Pregnancy, a missed opportunity to influence later health?

Report by the Infant & Toddler Forum calls for nutrition guidance in pre-conception and pregnancy to be a public health priority

A report released today by the Infant & Toddler Forum (ITF)  highlights the need for pre-conception and pregnancy  to be seen as a critical ‘window of opportunity’ to improve the health of the next generation.

Backed by stakeholders in early life nutrition, including baby charity Tommy’s, Borne and the Pre-school Learning Alliance, the report, ‘Early Nutrition for Later Health: Time to Act Earlier’, acknowledges the emerging evidence that a mother’s weight and nutritional status before, during and between pregnancies can have a long lasting effect on the baby’s health and the risk of disease later in life. In fact how and what mothers eat could potentially affect the health of future generations.

The reality, however, is that we are not doing enough to take advantage of this opportunity. The report paints a picture of confusion and lack of advice for mums on nutrition and healthy lifestyles in pregnancy informed by a survey of 1,000 mothers and over 150 healthcare professionals:

  • Just under half (46%) of mums said they made no changes to their diet after finding out they were pregnant
  • 64 per cent of mums would welcome more advice or support relating to their pregnancy, with another one in two confused about the correct diet or supplementation for breastfeeding
  • One in three healthcare professionals have had no training in nutrition in pregnancy or infant breast feeding and 43% had no training in obesity in pregnancy

“Pregnancy and pre-conception need to be our new focus.” says Dr Atul Singhal, Professor of Paediatric Nutrition at the UCL Institute of Child Health, and Chair of the ITF. “Although, the early years are now well-established as critical to influencing health outcomes in later life, and whilst the past ten years have seen a growing commitment to early years intervention, obesity is still a major public health issue that continues to threaten the health of younger people. England is the ninth fattest nation in Europe, and one in four seven to 11-year-olds are overweight or obese[i]. That is why we need to focus earlier on in the life cycle, to influence nutrition and life choices from before conception through to preschool.

As we celebrate our 10th anniversary there has never been a more crucial time to seize this opportunity for pregnant mothers to enhance the health of their child and for our health system to support them.”   

In response to the findings, the ITF is expanding its educational remit to take a life course approach to nutrition and health, from pregnancy and infancy through to toddlerhood. The ITF’s aim is to support and empower healthcare professionals to help families to make healthy lifestyle choices by delivering clear, practical advice on those critical early windows of opportunity to provide children with the best start in life.

Gill Perks, Midwifery Matron, Antenatal and Postnatal Services, NHS, said:

“This report supports the Department of Health’s mantra of ‘making every contact count’. In pre-conception and pregnancy we must not miss this opportunity to advise and influence a woman’s health, nutritional and dietary habits and midwives are in an ideal position to support women in this. 

“The report supports greater emphasis within primary care of pre-conception clinics to guide all parents-to-be on nutrition and lifestyle. It also calls for action to increase the uptake of recommended vitamins and supplements during pre-conception, pregnancy and breastfeeding. It’s not just about giving information, we need to be able to support women to change behaviour by recognising what works for them and having the healthy conversation. A move I support.”

 The first factsheet in the new pregnancy series, Healthy Eating in Pregnancy is available to download from the ITF website. To find out more information on health and development from pregnancy to preschool, visit the ITF website and sign up for monthly email bulletins with news and information about the Forum. 


Notes to Editors

  • The report was informed by an in-depth survey and input from healthcare professionals and experts in the area of pregnancy, obesity and nutrition.  A survey of 1000 mums and 150 healthcare professionals was carried out by OnePoll in July 2014. Further results and executive summary are available from
  • Childhood overweight and obesity remains at about 30% and this level shows no signs of declining[ii]
  • The seeds of diabetes are sown very early in life – most excess weight before puberty is gained before five years of age[iii]
  • Diet-related disease cost the NHS £5.8bn a year in 2006-7[iv]
  • The life course approach suggests that some factors in the risk of adult chronic disease may begin in foetal life due to the lifestyle choices and the physical and social environment of the mother before and during pregnancy and her genetic inheritance influence the foetal environment.[v] There is increasing evidence that these risks begin in foetal life and continue into old age. Adult chronic disease, therefore, reflects cumulative differential lifetime exposures to damaging physical and social environments
  • The Infant and Toddler Forum brings together an independent, multi-disciplinary team of experts and practitioners from paediatrics, neonatology, health visiting, dietetics, child psychology, midwifery and obstetrics to share new ideas and to debate the latest thinking in infant and toddler nutrition. Best practice guidance on food and feeding for all young families is paramount for children’s health and wellbeing now and in the future For ten years the Forum and its partners have strived to raise awareness and promote positive change in the field of toddler nutrition and feeding behaviour, with all guidance being in alignment with DH increased emphasis on early years intervention.
  • The Infant and Toddler Forum is supported by an unrestricted educational grant from Danone Nutricia Early Life Nutrition. The views and outputs of the group, however, remain independent of Danone Nutricia Early Life Nutrition and its commercial interest.

[i] European Association for the Study of Obesity. Facts and Statistics. 2013. Available at Last accessed 21.02.14

[ii] Health and Social Care Information Centre, Lifestyles Statistics. Statistics on Obesity, Physical Activity and Diet: England, 2013, London. Available at Last accessed 21.02.14

[iii] Gardner DS, Hosking J et al. Contribution of early weight gain to childhood overweight and metabolic health: a longitudinal study (EarlyBird 36). Pediatrics, 123: e67-e73. 2009

[iv] Scarborough P, Bhatnager P et al. The economic burden of ill health due to diet, physical inactivity, smoking, alcohol and obesity in the UK: an update to 2006 – 2007 NHS costs. Journal of Public Health, May 2011, Vol. 33, No. 4, pp. 527 – 535

[v] Darnton-Hill I, Nishida C et al. A life course approach to diet, nutrition and the prevention of chronic diseases. 2004. Public Health Nutrition: 7(1A), 101–121 DOI: 10.1079/PHN2003584

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Further Reading

  • By Melanie Pilcher and Dr. Gillian Harris Establishing bedtime routines for toddlers and young children
  • By Dr. Gillian Harris, Honorary Senior Lecturer in Applied Developmental Psychology at the University of Birmingham and ITF member Most parents will struggle at some point to get their toddlers to eat certain foods. Is toddler food refusal a sign of an eating disorder. or is it merely a phase? In the run up to Eating Disorder Awareness Week, Gill Harris provides practical advice to help parents tackle fussy eating in toddlers.  
  • By Lucy Upton, on behalf of the Infant and Toddler Forum On behalf of the members of the Infant and Toddler Forum, I am proud to announce the launch of a new infant feeding educational programme, which includes practical resources for frontline healthcare professionals (HCPs) working with parents and infants.