Improving Maternal and Infant Nutrition: A Framework for Action

More documents

Recommendations

Info

her wider community. The factors are varied and complex and are summarised inTable 1. 332.25 Categorising the influences in this way highlights that whilst the health servicehas a significant role in encouraging and supporting mothers to breastfeed, manyother organisations have a role to play in creating a supportive environment forbreastfeeding mothers, as well as in changing broader societal attitudes so thatbreastfeeding is accepted as the ‘cultural norm’.Table 1: Influences on Initiation and Duration of BreastfeedingMother, child, family • Age, parity, physical and psychological health of themother• Breastfeeding experience of the mother herself andwith previous children• Education, employment, social class, ethnicity, area ofresidence• Knowledge, attitudes, confidence in the ability tobreastfeed• Marital status, family size, support from partner andfamily• Lifestyles (smoking, alcohol, drugs, diet, physicalactivity)• Birth weight, gestational age, mode of delivery, healthof the newborn• Access to role models who have had positivebreastfeeding experiencesHealthcare system • Access to antenatal care and quality of care• Quality of assistance during delivery and in the first fewdays• Access to postnatal maternal and child healthcare andquality of care• Type and quality of professional support for lactationmanagement• Access to peer counselling and mother-to-mothersupportPublic health policies • Level of priority and financial support given tobreastfeeding• Official policies, recommendations and plans• Breastfeeding monitoring and surveillance systems• Quality of pre and in-service training of health workers• Financial support for voluntary mother-to-mothersupport activities• Communication for behaviour and social change anduse of different media for breastfeeding advocacySocial policies andculture• Legislation on and enforcement of the InternationalCode• Legislation on maternity protection and its enforcement• Representation of infant feeding and mothering in themedia
Infant Feeding and Growth• Obstacles and barriers to breastfeeding in public• Prevalence and activities of mother-to-mother supportgroups• Level of community awareness and knowledge2.26 It is well established that breast fed infants can have a slower rate of growththan formula fed infants due to the difference in composition between breast andformula milk. The composition of breast milk changes between and during each feedin response to the infant’s nutritional and developmental needs. From aphysiological perspective, frequent feeding in the early days and weeks is importantto establish maximum milk production. Breast fed infants are able to control theamount of milk they consume therefore they may learn to self-regulate their energyintake better than formula fed infants.2.27 It is suggested that the difference in protein intake between breast andformula fed infants may contribute to later adiposity. The higher protein intake informula fed infants is thought to programme later obesity through stimulation ofinsulin release and programming of higher long-term insulin concentrations. 34Emerging evidence strongly suggests the first few postnatal weeks are a criticalwindow for programming long-term health. Studies suggest that rapid weight gain ininfancy is strongly associated with later risk of obesity. 15 Conversely, there isevidence to suggest that poor weight gain and under nutrition in infancy areassociated with permanent stunting and cognitive impairment which leads to pooreroutcomes in adulthood, such as fewer years of attained education, and lower adultproductivity and earning capacity. 352.28 The new WHO Growth Charts were introduced in Scotland for all infants bornon or after 1 st January 2010. 36 The Growth Charts were developed following a studyof optimum growth in children undertaken in a selection of countries across theworld. The study showed that the growth patterns in breastfed infants were similarand recommended that one growth chart which reflects optimum growth – that ofbreastfed infants – should be adopted for use across the world. On previous chartsinfants who were breastfed appeared to grow slowly which was commonly thoughtby health professionals to cause anxiety among mothers, who took this to mean thattheir infant was receiving insufficient breast milk.Formula Feeding2.29 Although evidence shows that breastfeeding is undoubtedly the healthiestway to feed an infant, there are many mothers who for a variety of physical, social orpsychological reasons choose to feed their infant with infant formula. Most womenare physically able to produce enough breast milk for their infant, as long as theyreceive appropriate advice and care 37 .2.30 It is essential that a mother is not judged or discriminated against for choosingto formula feed her infant; she should receive the same level of support as abreastfeeding mother.
Page 1 and 2: Improving Maternaland Infant Nutrit
Page 3 and 4: © Crown copyright 2011ISBN: 978-0-
Page 5 and 6: • Indicators for Outcomes 6.9•
Page 7 and 8: Executive SummaryImproving the nutr
Page 9 and 10: IntroductionIn order to change infa
Page 11 and 12: important for the scope to go beyon
Page 13 and 14: 1.6 In 2003, the Royal College of P
Page 15 and 16: 1.17 The Healthy Start Scheme was i
Page 17 and 18: Chapter 2: Why is Maternal and Infa
Page 19: Birth Weight and Health2.10 A mothe
Page 24 and 25: 2.31 Infant formula is manufactured
Page 27: Summary2.48 The diet and nutritiona
Page 31 and 32: Birth weight of infants born in Sco
Page 33 and 34: Breastfeeding at Birth3.23 Informat
Page 35 and 36: Figure 5: Breastfeeding at the 6-8
Page 37 and 38: 3. Water should be added to the bot
Page 39 and 40: Chapter 4: Current Activity across
Page 41 and 42: AccreditedAyrshire Maternity Unit,
Page 43 and 44: Community Mothers Breastfeeding Sup
Page 45 and 46: 4.18 Just over half of Boards had a
Page 47 and 48: policies for each nursery, provisio
Page 49 and 50: 4.26 Eight Boards had an obesity st
Page 51 and 52: Promoting and Supporting Breastfeed
Page 53 and 54: Parents Cooking Group, Gowans Child
Page 55 and 56: Chapter 5: Process for Development
Page 57 and 58: FoodMediaKnowledgeSkillsIncomeCommu
Page 59 and 60: Government and WHO publications. It
Page 61 and 62: OUTCOMESShort Term (0-3 yr) Medium
Page 63 and 64: 5.24 The activities were compared t
Page 65 and 66: • Introduce new routinely collect
Page 67 and 68: Chapter 7: Action Plan7.1 It is rec
Page 69 and 70: training and be integrated into und
Page 71 and 72: 2. Baby Friendly InitiativeActivity
Page 73 and 74:
3.5 Work with private sector compan
Page 75:
Breastfeeding Mothers• Access to
Page 83 and 84:
18. Kelly Y, Panico L, Bartley M, e
Page 85 and 86:
56. Gregory J, Collins D, Davies P
Page 87 and 88:
Appendix 1: Membership of Maternal
Page 89 and 90:
Appendix 2: Membership of sub-group
Page 91 and 92:
Appendix 3: Healthy eating advice f
Page 93 and 94:
Appendix 4: NICE Public Health Guid
Page 95 and 96:
Appendix 5: Indicators for Short, M
Page 97 and 98:
6 All relevant national & localpoli
Page 99 and 100:
complementary feedingRelevant resou
Page 101 and 102:
15 Increased acceptability ofbreast
Page 103 and 104:
23 reduced inequalities in childnut
show all

Improving Maternal and Infant Nutrition: A Framework for Action

Create successful ePaper yourself

Delete template?

Save as template?