maternal and child nutrition implementing nice guidance 2008 nice public health guidance 11
TRANSCRIPT
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Maternal and child nutrition
Implementing NICE guidance
2008
NICE public health guidance 11
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What this presentation covers
Scope
Key priorities for implementation
Costs and savings
Discussion
Find out more
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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
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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
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• 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
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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
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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
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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
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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
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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
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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
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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
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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?
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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?
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Find out more
Visit www.nice.org.uk/PH011 for:
• Other guidance formats
• Costing statement
• Audit support