PROMOTING POSITIVE NUTRITIONAL PRACTICES DURING PREGNANCY AND LACTATION

This paper describes three key elements for promoting positive nutrition practices among women during pregnancy and lactation: 1) increasing access to prenatal care; 2) redirecting the content of prenatal care to include a greater emphasis on screening and intervention for behavioral risk factors, including poor nutritional practices; and 3) delivering nutritional care based on recent Institute of Medicine guidelines. These guidelines advise the practitioner to determine prepregnancy body mass index (BMI) and to recommend different weight gains during pregnancy according to BMI category, to assess dietary and lifestyle factors to determine the need for nutrient supplements and to base the supplement composition on the nature of the nutritional need identified, to provide routine supplementation of only 30 mg iron beginning in the second trimester of pregnancy, and to base the diagnosis of anemia on different cut-off values by stage of pregnancy and smoking status.