Nutrition and HIV/AIDS: A Training Manual - Linkages Project

previously existing malnutrition, underweight status at the start of pregnancy,anemia, gestational diabetes, and opportunistic infection.6. Discuss with the mother dietary management and appropriate interventions ofdiarrhea, nausea, vomiting, malabsorption, loss of appetite, oral thrush, andopportunistic infections. These conditions may prevent weight gain in the HIVinfectedpregnant woman or adolescent and have a profound impact onnutritional status and disease progression in an HIV-infected pregnant woman.7. Be aware of cultural foods, traditional therapies, and practices that are harmfulduring pregnancy and lactation and counsel the mother about them.8. Counsel the mother on foods to avoid, especially foods that expose her tobacterial or enteric infection, which can hasten disease progression. These foodsinclude raw eggs or foods with little nutritional value or that do not improvenutritional status. For example, coffee and alcohol decrease appetite, interferewith metabolism, and in the case of alcohol, may interact with some medicationsto decrease their efficacy.9. Note the medications, including ARVs, that the HIV-infected pregnant or lactatingwoman is taking and be aware of the food and drug interactions that can have anegative impact on the woman’s nutritional status by reducing food intake.Provide appropriate interventions as required.10. Improving micronutrient status is an important step to decrease maternalmalnutrition, although the additional amounts required by the HIV-infectedpregnant or lactating woman have not been determined. Provide multivitaminsand other vitamin or mineral supplements as per the country guidelines orWHO/UNICEF guidelines for all pregnant women. Stress the use of iodized salt toprevent iodine deficiency.11. If multivitamins are recommended to improve the adequacy of the diet or themothers’ nutritional status, carefully analyze their composition. High doses ofmany nutrients (more than 10 times the usual recommended dietary allowance)may harm the immune system rather than benefit the mother. For example,vitamin C in excess of 1,000 mg may cause or exacerbate diarrhea.In summary, it is important to improve the diet and eating habits of HIV-infectedpregnant or lactating women and adolescent girls. If the diet is not varied, a146