OG8.6-7 | Nutrition and Vaccination in Pregnancy — Summary & Reflection

KEY TAKEAWAYS

Nutrition and vaccination counselling are core ANC skills with direct impact on maternal and neonatal outcomes. Key facts: (1) IFA supplement: 60 mg elemental iron + 500 µg folic acid daily for a minimum of 180 days — mandatory, free, provided by NHM. (2) Calcium: 1 g/day (two 500 mg tablets) from the second trimester through lactation. (3) Weight gain targets by BMI: underweight 12.5–18 kg; normal 11.5–16 kg; overweight 7–11.5 kg; obese 5–9 kg. (4) TT/Td vaccination: in primigravidae — TT1 at first ANC contact, TT2 ≥4 weeks later; in previously immunised women (booster within 3 years) — one booster only. (5) SAFE vaccines in pregnancy = inactivated vaccines (TT/Td, inactivated influenza, IPV, COVID-19). (6) CONTRAINDICATED in pregnancy = live attenuated vaccines (MMR, varicella, OPV, LAIV, yellow fever, oral typhoid). (7) Counselling technique: OARS method; address side effects and vaccine hesitancy; summarise action points clearly; document in ANC card.

REFLECT

Think about the opening clinical scenario: the primigravida at 16 weeks, Hb 9.2 g/dL, husband asking whether to stop IFA, and no TT on the card. If you had given her only 10 minutes of structured counselling using the framework above — correcting the supplement misunderstanding, addressing the side-effect concern, and initiating her TT schedule — what measurable outcomes could you have influenced by her delivery date? Which parts of the counselling do you feel most confident performing in a real ANC setting, and which require more supervised practice? Kolb reflection: in your next clinical posting, ask to observe or participate in one ANC nutritional counselling consultation and notice how the clinician handles vaccine hesitancy. Jot down one technique you would adopt and one you would do differently.