UK midwives need more maternal nutrition information

UK midwives need more maternal nutrition information to effectively advise mums about vitamin D and iodine

Research amongst midwives from the UK reveals that they want more information on pregnancy and breastfeeding nutrients to help them effectively discuss nutrition with mothers.

The research conducted by Nutricia found that nine out of ten midwives said it is important that pregnant and breastfeeding women supplement their diet with additional vitamins. However, approximately only half of midwives (56.8 per cent) talk about supplementation with pregnant women during most or at
every appointment.1 Around 10 per cent said they never speak to breastfeeding mothers about supplementation.1

The Department of Health (DH) makes explicit recommendations for pregnant and breastfeeding mums to supplement their diet daily with additional vitamins and nutrients.2 However, not all midwives had the adequate information about these specific recommendations. “Midwives are busy and can find it challenging to include all the nutrition and dietary knowledge they have with mothers during appointments,” says Gill Perks, Lead Midwife at Queen Charlotte’s & Chelsea Hospital, Imperial College Healthcare NHS Trust.
Whilst nearly three out of four midwives (70.2 per cent) recognised folic acid as a DH recommended nutrient in pregnancy, only around half recognised vitamin D as a DH recommended in pregnancy (50 per cent) and breastfeeding (44.4 per cent).1
Less than 9 per cent of  midwives felt confident about discussing iodine.1 The World Health Organization recommends pregnant women have 250μg of iodine per day.3 The UK recommended nutrient intake (RNI) for pregnant women is 140μg/day (although this is considered too low).4 10-22 per cent of girls and young women in the UK have daily iodine intakes below these figures.5
“There is a vast amount of information that midwives are required to pass on to mums, in addition to providing the individual care every women needs – it is important that mums understand the significance of a healthy diet and the role of supplementation in meeting specific daily nutritional requirements which supports the future health of her baby,” says Gill. “Folic acid, vitamin D and
iodine are absolute essentials.”
Vitamin D plays an important role in keeping bones and teeth healthy in both mum and baby.6 Mild iodine deficiency during pregnancy can cause irreversible damage to the child’s cognitive ability, resulting in a lower IQ and consequently lower educational attainment.7 The World Health Organization recommend that pregnant and breastfeeding women take iodine supplements8 and a recent study published in the Lancet indicated cost effectiveness of supplementation which could result in huge cost savings for health care systems and society.7
“There is growing body of evidence that demonstrates the important role of nutrients in pregnancy and breastfeeding. By ensuring sufficient intake of a number of key nutrients, expectant mothers can positively affect the structure, function and adaptability of an infant’s organ, ensuring the lifelong health of their baby 9,10” says Charlotte Hemmings, Senior Science and Innovation Manager of Nutricia Early Life Nutrition.

Nutricia Materials for Midwives

The following resources are available for midwives on the nutrimum website, eln.nutricia.co.uk/midwifematerials  

1. Power of maternal nutrition visual to share with mums

A simple tool designed to support quality conversations about maternal nutrition.

2. Practical leaflet for mums

A short, printable guide to food and drink in pregnancy and breastfeeding that mums can take away with them.

References:

1. Nutrimum. Nutricia Midwives Survey. 2015. Data on file
2. Department of Health. The Pregnancy Book [Online]. 2009. Available at: http://webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/@sta/@perf/documents/digitalasset/dh_117166.pdf [Accessed:November 2015]
3. World Health Organization. Iodine supplementation in pregnant and lactating women [Online] Available online at: http://www.who.int/elena/titles/guidance_summaries/iodine_pregnancy/en/ [Accessed: November 2015]
4. Scientific Advisory Committee on Nutrition. Statement on iodine and health. 2014. Available online at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/339439/SACN_Iodine_and_Health_2014.pdf [Accessed
November 2015]
5. National Diet and Nutrition Survey: Headline results from years 1, 2 and 3 (combined) of the Rolling Programme [Online]. 2010. Available at: https://www.gov.uk/government/publications/national-diet-andnutrition-survey-headline-results-from-years-1-and-2-combined-of-therolling-programme-2008-9-2009-10 [Accessed November 2015].
6. NHS Choices. Vitamins and nutrition in pregnancy [Online]. 2015.
7. Monahan M, Boelaert K, et al. Costs and benefits of iodine
supplementation for pregnant women in a mildly to moderately iodinedeficient population: a modelling analysis. The Lancet. 2015;3(9):715-722
8. World Health Organization. Iodine supplementation in pregnant and lactating women. Available at: http://www.who.int/elena/titles/iodine_pregnancy/en/ [Accessed December 2015].
9. Scientific Advisory Committee on Nutrition. The influence of maternal, fetal and child nutrition on the development of chronic disease in later life. London, 2011.
10. British Nutrition Foundation Task Force. Nutrition and Development: short and long term consequences for health, 2013.
11. Williamson CS. Nutrition in Pregnancy. London: British Nutrition
Foundation [Online]. 2013. Available at: http://www.nutrition.org.uk/attachments/104_Nutrition%20in%20pregnancy.pdf [Accessed: November 2015].
12. Crawley H. Eating well for a healthy pregnancy. London: FirstSteps Nutrition Trust [Online]. 2014. Available at:
http://www.firststepsnutrition.org/pdfs/EatingWell_for_a_HealthyPregnancy_ for_web_6Mar2014.pdf [Accessed November 2015].
13. NHS Choices. Why do I need folic acid in pregnancy? Available online at: http://www.nhs.uk/chq/pages/913.aspx?categoryid=54&#close [Accessed November 2015].

Staff Writer