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Nutrition For Pregnancy and Lactation, Sixth Edition
C. M. Bareuther, RD
Edited by Mary Ann Cockram, MS, RD and Wolf J. Rinke, PhD, RDN

15 CPEUs
15 CPEUs

Manual with 1 Reporting Form, 176 pgs.
This up-to-date comprehensive program will enable you to:

  • utilize a five part nutritional assessment process
  • plan effective nutritional intervention strategies
  • recognize the physiological changes in pregnancy and how they affect nutritional
  • needs and feeding strategies
  • identify how alcohol, artificial sweeteners, caffeine, contaminants, nicotine and drugs affect nutritional intake and maternal-fetal health during pregnancy and lactation
  • relate how exercise influences prenatal nutritional needs and postnatal lactation
  • define gestational diabetes and pregnancy-induced hypertension, and identify nutritional intervention in these disorders
  • learn about special needs of teens, multifetal pregnancies, vegetarians and mothers who have diabetes, hypertension, allergies and HIV
  • formulate safe and effective nutrition intervention for weight reduction postpartum, for lactating and non-lactating women

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15 CPEUs

Nutrition For Pregnancy and Lactation, Sixth Edition
Carol M. Bareuther, RD
Edited by Mary Ann Cockram, MS, RD and Wolf J. Rinke, PhD, RDN

Copyright 2020 Wolf Rinke Associates, Inc. All rights reserved for this self-directed, accredited learning program. Reproduction in whole or part without written permission from the publisher is prohibited.


Nien-Jung Wu: "I'll have more evidence-based knowledge to discuss with pregnant women and help them to optimize their nutrition during this critical period."

Gretchen Earwood: "I learned more about twin pregnancy and more about specific nutrients needed in pregnancy."

Laura Willets: "This was helpful to break down the different nutritional concerns during each trimester of pregnancy as well as throughout lactation. I also found the section on fertility interesting.

Rachael King: "I will feel more comfortable when recommending nutrition plans and interventions for pregnancy and hyperemesis gravidarium."

Marilyn Musgrave: "This was an especially good product for anyone working for WIC, especially those just beginning work for WIC. All topics addressed. Fit right into what WIC does for pregnant women."


Conception, pregnancy, and lactation are a normal part of a woman’s life cycle that uniquely leads to the creation of another human being. In this way, a woman’s health is intimately linked to the health and well-being of future generations. Preconceptional nutritional status and adequate nutrient intake during pregnancy are key factors to a successful birth outcome. Data from the U.S. Department of Agriculture (USDA) Special Supplementary Nutrition Program for Women, Infants, and Children (WIC) aptly illustrate this point. Program participation is associated with higher dietary intakes of whole grains, fresh fruits and vegetables, and low and non-fat dairy products, all of which provide nutrients such as calcium, iron, protein, and vitamins A and C, which are needed in greater quantity by pregnant and breastfeeding women. Also, WIC enrollment has been found to decrease the incidence of low-birthweight by 36 percent, premature birth by 48 percent, and premature delivery by 31 percent. Plus, the percent of women enrolled in WIC that are breastfeeding has increased by over 45 percent to an incidence of 69.8 percent between 2002 and 2014 (Carlson and Neuberger, 2017). Furthermore, supplemental foods provided to WIC participants who exclusively breastfeed their infants have also been found to be cost-saving both in formula non-expenditures and infant health care costs. Thus, the nutrition professional plays an essential role in the health and well-being of both mother and infant.
Chapter I discusses the current status of woman’s nutritional health today and continues with a discussion of dietary factors that can affect fertility. A framework for preconception care is provided.
Chapter II reviews the five-part nutritional assessment process in the context of pregnancy.
In Chapter III, discussion begins with the physiology of pregnancy, followed by an explanation of specific nutrient needs and ways to fulfill these needs. This information is presented in the form of a prenatal meal plan. Guidance is provided for variations in this plan, such as vegetarian food choices, lactose intolerance, adolescence, multifetal pregnancy, and food safety. The chapter concludes by focusing on feeding problems such as hyperemesis, heartburn, pica, and constipation; lifestyle concerns like the use of artificial sweeteners, nicotine, caffeine, and alcohol during pregnancy; and the nutritional management of diabetes, hypertension and eating disorders during pregnancy.
Chapter IV progresses into the topic of lactation with a review of the status of breastfeeding initiation and the benefits of breastfeeding for mothers and infants. As with pregnancy, specific nutrient needs during lactation are discussed, followed by suggestions for implementation in the form of a general meal plan and advice on variations to this basic plan. The discussion then addresses lifestyle concerns that can affect the lactation process as well as the health of mother and infant.
Chapter V concludes with the topic of weight management for lactating and nonlactating women.
A case study provides the opportunity to apply the overall information gained and is included after the final chapter.
This CPE program is a level 2 Continuing Professional Education (CPE) program approved for fifteen (15) continuing professional education units (CPEUs). That means that the reader has a general knowledge of literature and professional practice in the area covered. The focus of the program is to enhance knowledge and application.
To get the most benefit from this program, we suggest you adhere to the following four steps:
Step 1: Review the objectives for the CPE program.
Step 2: Study each chapter. As you read, think of patients from your practice who fit the situation described.
Step 3: Assess what you have learned by completing the self-assessment instrument at the end of this CPE program.
Step 4: Compare your answers to the answer key and explanations that have been provided. If you score at least 80% (40 questions) correct, you are ready to transfer your answers to the CONTINUING PROFESSIONAL EDUCATION REPORTING FORM. If you scored less than 80% correct, re-read the appropriate sections of the program, and re-test yourself until you score at least 80% (40 questions) correct.
After you have completed the program, complete the CPE REPORTING FORM and the MANDATORY Critical Thinking Evaluation Tool (CTT) that must be completed by all credentialed practitioners per CDR and:
Submit them online at www.easyCPEcredits.com,
Or fax them to (410) 531-9282,
Or mail them to Wolf Rinke Associates, 3801 Schuylkill Road, Spring City, PA 19475.
Upon receipt of your CPE Reporting Form and the CTT, we will email you a Certificate of Completion within 3-5 business days.

NOTE: Per CDR we are NOT able to send you a Certificate of Completion unless we receive your completed CTT.

When you submit your CPE Reporting Form and the CTT to us via www.easyCPEcredits.com, fax, or mail, be sure to write your correct email address in the space provided on the CPE Reporting Form. If writing by hand, be sure to print your email address.
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Upon completion of this accredited, self-directed CPE program, you should be able to:

  • Recognize the link between past and present nutritional status, and its effect on conception, maternal health, fetal growth and a successful birth outcome.
  • Identify nutritional, non-nutritional and lifestyle factors that affect fertility.
  • Describe the relationship and importance of preconceptional and prenatal folic acid supplementation to the prevention of neural tube defects in infants.
  • Specify two key teaching frameworks for preconceptional, prenatal and postnatal nutrition counseling.
  • Recognize the five parts of the nutritional assessment process and understand their usefulness in planning nutritional intervention preconceptionally, prenatally, and postnatally.
  • Calculate BMI and relate this figure to recommended weight gain during gestation for single, twin and multifetal pregnancies.
  • Plot prenatal weight gain and assess the adequacy of the rate and total amount of weight gain.
  • Identify anemia in pregnancy, its definition, evaluation and dietary intervention.
  • Define the physiological changes that occur in pregnancy and lactation.
  • Interpret the nutritional needs of pregnancy and lactation as defined by the RDA into meal plans.
  • Relate the nutritional needs of pregnancy to a vegetarian eating style.
  • Define the nutritional, emotional and educational needs of pregnant teens.
  • Identify food assistance programs that can benefit pregnant and lactating women.
  • List situations when a vitamin-mineral supplement may be appropriate preconceptionally, prenatally and postnatally.
  • Recognize how alcohol, artificial sweeteners, caffeine, contaminants, nicotine and drugs affect nutritional intake and maternal-fetal health during pregnancy and lactation.
  • Relate how exercise influences prenatal nutritional needs and postnatal lactation success.
  • Define gestational diabetes and pregnancy-induced hypertension, and identify nutritional intervention in these disorders.
  • Specify breastfeeding benefits for both mother and infant.
  • Identify nutrient needs during lactation and ways women can consume them in regular and vegetarian meal plans.
  • Recognize the issues surrounding infant allergy and mother's diet in lactation.
  • Specify current policy regarding breastfeeding and HIV-1 infection.
  • Formulate safe and effective nutrition intervention for weight reduction postpartum, for lactating and nonlactating women.


A. Food and Nutrient Consumption Trends In Women
B. Effects of Undernutrition, Overnutrition and Diet Composition on Fertility
C. Oral Contraceptives' Effect On Nutrient Status
D. Preconceptional Nutritional Care
A. Medical, Social and Diet Histories
B. Anthropometrics
C. Biochemical Measurements
D. Clinical Evaluation
E. Drug Review
A. Physiology of Pregnancy
1. Blood Volume and Composition
2. Gastrointestinal System
3. Renal Function
4. Cardiovascular and Respiratory Systems
5. Placenta
B. Nutrient Needs
1. Calories
2. Protein
3. Fat
4. Vitamins and Minerals
C. Feeding the Prenatal Woman
1. Prenatal Meal Plan
a. Implementation
b. Variations
i. Vegetarian diets
ii. Lactose Intolerance
iii. Obesity
iv. Adolescence
v. Multifetal Needs
vi. Food Safety
c. Supplementation
2. Feeding Concerns
a. Nausea
b. Cravings and Pica
c. Gastroesophageal Reflux (Heartburn)
d. Constipation
e. Exercise
3. Substances of Concern During Pregnancy
a. Alcohol
b. Artificial Sweeteners
c. Caffeine and Herbal Teas
d. Contaminants
e. Nicotine
f. Recreational Drugs
D. Medical-Nutritional Concerns Of Pregnancy
1. Diabetes Mellitus
2. Pregnancy-Induced Hypertension
3. Eating Disorders
A. Incidence, Benefits and Promotion of Breastfeeding
B. Physiology of Lactation
C. Nutrient Needs
1. Calories
2. Protein
3. Fats
4. Vitamins and Minerals
5. Fluids
D. Feeding the Lactating Woman
1. Lactation Meal Plan
a. Implementation
b. Variations
i. Vegetarian Diets
ii. Infant Allergy and Intolerance in Breastfeeding
iii. Multifetal Needs
c. Supplementation
2. Special Concerns During Breastfeeding
a. Alcohol
b. Caffeine
c. Contaminants
d. Drugs
e. Exercise
f. HIV and Hepatitis Infection
g. Nicotine
A. During Lactation
B. NonLactation
APPENDIX B: Prenatal Weight Gain Grids for Underweight, Normal Weight, Overweight and Obese Women
APPENDIX C: MyPlate for Pregnancy and BreastfeedingREFERENCES


Carol M. Bareuther is a Registered Dietitian and member of the Women’s Health Dietetic Practice Group. A New Jersey native, she holds a Bachelor of Science degree in Dietetics from Marshall University, Huntington, WV, and completed a dietetic internship at the University of Kentucky Medical Center, Lexington, KY. She completed post-graduate training in nutrition at the University of Kentucky and Drexel University in Philadelphia, PA.
Bareuther started her career as a pediatric-obstetric dietitian at the University of Kentucky Medical Center. Subsequently, she worked as a clinical dietitian at the Hospital University of Pennsylvania, Philadelphia, PA; as a therapeutic dietitian at the Roy L. Schneider Community Hospital, St. Thomas, U.S. Virgin Islands; and currently as a nutritionist for the Virgin Islands Special Supplementary Nutrition Program for Women, Infants and Children (WIC). She has authored American Dietetic Association-approved, self-directed, accredited CPE programs, Nutrition for Infants and Children, and Nutrition Therapy for Children with Attention Deficit Hyperactivity Disorder, published by Wolf Rinke Associates, Inc.
Bareuther works part-time as a freelance writer and has contributed food and nutrition articles to national publications such as Cooking Light, Vegetarian Gourmet, Deli Business, Produce Business, Food Distribution Magazine, Veggie Life, HeartCorps, Cruising World, Best Recipes, Vegetarian Journal, Fancy Food, Chefs, Caribbean Travel & Life, Latitudes South, and Pillsbury’s Fast and Healthy Magazine. From 1995 to 1999, Bareuther was the syndicated columnist for Copley News Services’ Kitchen Kids.
An author as well as a journalist, Carol has published two books, Virgin Islands Cooking and Sports Fishing in the Virgin Islands. She has co-authored Slim-To-Shore with Jan Robinson and Native Recipes, produced by the University of the Virgin Islands Cooperative Extension Service.
Since 1996 she has co-hosted “Nutrition in Good Taste,” a weekday radio nutrition program on WVWI AM 1000, which airs throughout the eastern Caribbean. Since 2000, Bareuther has co-hosted “Shape Up Virgin Islands,” a monthly half-hour PBS TV program that seeks to show culturally relevant ways to prepare healthful foods and incorporate physical activity.
Carol is the mother of two children and, in her spare time, enjoys cooking with her children, swimming, hiking, and reading.


Mary Ann Cockram, MS, RD is retired from Abbott Nutrition where she was a Research Scientist in the Scientific and Medical Affairs group. In this role, she provided clinical nutrition education and brand support internally to Sales and Marketing and externally to clinicians and consumers for Abbott’s critical care and surgical enteral nutrition products. Her area of interest is enteral feeding.
Mary Ann received a Bachelor of Science in Home Economics from Valparaiso University in Valparaiso, Ind, and a Master of Science in Clinical Nutrition from Rush University in Chicago.
Mary Ann served as chair of the Medical Nutrition Practice Group, and as the assistant editor and editor of Medical Nutrition Matters, the newsletter of this practice group. Mary Ann participated as an evidence analyst on the Evidence Analysis Team for Adult Weight Management for the Academy of Nutrition and Dietetics, and she attended the test item writer workshop sponsored by the Commission on Dietetic Registration.

Wolf J. Rinke, PhD, RDN is the president and founder of Wolf Rinke Associates, Inc., a company that has provided high-quality CPE programs to nutrition and dietetics practitioners since 1990.
Dr. Rinke earned a BS at Drexel University, an MS at Iowa State University, a PhD in Continuing and Vocational Education (Adult Ed) at the University of Wisconsin, and interned at Walter Reed Army Medical Center. He participated in a test item writer workshop sponsored by the Commission on Dietetic Registration (CDR).
Dr. Rinke is a past Adjunct Associate Professor, Graduate School of Management & Technology at the University of Maryland, and a former Adjunct Faculty Member of the School of Continuing Studies at The Johns Hopkins University.
He has served as past president of the District of Columbia (DC) Dietetic Association and has been honored by the Academy of Nutrition and Dietetics with the Award for Excellence in the Practice of Management, the Outstanding Dietitian of the Year Award, and the Outstanding Service Award, in addition to delivering the Lenna Frances Cooper Lecture.
Dr. Rinke has served in numerous leadership roles at the Academy of Nutrition and Dietetics: Chair of the Scholarship Committee for Dietitians in Business and Communications; Chair of the Communication Committee, Honors Committee, and Licensure Panel and Ethical Practices Task Force for the Commission on Dietetic Registration; Chair of the Area Coordinating Committee and Chair for the Code of Ethics; Member of the Resource for Education Programs Committee; Member of the House of Delegates; and Member of the Board of Directors.
Dr. Rinke is the author of more than 500 articles, numerous CPE self-study programs, and several popular books including Make It a Winning Life: Success Strategies for Life, Love and Business; Winning Management: 6 Fail-Safe Strategies for Building High-Performance Organizations; and Don’t Oil the Squeaky Wheel and 19 Other Contrarian Ways to Improve Your Leadership Effectiveness.


Special thanks to the following individuals for their careful review.

Sally L. Campbell, RDN, LD
Consultant Dietitian, Plano, TX
Public Health Coordinator (Retired)
City of Dallas WIC Program,
Dallas, TX 

Lorna Concepcion, MS, RD
WIC Program—Virgin Islands Department of Health
Christiansted, St. Croix, USVI

Marleen Dykhuis, MA, RD
Consultant Dietitian
Nutritious Lifestyles Inc.
St. Petersburg, FL

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