Technical Paper 1:
Obesity in Australia: a need for urgent action
4.8 - Maternal and child health
There are serious adverse effects of overweight during pregnancy, with the risk of complications increased for both mother and baby. Obstetric risk increases with BMI among overweight and obese women. Programs targeting pregnant women in healthy eating, activity and weight could enhance obstetric outcomes and reduce healthcare costs of obesity-related increases in maternal and neonatal morbidity. Initiatives such as the UK Child Health Promotion Programme aim to identify families most at risk due to child weight issues through a series of health reviews, including assessments in the early stages of pregnancy, allowing health professionals to identify and provide mothers who are already obese or overweight with advice on healthy weight gain in pregnancy.
In addition to the protective role breastfeeding may have in several chronic diseases, breastfeeding (including delaying weaning until babies are six months old) plays an important role in helping to prevent obesity in children. This has been attributed to physiological factors in human milk as well as feeding and parenting patterns associated with breastfeeding. While the proportion of Australian infants ever breastfed was around 86–88% between 1995 and 2005, in 2001 less than half (48%) of all infants were receiving any breast milk at the age of six months, and none were being exclusively breastfed. The proportion of children receiving any breast milk declines steadily with age.
Australian recommendations for breastfeeding reflect the international recommendations of exclusive breastfeeding for the first six months of life, with the introduction of complementary foods and continued breastfeeding from six months of age.
In 2001, the proportion of Australian children receiving breast milk was higher among more highly educated and older mothers (aged over 30 years). Indigenous mothers in non-remote areas appear to be less likely to initiate and continue breastfeeding than other Australian mothers. These data suggest the need for targeted interventions among urban Indigenous mothers, as well as younger and less educated mothers to increase levels and duration of breastfeeding.
The Australian Government has announced funding to upgrade the existing breastfeeding helpline to a national 24-hour toll-free helpline, and to provide training for health professionals and research to support breastfeeding, including barriers and enablers to breastfeeding, indicators of breastfeeding rates and the development of dietary guidelines for pregnant and breastfeeding women.12
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New UK strategies to enhance breastfeeding behaviours include: promotion of breastfeeding as the norm for mothers (as part of a comprehensive healthy development marketing program); the implementation of the UNICEF ‘Baby-Friendly Initiative’ in hospitals and communities with low breastfeeding rates; a code of best
practice for employers and businesses on how to support and facilitate employees and customers who breastfeed; guidance for relevant professionals to encourage breastfeeding; and establishing parental support groups.
Due to the susceptibility of Indigenous women to obesity compared with non-Indigenous women, it is crucial that relevant National Indigenous Health Equality Targets from the ‘Close the Gap’ report are met, such that all Indigenous women and children have access to appropriate mother and baby programs within 5–10 years; 75% of all Indigenous pregnant women present for first antenatal assessment within the first trimester; and there is national coverage of maternal and child health services for Aboriginal and Torres Strait Islander people.
Develop targeted programs to encourage healthy eating for pregnant women and breastfeeding for newborns.