“Eat well” is a Key Message in both the Beginnings Pregnancy Guide
and the Parents Guide. Nutrition is a topic warranting consistent,
frequent discussion and planning with mothers in prenatal care and
postpartum visits, home visiting, parent education, medical home
outreach, and well-child and well-woman visits. We are reviewing
the nutrition information in the Parents Guide to prepare the
forthcoming 4th edition. Here’s why nutrition matters even more
than we thought:
Chronic disease starts in the womb
For every 10 Americans who die each year; seven succumb to a
chronic disease. Heart disease, cancer, and stroke account for half
of all deaths. Risks for- and protections against such diseases,
plus type 2 diabetes, obesity, hypertension and osteoporosis,
begin to accumulate before birth. Nutrition plays a major role.
Adult health problems can be set in motion during pregnancy and
early childhood through “early programming”. That term refers
to exposures during sensitive development periods that may
permanently alter the function of organs and body systems. For
example, if during pregnancy a mother gets too few calories, or
sufficient calories but few essential nutrients, the baby’s body
adjusts development to make use of whatever is available. These
adjustments help ensure survival of the infant, but create organs
and systems that do not fit a healthier environment, placing the
child at risk, even in the presence of nutritious foods. Children
who did not thrive in the womb, and then consume excess calories
are at greatest risk for adult health problems.
Risks (low quality food, lack of exercise, excess weight) accumulate
over time. On the other hand, protections (breastfeeding, prenatal
vitamins, high quality foods in appropriate portions) also accumulate.
Critical periods when exposure to risks and protections either promote
or compromise development and future health include pregnancy,
and birth to age 3, the timeframes addressed in the Beginnings Guides..
“Nutrition Literacy” is not enough
Enabling mothers and families to eat well, takes more than health
education to ensure understanding what makes a healthy diet. It
takes supports that enable mothers to act on their knowledge. It
takes supports for breastfeeding initiation and continuation after
return to work. It takes transportation to stores that carry quality
food at affordable prices. It takes time to plan and prepare meals.
It takes safe places to exercise. And it takes “food security”.
For most of us reading this, nutritious safe food is plentiful and
easy to get. That contributes to our physical and mental health
and school performance. But many of the families we serve enjoy
no such food security; 37% of households headed by a single woman
and 43% of families living below the federal poverty line live with
low quality food or hunger.
Want to know more, do something?
This information comes from a free online course from the
University of Washington Northwest Center for Public Health
Practice. The course is addressed to practitioners and includes
tools for addressing maternal child nutrition in your community.
It is self-paced and takes about an hour and 15 minutes to complete.