Nondietary factors may influence a woman's nutrient requirements, affect her ability to achieve adequate nutrition, signal previous problems with nutrition during pregnancy or lactation, or indicate the need for special approaches to care.
Excessive use of vitamin and mineral supplements is to be avoided. Vitamin A at high levels is a documented teratogen, and women considering pregnancy should be encouraged to discontinue vitamin A supplements, especially at dosages exceeding 800 RE (~4,000 IU) daily. Supplemental folate taken periconceptionally appears to help prevent neural tube defects in women who have previously had an affected pregnancy.12 Preventing or resolving anemia is encouraged as part of general health promotion. A currently breastfeeding woman who is considering becoming pregnant has increased nutritional requirements. A woman who is planning a pregnancy can be given specific health and nutrition guidelines.
A woman's perceptions of her weight status may influence her nutrition now as well as during pregnancy Rapid, substantial weight loss may decrease a woman's ability to conceive, as may obesity Preoccupation with weight, widely fluctuating weight, or excessive exercise or dieting signals the need to assess the woman for a potential eating disorder.