Nutrition During Pregnancy and Lactation An Implementation Guide (1992) / Chapter Skim
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Postpartum Visits
Postpartum Visits
Pages 69-88
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From page 69... ...
Basic Guidance AZ! Women Dietary Guidelines O Appropriate weight change Discharge advice: follow-up, avoidance of harmful substances, adequate rest Breastieeding Women To To o To Assistance with initiating breastteeding Additional nutrient, fluid, and energy needs Cautions concerning potentially harrnfuT substances Guidance for successful breastfeed~ng An Implementation Guide 69
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From page 70... ...
Basic Guidance O Support for breastLeeding O Healthful diet with ample fluids to prevent thirst Visit at 4 to 6 Weeks Post Partum Gathering Information O Diet and weight O Breastfeeding Basic Guidance O Dietary Guidelines with increased intake of milk products, fluids, and foods rich in vitamin A if breastfeeding Support for breastteecling Lo O Encouragement of physical activity Addressing Problems 17! Counsel how to correct inappropriate weight gain or Toss O Discourage restrictive food practices during lactation O Follow up on gestationaT diabetes meliitus O Combat the use of harmful substances 70 Nutrition Dunng Pregnant and Lactation
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From page 71... ...
An early office visit, a visit to the home by a trained health professional, or telephone counseling is often advisable for breastfeecling women. Later, more attention is directed toward the mother's concems about the adequacy of her milk supply, healthful weight Toss strategies, her return to work or school, and birth control.
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From page 72... ...
· Do you need birth control? Breastfeeding · Does the mother wish to breastteed?
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From page 73... ...
Combined estrogen and progestin pills may reduce milk volume and the duration of breastfeeding; progestin-only pills have not been found to have this effect.2 For the Lactating Woman: Special Recommendations for Lactating Women · Avoid criers and medications that promise rapid weight Toss. · Eat a wide variety of breads and cereal grains, fruits, vegetables, milk products, and meats or meat alternates each day.
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From page 74... ...
Prude Ideation on the usual patted of postpa~um Feint loss. Discharge Advice Avant ~r te~pbo~ ~llo~-up or ~ home Visit within s ~~ dam aRer hospital discharge to our Spun Ad air Mesa.
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From page 75... ...
· If the mother wishes to use beverages containing sugar substitutes, suggest moderation and discourage her from using these to replace important sources of nutrients. An Implementation Guide 75
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From page 76... ...
ltscb sD breast~edt~g motbers bo~ 1o express milk na~nually Dennonstrate the use ofpu mpsift~dicated. R~aBRrnatbattbe motberis doingsometbing ~ally impor~nt ~rberbaby a n~uB1v ~ ~ ~ v~ p~ sc~ed duhng p~gnancy consider condnued use of du~g lacution.
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From page 77... ...
· Provide practical suggestions for achieving high nutrient and energy intake with the resources available. · Refer the mother to a support groups · Assist the mother in enlisting support from others.
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From page 78... ...
. Encourage women with previous breast augmentation or reduction to monitor the infant's weight gain regularly.
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From page 79... ...
· Radiopharmaceuticals that require temporary cessation of breastLeecTing include gallium-67, indium111, iodine-125, ioctine-131, radioactive sodium, and technetium-99m.~6 · If the mother wishes to breastfeed after treatment with a contraindicated drug is discontinued, assist her with pumping her breasts to maintain lactation and explain why the milk must be discarclecT. - Request consultation concerning safe medically indicated drugs for use when breastfeeding.
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From page 80... ...
- How are you feeding your balky? Breastfeeding Experience If the woman is breastfeecling, ask: · How often are you breastfeeding your baby?
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From page 81... ...
Perhaps I can make some suggestions about feeding your balky while you're at work, expressing milk, stonug milk, and managing on days offfrom work. Physical Examination Slow infant growth may be a sign that the mother needs assistance with breastLeeding or with formula feeding.
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From page 82... ...
Encourage the mother to consume a healthful diet based mainly on the Dietary Guiclelines (see "Basic Dietary Guidance," Tab 2~. · Discourage her from trying diets and drugs that promise quick weight Toss.
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From page 83... ...
How? What is your weight loss goal?
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From page 84... ...
Weight Toss is usually graclual; it may take many months to achieve prepregnant weight. Some women resume smoking to lose weight more easily, but this poses Tong-term health risks for the mother, exposes the infant to smoke, ant!
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From page 85... ...
· Assist the mother or primary meal preparer with strategies for a healthful diet for the family · Clarify that (further) weight loss will occur only if energy intake is less than energy expenditure (plus the energy content of the milk produced)
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From page 86... ...
/month after the first month post panum. · Weight falling below normal weight for height.
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From page 87... ...
~e. Restrictive Food Practices During Lactation If a breastLeeding mother is restricting her food intake to prevent colic, allergic reactions, or other problems in her infant, ted her that the evidence does not support routine elimination of milk or other basic foods to prevent these problems.
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From page 88... ...
. Assist women who smoke cigarettes, use smokeless tobacco, abuse alcohol, or use illegal drugs to quit.
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