Review decision: 

The guideline will be fully updated after the reports detailed in section 8 of the review decision paper have published.

This guidance has been partially updated by PH56 Vitamin D: increasing supplement use among at-risk groups

This guidance is for health professionals, commissioners and managers, pharmacists, those providing pre-school childcare and other relevant public, community, voluntary and private sector organisations. 

It relates to pregnant women (and those who are planning to become pregnant), mothers and other carers of children aged under 5 and their children. It is particularly aimed at those on a low income or from a disadvantaged group.

Recommendations for health professionals include:

  • Provide women with information and advice on the benefits of taking a vitamin D supplement (10 micrograms [μg] per day) during pregnancy and while breastfeeding.
  • Provide Healthy Start vitamin supplements (folic acid and vitamin C and D) for eligible pregnant women.
  • NHS commissioners and managers are advised to implement a structured programme to encourage breastfeeding within their organisations. It should include training for health professionals.
  • Encourage breastfeeding by providing information, practical advice and ongoing support – including the help of breastfeeding peer supporters and advice on how to  store expressed breast milk safely.
  • Once infants are aged 6 months, encourage and help parents and carers to progressively introduce them to a variety of nutritious foods, in addition to milk.   

Recommendation 3  has been replaced by Vitamin D: increasing supplement use among at-risk groups NICE guideline PH56.

The guidance complements and supports, but does not replace, NICE clinical guidelines on: antenatal care, diabetes in pregnancy, intrapartum and postnatal care.

Recommendations 14, 17 and 20 in this guidance have been amended to be consistent with UK World Health Organization growth charts (2009) and advice from the Department of Health on bottle feeding (2011). Most recent changes: July 2011

In line with ‘The NICE public health guidance development process: An overview for stakeholders including public health practitioners, policy makers and the public (second edition, 2009)’, the next scheduled date for review for update will be in July 2014. For more information about how this decision was reached, please see PH11 Maternal and child nutrition: review decision

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The application of the recommendations in this guideline is not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.