[Acceptance of Recommendations of "Healthy Start - Young Family Network" on Infant Nutrition and Nutrition for Breastfeeding Mothers. A Survey of Different Professional Groups]. / Akzeptanz von Handlungsempfehlungen des Netzwerks "Gesund ins Leben ­ Netzwerk Junge Familie" zur Säuglingsernährung und Ernährung der stillenden Mutter. Befragung unterschiedlicher Berufsgruppen.

STUDY AIM: This study aims to measure the level of acceptance of the recommendations of the "Healthy Start - Young Family Network" on infant nutrition and nutrition for breastfeeding mothers among different professional groups. METHODS: A standardised online questionnaire was used to investigate the level of acceptance (dichotomised response mode: accept vs. not accept). The first survey was of midwives, gynaecologists and paediatricians among others, the second survey was of paediatricians. The level of acceptance was categorised as low (<75%), moderate (75-89%), strong (90-94%), very strong (95-99%) and absolute (100%). RESULTS: 1 311 health professionals participated in the first survey (n=908 midwives) and 77.6% reported having knowledge of the recommendations. The average level of acceptance was lowest among midwives (67.5%). 119 paediatricians participated in the second survey and 86.5% of this group said they had knowledge of the recommendations. A low acceptance level was mainly found with regard to recommendations on supplementation (fluoride and iodine). A focus on the individual situation of young families, an orientation towards other recommendations and subjective assessment were the main reasons for non-acceptance. CONCLUSION: Recommendations have not been successfully implemented in midwives' practices. Due to overrepresentation of midwives, the observed results do not necessarily apply to other occupational groups. However, the implementation of the recommendations into training and education of health professionals, revision of ambiguous statements as well as the communication of the scientific background of the recommendations are meaningful measures to raise acceptance levels.

German national consensus recommendations on nutrition and lifestyle in pregnancy by the 'Healthy Start - Young Family Network'.

Diet and physical activity before and during pregnancy affect short- and long-term health of mother and child. The energy needs at the end of pregnancy increase only by about 10% compared to nonpregnant women. An excessive energy intake is undesirable since maternal overweight and excessive weight gain can increase the risks for a high birth weight and later child overweight and diabetes. Maternal weight at the beginning of pregnancy is especially important for pregnancy outcome and child health. Women should strive to achieve normal weight already before pregnancy. Regular physical activity can contribute to a healthy weight and to the health of pregnant women. The need for certain nutrients increases more than energy requirements. Before and during pregnancy, foods with a high content of essential nutrients should be preferentially selected. Supplements should include folic acid and iodine, iron (in case of suboptimal iron stores), the ω-3 fatty acid docosahexaenoic acid (in case of infrequent consumption of ocean fish) and vitamin D (in case of decreased sun exposure and decreased endogenous vitamin D synthesis). Pregnant women should not smoke and not stay in rooms where others smoke or have smoked before (passive smoking). Alcohol consumption should be avoided, since alcohol can harm unborn children.

[Nutrition in pregnancy - Practice recommendations of the Network "Healthy Start - Young Family Network"]. / Ernährung in der Schwangerschaft - Teil 1.

Nutrition, physical activity and lifestyle in pregnancy influence maternal and child health. The "Healthy start - Young Family Network" supported by the German Government with the national action plan IN FORM developed recommendations on nutrition in pregnancy. Energy needs increase by only ≈10 % by the end of pregnancy whereas micronutrient needs increase much more. Normal weight should preferably be achieved before pregnancy. Dietary recommendations follow those for the general population. Folic acid supplements (400 µg/day) should be started before pregnancy and continue for at least the first trimester. Iodine rich foods and salt and an iodine supplement (100-150 µg/day) are recommended. Long-chain omega-3 fatty acids should be provided with ≥ 1 weekly portion of oily sea fish, or a DHA-supplement if regular fish consumption is avoided. Vitamin D supplementation is advisable unless there is regular exposure to sunlight. Health care professions should lead parents to health-promoting lifestyles. Subjects of part 2 of the article are practice recommendations on nutrition in pregnancy, especially vegetarian diets, recommendations on micronutrient supplementation, risk reduction of listeriosis and toxoplasmosis, alcohol, tobacco, caffeine and physical activity in pregnancy.

[Nutrition in pregnancy - Practice recommendations of the Network "Healthy Start - Young Family Network"]. / Ernährung in der Schwangerschaft - Teil 2. Handlungsempfehlungen des Netzwerks "Gesund ins Leben - Netzwerk Junge Familie".

Nutrition, physical activity and lifestyle in pregnancy influence maternal and child health. The "Healthy start - Young Family Network" supported by the German Government with the national action plan IN FORM developed recommendations on nutrition in pregnancy. Folic acid supplements (400 µg/day) should be started before pregnancy and continue for at least the first trimester. Iodine rich foods and salt and an iodine supplement (100-150 µg/day) are recommended. Long-chain omega-3 fatty acids should be provided with ≥ 1 weekly portion of oily sea fish, or a DHA-supplement if regular fish consumption is avoided. Vitamin D supplementation is advisable unless there is regular exposure to sunlight. Iron supplements should be used based on medical history and blood testing. Vegetarian diets with nutritional supplements can provide adequate nutrition, but counselling is recommended. In contrast, a vegan diet is inadequate and requires additional micronutrient supplementation. For risk reduction of listeriosis and toxoplasmosis, raw animal foods, soft cheeses and packed fresh salads should be avoided; fresh fruit, vegetables and salad should be washed well and consumed promptly. Pregnant women should remain physically active and perform sports with moderate intensity. They should avoid alcohol, active and passive smoking. Up to 3 daily cups of coffee are considered harmless, but energy drinks should be avoided. Childhood allergy is not reduced by avoiding certain foods in pregnancy whereas oily sea fish is recommended. Health care professions should lead parents to health-promoting lifestyles. Subjects of part 1 of the article are practice recommendations on nutrition, on energy needs, micronutrient needs and body weight/weight gain in pregnancy.