“Examples of Nutritious Snacks and Fast Foods" or "Ways to Increase Your Calcium Intake If You Avoid Most Milk Products" in Tab 7.)

  • Jointly decide on strategies for increasing intake of nutrients from foods.

  • Consider vitamin/mineral supplementation for women at risk of inadequate nutrient intake. For guidelines see the "Indications for Nutrient Supplementation" chart in Tab 1.

Disorders Requiring Diet Therapy

For women with common nutrition-related conditions (e.g., obesity, low body weight, lactose intolerance, or diet-related discomforts of pregnancy), do one or more of the following:

  • Provide individual or group counseling.

  • Refer the woman to the 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 from a specialized team.

  • For hemoglobin levels below 11.0 g/dl in the first and third trimesters or below 10.5 g/dl in the second trimester (nonsmokers), start a therapeutic regimen of approximately 60 to 120 mg/day of ferrous iron. At a different time, give zinc and copper as part of a vitamin/mineral supplement. (See Tab 9.) Check hemoglobin level again in about 1 month.

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