A nurse is reinforcing teaching with a client who is breastfeeding. Which of the following instructions should the nurse include in the teaching?
"Reduce your intake of iron."
"Increase your caloric intake by 600 kcal per day."
"Increase your fluid intake to 2.5 L per day."
"Avoid shellfish."
The Correct Answer is A
a. The Recommended Dietary Allowance for iron is 27 mg/day during pregnancy while in lactation its only 9 mg/day because of the expectation that there will be no menstrual losses during the first 6 months postpartum, and the iron accumulated during prenatal formation of maternal red blood cells can be recycled and used by the mother postpartum. Additionally some clients have difficulty tolerating prenatal vitamins in the lactation period because of their high iron content. A multivitamin that contains less than 30mg of iron may have fewer GI effects and be better tolerated.
b. While breastfeeding does require additional calories, the typical recommendation is an increase of about 500 calories per day, not 600.
c. Proper hydration is essential for milk production and overall health. However, The Institute of Medicine (IOM) established total water intake (TWI) at 3.0 L/day for pregnant women and 3.3 L/day for breastfeeding women.
d. While some individuals might avoid shellfish due to allergies or concerns about mercury, there is no general recommendation for all breastfeeding mothers to avoid shellfish.
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