Nutrition Services in Perinatal Care Second Edition (1992) / Chapter Skim
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3 Basic and Special Nutrition Services for Women in the Preconceptional, Prenatal, and Postpartum Periods
3 Basic and Special Nutrition Services for Women in the Preconceptional, Prenatal, and Postpartum Periods
Pages 41-56
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From page 41... ...
Some WIC nutritionists or other "competent professional authorities do not have the advanced training or experience needed to provide special nlltnt~on services a"Competent professional authonn~r," according to federal regulations, is the term applied to "an individual on the staff of the local agency authorized to determine nutritional risk and prescribe supplemental food.n1 41
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From page 42... ...
DELIVERY OF BASIC NUTRITION SERVICES Physicians, midwives, nurse practitioners, and other primary care providers can and should integrate basic nutritional care into the care of all expectant and new mothers. Preconceptional care may be provided as part of a woman's routine health care, in family planning clinics, and during visits specifically to address planning for pregnancy.
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From page 43... ...
, or other venues. -- a -- -- I- ~~ -a The effectiveness of nutritional care may be substantially increased by an expanded health care team that provides outreach activities, home visits, and streamlined services, or that uses other strategies to increase the utilization of prenatal care by disadvantaged women.8 Such activities involve visiting nurses, social workers, dietitians, case managers, trained communist health workers, peer counselors, and others.9 The support of breastfeeding needs special attention.
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From page 44... ...
Assessment Weigh at each visit; measure height and estimate nonpregnant body mass index at the first Sit. Monitor and interpret data such as hemoglobin level, blood pressure, and weight change.
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From page 45... ...
Provide nutritional counseling for women with commonly occurring conditions such as lactose intolerance, gestational diabetes mellitus controlled by diet and exercise, iron-deficiency anemia, mild gastrointestinal disorders, obesity, low weight for height, and inadequate prenatal weight gain; or, if possible, refer the woman to a dietitian for this service. Recommend nutrient supplements if indicated by the assessment.
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From page 48... ...
· Classic women by nonpregnant body mass index. · Provide basic assessment of dietary practices.
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From page 49... ...
· Educate or counsel women concerning the appropriate use of supplements. Intervention 51~11s · Following established guidelines or protocols, provide basic individualized diet counseling for improving nutrient intake, managing common dietary problems, and addressing inadequate or excessive weight gain.
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From page 50... ...
that lead to inadequate intake or malabsorption; · genetic disorders that affect nutrition, such as cystic fibrosis and inborn errors of metabolism; and · serious eating disorders. Conditions that sometimes entail complicated management include gestational diabetes mellitus treated with diet and exercise, high risk of preterm birth, suspected fetal growth restriction, substance abuse, multifetal gestations, and hypertension.
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From page 51... ...
For special circumstances, the team will need to be expanded. For example, a physical or occupational therapist may provide necessary services to pregnant or lactating women with certain disabilities, a pharmacist is a valuable addition to a team caring for a pregnant woman who requires parenteral nutrition, and an experienced social worker or public health nurse may help the seriously stressed pregnant woman to marshal!
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From page 52... ...
, plan diet modifications as needed. Develop and implement nutritional care plans in collaboration with others on the health care team.
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From page 53... ...
Knowledge Base and Clinical Skills The team that provides nutrition services for women with special nutritional needs must have the knowledge and skills listed earlier for providers of basic nutrition services, as well as the knowledge and skills listed below. Knowledge and Understanding · Physiologic and metabolic changes associated with pregnancy and lactation and the diagnostic implications of these changes for high-risk conditions.
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From page 54... ...
Intervention Skills · Set goals for achievable outcomes, and develop an individualized nutritional care plan to reach those goals, including diet or special feedings, specific behavioral objectives, other interventions, referrals, and monitoring methods and other forms of follow-up. · Provide nutrition counseling that considers the woman's food habits, changing nutrient requirements, medical or surgical condition, and financial and other constraints and assets.
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From page 55... ...
SUMMARY Basic nutrition sentences can and should be integrated into the routine health care of expectant and new mothers by physicians, midwives, nurses, and dietitians. Experts should be involved in providing prenatal and postnatal services to women with health problems that require complex diet modification or nutritional support.
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From page 56... ...
56 ~3 11. ampule of Inane.
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