A

Adolescents

educational materials suitable for, 121

goal-setting abilities, 93

nutritional care, 41, 93, 121

peer counseling, 96

professional approach to, 93

weight gain during pregnancy, 41, 44, 46

Alcohol consumption/alcohol abuse

breastfeeding and, 75

interventions, 56

and nutrient supplementation, 17

and nutrition, 24, 26

prenatal use, 42, 45

prepregnancy use, 29

sample questions about use, 8, 10, 11

Anemia

additional testing, indications for, 30, 110

blood sampling, 109

causes, 31

hemoglobin/hematocrit cutoff values, 16, 26, 30, 43, 49, 109-110

history, 22, 38

identifying, 16, 109-110

iron therapy, 17, 30, 31, 40, 43, 49, 62, 110-111

postpartum, 77

preconception/interconception, 24, 30-31

prenatal, 38, 40, 43, 49, 59, 62

serum ferritin, 30, 110

Appearance

preconception/interconception examination, 23, 25

prenatal examination, 39, 42

Appetite

breastfeeding and, 75

sample questions, 9

stimulant drugs and, 67

Approach of Guidebook, 4-5

B

Battering, 25, 42

Bed rest, 66

eating well during, 67

Birth control, 72, 73, 85

Body mass index

chart for estimating, 14

instructions for estimating, 12

prepregnancy, 12-13, 23

weight classification and, 13

see also Weight gain during pregnancy

Bottle feeding, 47, 60, 81

Breast

examination, 39, 42

inverted or flat nipples, 42, 48, 60, 72, 78

sore nipples, 75, 76, 82, 85

surgery/anatomical variants, and

breastfeeding, 78

Breastfeeding

adequacy of milk supply, 71, 75, 76, 84

and allergic reactions, 87

and birth control, 72, 73, 85

breast surgery/anatomical variants and, 78

cesarean delivery and, 78

and colic, 87

and diet, 75, 85-86

discharge advice, 76

drug use and, 72, 79

duration of, 76

and energy intake, 75, 85

and engorgement, 73, 84, 85

exclusive, 76, 81

frequency, 74-75, 76, 81, 82, 85

history, 22, 38, 39, 83-84

infant growth and, 81, 82, 86

initiation of, 74-75

inverted or flat nipples and, 42, 48, 60, 72, 78

low birth weight baby/neonatal

complications and, 72, 78

and manual expression of milk, 76

mastitis, 76

nutritional care in hospital and, 72

pediatric visit, questions, 80-82

peer counseling, 96

positioning during, 81

postpartum, 4 to 6 weeks, 83-85

problem-solving, 78-79, 81-82

projects to assist health professionals, 123

promotion of, 60-61

pumps/pumping milk, 76, 78, 82

recommendations, 42, 71

resources, 122-123

rooming-in arrangements, 75

smoking and, 79, 84

sore nipples, 75, 76, 82, 85

supplemental feedings and water, 75, 76, 81-82

support for, 48, 71, 78, 85

vitamin/mineral supplements, 76

see also Lactation

C

Caffeinated beverages, 10, 45, 73, 75

Calcium intake

food sources, 10, 102

interference with iron absorption, 112

lactose intolerance and, 101

milk products avoidance and, 102

supplements, 10, 11, 101, 102, 112

Cesarean delivery, and breastfeeding, 78

Cigarettes, see Smoking

Cocaine, 79;

see also Drugs

Colic, 87

Comfort, prenatal, 47

Commodity Supplemental Food

Program, eligibility and benefits, 114

Constipation

bed rest and, 67

iron supplements and, 62, 111

management, 9, 47, 57, 63

Contents of Guidebook, 3

Cooperative Extension—Expanded Food and Nutrition Education Program, eligibility and benefits, 115

Copper supplements, 30, 49, 62, 77, 111, 112

Cultural/ethnic considerations

childrearing practices, 94

in dietary guidance, 27, 95-96

in educational materials, 121-122

elements of effective programs, 95

family members and roles, 94

interaction/communication styles, 94-95

in nutrition questionnaire, 6

in nutritional care, 94-96

peer counseling, 96

religious beliefs and practices, 94

in weight gain, 46

D

Dehydration, 41, 61

Dental disease, 25, 42

Depression, 25, 42

Diabetes mellitus

educational materials for, 121-122

gestational, 63, 65, 88, 121-122

glucose tolerance and, 88

insulin therapy, 63

need for diet therapy, 30, 49

testing for, 63

Diarrhea, 57, 62, 111

Dietary guidance

avoidance of specific foods and, 10-11

for breastfeeding, 75, 85-86

calcium intake, 101, 102

foods and servings, 27, 45

goal setting, 44

identifying the need for, 9-11

lactose intolerance, 101

low-calorie/high-nutrient foods, 103

positive reinforcement, 44, 60

postpartum, 74

prenatal, 43-45, 60

prepregnancy/preconceptional, 27-28

snacks and fast food, 45, 100

Dietary Guidelines, 27, 28, 74, 82

Dietary intake assessment

checklist, 7-11, 98

computer software, 100

diet or food recall, 97

diet or food records, 98

dietitian's role in, 99-100

food frequency questionnaire, 97-98

objectives, 99

resources for, 99

selecting an approach, 98-100

standard of comparison, 99

uses of information gathered, 99

Dietary practices

basic guidance, 27-28, 43-45, 60, 74, 75, 85-86

breastfeeding and, 75

discomforts and, 39, 41

postpartum, 83, 84

preconception/interconception, 25, 27-28

prenatal, 43-45

Dietitians

defined, 5

dietary assessment role, 99-100

referral and consultation, 5, 9, 25, 41, 49, 63, 113, 116

Disabilities, weight-for-height measurement in women with, 105-106

Discomforts

and dietary practices, 39, 41

from iron supplements, 111

Disorders requiring diet therapy, 30, 49

Drugs

breastfeeding and use of, 73, 79, 85

illegal, 8, 11, 24, 26, 29, 79

information sources, 122

and nutrition, 24, 26

over-the-counter, 8, 47, 61

prepregnancy use, 29

prescription, 8, 47, 79

use during pregnancy, 47

E

Eating behavior

avoidance of specific foods, 10, 87

change in, 91-92

guidance on, 27, 43-44

meal size, 45

overeating, 9, 65

questions, 7, 9-10, 22, 44, 55, 80, 83-84

skipping meals, 9, 25

special diets, 9, 41

see also Nutrition education

Eating disorders, 22, 24

nutritional care, 30, 49

signs of, 25, 41, 42, 86

Edema, 56, 59

Education, see Nutrition education

Energy intake, 17, 58, 66, 85, 87

Environmental contaminants, 75

Exercise/physical activity, 8, 11

and constipation, 63

contraindications, 108

postpartum, 74, 85

prenatal, 55, 65,108

prepregnancy, 27, 28

and weight gain, 65, 107, 108

F

Federal food and nutrition programs and benefits, 29, 48, 114-115

Fetal growth, 26, 59

Fiber, dietary, 11, 27

Fluids

and bed rest, 67

and constipation, 63

during lactation, 73

low intake during pregnancy, 61

Folate

food sources, 10, 11

and neural tube defects, 24, 31, 40, 50

supplements, 24, 31, 40, 50, 112

Food and drink

bed rest and, 67

concerns of low-income women, 104

cultural/ethnic considerations, 95-96

high in calories, 103

high in vitamins and minerals, 103, 107, 108

high intakes, 65

low-calorie versions of common foods, 103

low in vitamins and minerals, 103

low intakes, 30, 41, 48-49, 55, 58, 61, 107-108

nutrition questionnaire, 7-8, 10-11

to promote weight gain, 107

Food Distribution Program for Indian Reservations, eligibility and benefits, 115

Food resources

access to, 29, 48, 77, 107, 108

federal assistance programs, 10, 107, 108, 114-115

nutrition questionnaire, 7, 10

postpartum, 77

Food Stamp Program

eligibility and benefits, 114

referral to, 77

Fundal height, 56, 59, 65

G

Gastrointestinal disease, 30, 49

Glucose

intolerance, 59, 88

screen, 23, 40, 57, 59, 63

H

Harmful substance use

basic guidance, 29, 31, 50, 60

history, 39, 55-56

postpartum, 88

preconception/interconception, 23, 25, 26, 29

prenatal, 39, 42, 50, 55-56, 60

treatment programs, 31, 50

see also Alcohol consumption/alcohol abuse; Drugs; Smoking

Health Services Resources, 117-118

Heartburn, management, 9, 47, 57, 63

Height

measurement procedure, 106

see also Weight-for-height status

Hemoglobin/hematocrit

altitude adjustments, 23, 109-110

cutoff values for anemia, 16, 26, 30, 43, 49, 57, 109

postpartum, 77

prenatal, 40, 43, 57, 109

prepregnancy/preconceptional, 23, 109

smoking and, 16, 23, 40, 49, 109, 110

History

behavioral changes, 54, 55-56, 58

breastfeeding, 72, 83-85

dietary practices, 23, 25, 39, 41, 55, 57, 83, 84

discomforts, 39, 41, 54, 57

explanations, 40-42, 57-59

harmful substances, 23, 25, 26, 39, 42

infant feeding, 39, 42

neural tube defect in prior pregnancy, 31, 50

nutrient supplements, 55, 58

for postpartum nutritional care, 72, 83-84

preconception/interconception visit, 22-23

prenatal visit (first), 33, 35, 38-39, 40-42

prenatal visits (follow-up), 54-56, 57-58

sociodemographic, obstetric,

medical, and life-style factors, 22, 24, 38, 40

weight status, 22, 24, 38, 41, 83, 84

Hospital

discharge advice, 74, 76

postpartum nutritional care, 72-79

rooming-in arrangements, 75

I

Infant feeding, 39, 42, 48, 81;

see also Bottle feeding;

Breastfeeding

Instructions for Guidebook use, 4

Iron, enhancing absorption of, 45, 111

Iron supplements

effective forms of, 111

history, 55

interference with absorption, 112

in multivitamin/mineral preparation, 111, 112

postpartum, 77

routine, initiation, 16, 47, 110

side effects, 62, 111

therapeutic dose for anemia, 17, 30, 31, 40, 43, 49, 62, 77, 110-111

K

Ketosis, 11, 61

L

Laboratory tests

and nutrient supplements, 16-17

preconception/interconception, 23, 26-27

prenatal, 40, 43

see also Hemoglobin/hematocrit

Lactation

diet during, 73

indications for nutrient supplements, 17

restrictive food practices during, 87

weight loss during, 73

weight-related problems during, 86

see also Breastfeeding

Lactose intolerance

and calcium intake, 101

diet therapy for, 30

symptoms, 57

Leg cramps, 57

Life-style, nutrition questionnaire, 8, 11-12

Lipid screen, 23, 26

Low-birth-weight babies

breastfeeding, 72, 78

maternal weight-for-height and, 26

smoking and, 42

weight gain during pregnancy and, 46

Low-income women

nutrition-related concerns of, 104

referral to WIC, 116

M

Magnesium, 112

Maternal and Child Health Program, 117

Medications, see Drugs

Milk products

avoidance of, 17, 102

discomforts caused by, 54

during lactation, 73

lactose intolerance, 101

servings, 27, 28, 45, 73, 99

vitamins and minerals in, 10

Multiple gestation, 17

and exercise, 108

weight gain for, 46, 59, 65

see also Twins/triplets

N

National Center for Education in Maternal and Child Health, 118

National Maternal and Child Health Clearinghouse, 120

Nausea and vomiting

effects, 41, 58, 61

history, 54

from iron supplements, 62, 111

management, 9, 47, 57, 61

Neonatal complications, and breastfeeding, 72, 78

Neural tube defects in prior pregnancy

folate supplements and, 24, 31, 40, 50

Nutrients

bed rest and intakes of, 66

low intakes, 30, 48-49, 61

lower-calorie sources of, 103

see also individual vitamins, minerals, and food groups

Nutrition Assistance Program for Puerto Rico, eligibility and benefits , 115

Nutrition education approach, 43-44

essential steps, 91-92

literacy/reading level considerations in, 119, 121

peer counseling, 96

prenatal, 43-44

promotion of effective use of, 119

selecting and using educational materials, 118-119

Nutrition questionnaire

adaptations of, 6, 21

eating behavior, 7, 9-10, 23

face-to-face interview, 6

food and drink, 7-8, 10-11

food resources, 7, 10

instrument, 7-8

interpretation of, 6, 9-11

life-style, 8, 11-12, 23

at prenatal visit, 37

purpose, 6

Nutritional care

cultural/ethnic differences and, 94-96

developmental differences and, 93

diabetes mellitus (gestational), 121-122

information sources, 120-123

peer counseling, 96

perinatal, 120

postpartum, in-hospital, 72-79

prenatal, 121

problem solving, 77-79, 91-92

O

Obesity

and complications of pregnancy, 26

and conception, 24

diet counseling for, 30

and weight gain during pregnancy56, 58

Overeating, 9

P

Patient education, see Nutrition education

Pediatric visit

basic guidance, 82

breastfeeding experience, 80-82

explanations, 81-82

first, 74, 80-82

future plans for nutrition, 81

history, 80

information gathering, 80-81

physical examination, 80, 81

problem solving, 82

Peer counselors, 96

Perinatal mortality, 59

Phenylketonuria, 30, 49

Physical examination

breast examination, 39, 42

explanation, 42-43, 58-59

general appearance, 23, 25, 39, 42

laboratory evaluation, 23, 26, 40, 43, 57, 59

pediatric (first visit), 80, 81

postpartum 4 to 6 weeks, 84, 85

preconception/interconception, 22-23

prenatal visit first), 33, 35, 38-39, 42-43

prenatal visits follow-up), 56-57, 58-59

weight-for-height status, 23, 26, 39, 43

weight changes, 56, 58-59

Pica, 55, 57, 66

Positive reinforcement, opportunities for, 27, 58, 59, 60, 92, 116

Postpartum visits

4 to 6 weeks, 83-88

checklist, 69-70

nutritional care in hospital, 72-79

pediatric visit (early), 80-82

Preconception/interconception visit

basic guidance, 27-29

checklist, 19-20

dietary guidance, 27-29

goals, 21

history, 22-23

indications for nutrient supplements, 17

information gathering, 19, 22-25

physical examination, 23, 25-26

problem solving, 29-31

Pregnancy

history, 22

indications for nutrient supplements, 17

weight gain assessment, 13

see also Prenatal visits;

Weight gain during pregnancy

Prematurity, 59

Prenatal visits

basic guidance, 43-48, 51, 59-61

checklists, 33-36, 51-52

explanations, 40-43, 57-59

first, 9, 33-50

follow-up, 51-67

history, 38-39, 40-42, 54-56, 57-58

information gathering, 9, 33, 35, 38-40

physical examination, 39-40, 42-43, 51, 56-57, 58-59

positive reinforcement, 43, 50

problem solving, 48-50, 52, 61-67

weight gain, 15

Purpose of Guidebook, 3

Q

Questionnaire, see Nutrition questionnaire

R

Record keeping, 5-6

Renal disease, 30, 48

S

Salt and salty foods, 28, 45

Serum ferritin, 30, 110

Smoking, 8, 11

and anemia, 16, 17, 40, 109, 110

breastfeeding and, 79

cessation programs, 122

and low birth weight, 42

and nutrition, 24, 26, 88

before pregnancy, 29

during pregnancy, 55-56

and weight, 65, 84, 88

Snacks and fast food, 44, 45, 67, 100

Soft drinks, 28

Special Supplemental Food Program for Women, Infants, and Children, see WIC

State and local public health departments, 117

Sugar substitutes, 75

Supplements, see Vitamin/mineral supplements

Sweets and sugars, 28

Temporary Emergency Food Assistance Program, eligibility and benefits , 115

Terminology, 5

Twins/triplets

support for mothers of, 77

see also Multiple gestation

U

Underweight, 30

Users of the Guidebook, 3-4

V

Vegetarians, 17

Vitamin A

food sources, 73

postpartum, 85

supplements, 24, 40, 112

Vitamin C

food sources, 10, 11, 45

smoking and, 26

supplements, 112

Vitamin D

food sources, 10, 101

supplements, 112

Vitamin/mineral supplements

calcium, 10, 17

cautions about, 17, 24, 40

content of, 112

folate, 24, 40

guidance on use, 58

history, 22, 38

indications for, 10, 17, 49

iron deficiency anemia and, 30, 49, 62, 111-112

laboratory tests and, 16-17

during lactation, 76

postnatal, 87

prenatal, 47, 49, 61, 112

vitamin A, 24

see also Iron supplements

W

Weight

classification, by body mass index, 13

control, promotion of, 27, 108

Weight-for-height status

and birth weight, 26

postpartum, 83, 84, 86, 87

preconception/interconception examination, 23, 26

prenatal examination, 39

problem solving, 87, 107-108

Weight gain during pregnancy

allocation among tissues, 46

basic guidance, 46, 59

and birth weight, 46

body mass index and, 12-15, 43, 44

charts for assessing, 12-15, 46

determinants of, 41, 65

explanations, 43, 46

first trimester, 58

goal setting, 46, 59

high, factors calling for, 46, 59

inappropriate, 61

plotting, 13, 46

promotion of, 106-107

rate of, 46, 108

recommended ranges, 44

second trimester, 58-59

smoking and, 65

slow/low, 56, 59, 61, 64, 107-108

very rapid, 56, 65

Weight loss

causes, 58, 64

and conception, 24

dieting, 9, 84, 88

postpartum, 84, 85, 86, 87

prenatal, 64

Weight measurement

infant, 80

procedures, 23, 105-106

quality control, 106

Weight status, 43

changes requiring further evaluation, 56

history, 38

perceptions of and attitudes about, 24, 26, 41, 50, 58, 86

physical examination, 39, 56

postpartum, 86

prepregnancy, 29

questions about, 22

WIC

eligibility and benefits, 104, 114

questions on use of, 56, 107

referral to, 37, 48, 77, 104, 116

Z

Zinc

supplements, 30, 49, 62, 77, 111, 112