Editing Maternal and Newborn Nursing (section)

=== Nutrition and teaching ===

* Weight gain guidance by prepregnancy BMI: underweight 28 to 40 lb, normal weight 25 to 35 lb, overweight 15 to 25 lb, obese 11 to 20 lb.
* '''Folic acid 400 to 800 mcg daily''' before conception and in early pregnancy prevents neural tube defects; 4 mg daily is recommended with a prior affected pregnancy. Iron requirement is about 27 mg daily. Calcium about 1,000 mg daily.
* Avoid alcohol entirely (no known safe amount; fetal alcohol spectrum disorders), avoid tobacco and cannabis, limit caffeine, avoid high-mercury fish (shark, swordfish, king mackerel, tilefish), avoid unpasteurized dairy, deli meats unless steaming hot, and raw or undercooked meat, fish, and eggs (''Listeria'', ''Toxoplasma'', ''Salmonella''). Avoid changing cat litter and wear gloves when gardening (toxoplasmosis).
* Avoid live vaccines in pregnancy (MMR, varicella). Inactivated influenza vaccine and Tdap (given at 27 to 36 weeks for infant pertussis protection) are recommended ''during'' pregnancy.
* Common discomforts and nursing responses: nausea (small dry carbohydrate before rising, small frequent meals), heartburn (small meals, upright after eating, avoid lying flat), constipation (fiber, fluids, activity; docusate rather than stimulant laxatives), varicosities and edema (elevate legs, avoid crossing legs, support hose), and back pain (pelvic tilt, good body mechanics, low-heeled shoes).