83developmental considerations for the adolescent

Despite the high risk for pregnant teens, there is a paucity of research on effective interventions for their care and nutrition [7]. Providers can extrapolate from the research on adolescents in general to identify strategies to motivate and guide these young women to nourish themselves and their babies. To develop an approach for pregnant adolescents it is first appropriate to examine theories of development for this age group.

Erickson proposed the developmental tasks of teenagers as accepting body image, determining and internalizing sexual identity, developing a personal value system, preparing for productive function, achieving independence from parents and, finally, developing an adult identity [8]. Pregnancy, planned or unplanned, has a tremendous impact on all of these tasks, both positive and negative. How does a young woman accept a body image that is changing every week? How does she deal with a rapid weight gain in a culture that is fraught with "skinny" images and advertisements for weight loss products? It has been reported in the literature that lesbian and bisexual young women are at higher risk for pregnancy compared with their peers, although it is unclear why this is the case; how do their attempts to internalize their sexual identity impact on this risk [10]? Some young women may plan their pregnancy to demonstrate their complete rejection of their parents' value system (thus stating their own) and achieving independence through their actions. And, some may become pregnant as acceptance of a value system where parenthood is a defining necessity of adulthood.

Against this background, providers struggle to provide the interventions that will assist young women to successfully navigate into adult roles and maintain health for themselves and their infants. Appropriate nutrition is one aspect of these interventions for their patients. The first step is to establish the individual needs of the pregnant adolescent in light of the current recommendations.

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