1. Nutritional Concerns of Pregnant Women l Kcals »adequate weight gain »(prepregnancy weight and nutritional status) l Calcium l Folate »prevention of neural tube defects l Iron »prevention of anemia l **NO alcohol intake** »prevention of FAS/FAE

2. Fetal Alcohol Syndrome l 1 to 3 per 1000 live births l Fetal Alcohol Effects (FAE) »10x as many »subtler effects l Symptoms: »growth retardation »small head circumference »mental retardation »irritability »hyperactivity »physical abnormalities l Alcohol related to LBW, spontaneous abortions

3. Advantages of Breastfeeding for Baby l Microbiologically safe; fresh l Automatically ideal l Anti-infective properties l morbidity »diarrhea »Type I diabetes, respiratory diseases »celiac disease, Crohn’s disease? l risk for atopic dermatitis and ear infections l Promotes better jaw and teeth alignment

4. l risk of allergy »no foreign antigens »early closure of GI barrier »protective action of breast milk l Slower growth past 3-4 months l Best fatty acids for brain development and visual acuity? l *Bonding* »hormonal “mothering” response? »feeling of security for infant Advantages of Breastfeeding for Baby

5. l *Bonding*--emotional ties l Maternal self-esteem l Necessitates daily rest l Ease and convenience l Recovery from pregnancy »shrinking of uterus »lessening of blood loss »suppression of ovulation l risk of cancer: breast, ovarian l Improved blood lipid profile l Cost: personal, society, environment Advantages for Mother

6. Community Programs Re: Pregnant Women l Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) [USDA] l WIC Farmers’ Market [USDA] l Commodity Supplemental Food Program [USDA] l Title V Maternal and Child Health Program [DHHS] »federal block grant

7. Monitoring Systems l CDC »Pregnancy Nutrition Surveillance System –“convenience population” »Pregnancy Risk Assessment Monitoring System –mail and phone survey –population-wide l National Center for Education in MCH (NCEMCH)

8. Focus on WIC Entitlement program? Who is eligible? What are the benefits? Are there restrictions? What is the goal/purpose? Is education mandated? Proven outcomes?