Fast Track Analysis


  1. 7-Day Food Intake

  2. Prepare Nutrition Prescription

  3. Implement Nutrition Prescription

  4. Iron Deficiency Anemia(Client PDF Handout)

  5. Global Issues

    The Higgins Method of Nutritional Rehabilitation During Pregnancy

Agnes Higgins

  Agnes Higgins Agnes C. Higgins, CM, BSc, PDt, FRSH, LLD was a nutritionist and later the Executive Director of the Montreal Diet Dispensary from 1948 until her retirement in 1981. She died August 27, 1985. Mrs. Higgins cared deeply about the women who came for nutrition services and for their wellbeing and that of their babies. Described as "a woman of vision," she developed a system for nutrition assessment and counseling during pregnancy. She carefully evaluated her outcomes and refined her method.

This was "....the first systematic approach to defining the nutrition needs, problems and risk factors for individual pregnant women, a concept that was well ahead of its time. She went on to formulate a program for meeting these needs, sometimes to the extent of actually providing the needed foods to women who could not afford them.....Mrs. Higgins, who also was responsible for introducing the WIC program in Canada, sought what she called "Blue Ribbon Babies." (March of Dimes)

The following quotation is from her "Preliminary Report of a Nutrition Study on Public Maternity Patients 1963 - 1972:"

"Prenatal nutrition studies published since 1941 have demonstrated the benefits of improved nutrition regarding mortality and morbidity of infants and mothers and the vulnerability of the pregnant woman and fetus to the effects of malnutrition.

Prompted by these research findings, the Montreal Diet Dispensary in 1948 requested permission of the Royal Victoria Hospital to give nutrition counseling to mothers attending its settlement maternity clinics located in Verdun, Rosemount and at the Chandler Health Center and the Montreal General Hospital. With the experience gained in the fifteen years of service at these clinics prior to the inception of the study in 1963, a procedure of nutrition counseling was developed which has been used in the current study."

Her results (see references below), so interested the March of Dimes that they sent teams of health professionals to Montreal to learn her methods. Between May 15, 1978 and June 26, 1981 23 teams of nutritionists, nurses, physicians and certified nurse-midwives from the United States, for a total of 135 participants, attended three week intensive courses. An additional 8 Canadians participated in the final year. I was fortunate to be one of her students through this March of Dimes sponsorship.

Montreal Diet Dispensary

  The Montreal Diet Dispensary began in 1880 as a food kitchen for the poor of Montreal. Over the years, through the efforts of a dedicated staff of nutritionists, and a voluntary Board of Directors, it developed into a major force in the community for improvement of maternal and child health. In addition, through dissemination of the Higgins Method, it has had, and continues to have, a significant international impact on the nutrition care of pregnant women and the subsequent health and wellbeing of childbearing women and their babies.

The Higgins Method Of Nutritional Rehabilitation During Pregnancy

  Goal: "The goal of the Higgins Nutrition Intervention Program is to identify pregnant women at risk for adverse pregnancy outcomes and to intervene so as to prevent those adverse outcomes." (1989)

Process: "The Higgins program utlizes an individualized approach to dietary treatment that combines an assessment of the risk profile for the presenting pregnancy with the application of specific nutritional rehabilitation allowances to compensate for the negative impact of diagnosed risks.." (1989)

Procedures: See Tutorials 1, 2 and 3

Agnes Higgins' Guiding Concepts

  1. For every individual there is a genetic design which cannot be fulfilled without adequate nutrition

  2. The origin of much of the mental, motor and sensory disability occurs in the third trimester and may be prevented through improved perinatal care with emphasis on nutrition.

  3. Mothers enter pregnancy in varying degrees of nutritional status. Experience at the Montreal Diet Dispensary has demonstrated that it is possible through an intervention program of individual nutritional assessment and rehabilitation for an undernourished disadvantaged mother to produce an advantaged child.

  4. The success of nutritonal intervention depends not only on the science of determining individual nutritional requirements but also on the art of counseling involving behavioral skills.

  5. Birth weight is the crucial factor relating nutrition of the mother to infant mortality and morbidity.

  6. The factors relating to birth weight are pre-pregnancy weight, weight gain during pregnancy, and smoking, all of which are related directly or indirectly to nutrition.

  7. The recommended weight gain for each mother is the one which provides adequate nutrition for optimal growth and development of her baby.
Montreal Diet Dispensary 1979

References (partial list)   Higgins, Agnes C. : Nutritional status and the outcome of pregnancy. J Can Diet Assoc 37:17, 1976

Sweeney, C., Smith,H., Foster, J., Place, J., Specht, H., Kochenour, N., & Prater, B. (1985, May/June). The effects of a nutrition intervention program during pregnancy: Maternal data Phases I and II. Journal of Nurse-Midwifery, 30(3), 149 - 158

Higgins, Agnes C., Pencharz, Paul B., Mikolainis, Denise, and Dubois, Sheila: Impact of the Higgins Nutrition Intervention Program on birth weight: a within-mother analysis. J Am Diet Assoc 89:1097 - 1103, 1989

Dubois, S., Coulombe, C., Pencharz, P., Pinsonneault, O., and Duquette, M-P. Ability of the Higgins Nutrition Intervention Program to improve adolescent pregnancy outcome. J Am Diet Assoc. 1997; 97:871 - 878

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