Nutritional Counseling for Vegetarians During Pregnancy and Lactation

Debra S. Penney, CNM, MS, MPH; Kathleen G. Miller, CNM, MS


J Midwifery Womens Health. 2008;53(1):37-44. 

In This Article


Maternal and neonatal health outcomes are influenced by maternal diet, and therefore deserve adequate attention during pregnancy and lactation. There is much that is still unknown and unquantified regarding vegetarian nutrition during pregnancy and lactation; thus, guidance must be based on what is known. A diet history that quantifies all foods consumed is a good place to start; this can be repeated throughout the pregnancy as needed to assess energy needs and nutrient intake. Asking the patient to list daily exercise will also be helpful in assessing energy needs. A vegetarian patient education packet could include lists of food sources for specific nutrients, a graph for charting expected weight gain during pregnancy based on prepregnancy body mass index, forms for recording dietary intake, sample menus, and a list of informational resources ( Table 3 ). The provider should review the woman's diet each trimester and during the postpartum period to reinforce the patient's vegetarian choices and to assess intake. The American Dietetic Association endorses intake of DHA supplements or sources of linolenic acid for the pregnant and lactating vegetarian.[6] Consulting with a registered dietitian may be helpful for the woman who may need more information or time to discuss her nutrition needs and food choices. As with all clients who may have a different cultural orientation, the health care provider's approach is most effective when it engenders acceptance and establishes good rapport.


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