28/06/17 – Working Group Report – Maternal Obesity

Speakers: Baroness Benjamin, Helen Clark (lead author), and Jenny Caven of Slimming World, Sponsors of the Report

28th June 2017  – meeting notes

All-Party Parliamentary Group on a Fit and Healthy Childhood

The launch of the 7th Working Group report “Maternal Obesity”

Download the Report

Chair: Baroness Benjamin

The meeting was opened by Baroness Benjamin who welcomed the members and the speakers.

Baroness Benjamin

This is the 27th meeting of the group, and the seventh report, which is quite remarkable. I am very pleased to see so many familiar faces here, including Public Health England. Welcome also to the Department of Health: you hearing what we have to say is terribly important when you are formulating your views, your ideas and your recommendations. I thank you all for realising that this All Party Group means business!

Childhood lasts a lifetime.  We all need to work together to effect change: without that nothing gets done. We’re here to celebrate something tonight that we need to concentrate on – what kind of child are we going to bring into this world? That starts even before the child has been thought about. This particular report – Maternal Obesity – is SO important because much of what happens to a child who enters the world has been laid down beforehand by the fitness and preparedness of the parents, especially the mother. They are not just bringing a baby into the world, but a human being, an adult, because childhood lasts a lifetime.

So, we are launching our latest report, which is such a joyful moment for me, and I want to thank our sponsors, Slimming World, who have been in the group since the beginning. Slimming World is the only weight management company to offer advice to pregnant women, which is shocking, considering how important it is to get the right advice from competent professionals, as the report highlights. Leaving it until the child is born to think about embedding healthy eating in your lifestyle is leaving it too late.

I’ll be raising some of these matters in my Queen’s Speech Debate tomorrow. I’ll be asking why there was no mention of child health and fitness in the Queen’s speech, and what the Government intends to do about it. We need to keep children at the forefront of our minds.

I would like to thank our lead author, Helen Clark, for her hard work and passion on this subject. This is such a valuable report and we hope that, like past reports, the contents will feed into policy decisions by the Government and the relevant departments.

Helen Clark, Lead Author

I would like to start by paying tribute to our magnificent leader, Baroness Benjamin, who right from the start in 2014 has given us incredible passion and leadership. As she always says, “childhood lasts a lifetime”.

The main point of this report, indeed all our reports, is that if we want a healthy and productive economy and a healthy nation, we have to invest in children. This is one of a series of reports and I’m glad that Baroness Benjamin highlighted the invaluable contribution of Slimming World – Jenny Caven and Sarah Clothier are both here tonight and they will remember how we first started with a report (also sponsored by Slimming World) on “Healthy Patterns for Healthy Families”. We touched on a lot of issues in that report that have been expanded on in subsequent reports.

The University of Northampton sponsored our next report, “The Early Years” and that was followed by “Food in Schools and the Teaching of Food”, sponsored by Quorn, and dealing with a subject that has recently arisen during the election. In a YouGov poll, only 12% of those polled agreed with the proposed decision to remove the school meals that we had campaigned for in our report. We’re very pleased that the Government has dropped these plans, at least temporarily, and this group will do its best to make sure it’s permanent.

LeapFrog Toys sponsored “Play”, which highlighted the importance of a previously neglected area, with invaluable contributions from a range of experts.

Two coalitions of sponsors helped our next two reports: the first a critique on the National Obesity Framework and the second on Physical Education. We were encouraged to hear originally from Sarah Wollaston MP that the National Obesity Framework would be 60 pages, and dismayed later to find out that it was just 13. The Physical Education report looked at moving to more responsive forms of exercise whereby children direct their own PE in the context of wider learning.

And then, in considering “what next?”, we decided that if you really want a fit and healthy childhood and adulthood, you need to start with pregnancy and pre-pregnancy. And to really get it right, you need to start at school with that type of healthy eating education embedded in the national curriculum. We need to stop talking about “blooming” and “eating for two” and giving attention to the celebrity culture where extreme dieting following the birth of a child is seen as a balance to over-eating during the pregnancy. We need to educate people out of this and, as was previously mentioned, Slimming World is doing great work towards this end by being the only weight loss organisation to support pregnant woman.  Very often, overweight pregnant women receive little help from GPs and health workers, who are not generally trained in how to raise the subject of overweight or obesity in a sensitive and supportive way.  We’ve also got a situation in the UK where we don’t have a proper method of measurement of pregnant women, bearing in mind that that measurement will change with ethnicity, socio-economic situation and other issues. We also need to look at advertising, social media, celebrity culture, training needs of health workers – and also men. Male obesity as well as female obesity is very detrimental to the health of children in so many different ways.

I’m delighted that today we have Beelin Baxter of the Department of Health with us, and in a moment I would like to ask her to say a few words because tomorrow Catherine Calderwood, the Chief Medical Officer of Scotland, is going to announce a four-nations approach to physical activity during pregnancy. Beelin has noticed that we don’t mention physical exercise in this report, which we should have done, and so we hold our hands up to that. I hope that we can take this report and work together and get this issue on the table and not leave it gathering dust on the shelf.

Finally I’d like to repeat my thanks to everyone who contributed, no matter how small the contribution, as well as the wider membership of the group.

Beelin Baxter, Department of Health

Tomorrow the four Chief Medical Officers of the UK will be launching guidelines on physical activity during pregnancy. The reason is that, for a long time, when pregnant women have asked for advice about whether they should continue their pre-pregnancy physical activity, health professionals have tended to fudge the issue. This is not because they don’t care, but rather that they haven’t really known what to say. We were asked to look at all the latest research and evidence on whether it is safe to do physical activity during pregnancy and as a result the guidelines and accompanying infographic will be available tomorrow. I will send a link to Phil tomorrow for wider circulation to this group.

Jenny Caven, Slimming World (Report Sponsors)

Slimming World is delighted to have been involved in this very important report as it’s an issue that we have been concerned about for many years. At a meeting of this group addressed by Louise Silverton of the Royal College of Midwives, we heard of a policy day where policy makers, politicians, people from industry and health professionals were brought together, and it emerged that there is a strong will to get Government to do something about this issue of maternal obesity.

For 50 years Slimming World has been supporting people, the majority of whom are women of child-bearing age. We know only too well about the anguish of weight gain, and pregnancy is time when women often feel vulnerable and unsure about the best way to manage a healthy weight. Couple that with concern about the health of the unborn child, and it’s easy to see why women who are struggling with their weight need extra help. And yet, as we have heard, Slimming World is the only weight management organisation to support women at this time.

Maternal obesity, as the research in this report shows, and as Baroness Benjamin has said in her article in Politics Home today, affects the whole life cycle. The facts around this theme are shocking: I’m sure you’re all aware but I’ll remind you of them anyway.  The latest 2017 national statistics on obesity have shown that 1 in 3 children leaving primary school are obese or overweight. These are the children who are entering their teens, and who are the parents of the future. Furthermore, 2 in 3 women are obese or overweight and 1 in 5 women attending ante-natal care in the UK are obese or overweight.

For some years, Slimming World has worked with the Royal College of Midwives to raise awareness among midwives, who are enormously influential, about the importance of raising issues of weight and to provide advice to women about weight management during pregnancy.  We also work closely with the RCN to ensure that the support that Slimming World offers to women is sound and based on the best evidence. We also conduct our own research into the issue too. That research has shown that the support provided by Slimming World during pregnancy leads to the adoption of healthier lifestyles, which leads to improvements in self-esteem, self-confidence and well-being – all qualities that are passed on to the next generation.

This All Party Group continues to do great work to challenge the Government and raise awareness of the importance of a fit and healthy childhood, and tackling child obesity is a key element. Maternal health and maternal obesity is fundamental to this. It is essential to give children the best start in life, and that starts with their mothers being fit and healthy at every stage: before they become pregnant, as well as during and after pregnancy.  I would like to thank Baroness Benjamin, Helen Clark, and the working group members for the detailed research and excellent recommendations made in the report. Slimming World is very proud to be associated with it.

Questions and Comments

Charlotte Davis, Fit 2 Learn – Is there any chance of further research into low income and obesity? From what we see when we go into such situations, it’s an area that is crying out for investigation.

Response from Phil Royal –  Yes, this is an area that is very much on our minds and we would be very keen to hear of anyone interested in sponsoring a working group on this. We rely on sponsorship for these reports. We are currently doing a report on Physical Activity in Early Childhood and following that, we hope it will be Mental Health. But we actively wish to tackle that issue, and if there is anyone keen to help us raise the sponsorship required to do that work, please drop me a line. It’s £10,000 – and we’re happy to take on a coalition of sponsors which is something we’ve done in the past. I know it’s a significant sum of money, but that’s what it takes to produce a meaningful report.

Charlotte Davis, Fit 2 Learn – There is a charities meeting tomorrow talking about poverty, and mental health is a big part of that.

Baroness Benjamin – I am very happy at the prospect of a report on mental health, as it’s something that everyone is talking about now – even the princes (William and Harry) are opening up and getting people talking about what causes children and adults to have mental health problems. People can be made to feel very inadequate by the apparent success of other people – I know now that when I had my first child and was very enthusiastic and talkative about it that I was no doubt making other people feel mentally inadequate. I didn’t realise it at the time but later, going through seven years of torment with three miscarriages, I realised that how we present things and what you say publicly comes with a responsibility as to how it affects other people. I really hope that when we do get the sponsorship that we are able to dig deep into this topic.

Sarah Clothier, Slimming World – During the research and compilation of the report, what surprised you the most?

Helen Clark – The complete lack of international consistency was a big surprise, with surprisingly different advice, attitudes and practices in different counties such as Norway, Germany, France, Italy, etc. In Finland and Norway there are some very sensitive approaches, France is very strict and Italy quite lax. In the UK, Scotland leads the way and is doing quite well, while Wales lags behind. We need to get our act together in the four countries of the UK as well as internationally. In a similar way to the statement of the rights of the child, it would be great if we could have an international statement on what people should expect in terms of provision and care during pregnancy.

Phil Veasey – When you get a new car you get a manual but when you get a new baby there is no formalised direction on what to do with it, and a lot of mixed messages.

Baroness Benjamin – Yes, up until now it’s been a free-for-all, with people doing what they instinctively feel or what their own parents and grandparents did. We’ve lost that tight family unit and you’re absolutely right that it’s part of the problem of the society that we live in now.  We should be producing more detail and formal direction, and as Helen has said, education in schools should include these aspects of family life so that young people learn what to do. You’re right, we need something and hopefully this report will help to get the ball rolling.

Keith Taylor – One area not covered strongly enough is the role of men. Most men’s attitudes centre around their job being done at conception and that after that, it’s all about the woman. Men need to know what they need to do to keep themselves healthy and to produce good sperm to produce healthy children. This needs to start even six months before conception.

Georgia P – Many women do not have adequate support after giving birth. In Tower Hamlets, many mothers are left alone once fathers go back to work. Even if there are mothers-in-law present there can be conflict within generations if the mothers-in-law are too strict.

Baroness Benjamin – It’s true that new mothers can feel inadequate and we need to talk about it and not treat it as a taboo subject. If new mothers don’t know what to do they can be unduly influenced by trendy behaviour and what they think makes them look good. We have got to free people from anxiety as otherwise it can be stressful and babies pick up on a stressful environment.

Further comment – Keith is absolutely right and we do need consistent and formal advice for everyone involved in the pregnancy and new baby – the mother, the father, the whole family. It’s hard for a mother to change on her own – she needs the support of those around her, particularly the father. She needs to know about what she should and shouldn’t be eating, what exercise she should do

Charlotte Davis, Fit 2 Learn – It would be great if government policy could be about the health of pregnant women and address important areas like bad accommodation.

Helen Clark – The whole socioeconomic situation is at the forefront of our minds because it has cropped up time and time again in every single one of our reports, ever since Sue Greenwood of the University of Roehampton highlighted the issue in our first report.

Charlotte Davis, Fit 2 Learn – If only every government policy was scrutinised for its impact on developing children. The 70/30 campaign called for 70% of maltreatment of children to be eliminated by 2030. Many MPs signed up for it (but David Cameron didn’t).

Baroness Benjamin – If only we could get our wish for a Minister for Children. We need to keep banging the drum to get these issues raised. In the meantime, there are a lot of new and younger politicians coming through and they might see these issues as more of a priority, so we must keep the pressure up.

Question – What would you say to a government minister sitting here now, if you only had a few minutes? What would be your headline things?

Helen Clark – Three things. One, ensure that every single departmental policy is audited for its effect on children. Two, more resources for health professions. More time and training is needed for a fit and healthy family and the Government needs to realise this. Three, start with the National Curriculum in Early Years education and build on that through secondary education.

Deborah Alborn – University of Roehampton – A multi-disciplinary approach is needed and not just the specific health professionals.

Baroness Benjamin – The Empathy for Life programme in Scotland has a mother (and father) taking a baby into schools for a year to educate the pupils on how the baby develops.  Cbeebies has also done a few programmes aimed at educating children in the growth of a baby. These are two examples about how children are being educated in the process of life.

Incidentally, I was the first woman to appear on TV fully pregnant and it caused a big uproar at the time. However, the children who watched Play School adopted “the baby” as their own and loved to see me getting bigger and bigger, watching the baby kicking, etc. This really helped them to learn about the developing unborn child.

Kate Day – On the subject of depression, it’s interesting that serotonin is produced in the gut, and so healthy eating can have an effect on state of mind and depression. The idea of “a healthy gut is a healthy mind” can help drive home the healthy eating message and getting people to realise that there can be a connection between anxiety and depression, and high levels of e.g. sugar consumption is a great step forward.

Jenny Caven, Slimming World – One of the things we hear time and again from Slimming World clients who have followed our healthy eating advice during pregnancy is that their babies, when they are born, have a propensity and preference for fruit and vegetables and other healthy food. And going back to what Keith was saying earlier about men, when the husbands also adopt healthy eating habits during pregnancy there is a very strong chance of having those habits established within the family when the baby arrives.

Baroness Benjamin – Well, thank you all for coming tonight and I hope you will all spread the word about this report. Thank you to everyone for your passion and enthusiasm, and I am so grateful for those of you who go the extra mile and keep pushing. We will see you at the next meeting, which will be in the autumn, when we’ll be concentrating on mental health, so think about some of things we can discuss and address.

The meeting closed at 7pm.