Healthy weight - local health systems support for pregnant women and young children: research

Research findings about how effectively local health systems seek to support pregnant women and children up to Primary 1 to have a healthy weight.


Footnotes

1. Primary 1 Body Mass Index (BMI) statistics Scotland, school year 2019 to 2020

2. This document will use the term 'women'/'woman' throughout. It is important to highlight that it is not only those who identify as women who require access to women's health and reproductive services. For example, some transgender men, non-binary people, and intersex people or people with variations in sex characteristics may also experience menstrual cycles, pregnancy, endometriosis and the menopause.

3. Scottish Health Survey 2019, Chapter 6: Diet and Obesity

4. A Castle (2015) Obesity in Scotland. SPICe Briefing, 15/01. 7 Jan 2015. Obesity in Scotland (parliament.scot)

5. Increased risks include: thrombosis, gestational diabetes, high blood pressure, pre-eclampsia, induction of labour, caesarean birth, anaesthetic complications and wound infections, miscarriage, giving birth early, having a big baby or having a stillbirth. See: Being overweight in pregnancy and after birth (rcog.org.uk)

6. Report of the commission on ending childhood obesity by WHO

7. Primary 1 Body Mass Index (BMI) statistics Scotland, school year 2019 to 2020

8. Puhl RM and Heuer CA. Obesity stigma: important considerations for public health. American Journal of Public Health. 2010 Jun;100(6):1019–28.

9. World Health Organization (2017). Weight bias and obesity stigma: considerations for the WHO European Region.

10. Health, The Lancet Public (2019). Addressing weight stigma. e168.

11. Simmonds M, Llewellyn et al. (2016). Predicting adult obesity from childhood obesity: a systematic review and meta-analysis. Obesity reviews, 17(2), 95–107.

12. Primary 1 Body Mass Index (BMI) statistics Scotland, school year 2019 to 2020

13. Food Standards Scotland - The Scottish Diet - It needs to change 2018 update

14. NHS National Services Scotland, Information Services Division 2018

15. Scotland's Public Health Priorities

16. Improving maternal and infant nutrition: a framework for action

17. National Performance Framework

18. Getting it right for every child (GIRFEC)

19. Scotland's Public Health Priorities - Eat well, have a healthy weight and are physically active

20. Consultation responses on the restrictions on the marketing of junk foods

21. BBC article - Junk food promotion ban 'paused' by coronavirus

22. A healthier future: Scotland's diet and healthy weight delivery plan

23. Preventing Overweight and Obesity in Scotland: A Route Map Towards Healthy Weight

24. Active Scotland Delivery Plan

25. Scottish Government (2017) The Best Start: a Five-Year Forward Plan for Maternity and Neonatal Care in Scotland

26. Universal Health Visiting Pathway in Scotland: pre-birth to pre-school

27. Child healthy weight is a term used in Scotland to capture both prevention and early-intervention/treatment activity

28. A healthier future: Scotland's diet and healthy weight delivery plan

29. Standards for the delivery of tier 2 and tier 3 weight management services for children and young people in Scotland

30. Department of Health (2013) Developing a Specification for Lifestyle Weight Management Services: Best Practice Guidance for Tier 2 Services.

31. This document will use the term 'women'/'woman' throughout. It is important to highlight that it is not only those who identify as women who require access to women's health and reproductive services. For example, some transgender men, non-binary people, and intersex people or people with variations in sex characteristics may also experience menstrual cycles, pregnancy, endometriosis and the menopause.

32. Report of the commission on ending childhood obesity by WHO

33. One case study board had to be replaced due to lack of capacity linked to the COVID-19 pandemic after two interviews had already been conducted

34. In one health board, four midwives took place in a mini group due to their preference for this method.

35. Using Excel, with each column representing a theme and each row an individual interview, so that the data can be sorted in different ways for further analysis.

36. Report of the commission on ending childhood obesity. Implementation plan executive summary by WHO

37. UNICEF Baby Friendly Accreditation website

38. This type of formula contains more casein than whey, and casein is harder for babies to digest. Although it's often described as suitable for "hungrier babies", there's no evidence that babies settle better or sleep longer when fed this type of formula.

39. The Family Nurse Partnership (FNP) is a programme in which specially trained nurses aim to improve the outcomes for young first time mothers (aged 19 and under across Scotland and aged 25 and under in some parts of Scotland). The programme is offered from pregnancy until the child is two years old.

40. Breastfeeding rates in Scotland have been steadily increasing. More than half (53%) of babies were being breastfed at 10-14 days of age in 2019/20 compared with 44% in 2002/03.

41. HENRY programme website

42. A Primary 1 review is offered to all children in mainstream and special state schools as part of the wider child health programme. Height and weight measurements are conducted by health staff and are entered into the Child Health Surveillance Programme - School (CHSP-S) national information system to support the production of national statistics. Although surveillance is the primary purpose of the reviews, some boards contact parents when a child is identified as having a high (or low) BMI.

43. School nurses' roles have changed in recent years as part of a wider programme of work to transform the roles of several health professions. They are less directly involved in Primary 1 health reviews but do still have a focus on prevention and early intervention.

44. Note that the 2010 SIGN Guidelines recommend the use of BMI centiles: Scottish Intercollegiate Guidelines Network (2010). Management of obesity: a national clinical guideline.

45. Public Health Scotland – BMI in Primary 1 Children in Scotland, Technical Report, School Year 2019/20

46. Near Me is a video consulting service that enables people to attend appointments from home or wherever is convenient. It is a secure form of video consulting approved for use by the Scottish Government and NHS Scotland.

47. The 2009 Institute of Medicine guidelines are generally used to define excess weight gain during pregnancy

48. The Scientific Advisory Committee on Nutrition is currently undertaking a review of maternal nutrition and maternal weight. The Scottish Government is awaiting the outcome of this to inform next steps on advice and training for healthcare professionals.

49. Counterweight is an intervention that aims to empower people to lose weight through clinically proven, dietician-led behaviour change programmes. It features structured informational sessions, educational learning materials, and regular monitoring for participants. It supports people to make sustainable changes so they can lose weight and reduce their risk of chronic disease.

50. More information can be found on the HENRY website

51. Early-Life Obesity Prevention: Critique of Intervention Trials During the First One Thousand Days (2017)

52. Scottish Intercollegiate Guidelines Network (2010). Management of obesity: a national clinical guideline.

53. Scottish Government (2017) The Best Start: a Five-Year Forward Plan for Maternity and Neonatal Care in Scotland

54. Scottish Intercollegiate Guidelines Network (2010). Management of obesity: a national clinical guideline

Contact

Email: socialresearch@gov.scot

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