"Lactating women are considered a nutritionally high risk group
and so documentation of nutrition counseling is required."

Liz,

Who determined this? The hospital, feds, the Joint Commission on Hospital
Accreditation?  What are they at risk from?  Vitamin E deficiency? Zinc
depletion?  I am a dietitian who has worked at county health department
clinics for 8 years and I have never considered Lactating women to be high
risk.  Even the Women, Infants and Children's Supplemental Feeding Program
(or WIC) doesn't consider them high risk.  Only a higher priority.

And, if someone has determined them to be high risk, why isn't the
dietitian seeing them?  Seems a contradictory policy.

Most dietitians have limited resources (after all, we just tell people how
to feed themselves and their families… a task for simpletons).  Thank God,
most of the dietitians I work with have imaginations, ingenuity and
initiative.  If a handout is needed for the complicated diet of lactating
women (careful not to bite the tongue while it's in your cheek), there are
often materials that are not copywritten and are available from Cooperative
Extension, the Journal of Nutrition Education, pictures of foods from seed
catalogs, etc.  Am I allowed to mention (?) that our local dairy counsel
has given us freebie information with pictures and some are available in
Spanish.  This is also true of WIC.  Is there a local college around? 
There are usually dietetic and/or nursing students DYING for volunteer
experiences.  Tell them what you need and let them loose.  I have had
dozens and they are wonderful, enthusiastic, and worth the time that you
spend with them.  (While you're at it, can the nursing or dietetic students
follow you around for a day?)  ADA pamphlets are notoriously dry, boring,
expensive, and out of touch with the population that I work with, but there
are local dietetic associations (she should be a member) and practice
groups that are a fount of ideas

My diet counseling of Lactating women consists of this "eat when your
hungry, drink when you're thirsty".   I haven't had one Lactating mom die
on me yet.  Counseling mothers who are formula feeding babies… now that's
hard!

Incidentally, as a Lactating mother, I follow my own advice.

Luz Smeenk, MS, RD, whose baby girls (4 months and 3 ½ years old) are fast
asleep