Maternal and child nutrition

Implementing NICE guidance

2008

NICE public health guidance 11

What this presentation covers

Scope

Key priorities for implementation

Costs and savings

Discussion

Find out more

Scope

Maternal diet and nutrition – pre-pregnancy,

during and post-pregnancy

Infant feeding – infant formula and breastfeeding

Diet and nutrition for babies from 6 months old

and pre-school children – including weaning, weight monitoring, allergy prevention and oral health

Addresses disparities in low-income and

other disadvantaged groups

Key priorities for implementation

• Promote the Healthy Start scheme• Train staff in maternal and child nutrition• Advise women to take folic acid and vitamin

D supplements, as appropriate• Promote and support breastfeeding

• Encourage all those who may be eligible to apply: ensure forms and vitamin supplements are available

• Offer Healthy Start vitamin supplements to all women and children who are eligible

• Offer eligible parents tailored support and advice on using Healthy Start vouchers, on breastfeeding and on how to introduce infants to solid foods

• Audit local uptake

Training

Caring for women who may become (or who are) pregnant and children under 5 requires training in:

• their nutritional needs • the rationale for recommending supplements • how to provide dietary advice• breastfeeding management (BFI minimum standard)• practical ways of changing eating behaviour

Vitamin D for pregnant and breastfeeding mothers

Ensure health professionals know about the importance of vitamin D supplements

Offer pregnant women information and advice at first booking appointment, on the benefits of taking a suitable daily 10 mcg supplement – such as Healthy Start

Ensure those at greatest risk of a deficiency are taking vitamin D

Breastfeeding promotion

• Use a multi-faceted approach or coordinated programme of interventions across different settings

• Use the Baby Friendly Initiative (BFI) as a minimum standard

• Develop a written, audited and well-publicised breastfeeding policy that includes support for staff who are breastfeeding

• Identify a health professional responsible for implementing this policy

Breastfeeding support

Peer supporters should:

• receive externally accredited training

• be part of a multidisciplinary team and receive ongoing support

• contact new mothers within 48 hours of their transfer home (or 48 hours of a home birth)

• offer mothers ongoing support according to need

Folic acid

Advise women who may become pregnant and those up to 12 weeks pregnant to follow a folate rich diet and take a 400 mcg folic acid supplement daily

Prescribe 5 mg a day if they have a family history of neural tube defect (NTD), have given birth to a baby with NTD or have diabetes

Ensure local initiatives stress the importance of folic acid and the availability of suitable supplements

Costs

This guidance is unlikely to have a significant impact on costs, based on national assumptions

Locally this may vary and additional resources may be required for:

•breastfeeding peer support•training•the provision of Healthy Start vitamins•link workers•family nutrition programmes

Savings

Implementing this guidance may reduce:

• some childhood illnesses

• the rate of obesity among adults and children

• the risk of some cancers among mothers

• neural tube defects

Discussion: breastfeeding

• To what extent have we implemented the BFI standard or its equivalent?

• How do we train our peer supporters?

• How well are peer supporters working as part of a multi-disciplinary team?

Discussion: diet and nutrition

• How do we encourage healthy eating among women who are (or who may become) pregnant and pre-school children?

• How can we improve uptake of Healthy Start?

• How can we improve awareness of the importance of vitamin D and folic acid supplements?

• How can we improve uptake of vitamin D/folic acid?

Find out more

Visit www.nice.org.uk/PH011 for:

• Other guidance formats

• Costing statement

• Audit support