Integrated Maternal and Newborn Care Basic Skills Course ...

Reference Manual
Have the woman take the dose in front of the provider. Do not give the dose on an
empty stomach; ask the woman to eat something before taking the tablets. There should
be at least one month between doses.
Note: Studies are looking for evidence of an interaction between folic
acid and SP when these drugs have been used together in the
management of acute malaria. Refer to national protocols for the latest
recommendations.
• An insecticide-treated bednet is another way to
protect the pregnant woman against malaria, reducing
cases of malaria and subsequent risks of maternal
anemia and death. Advise the mother to use an
insecticide-treated bednet (see also the chapter on
postpartum care of the mother).
Prevent iodine deficiency
In areas where iodine deficiency is high, consult country protocols for pregnant women.
Advise women to use iodized salt.
Prevent iron-deficiency anemia
Iron is essential to compensate for the increased blood volume that occurs during pregnancy
and to ensure adequate fetal growth and development. Iron needs increase during the
pregnancy as the fetus grows. The pregnant woman can help meet these increased needs for
iron by taking iron and folic acid tablets and by ensuring that she has an adequate and balanced
diet. Iron-rich foods include meat, especially liver and giblets, apricots, prunes, eggs, dry
legumes, peanuts, other nuts, and green leafy vegetables.
Iron/folate supplementation to prevent anemia is administered as follows:
• If the woman’s hemoglobin is between 8-11 g/dL, give
ferrous sulfate or ferrous fumarate 60 mg by mouth plus folic
acid 400 mcg by mouth once daily.
• If the woman’s hemoglobin is ≤7 g/dL, treat for anemia: give
ferrous sulfate or ferrous fumarate 120 mg by mouth plus
folic acid 400 mcg by mouth once daily for 3 months/follow
national protocols.
• Continue to give ferrous sulfate or ferrous fumarate 60 mg
by mouth plus folic acid 400 mcg by mouth once daily for at
least 3 months after childbirth.
Intermittent preventive treatment of hookworm to prevent anemia
Hookworm is a major cause of iron deficiency anemia and should be treated with a dose of
mebendazole or albendazole every 6 months. A pregnant woman can safely take mebendazole
or albendazole during the second and third trimesters of her pregnancy. Hookworm can also be
prevented by always wearing shoes when walking outside.
Integrated maternal and newborn care
Basic skills course
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