Index

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



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Index 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

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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

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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

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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

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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

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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

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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