NP20003 Nutrition Through Life Cycles
Tutorial Class 2: Lactation – Critical Application of Malaysian RNI (Group-Based
Activity)
Focus: RNI During Lactation (Extended Scenario Practice)
Time Allocation: 45–60 minutes per group
Group: 10 group (6 participants per group for 9 group, and 7 participants for 1 group)
CLO2: Apply nutrition standards and guidelines to guide people in different life
cycles to achieve optimum nutrition (C3, PLO2)
Topics with Instructions (Tutorial 2 – Advanced Application)
Topic 1: Early Postpartum Mother with Low Energy
Scenario Extension: She now complains of dizziness and headaches. Her 24-hour diet recall
shows low iron and thiamine intake.
Instructions:
1. Use Malaysian RNI to identify her key nutrient gaps.
2. Evaluate her diet and suggest improvements using a food-based approach.
3. Develop a 1-day corrected meal plan with estimated nutrient values.
Topic 2: Vegetarian Lactating Mother
Scenario Extension: She presents with signs of fatigue and hair loss. Blood work indicates
borderline B12 and low ferritin.
Instructions:
1. Cross-check her nutrient intake vs RNI for lactation.
2. Suggest food modifications, supplementation (if necessary), and practical strategies to
improve nutrient status.
3. Propose a simple nutrition education flyer outline for her.
Topic 3: Teenage Lactating Mother
Scenario Extension: Her BMI is low (17.5) and she’s breastfeeding twins.
Instructions:
1. Determine her updated energy, protein, and micronutrient needs.
2. Discuss challenges of adolescent lactation and nutritional strategies to support growth
and lactation.
3. Design a culturally appropriate food basket list (for food aid) that meets her needs.
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Topic 4: Low Milk Supply Concern
Scenario Extension: Despite dietary changes, her supply remains low. She’s considering
formula supplementation.
Instructions:
1. Re-assess her dietary intake and hydration.
2. Identify non-nutritional factors affecting lactation.
3. Prepare a simple checklist tool for healthcare staff to assess lactation adequacy from
a nutritional perspective.
Topic 5: Exclusive Breastfeeding While Fasting
Scenario Extension: She is experiencing constipation and low milk output during fasting.
Instructions:
1. Assess hydration status and fiber intake.
2. Recommend culturally appropriate pre-dawn and post-sunset food combinations that
meet RNI, and hydration needs.
3. Justify why each meal/snack meets her key nutrient requirements.
Topic 6: Lactation in Overweight Mothers
Scenario Extension: She reports skipping meals and consuming diet drinks to lose weight.
Her baby’s weight gain is now stagnant.
Instructions:
1. Critically assess her approach to weight loss during lactation.
2. Reconstruct a healthy 3-meal, 2-snack plan using local foods and portion control.
3. Use RNI to justify nutrient adequacy of your plan.
Topic 7: Mothers with Dietary Restrictions Due to Infant Colic
Scenario Extension: The mother has now eliminated wheat and soy based on online advice.
Her weight is dropping.
Instructions:
1. Recalculate her nutrient intake (macros and key micronutrients).
2. Develop a 1-day exclusion diet that still meets Malaysian RNI.
3. Write a 5-bullet nutrition counselling script to help her make evidence-based food
decisions.
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Topic 8: Working Mother Struggles with Balanced Diet
Scenario Extension: After 2 weeks of returning to work, she only eats 2 full meals daily and
skips snacks.
Instructions:
1. Analyse her intake based on RNI for energy, protein, calcium, and iron.
2. Prepare a realistic and flexible workplace meal plan (with backup snack ideas).
3. Suggest 3 environmental/behavioural strategies to support her diet adherence.
Topic 9: Inadequate Iron Intake During Lactation
Scenario Extension: She refuses supplements due to side effects and avoids red meat for
cultural reasons.
Instructions:
1. Calculate iron intake using Malaysian food database and compare with RNI.
2. Recommend 3 culturally acceptable iron-rich meals with enhanced absorption
techniques.
3. Draft a weekly meal schedule to maintain consistent iron intake.
Topic 10: Educating Rural Women on Lactation Nutrition
Scenario Extension: You’re now tasked with designing a basic food demo + handout for
low-income breastfeeding mothers in rural Sabah.
Instructions:
1. Identify 3 key nutrients to promote in the food demo.
2. Choose 2 simple, affordable recipes with locally available ingredients that support
lactation.
3. Draft a basic educational message in BM for the handout (max 100 words).