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Nutrition During Pregnancy and Lactation: An Implementation Guide (1992)
Institute of Medicine (IOM)

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. "Follow-Up Visits." Nutrition During Pregnancy and Lactation: An Implementation Guide. Washington, DC: The National Academies Press, 1992.

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Diet and the Avoidance of Harmful Substances
  • At every visit, encourage a healthful diet, reinforce healthy dietary practices and the positive changes that have been made, encourage avoidance of potentially harmful substances, and address the woman's questions and concerns.

  • As needed, try to involve the person responsible for food shopping and meal preparation when discussing strategies for improved dietary intake.

Promotion of Breastfeeding

Early in pregnancy, if there are no medical contraindications to breastfeeding:

  • Provide information on the advantages and challenges of breastfeeding and bottle feeding.

  • X (name of person) would like to speak with you about her experience with breastfeeding. You can reach her by . . .

  • Support infant feeding decisions and encourage undecided women to breastfeed.

  • As appropriate, provide anticipatory guidance on how to obtain assistance for successful lactation and realistic information about feeding frequency.

In the third trimester, resume the discussion of infant feeding. Include the partner in the discussion if possible.

  • If breastfeeding is planned, build on previous experiences, address fears, explore possibilities for family support, and ask about work plans. If the woman's nipples are flat or inverted, consider breast shells and assist with their proper use. Provide education and encouragement.

  • If bottle feeding is planned, address questions and concerns. Provide anticipatory guidance and support the mother.

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