Quality standard

Quality statement 1: Healthy eating in pregnancy

Quality statement

Pregnant women attending antenatal and health visitor appointments are given advice on how to eat healthily in pregnancy.

Rationale

A healthy diet is important for both mother and baby throughout pregnancy because this will help them to get the nutrients they need to stay healthy and for the baby to develop and grow. Advice on how to eat healthily and foods which should be avoided will enable pregnant women to make informed choices about their diet while pregnant.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured and can be adapted and used flexibly.

Structure

Evidence of local arrangements for midwives and health visitors to advise pregnant women how to eat healthily in pregnancy.

Data source: Local data collection.

Process

a) Proportion of pregnant women attending their antenatal booking appointment who receive advice on how to eat healthily during pregnancy from a midwife.

Numerator – the number in the denominator who receive advice on how to eat healthily during pregnancy from a midwife.

Denominator – the number of pregnant women attending their antenatal booking appointment.

Data source: Local data collection.

b) Proportion of pregnant women attending their health visitor appointment who receive advice on how to eat healthily during pregnancy.

Numerator – the number in the denominator who receive advice on how to eat healthily during pregnancy from a health visitor.

Denominator – the number of pregnant women attending their health visitor appointment.

Data source: Local data collection.

Outcome

Healthy eating in pregnancy.

Data source: Local data collection.

What the quality statement means for different audiences

Service providers (such as primary and secondary care including maternity services, community and public health providers) ensure that systems are in place for midwives and health visitors to advise pregnant women how to eat healthily during pregnancy.

Midwives and health visitors ensure that they give advice to pregnant women on how to eat healthily during pregnancy at their antenatal booking appointment and their health visitor appointment.

Commissioners (such as clinical commissioning groups or integrated care systems, NHS England and local authorities) specify that providers give advice to pregnant women on how to eat healthily during pregnancy at the antenatal booking appointment and the health visitor appointment.

Pregnant women are offered advice on how to eat healthily and which foods to avoid during pregnancy. This should happen when they have their first appointment with their midwife and when they have an appointment with their health visitor.

Source guidance

Definitions of terms used in this quality statement

Healthy eating in pregnancy

Where appropriate, the advice should include: eating 5 portions of fruit and vegetables a day and 1 portion of oily fish (for example, mackerel, sardines, pilchards, herring, trout or salmon) a week. If there are special dietary considerations then advice should be tailored to the woman's needs and additional advice sought from a dietitian. [NICE's guideline on maternal and child nutrition, recommendation 5]

Foods that should be avoided or limited in pregnancy

There are some foods that a pregnant woman should avoid eating because they could make her ill or harm her baby. These include:

  • raw or undercooked meat

  • liver

  • raw shellfish

  • some types of cheese

  • raw or partly cooked eggs that are not produced under the British Lion or Laid in Britain food safety schemes.

A detailed list of foods to limit or avoid can be found on the NHS website. [Adapted from the NHS website and expert opinion]