Improving Maternal and Infant Nutrition: A Framework for Action

Executive SummaryImproving the nutrition of mothers and infants cannot and must not operate inisolation, it should be seen in the broader context of improving the health andwellbeing of everyone of who lives in Scotland. This Framework is aimed at a varietyof organisations with a role in improving maternal and infant nutrition. There aremany partner organisations but, primarily, the NHS, local authorities, employers, thecommunity and voluntary sector have the most opportunity to influence culture andbehaviour change. The framework is aimed at policy makers within theseorganisations as well as frontline staff and volunteers.We know that the diet and nutritional status of the mother before conception andduring pregnancy, the feeding received by the infant in the first few months of life,the process of weaning onto solid foods and the diet and nutrition status of thegrowing infant all contribute significantly to the long term health of the population.Although there has been national and international recognition of the need topromote and support breastfeeding for a number of years, resulting in positive actionacross many agencies, there has not always been the same focus on improving thenutrition of pregnant women, nor on the nutrition of young children beyond milkfeeding. The framework stresses the importance of nutrition in the earliest years forlong term health and wellbeing, but also provides case studies demonstrating someof the good practice already in place across Scotland.The framework also highlights the vital role of significant others to the family in thechoices made by parents in feeding their children. The existence of supportiveenvironments facilitating parents to provide optimum nutrition for their family iscrucial to success.The detrimental effect of health inequalities on maternal and infant nutrition is alsorecognised in the framework, resulting in the recommendation of targeted support tothose most in need to ensure that health outcomes for children are maximised andthe gap between the most and least healthy is reduced.It is vital that a mother’s diet contains adequate nutrients and energy at each stageto allow proper foetal growth and development as well as providing the nutrients themother needs for maintaining her own health. Poor foetal growth and developmentcan lead to cognitive impairment and influence the development of chronic diseasein later life. The impact of birth weight on long term adult health is well established.It is therefore crucial that women are given advice and support to eat healthilybefore, during and after pregnancy. Also, given the rise in overweight and obesity inthe general population and in women of childbearing age, the number of womenlikely to be entering their first pregnancy and subsequent pregnancies alreadyoverweight or obese is of concern. The Framework therefore includes measures toaddress the needs of this population group.The Scottish Government has adopted as policy World Health Organisation (WHO)guidance recommending exclusive breastfeeding for the first six months of an