An antenatal wish list: A qualitative systematic review and thematic synthesis of UK dietary advice for weight management and food borne illness

Abstract

Objectives: To understand UK women's experiences of antenatal dietary advice for risk of food borne illness and weight gain.Design: A systematic review and thematic synthesis of peer-reviewed qualitative studies. PubMed, MEDLINE, CINAHL and PMC databases were searched for articles published from June 2008 to June 2018. The search strategy combined terms for pregnancy with terms for body composition, weight change, food safety, nutrition, diet and qualitative terminology. Studies were eligible for inclusion if (1) they explored experiences of implementing advice received during pregnancy for nutrition, physical activity and/or weight gain, and (2) participants were women who had experienced maternity care in the UK. Study quality was appraised using the Critical Appraisal Skills Programme (CASP) qualitative research appraisal tool.Findings: Of 25,688 articles identified by the search strategy, 20 studies were identified that met the inclusion criteria. Five major themes were recognised: control, barriers to diet and exercise, motivators, relationship with weight, information, with a further 12 subthemes. The majority of studies reported on weight gain (n = 10).

Factors influencing health behaviour change during pregnancy: a systematic review and meta-synthesis

“…Women reported feeling exempt from societal beauty standards, in relation to their body size and shape, and for some this led to indulgence in high-calorie, low-nutrient dense food. This is consistent with findings reported elsewhere in the literature (Hodgkinson et al, 2014;Stockton & Nield, 2020). Accordingly, women were keen to retain control and ownership over their decision-making, rather than passively accepting advice and guidelines that might suggest pleasurable behaviours should be limited.…”

“…This is consistent with several behavioural theories which suggest that risk perceptions and outcome expectancies are a key element underpinning motivation to change (Becker, 1974;McBride et al, 2003). Women's understanding was further hindered by confusing and conflicting messages received from health professionals and government advice, which is also evident in the findings of other studies (Stockton & Nield, 2020;Weeks et al, 2018). This is important to reflect upon, as delivering a consistent message has been shown to increase adherence to antenatal advice (Shanmugalingam et al, 2020), highlighting the need for dissemination of clear messages, through health professionals to service users.…”

“They Just Need to Come Down a Little Bit to Your Level”: A Qualitative Study of Parents’ Views and Experiences of Early Life Interventions to Promote Healthy Growth and Associated Behaviours

“…In line with previous research, participants were generally supportive of health professionals raising issues such as maternal weight and pregnancy weight gain [25,26,74,82,83] and to child growth/weight [29], even if they would be hard to hear, if done in a non-judgemental, supportive way. Continuity of care, and the associated development of trusting, respectful relationships and rapport with health professionals, were highly valued by parents in this study, similar to prior research concerning antenatal care [74], weight and/or gestational weight gain [84][85][86], and infant feeding [47,64]. Thus, parents desire more support and for health professionals-with whom they have good rapport with-to be more pro-active in raising such issues.…”

“…Introducing solids and infant growth were other areas where parents felt they needed more support. Information and support received from health professionals during pregnancy was highly varied; as noted elsewhere, e.g., in relation to weight and/or gestational weight gain diet/nutrition and physical activity [71][72][73][74]. Resultantly, parents expressed a desire for health professionals to be more pro-active in raising issues, with many feeling interactions to be tick-box exercises, something that health professionals themselves acknowledge [75].…”

“It only takes two minutes to ask”—a qualitative study with women on using the FIGO Nutrition Checklist in pregnancy

“…6,7 Despite this, studies demonstrate that women may not receive nutrition advice during pregnancy unless they specifically request it and practices around nutrition advice vary substantially. 8,9 The effect of this can be seen in the lack of adherence to recommended healthy dietary intakes for pregnancy internationally. 10 Previous work identified lack of resources and relevant training as barriers to addressing nutrition in practice.…”