Basic nutritional care activities in support of pregnancy, lactation, and women's health are listed below. They are covered in more detail in Nutrition During Pregnancy and Lactation: An Implementation Guide. ⁶ Physicians, physicians' assistants, midwives, nurses, nurse-practitioners, dietitians, and other primary care providers should all participate in integrating these activities into routine care.

Assessment

• Weigh at each visit; measure height and estimate nonpregnant body mass index at the first visit.

• Monitor and interpret data such as hemoglobin level, blood pressure, and weight change.

• Collect data on attitudes, current dietary practices, cooking facilities, housing, and other factors pertinent to nutritional status.

• Consider the above information to identify women at risk of nutritional problems, that is, those who require more thorough assessment or intervention, or both.

Health Maintenance

• Provide information, education, or counseling concerning the following:

– diet and fluid intake, weight, managing gastrointestinal discomforts and other common nutrition-related problems, the safe and appropriate use of vitamin-mineral supplements, and avoiding or stopping the use of harmful substances;^a

– adjusting dietary intake for relatively common situations such as prescribed bedrest or twin pregnancies;

– breastfeeding, considering the mother and infant as a unit.

• Recommend a low-dose (30 mg) iron supplement to all pregnant women beginning in the second trimester of pregnancy.¹¹