NUTRITION FOR PREGNANCY AND LACTATION
Third Edition
Carol M. Bareuther, RD
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Copyright 2006 Wolf Rinke Associates, Inc. All rights reserved for this self-directed, accredited learning program. Reproduction in whole or part without written permission from the publisher is prohibited.
CUSTOMER COMMENTS
Melissa Hemond: "I wish I had read this before I had my twins! There was info here I didn't find elsewhere. A great resource and help for next time and to assist friends, family and clients."
Perbhjot Sran, MA, RD: "Very organized and user friendly."
Randi Freedman: ". . . easily understandable information- very useful in my practice."
Michelle Landry: "I like the questions being practical case study."
Stephanie Collins: "Exercises to practice skills."
Beth Yuro: "The tables were included throughout the chapters. They were informative and easy to follow."
Laura Gomez-Vega: "Deep and actualized information."
Brenda Tucker: "Excellently organized, very current information and a quick and easy reference tool."
Anna Petrov, RD: "Concise, to the point, no "fluff" to wade through."
Melissa Wiles, RD: "I've been a WIC nutritionist. This should be required reading to have that job. Wonderful!"
Amelia Murphy Bell: "Peer-reviewed course. Well referenced text. Questions dove-tailed with the course book well."
Marilyn Musgrave, MS RD LD: "This was an especially good product for anyone working for WIC, especially those just beginning work for WIC. All topics addressed. Fit right into what WIC does for pregnant women.
OVERVIEW AND INSTRUCTIONS
Conception, pregnancy and lactation are a normal part of a woman's life cycle
that uniquely leads to the creation of another human being. In this way, a woman's
health is intimately linked to the health and well-being of future generations.
Preconceptional nutritional status and adequate nutrient intake during pregnancy
are key factors to a successful birth outcome. Data from the USDA's Special
Supplementary Nutrition Program for Women, Infants and Children (WIC) aptly
illustrate this point. Program participation is associated with higher dietary
intakes of energy, protein, iron, calcium, magnesium and vitamins C, B6, B12,
thiamin, riboflavin and niacin (Ponza et al. 2004). More specifically, WIC enrollment
has been found to reduce low-birth-weight (<2,500 gm) and very-low-birth-weight
(<1,500 gm) rates by 25 percent and 44 percent, respectively, such that for
every dollar invested in prenatal WIC services-supplemental foods, nutrition
education and referrals-$3.07 was saved in infant medical services during the
first year of life (Owen and Owen, 1997). Furthermore, supplemental foods provided
to WIC participants who exclusively breastfeed their infants have also been
found to be cost saving both in formula non-expenditures and infant health care
costs. Thus, the nutrition professional plays an essential role in the health
and well-being of both mother and infant.
Chapter I discusses the current status of today's woman's nutritional health.
Information continues with a discussion of dietary factors that can affect fertility.
A framework for preconceptional care is provided.
Chapter II reviews the five-part nutritional assessment process in the context
of pregnancy.
In Chapter III, discussion begins with the physiology of pregnancy, followed
by an explanation of specific nutrient needs and ways to fulfill these needs.
This theoretical information is presented in the form of a prenatal meal plan.
Guidance is given for variations in this plan, such as vegetarian food choices,
lactose intolerance, adolescence, multifetal pregnancy and food safety. The
chapter concludes by focusing on feeding problems such as hyperemesis, heartburn,
pica and constipation; lifestyle concerns like the use of artificial sweeteners,
nicotine, caffeine and alcohol during pregnancy; and the nutritional management
of diabetes, hypertension and eating disorders during pregnancy.
Chapter IV progresses into the topic of lactation with a review of the status
of breastfeeding initiation and benefits of breastfeeding for mother and infant.
As with pregnancy, specific nutrient needs during lactation are discussed, followed
by suggestions for implementation in the form of a general meal plan and advice
on variations to this basic plan. Discussion then addresses lifestyle concerns
that can affect the lactation process as well as the health of mother and infant.
Chapter V concludes with the topic of weight management for lactating and nonlactating
women.
A case study provides the opportunity to apply the overall information gained
to life situations and is included after the final chapter.
This learning program is a Level 2 Continuing Professional Education (CPE) program
approved for 12 CPE units (CPEUs). Level 2 means that you have general knowledge
of the literature and professional practice in the areas covered. The focus
of the program is to enhance knowledge and application.
To get the most benefit from this program, we suggest you adhere to the following
four steps:
" Step 1: Review the objectives for the learning program.
" Step 2: Study each chapter. As you read, think of patients from your
own practice that fit the situation described.
" Step 3: Assess what you have learned by completing the self-assessment
instrument at the end of this learning program.
" Step 4: Compare your answers to the answer key that has been provided.
If you score at least 80 percent correct, you are ready to transfer your answers
to the CONTINUING PROFESSIONAL EDUCATION REPORTING FORM. If you scored less
than 80 percent correct, re-read this learning program until you score at least
80 percent correct.
After you have successfully completed this program, mail or fax the completed
CONTINUING PROFESSIONAL EDUCATION REPORTING FORM to:
Wolf Rinke Associates, Inc.
P.O. Box 350
Clarksville, MD 21029
Fax: (410) 531-9282
Upon receipt of your successfully completed CONTINUING PROFESSIONAL EDUCATION
REPORTING FORM, we will send you a Certificate of Completion for 12 CPEUs.
HAPPY LEARNING! Carol M. Bareuther, RD
OBJECTIVES
Upon completion of this accredited, self-directed learning program, this nutrition professional should be able to:
ABOUT THE AUTHOR
Carol M. Bareuther is a registered dietitian and member of the Women and Reproductive
Nutrition Practice Group. A New Jersey native, she holds a bachelor of science
degree in dietetics from Marshall University, Huntington, WV, and completed
a dietetic internship at the University of Kentucky Medical Center, Lexington,
KY. She completed post-graduate training in nutrition at the University of Kentucky
and Drexel University in Philadelphia, PA.
Bareuther started her career as a pediatric-obstetric dietitian at the University
of Kentucky Medical Center. Subsequently, she worked as a clinical dietitian
at the Hospital University of Pennsylvania, Philadelphia, PA; as therapeutic
dietitian at the Roy L. Schneider Community Hospital, St. Thomas, U.S. Virgin
Islands; and clinic nutritionist for the Virgin Islands Special Supplementary
Nutrition Program for Women, Infants and Children (WIC). She is currently employed
part-time as a public health nutritionist by the Virgin Islands' Department
of Health's Bureau of Nutrition & Physical Activity. In 1995, she authored
an American Dietetic Association-approved, self-directed, accredited learning
program, Nutrition for Infants and Children, published by Wolf Rinke Associates,
Inc.
Bareuther works part-time as a freelance writer and has contributed food and
nutrition articles to national publications such as Cooking Light, Vegetarian
Gourmet, Deli Business, Produce Business, Food Distribution Magazine, Veggie
Life, HeartCorps, Cruising World, Best Recipes, Vegetarian Journal, Fancy Food,
Chefs, Caribbean Travel & Life, Latitudes South, and Pillsbury's Fast and
Healthy Magazine. From 1995 to 1999, Bareuther was the syndicated columnist
for Copley News Services' Kitchen Kids.
An author as well as a journalist, Bareuther has published two books, Virgin
Islands Cooking and Sports Fishing in the Virgin Islands. She has co-authored
Slim-To-Shore with Jan Robinson and Native Recipes, produced by the University
of the Virgin Islands Cooperative Extension Service.
Since 1996 she has co-hosted "Nutrition In Good Taste," a weekday
radio nutrition program on WVWI AM 1000, which airs throughout the eastern Caribbean.
Since 2000, Bareuther has co-hosted "Shape Up Virgin Islands," a monthly
half-hour PBS TV program that seeks to show culturally relevant ways to prepare
healthful foods and incorporate physical activity.
Bareuther is the mother of two children and, in her spare time, enjoys cooking
with her children, swimming, hiking and reading.