Developing a nutrition resource for midwives, incorporating a patient and public involvement approach

UK antenatal guidelines state that midwives should discuss nutrition, diet, and vitamin supplementation at booking-in appointments (1) . Our earlier research suggests that this rarely happens (2) . Participant and Public Involvement (PPI), enhances research by making it more meaningful and reliable. This study incorporated PPI to elicit the experiences of postnatal women regarding the nutrition and weight management advice they received during antenatal care and their opinions regarding the design of a future resource for midwives. Eight postnatal women were recruited from a Children’s Centre in Liverpool. They were asked questions by one researcher, about: a) any nutrition advice given by midwives during their antenatal care and b) their opinions regarding the development of a nutrition resource for midwives in future. Notes of the conversations were made by a second researcher; these were then transcribed and analysed thematically. Participants were given a shopping voucher to thank them for their input. Regarding the development of a resource, three themes were identified: 1) Factual information, 2) The Midwives approach, 3) Include us. They identified that they wanted more in-depth facts from midwives, particularly regarding key nutrients and food that should be included in a healthy diet “ Good nutrition grows babies ”. However, they felt that midwives needed to improve their approach to discussing diet and weight, to include more empathy and sensitivity , as women often felt judged or anxious by comments that were made “ It’s not what they say – it’s the way they say it ”. Finally, they agreed that their voices should be included in the development of a resource, with midwives and service users coming together to share their views “ Get them [midwives] involved in something like this ”. All women agreed that a nutrition resource for midwives was needed as they were dissatisfied with the advice they received. They wanted less focus on food safety/food to avoid and increased emphasis on food and essential nutrients to include. Involving the expertise of dietitians/nutritionists in the resource would help to address knowledge gaps and inconsistencies. Midwives would benefit from training regarding sensitive weight management advice too, as weight was rarely discussed or was approached in a distressing way. This has been documented elsewhere with the recommendation that training regarding sensitive weight management advice should be included in the midwifery curriculum and mandatory training (3) . Support and expertise from a health psychologist would help to develop this aspect of the resource. Including the experiences and opinions of service users alongside midwives will be vital to the success of developing a suitable resource for midwives, so ongoing PPI activities need to be considered.