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Discussion Topic

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.