When looking over the woman's responses to the nutrition questionnaire, look at the items below for reasons for concern, sources of additional information, and suggested follow-up questions or actions. The numbers below match the question numbers.
Introduce the follow-up questions by telling the woman that: It would help us with planning your care if you would answer some additional questions.
1. Regardless of the responses on the questionnaire, ask: How has your appetite been recently?
At the initial prenatal visit, ask:
• Is_______ [symptom] keeping you from eating or from drinking liquids?
• What have you done to try to decrease _____ [these symptoms]? Has this helped?
Strategies for managing nausea and vomiting are on page 47; those for heartburn and constipation are on page 63.
2. Skipping meals one or more times daily, three or more times per week, may lead to inadequate nutrient intake or to the eating of large meals, which may cause discomfort.
3. If yes, ask, Do you sometimes feel that you can't stop eating? Women who consistently restrict their food intake to control weight may have difficulty changing to more appropriate eating habits to support a healthy pregnancy or may find they gain large amounts of weight when their eating becomes less restricted. Further assessment may be desirable.
4. If on a special diet, ask, What kind? Who told you to follow this diet? Women who require special diets benefit from referral to a dietitian. Self-imposed diets require further assessment.