Help the woman develop a concrete plan for eating enough food to achieve or maintain a healthy weight. (See Tabs 7 and 8.)
Engage her in identifying acceptable food sources of needed nutrients.
Jointly decide on strategies for increasing nutrient intake from foods.
For women with common nutrition-related conditions (e.g., obesity, low body weight, or lactose intolerance), do one or more of the following:
Provide individual or group counseling.
Refer the woman to a dietitian.
If a woman has diabetes mellitus, phenylketonuria, renal disease, serious gastrointestinal disease, or other conditions requiring diet therapy, she should receive care from an experienced physician and dietitian. These providers should be consulted about appropriate follow-up care. (See "Referral to a Registered Dietitian," Tab 10.)
Women with eating disorders require comprehensive care by a specialized team.
If the hemoglobin is below 12.0 g/dl (nonsmokers), consider determining the serum ferritin. A low serum ferritin (<20 µg/liter)14 indicates that the anemia is due to iron deficiency.
For hemoglobin levels below 12.0 g/dl, start a therapeutic regimen of approximately 60 to 120 mg/day of ferrous iron, and give a multivitamin/mineral supplement that contains ~15 mg of zinc and ~2 mg of copper. See Tab 9.