnant women and their babies.
• When considering whether to breastfeed or formula-feed, remember that breastfeeding offers important health advantages to babies.

Learning Objectives

After completing this lesson, participants will be able to:

1. Define “normal” pregnancy weight gain.
2. Plan a day of food choices appropriate to meet nutritional needs for pregnancy.
3. Identify at least one way to control pregnancy-related nausea, vomiting, and constipation.
4. Name at least one substance to be avoided and/or limited during pregnancy.
5. State at least one advantage of breastfeeding over formula-feeding.

Instructional Activities

The following activities can be used with either individuals or groups. Complete descriptions are included in the activities immediately following this chapter. Facilitators are encouraged to provide handouts for the activities you do not have time to complete.

1. Pregnancy—It’s a Weighting Game
2. Weighing In—The What and Where of Weight Gain during Pregnancy
3. Eating for Mom and Baby—Daily Food Choices for Pregnant Women
4. It Never Bothered Me Before—Common Nutritional Concerns during Pregnancy
5. Just Say No, Thank You
6. Baby-feeding Decisions

Conclusions

See individual activities for specific topics.

Check for Understanding and Behavior Change

See individual activities for specific topics.

References and Resources

Complete references and additional resources for each activity are listed at the back of this unit.

Background on Pregnancy

Begin the session by asking participants to list one thing about their eating habits that they have improved or would like to improve because they are pregnant. Tell participants: The foods you eat and drink during your pregnancy can affect the health of your baby. The mother is the developing baby’s only source of the nutrients he or she needs to grow. If the mother does not provide the nutrients that the baby needs through the foods she eats, both mother and baby are more likely to have problems during pregnancy or after delivery.

Activity 1

Pregnancy—It’s a Weighting Game

Purpose:	(1) To instruct participants on appropriate weight gain during pregnancy; (2) To teach participants about adjustments in what they eat to meet their calorie and nutrient needs for pregnancy.
Materials needed:	Handout: “Healthy Weights for Adults”; visual aids to represent examples of foods that would supply about 300 extra calories, such as magazine pictures, Dairy Council Food Models or NASCO Life/form® Food Replicas, empty containers, etc. (refer to the activity for possible examples to use); flipchart or writing board; pens/markers or chalk.
Estimated time:	30 minutes

Begin the Session

(1) Catch up from last lesson: briefly review the material covered in the previous lesson. Ask participants: What have you tried from last week’s session, or what have you done differently from the last time we met? Congratulate participants on their successes and encourage them to try new skills or behaviors. (2) Today’s lesson: briefly explain its purpose and some of the activities.

1. Ask participants: Since you became pregnant, has anyone told you, “Now that you’re pregnant, you have to start eating for two”? Does that mean that you need to double your food intake? How many extra calories per day do you think the average pregnant woman needs?ksdjlfkjasdl;kfjas;ldkj asl;kj asl;dkj as;ldkfj sadlkfj

Tell participants that women who have started their pregnancy at a healthy weight for their height need about 300 calories of extra energy per day during the pregnancy, which is about 15 percent higher than a woman’s usual calorie needs. This may need to be adjusted for women who are either underweight or overweight, or who are expecting twins or triplets. Even women who are overweight at the start of pregnancy should not restrict food intake or try to lose weight. Encourage participants to talk with their health care providers for specific information about how to best meet their calorie needs during pregnancy.

2. Ask participants: How much weight do you think 300 extra calories per day will cause you to gain? How much weight do you think you should gain with your pregnancy?
3. Tell participants the recommended weight gain levels below. Tell them that these ranges are general guidelines and that participants need to follow their doctors’ advice about appropriate weight gain:
   • 25 – 35 pounds for women who begin pregnancy at a healthy weight for their height
   • 28 – 40 pounds for women who are underweight
   • 15 – 25 pounds for women who are overweight
   • At least 15 pounds for women who are significantly overweight
   • 35 – 45 pounds for women carrying twins
4. Distribute the “Healthy Weights for Adults” handout (Table 1 below) and review, to help participants assess their pre-pregnancy weight and consider how much weight gain may be appropriate for them. Remind participants that this is only a general guideline and that they need to follow their doctors’ advice about how much weight gain is appropriate for them.
5. Tell participants that these ranges allow for differences in individuals. In general, young mothers (adolescents) and African-American women should gain at the upper end of the recommended range, because both groups are more likely to have small babies. Women who are short (for example, less than 5’2”) are often encouraged to try to gain at the lower end of their range

Table 1: Healthy Weights for Adults

Healthy Weights for Adults
	Midpoint	Range*
4'10"	105	91 - 119
4'11"	109	94 - 124
5'0"	112	97 - 128
5'1"	116	100 - 132
5'2"	120	104 - 136
5'3"	124	107 - 141
5'4"	128	110 - 145
5'5"	132	114 - 150
5'6"	136	118 - 155
5'7"	140	121 - 159
5'8"	144	125 - 164
5'9"	149	128 - 167
5'10"	153	132 - 174
5'11"	157	136 - 179
6'0"	162	140 - 184
Note: The higher weights in the ranges generally apply to men, and lower weights to women, because men tend to have more muscle and bone. * Without shoes or clothes Adapted from United States Department of Health and Human Services and Department of Agriculture. Dietary Guidelines Americans 2005. Online: http://www.healthierus.gov/dietaryguidelines/; and United States Department of Health and Human Services, National Institutes of Health, National Heart, Lung and Blood Institute. ‘‘Body Mass Index Table.’’ Online: http://www.nhlbi.nig.gov/guidelines/obesity/bmi_tbl.htm

6. Discuss with participants the appropriate weight gain for each of them. If you feel that this might be a sensitive topic, or if responses seem inappropriate, you could have each participant write down on paper what they think their target weight gain should be and discuss this with them individually.
7. Ask participants to name some nutritious foods that they could add to what they usually eat to equal 300 calories.

   Note: Use visual aids to represent the following examples of foods that would supply about 300 extra calories, if possible (magazine pictures, Dairy Council Food Models, NASCO Life/form® Food Replicas, empty containers, etc.):

   • One extra serving from each of the following MyPyramid groups: the Grain Group; the Vegetable Group; the Fruit Group; and the Milk, Yogurt, and Cheese (Milk) Group; and one extra ounce of meat/protein from the Meat, Poultry, Fish, Dry Beans, Eggs, and Nuts (Meat & Beans) Group.
   • One slice of whole grain bread, one serving of broccoli, one orange or apple, one cup of skim or 1% milk, and one extra ounce of chicken or 1/2 cup of beans.
   • Other examples include:
     • Three 8-ounce glasses of skim milk
     • Two 6-ounce containers of low-fat, flavored yogurt
     • A chicken leg and 1/2 cup of rice
     • One large tortilla and 1/2 cup of beans

Conclusions

Tell participants: To have a healthy baby, one does need to gain some weight. It is understandable that gaining the amount of weight needed for a healthy pregnancy is hard for some people. Women who have struggled to keep their weight under control especially might feel this way. But the weight that you gain during pregnancy does not have to be permanent and can be managed with careful attention to your eating and activity habits. The right time to begin thinking about losing weight is after the baby is born.

Check for Understanding and Behavior Change

Ask participants to state one idea that they learned and plan to use during the next week. Ask others if they also might plan to try that idea during the week. List the ideas on the flipchart or writing board.

Also ask participants:

1. From what you have learned today, how much weight do you think you might need to gain to have a healthy pregnancy?
2. How do you plan to adjust your eating habits or activity level to allow for weight gain that is healthy for you?

Thank each participant for coming. Ask for final questions and discussion. Provide some information or teaser about the next session, to encourage attendance.

References and Resources

(1) Dairy Council Food Models; (2) NASCO Life/form® Food Replicas; (3) Understanding Nutrition; (4) Dietary Guidelines for Americans 2005; (5) “Body Mass Index Table.”

Activity 2

Hand Washing Songs (suggested age group: preschool — third grade; or let facilitator decide)

Purpose:	To teach the children how to gauge appropriate length of hand washing by singing the songs.
Materials needed:	Handouts: “Hand Washing Rap” (optional), “Hand Washing Songs Facilitator Reference” (“Twinkle, Twinkle, Little Star” and “The Alphabet Song”); soap; towels; sink and water, if possible.
Estimated time:	10 minutes

Before the Session

Consider the ages of the children you will be teaching, and decide which song will be most appropriate for them. Very young children will likely know “Twinkle, Twinkle, Little Star,” while first- to second-graders will know “The Alphabet Song.” The “Hand Washing Rap” may be appropriate for older children.

Begin the Session

(1) If you have met with the children previously, remind them of what you talked about and ask what they remember. Ask: What have you tried since we last met? Congratulate the children on what they have accomplished, and encourage them to try the new skills or behaviors that you are teaching. (2) Today’s lesson: briefly explain its purpose and some of the activities.

1. Introduce the topic: Ask the children if they know what germs are, and that they can make us sick. Tell the children that washing our hands is the single most important way that we can help keep germs from spreading, and keep people from getting sick.

2. Tell the children: When washing our hands, we start with warm water, lather up with soap, and scrub our hands for 20 seconds. We need to be careful to clean between all of the fingers and beneath the fingernails.

   Note: Demonstrate the hand washing steps, if possible.

3. Tell the children: To make sure that we scrub our hands for 20 seconds, let’s practice while singing (name the song). The song takes about 20 seconds to sing—if you don’t rush through it!

   If you select the “Hand Washing Rap,” give the children the “Hand Washing Rap” handout. Ask the children if they have heard this song before. First, read the rap all the way through to the class. Then ask the children to repeat each line after you say it, and finally, say the rap in unison with the class.

   Twinkle, Twinkle, Little Star
   (Traditional, Author Unknown)

   Twinkle, twinkle, little star,
   How I wonder what you are.
   Up above the world so high,
   Like a diamond in the sky.
   Twinkle, twinkle, little star,
   How I wonder what you are!

   The Alphabet Song
   (Traditional, Author Unknown)

   A - B - C - D - E - F - G,
   H - I - J - K - L - M - N - O - P.
   Q - R - S and T - U - V,
   W - X and Y and Z,
   Now I know my A - B - C’s;
   Next time won’t you sing with me?

   Hand Washing Rap*

   You gotta’ wash your hands, and
   You gotta’ wash ‘em right,
   Don’t give in to germs
   Without a fight.

   Use water that’s warm
   And lots of soapy bubbles,
   These are your weapons for preventing germ troubles.

   Don’t cut your time short
   Your fingers—get between—
   It takes 20 seconds
   To make sure they’re clean.

   Gotta’ wash, gotta’ wash
   Gotta’ wash your hands,
   Gotta’ wash, gotta’ wash
   Gotta’ wash your hands.

   * “Hand Washing Rap” lyrics by Operation RISK team of Michigan State University Extension and the MSU College of Human Ecology. Used with permission.

Conclusions

Tell the children: When washing our hands, we start with warm water, lather up with soap, and scrub our hands for 20 seconds. We need to be sure to clean between all of the fingers and beneath the fingernails. Scrubbing for 20 seconds is important, but we often forget to scrub for the full 20 seconds. Singing the song we just practiced while scrubbing helps us to remember to scrub for the right length of time.

Check for Understanding and Behavior Change

Ask the children to state one idea that they learned and plan to use during the next week. Ask others if they also might plan to try that idea during the week.

Also ask the children:

1. How do you plan to wash your hands from now on?
2. What do you plan to change about how you wash your hands?

Thank the children for allowing you to share information with them. Ask for final questions and discussion. Provide some information or teaser about the next session.

References and Resources

Michigan State University Extension and the MSU College of Human Ecology Operation RISK team: “Hand Washing Rap” lyrics.