Here we share news and information of interest to GPs and other Health Care Professionals in the field of perinatal health. Please also visit our Useful Resources page where we link relevant new and important resources.
January 15th 2025
GPCPC welcomes the release of NICE guideline on Maternal and child nutrition NG247 on Wednesday 15th January 2025 https://www.nice.org.uk/guidance/ng247
The guideline is aspirational. Resources to support implementation, education, training and additional work are left to local commissioners and providers to fund, without additional resources. Examples include referral during pregnancy to local cookery classes or healthy eating groups (1.2.4), weighing babies at 12 and 16 weeks at the time of immunization (1.4.2) and a new 4-5 month discussion about the introduction of solid foods for babies by a health visitor or community worker (1.5.5).
Significant changes for GPs include a recommendation to take 400 micrograms of folic acid rather than 5mg/day for those with a BMI >25kg/m2 and those at risk of pre-eclampsia (1.1.6 and 1.1.7) in the pre-conception period and the first 12 weeks of pregnancy, if they have no other risk factors for neural tube defect or other congenital malformation.
The guidelines recommend that women and people who have had bariatric surgery and who are planning a pregnancy or in early pregnancy should be referred to their bariatric unit for specialised advice on folic acid and micronutrients (1.1.8). GPCPC is aware that approximately half of those who have bariatric surgery have this performed outside the UK and are concerned about where they will receive their advice, without overloading bariatric services.
GPCPC is concerned that the advice regarding taking Vitamin D supplements during pregnancy and breastfeeding in current UK Government guidance and in this updated guideline is potentially confusing for healthcare professionals and the public, as recommendations to take a daily supplement vary based on the season, a persons’ skin tone, clothing or indoor lifestyle. We note that advice on taking a daily Vitamin D supplement in pregnancy and breastfeeding currently differs across respected national healthcare resources and we would welcome consistency, clarification and rationale around this.
GPs need to be aware of the Healthy Start scheme, although this is only relevant for those on benefits, and is not available until 10 weeks of pregnancy.
In addition, free and low-cost Health Start Vitamins are commissioned in some areas of the country for those who do not qualify for the Health Start scheme, and are widely available from primary or community care and pharmacies in those areas. GPCPC feels that every area in England should be obliged to commission and promote this service. This should include access for women and people who are planning to become pregnant and early in pregnancy when folic acid for the prevention of neural tube defects is recommended by the guideline. A failure to commission this service could have an impact on health inequalities.
We are pleased to see that information about returning to work for breastfeeding parents has been expanded to include advice for employers and education providers as well as for the parent (1.3.14).
Finally, as GPs we are extremely pleased that the Guideline has retained the vitally important recommendation regarding the use of ‘appropriate resources for safe medicine use and prescribing during breastfeeding’ (1.3.6) and reference to the UKDILAS service.