Download Pregnant Teenagers

Nutrition Counseling For Pregnant Teenagers
Especially age 17 or less
Do nutrition and weight evaluation.
Evaluate if patient is taking prenatal vitamin daily and the prescribed amount (if
any) of supplemental iron.
Plan to assess weight and dietary intake frequently, as teenagers are at greater
risk for nutrition related problems, and generally need more reinforcement than
adult pregnant women.
Expected weight gain during pregnancy is 28 to 40 pounds for teens with a
normal pre-pregnancy (Body Mass Index) BMI. If pre-pregnant BMI is in the
underweight, overweight, or very overweight categories, expected weight gain
should be at the higher end of the range recommended for those categories.
Important to teach on first visit:

As a teenager your nutritional needs are high, because in addition to the extra
nutrition needs of pregnancy, your body is still growing. The goal is to
optimize nutrition for the baby’s health and to optimize your health and
growth.

To avoid deficiencies such as anemia – it is important to avoid processed
foods that are low in nutrition and eat foods that are rich in nutrition.

Foods that usually have no nutrition or very little nutrition are sugary foods
and sugary drinks. They should be avoided. (point out those eaten on food
recall or food diary)

Also, limit fruit juice to 4 ounces per day or less - fruit juice will ruin the
appetite for more nutritious foods (point out any excess fruit juice they drank
on their food recall or food diary)

Give them a list of sugary foods and sugary drinks that should be avoided – it
is best to keep these out of the house so they are not a temptation:
cakes, cookies, candies , ice cream, chocolate, sweet breads, lollipops,
popsicles, Jello, flan, sugary cereals, flavored yogurts, (Hispanic favorites:
’pan dulce’, ‘arroz con leche’),
and sugary drinks:
soda , Gatorade, Koolaid, fruit punch, Sunny Delight , Tampico, Tang,
Caprisun, lemonade, instant iced tea from powder, bottled iced tea,
Powerade, Kern’s, Schnapple, Quik, ‘high energy drinks’, (Hispanic favorites:
‘agua de jamaica’, ‘agua de tamarindo’ , ‘horchata’, ‘maicena’, ‘atole’,
‘champurrado’, ‘Chocomil’, ‘Jackult’ ‘aguas de fruta’),
“and there’s many more”

Point out that in soda (and most other sugary drinks and sugary foods) there
are absolutely no nutrients at all, so people who drink it are more likely to
develop deficiencies such as anemia

Teach the WIC (Women, Infants, and Children Supplemental Food Program)
Daily Food Guide for how to eat during pregnancy (Guia de Alimentación
Diaria):
Emphasize the importance of following the food guide
Refer to ‘servings needed’ as a minimum for each day
Emphasize to avoid sugary foods & sugary drinks and to limit fruit juice to
4oz per day or less
Healthy foods are divided into 5 different food groups: (point to the handout
and the appropriate columns as you teach these principles i.e. the
‘servings needed’ column and the ‘serving sizes’ column
Fruits---2 or more every day
Vegetables—3 servings or more daily
Grains—7 servings or more daily,
preferably whole grains – this is not always addressed on the first
visit in order not to overwhelm the patient; it may be addressed on
a follow-up visit depending on time, patient’s educational level, etc.
Milk & Milk products---3 servings or more daily
Check and see if they use whole (3.5%), reduced fat (2%), lowfat
(1%) or nonfat milk (0%)
Encourage to change to reduced fat or lowfat or nonfat
If low in the milk group, and depending on time, patient’s
educational level, etc. discuss the importance of calcium for bone
health/strength for the baby and mother . Ask them if they know
what nutrient/mineral in milk group is important and why it is
important.
Protein---3 servings or more

Eating the daily recommended 3 servings of vegetables is an important
source of fiber, phytochemicals (plant chemicals), antioxidants, and vitamins
and minerals

Emphasize the importance of taking prenatal vitamin supplements daily and
iron supplements as prescribed by the provider.
(brainstorm strategies to help them do this, as needed)
May be important to teach on the first visit:

Sugary foods and sugary drinks and too much fruit juice cause excess weight
gain (in addition to being a major cause of anemia and other deficiencies)

During pregnancy it is recommended to eat 5 to 6 smaller meals per day
Optional teaching for first visit:

If you avoid sugary foods and sugary drinks and fruit juice, you will have more
appetite for the nutritious foods found on the Daily Food Guide (point to all the
foods on the handout). That will result in a better health with less chance of
infections, discomforts.

To avoid constipation - a common side effect of taking iron supplements - if
you eat the recommended number of servings of vegetables (3+/day) and
fruits (2+/day) every day, you are unlikely to have constipation.
Information for the professional:

Adolescent pregnancy is associated with an increased risk of preterm
delivery, low birth weight, and other problems. A teen pregnancy increases
the need for optimizing calories and nutrients because the teen needs
calories for her own continued growth in addition to the increased needs of
pregnancy. Adolescent girls may restrict their caloric intake in order to lose
weight, or to maintain a slim, non-pregnant appearance in an effort to
conceal the pregnancy. Teens may have poor eating habits in general or
suffer from eating disorders such as anorexia or bulimia that can increase in
severity during pregnancy.

Refer for psychosocial and nutrition consultation if eating disorders are
identified.

If adolescent girls are preoccupied with their weight, appearance, or have a
history of eating disorders, assess the teen client’s ability to maintain
adequate nutritional intake during lactation. Some adolescent girls might view
breastfeeding as a mechanism for rapid weight loss. Refer them to
counseling, if appropriate.