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High Risk Nutrition Care Plan Guidelines 8

an increased risk of long-term health problems, including metabolic syndrome, diabetes, hypertension, weight problems, and eating disorders. People with substance addiction may suffer from calorie and protein malnutrition. Substance use can impact the family and parenting in many ways, and may be linked with poor parenting practices, child neglect, and abuse. Maternal substance use during and after pregnancy can have a long-term impact on both the mother and her child and can impact many areas of life. Children who are exposed to alcohol and other substances prior to birth can experience long-term cognitive, behavioral, social, and emotional developmental consequences.

Assessment, counseling, and referral guidelines: • Complete nutritional assessment according to WIC protocol. • Using Crossroads Health Information screen and VENA protocol for any indication of substance use. • Counsel and provide nutrition education based on assessment findings. • WIC staff are required to refer participants suspected of substance use, and those who disclose substance use, to existing assessment agencies for professional evaluation and treatment, as appropriate. Refer to WIC Procedure Manual, Chapter 3 (3.5).

Documentation: • Check “High Risk Education” on the Nutrition Education screen under Nutrition Education Topics and enter “Reinforcement/Substance Abuse Counseling” under Topic Status. • Document the specific details regarding the nutritional assessment and nutrition care plan in the Nutrition Assessment field on the Care Plan Summary. Also include documentation of any referrals and/or resources provided.

Recommendations for the WIC CPA: • Encourage improved intake of vegetables, fruits, whole grains, low-fat or fat-free dairy products, fish, poultry, beans, and nuts. • Encourage participant to take any prescribed supplements, including prenatal vitamins, or medications as directed. • May refer to Risk 382 Fetal Alcohol Spectrum Disorders for counseling information.

Risk 382 Fetal Alcohol Spectrum Disorders

Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person whose mother consumed alcohol during pregnancy. FASDs is an overarching phrase that encompasses a range of possible diagnoses, including fetal alcohol syndrome (FAS), partial fetal alcohol syndrome (pFAS), alcohol-related birth defects (ARBD), alcohol-related neurodevelopmental disorder (ARND), and neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE).