Improving Maternal and Infant Nutrition: A Framework for Action

important for the scope to go beyond the recognised definition of an infant (which is12 months). The Strategy Group recognised the considerable amount of work thathas previously focused on the nutritional wellbeing of children in early years settingsand therefore the Framework builds on that work. The Strategy Groupacknowledged that the nutritional requirements of children varies between thoseaged 1-3 years and 4-6 years therefore in practical terms, it was considered that theFramework should include children up to their third birthday.What will the Framework not Cover?The Framework takes a population approach and while it considers healthinequalities in the broadest sense, it does not specifically address the nutritionalneeds of particular groups of children such as those in hospital/neonatal units orthose with medical conditions. Similarly the Framework does not seek to addressthe nutritional needs of mothers with chronic illness. The nutritional needs for boththese groups is covered elsewhere in other work streams such as NHS QualityImprovement Scotland standards on food, fluid and nutritional care in hospitals andBaby Friendly Initiative standards for neonatal units.What will it Require to Achieve Success and how will we Measure it?An outcomes framework identifying short, medium and long term outcomes has beendeveloped together with a set of indicators for each outcome, and these will beessential components in measuring our success. Strong leadership and localchampions at every level will form an essential element to the success of theFramework. In order to achieve success, there may be a need to reprioritiseresources and refocus efforts on the very early years.At local level, activities to improve maternal and infant nutrition must be embedded inrelevant NHS strategies and crucially in joint inter-agency plans for healthimprovement including Community Plans, Single Outcome Agreements andChildren’s Service Plans.The majority of the activities recommended in the action plan are underpinned by arobust evidence-base, however for some activities there is a lack of evidenceavailable. Practice evaluation will be crucial in growing our understanding of whatare the most effective interventions to improve maternal and infant nutrition. Despitethe lack of evidence in some areas, a pragmatic approach using practitioner opinionand experience was adopted, therefore, some activities are evidence-informed ratherthan evidence-based. The rationale underpinning each activity is presented in asupporting document ‘Rationale supporting the Maternal and Infant Nutrition ActionPlan activities’ accompanying this Framework.