1. Maternal & Early Years Healthy Weight Service Evaluation December 2010

2. What is MEYs? Investing For Health Project 2b (childhood obesity work stream) 6 PCTs recruited for pilot Health Improvement Programme for:- Pregnant women Postnatal women Babies/toddlers up to age 2

3. Aims of the service To minimise excessive weight gain during pregnancy (7-10kg) To support weight loss post pregnancy To prevent the development of obesity in infants (up to age 24 months) To reduce health inequalities Women are given 1:1 support from a Healthy Weight Advisor to achieve personal health goals

4. Referral pathway Opt out referral for pregnant women with BMI 35 or over at booking with midwife Self referral or healthcare professional Childrens Centres Can be referred until child age 2 years

5. Cost to health and NHS Women with increased BMI’s are at increased risk of : Gestational diabetes Hypertensive disorders Caesarian section Post-partum haemorrhage Premature labour Miscarriage Stillbirth Birth defects

6. Women with increased BMI less likely to breastfeed, so babies at increased risk of: Gastroenteritis Otits media Allergies

7. PODCAST http://ifh2.westmidlands.nhs.uk/InvestingforHealthKeyProjects/P02bChildhoodObesity.aspx http://www.vimeo.com/17437032

8. Source of referral

12. Increased health risks Obese women are more likely to need a caesarean section which costs an additional £1,987 compared to a vaginal delivery (payment by result tariff 2010/11)

16. December 2010 390 referrals Average pregnancy weight gain 8.75kg Just over a third engaged Increasing success with post natal weight loss and breastfeeding support Wider health outcomes include improved social support (via signposting to children’s centres and other agencies) Smoking cessation support

17. Evidence & Evaluation NICE Guidance, RCOG/CMACE (2010) both recommend interventions during pregnancy & post-natally. Regional & Local Qualitative & Quantitive Evaluation. (Coventry University, SHA & NHS Worcestershire) Cost of service £256 per person

18. Evidence & Evaluation “Overall, for the women who have engaged with the service, they have experienced far reaching benefits, across many aspects of their lives and lifestyle. The potential of the service to impact on childhood obesity is apparent from the evidence of healthy eating and physical activity during pregnancy, and from the evidence of establishing healthy weaning and family food and activity habits.” (Coventry University,summary 2010)

19. “She (the HWA) has been really good and supportive, she’s got a lot of breastfeeding experience as well as knowledge around food, what you should and shouldn’t be eating and around portion control”. (R1)

20. “ I used to get a lot of take-aways and I don’t do that at all now and I don’t eat chocolate, crisps anything like that. Activity as well, I walk more now and I attend an exercise class which I didn’t think I would ever do. So its definitely changed my lifestyle”.(R6)

21. “The HWA is supportive – I mean I’ve lost weight!!”(R5)

22. Lessons learnt from pilot Provide referral agents with more information regarding the service and outcomes. Healthcare Professionals would benefit from training on how to “raise the issue of weight”. Frequent contact is required especially when clients are initially recruited. Subsequent appointments should be made proactively by the Healthy Weight Advisor.