Healthy start: Impact of new food provision schemes

Picture of baby being held by mother

Principal Investigator:

Fiona Ford (Reproductive and Developmental Medicine); Robert Fraser (Reproductive and Developmental Medicine)

Researcher:

Rebecca Roberts; Theodora Mouratidou; Kate Percival; Sarah Wademan.

Aims and objectives:

From a date to be notified in mid to late 2006, the longstanding UK Government Welfare Food Scheme for low-income pregnant women and children, which provides liquid and formula cow´s milk, is to be replaced by an initiative called `Healthy Start´ which will:

  • Include fresh fruit and vegetables as well as milk and infant formula milk;
  • Support breastfeeding;
  • Encourage earlier and closer contact between health professionals such as midwives and health visitors and families from disadvantaged groups

Low-income mothers are at nutritional risk and more likely to have a poor pregnancy outcome such as a low birth weight (LBW) baby i.e. birth weight less than 2500g. Apart from being undernourished low-income women are likely to have a low level of education, smoke, live in poor housing and have stressful lives. Intertwined with the effects of low income are stress and anxiety from many sources including increased physical work, isolation, lack of social support, illness, close birth intervals and ambivalence about pregnancy outcomes.

A key objective of this part of the Changing Families, Changing Food Programme will be to identify current practice in maternal and child nutrition and breastfeeding in a disadvantaged community. Outcomes will include assessment of dietary intakes, feeding and eating patterns in low-income pregnant women and their infants, and an evaluation of the introduction of `Healthy Start´ on these behaviours.

Research questions:

  • Do pregnant women and new mothers in Sheffield eat an adequate diet?
  • How do household income, ethnicity, maternal age and education level, dietary intake, cooking ability and shopping behaviour of mothers in Sheffield, influence the feeding of their infants?
  • Will the introduction of the new ‘Healthy Start’ initiative affect the dietary intake of pregnant women and new mothers in Sheffield?
  • Do health and social care practitioners in Sheffield have the expertise, confidence and capacity of to provide the dietary information recommended under the ‘Healthy Start’ initiative, to low-income pregnant women, new mothers and their infants?

Research design:

The project will consist of a Service Evaluation before and after the introduction of the `Healthy Start´ initiative amongst recipient women and their children in Sheffield.

It is hoped to recruit as many eligible women as possible up to a maximum of 500 between November 2005 and the autumn of 2006 (Before `Healthy Start´ evaluation). After `Healthy Start´ is introduced in September 2006 a similar number of women will be recruited (After `Healthy Start´ evaluation).

The following four instruments will be administered as appropriate to Caucasian and Pakistani pregnant and postpartum women, by the nutrition research team (NRT) based at the Jessop Wing:

  • Food Frequency Questionnaire (FFQ);
  • 24-hour dietary recall;
  • Subject Information Questionnaire (SIQ);
  • Infant Feeding Questionnaire (IFQ).

Before the `Healthy Start´ Evaluation...

November 2005 – September 2006

  • Administer FFQ and SIQ to Caucasian pregnant women
  • Administer SIQ and 24 hour dietary recall to Pakistani pregnant women
  • Administer SIQ, IFQ and FFQ to Caucasian postpartum women at 1, 2, 3, 4, 5, 6 and nine months postpartum
  • Administer SIQ, IFQ and 2 x 24 hour dietary recalls to Pakistani postpartum women at 1, 2, 3, 4, 5, 6 and nine months postpartum.

After the `Healthy Start´ Evaluation...

October 2006 – September 2007

  • Administer FFQ and SIQ to Caucasian pregnant women
  • Administer SIQ and 24 hour dietary recall to Pakistani pregnant women
  • Administer SIQ, IFQ and FFQ to Caucasian postpartum women at 1, 2, 3, 4, 5, 6 and nine months postpartum
  • Administer SIQ, IFQ and 2 x 24 hour dietary recalls to Pakistani postpartum women at 1, 2, 3, 4, 5, 6 and nine months postpartum