feres with adequate dietary intake. Glucose intolerance may occur, further complicating nutritional management.

Other. Cancer, cerebral palsy, and many other conditions may greatly complicate the nutritional care of pregnant women if they interfere with adequate food intake by mouth.

POSTPARTUM NUTRITION

Basic nutrition services for all women warrant increased attention during the postpartum period, but nutritional requirements and the kinds of nutrition services needed at this time differ, depending on whether or not the woman is breastfeeding. The main nutritional focus may be on efforts to replenish nutrient stores, achieve adequate nutrient intake during lactation, or assist with breastfeeding (see Chapter 4). Regardless of breastfeeding status, many women are concerned about returning to their prepregnancy weight and are likely to need guidance to do so in a way that promotes their health.

A study by Caan and colleagues109 indicates that interconceptional dietary intervention may improve the outcome of a subsequent pregnancy. Women with intervals of ≤27 months between pregnancies, who did not breastfeed but who received benefits from WIC during the first 5 to 7 months of the postpartum period, had heavier, longer infants in their second pregnancy than did women who received WIC benefits for 2 months or less post partum. This difference occurred even though both groups of women had received WIC benefits during pregnancy. On average, infants born to the women who were supplemented for 5 to 7 months postpartum weighed 131 g more, were 0.3 cm longer, and had a lower risk of being of low birth weight.

Replenishing Nutrient Stores

Stores of several nutrients (e.g., calcium, vitamin B6 , folate) may need to be replenished during the postpartum period. Women who do not consume an adequate diet despite counseling, or those who are in high-risk categories because of having carried more than one fetus or because of heavy smoking, alcohol abuse, or abuse of illegal drugs,10 may benefit from continuing to take the low-dose multivitamin-mineral supplement that was prescribed during pregnancy.



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