Postpartum participation in WIC may reduce the risk of low birth weight in subsequent pregnancies.17
Home health visits with a nutrition component may contribute to earlier discharge of very-low-birth-weight infants.18
In some situations, the reduction in the number of low-birth-weight infants requiring expensive care in the hospital may offset the costs of prenatal nutrition counseling.19
Other studies20–23 suggest that comprehensive careb improves pregnancy outcomes such as birth weight, especially for high-risk women23 and for primiparous women,22 and that it reduces complications for women with preexisting diabetes mellitus and their infants.24 It is not clear, however, to what extent the nutrition services that were part of such care contributed to the improved outcomes.
The Food and Nutrition Board's Committee on Nutritional Status During Pregnancy and Lactation considered it important to revise the board's 1981 report Nutrition Services in Perinatal Care25 to be consistent with current recommendations for nutritional care. It also sought to provide expanded coverage of the preconceptional period and of breast-feeding, and to make the report adaptable to different systems of care delivery. For this revision, three documents from the National Academy of Sciences and the Institute of Medicine (IOM) provide much of the scientific foundation for its content: the 1989 revision of Recommended Dietary Allowances,26Nutrition During Pregnancy,5 and Nutrition During Lactation.6
The expanded coverage of preconceptional nutrition in this second edition of Nutrition Services in Perinatal Care is consistent with one of the main messages in Caring for Our Future. The Content of Prenatal Cares8 and with the increased attention to this period now being given by the American College of Obstetricians and Gynecologists and other professional organizations. Similarly, the increased emphasis on breastfeeding is