gms | German Medical Science

Background: The project “Healthy Start – Young Family Network” aims to distribute uniform nationwide recommendations on infant nutrition and nutrition for breastfeeding mothers [1] as well as on nutrition in pregnancy [2] to expert circles. Disseminators can impart these recommendations close to the everyday life of young families. Especially midwifes enjoy the trust and confidence of parents and parents-to-be. Consequently, their role as disseminator of the practice recommendations is particularly important.

Aims/Research question: In order to effectively and successfully implement the practical recommendations, their acceptance by disseminators, such as midwifes, has to be insured. Based on two evaluation projects, carried out by researchers from Bielefeld University in cooperation with the project “Healthy Start – Young Family Network”, the level of acceptance was measured among different occupational groups.

Methods: A standardised online questionnaire was used to investigate the level of acceptance (response mode: do accept vs. do not accept). The first survey comprised 60 recommendations on infant nutrition and nutrition for breastfeeding mothers (including breastfeeding, infant formula, supplementary nutrition, allergy prevention) and was carried out between December 2011 and February 2012. In total, 1311 disseminators participated in the first survey (87.4% midwifes, 3.6% gynaecologists, 3.4% paediatricians, 0.8% paediatric nurses, 0.8% ecotrophologists, 3.5% other occupational groups). The second survey comprised 34 recommendations on nutrition in pregnancy (including weight development, nutrition, supplements, physical activity, alcohol and tobacco use) and was carried out between May and August 2014. 864 disseminators participated in the second survey (76.3% midwifes, 11.7% gynaecologists, 12.0% other occupational groups).

Results: Results were stratified by occupational group. The level of acceptance regarding the recommendations on infant nutrition was 67% among midwifes and thus lower compared to all other occupational groups. An acceptance level of <75% was found in terms of the following topics: vitamin k, vitamin d, additional drinks for infants and follow-on formula. The level of acceptance concerning the recommendations on nutrition in pregnancy was 90% among midwifes. A low acceptance level (<75%) was found with regard to the topics supplements (folate, iodine, omega-3 fatty acids) and vegan nutrition. Participants stated that they did not use academic sources to reason their non-acceptance. The majority explained non-acceptance with intuition, usual (regional) practice and subjective assessment.

Relevance: Due to the high participation rate among midwifes (>70%), the findings are also indicative of the practical implementation of the recommendations. It can be assumed that midwifes do not or do not consistently disseminate the recommendations to young families. Inconsistent information might, however, upset young families in their decisions on pregnancy and child birth.

Recommendations/Conclusions: Acceptance of the recommendations seems to be high. Successful practice implementation, however, has not yet been fully achieved. Midwifes seem to vary in terms of their state of knowledge. Thus, this group needs to be increasingly informed about the uniform nationwide recommendations and their scientific background. As a consequence, the project “Healthy Start – Young Family Network” aims to implement these recommendations into the training and education of midwifes. This might help to familiarise midwifes with the recommendations – already at the start of their training. Such possibilities are to be discussed subsequent to the presentation.