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BREASTFEEDING IS BEST FOR BABIES FOR HEALTHCARE PROFESSIONALS ONLY Which First Infant Milk is most in line with expert opinion on growth? The Department of Health recommends exclusive breastfeeding for the first six months of life.1 Protein and the importance of slower growth rates Because the protein in breast milk is adapted to a baby’s needs,2 a breastfed baby tends to grow more slowly than a formula fed baby.3 This slower growth rate has shown to have significant long-term health benefits, including a lower risk of obesity, cardiovascular disease and diabetes.4 SMA PRO First Infant Milk is the only first infant milk clinically proven to achieve a growth rate comparable with a breastfed baby as defined by WHO growth standards10 SMA PRO First Infant Milk versus WHO growth standard z-scores at 4 months Retarded growth Weight-for-age WHO growth standard Accelerated growth Length-for-age Head circumference BMI -3 -1.5 -1 -0.5 0 0.5 1 1.5 2 2.5 3 -2.5 -2 Z-scores Green dots represent average growth measurements in infants fed SMA PRO First Infant Milk compared to WHO growth standards. Growth within -/+ 0.5 standard deviation of WHO growth standards is desirable. We’ve responded to expert opinion about proteins in SMA® PRO First Infant Milk “ Protein intakes of infants are generally well above the requirements, so protein content of Infant Formula and Follow-on Formula could be reduced” European Food Safety Authority 20145 ›› SMA PRO First Infant Milk is the lowest protein formula available at 1.25 g*/100 ml (1.87 g*/100 kcal)6 *Powder only, liquids will vary “ The breast milk content of amino acids is the best estimate of infant amino acid requirements” WHO/FAO/UNU 20147 Of the essential amino acids, four have been shown, when supplied in excess, to be associated with increased release of insulin. This may trigger a cascade of reactions in the body which may result in faster growth.9 European Childhood Obesity Trial Study Group 20159 ›› SMA PRO First Infant Milk has an essential amino acid profile similar to that of breast milk8 ›› SMA PRO First Infant Milk has lower levels of insulinogenic amino acids compared with other first infant milks8 Visit us: smahcp.co.uk or smahcp.ie Getting the right quantity and quality of protein in infant and toddler diets has lifelong health benefits. With SMA PRO First Infant Milk, you can help build a nutritional foundation for life in the first 1000 days. IMPORTANT NOTICE: Breast milk is best for babies and breastfeeding should continue for as long as possible. Good maternal nutrition is important for the preparation and maintenance of breastfeeding. Introducing partial bottle-feeding may have a negative effect on breastfeeding and reversing a decision not to breastfeed is difficult. A caregiver should always seek the advice of a doctor, midwife, health visitor, public health nurse, dietitian or pharmacist on the need for and proper method of use of infant formulae and on all matters of infant feeding. Social and financial implications should be considered when selecting a method of infant feeding. Infant formulae should always be prepared and used as directed. Inappropriate foods or feeding methods, or improper use of infant formula, may present a health hazard. ® Registered trademark Supporting you to support parents References: 1. UNICEF. The Health benefits of breastfeeding. 2. Lönnerdal B. Am J Clin Nutrition 2003; 77: 1537–43. 3. WHO UK Growth Charts. http:// www.rcpch.ac.uk/improving-child-health/publichealth/uk-who-growth-charts/faqs/uk-who-growthchart-faqs. 4. Singhal A & Lucas A. Lancet 2004; 363: 1642–1645. 5. EFSA. Scientific Opinion on the essential composition of infant and follow-on formulae. EFSA Journal 2014; 12(7): 3760. 6. SMA® PRO First Infant Milk Datacard. 7. Protein and Amino Acid Requirements in Human Nutrition. Report of a Joint WHO/FAO/UNU Expert Consensus 2007. 8. Nestlé data on file, 2014. 9. Kirchberg FF et al. J Clin Endocrinol Metab 2015; 100(1): 149–58. 10. Grathwohl DJ et al. Abstract at EAPS Congress, 2010. ZTC1238/12/15
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CONTENTS CONTENTS Joint Editors-in-Chief Dame Tina Lavender and Yana Richens Editor Madeleine Murphy bjm@markallengroup.com Associate Publisher James Demery james.demery@markallengroup.com Group Classified Manager Lauren York lauren.york@markallengroup.com Circulation Director Sally Boettcher sally.boettcher@markallengroup.com Group Production Manager Jon Redmayne Production Assistant Jamie Hodgskin Publisher Chloe Benson Managing Director Jon Benson Chief Executive Officer Ben Allen UK PERSONAL SUBSCRIPTION RATES Quarterly Direct Debit £42 Annual Direct Debit £165 Annual Credit Card £174 Two year Annual Credit Card £296 Three year Annual Cr edit Card £418 Subscribe online at: www.magsubscriptions.com F or further information please contact the subscriptions department on 0800 137201 or +44 (0)1722 716997 when calling from outside of the UK. Contact institutions@markallengroup.com for institutional pricing EDITORIAL Whatever happened to safety in numbers? Madeleine Murphy 757 BIRTHWRITE Nurturing tomorrow’s leaders Jacqueline Dunkley-Bent 758 COMMENT Ethics of egg freezing George Winter 760 Vitamin B12 deficiency Samantha Nash 763 CONFERENCE REPORT Safety, standards and experience in the midwifery profes sion Jonathan Cliffe 766 CLINICAL PRACTICE Immune thrombocytopaenia in pregnancy: Key principles for the midwife Carol Hindley 768 Ltd Healthcare MA 2016 © www.markallengroup.com The British Journal of Midwifery is published by MA Healthcare Ltd, St Jude’s Church, Dulwich Road, London SE24 0PB, UK Tel: +44 (0)20 7738 5454 Website: www.britishjournalofmidwifery.com © MA Healthcare Ltd, 2016. All rights reserved. No part of British Journal of Midwifery may be reproduced, stored in a retrieval system, or transmitted in any form or by any means electronic, mechanical, photocopying, recording, or otherwise without prior written permission of the Publishing Director. The views expressed do not necessarily represent those of the editor or the British Journal of Midwifery. Advertisements in the journal do not imply endorsement of the products or services advertised. The journal accepts advertising from all companies operating ethically and in accordance with UK law and regulations. Editorial content in the journal is entirely separate from advertising and, unless clearly stated, commercial companies have no influence over the content of articles. ISSN 0969 – 4900 Printed by Pensord Press Ltd, Blackwood, NP12 2YA Cover picture: Adobe/MAK EDUCATION Heightening levels of compassion towards self and others through use of compassionate mind tr aining Elaine Beaumont and Caroline J Hollins Martin 777 University midwifery societies: Support for student midwives, by s tudent midwives Alison Power and Ilaria Grzelak 787 Navigating the midwifery undergraduate programme: Is resilience the key? Jacqui Williams 790 British Journal of Midwifery • November 2016 • Vol 24, No 11 Volume 24 Number 11 November 2016 A D O B E / D O M F O R S T O C K Factors influencing postnatal weight management 806 RESEARCH The case for developing an online intervention to support midwives in work-related psychological distress Sally Pezaro 799 Factors influencing engagement in postnatal weight management and weight and wellbeing out comes Amanda Avery, Sarah Hillier, Carolyn Pallister, Jenny Barber and Jacquie Lavin 806 LEGAL Midwives must do more to comply with health car e sharps regulations Richard Griffith 814 CLASSIFIED 816 MIDWIFE BLOG Acting up as the labour ward matron Sophie Windsor 818 755

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CONTENTS

CONTENTS

Joint Editors-in-Chief Dame Tina Lavender and Yana Richens Editor Madeleine Murphy bjm@markallengroup.com Associate Publisher James Demery james.demery@markallengroup.com Group Classified Manager Lauren York lauren.york@markallengroup.com Circulation Director Sally Boettcher sally.boettcher@markallengroup.com Group Production Manager Jon Redmayne Production Assistant Jamie Hodgskin Publisher Chloe Benson Managing Director Jon Benson Chief Executive Officer Ben Allen

UK PERSONAL SUBSCRIPTION RATES Quarterly Direct Debit £42 Annual Direct Debit £165 Annual Credit Card £174 Two year Annual Credit Card £296 Three year Annual Cr edit Card £418 Subscribe online at: www.magsubscriptions.com F or further information please contact the subscriptions department on 0800 137201 or +44 (0)1722 716997 when calling from outside of the UK. Contact institutions@markallengroup.com for institutional pricing

EDITORIAL Whatever happened to safety in numbers? Madeleine Murphy

757

BIRTHWRITE Nurturing tomorrow’s leaders Jacqueline Dunkley-Bent 758

COMMENT Ethics of egg freezing George Winter

760

Vitamin B12 deficiency Samantha Nash

763

CONFERENCE REPORT Safety, standards and experience in the midwifery profes sion Jonathan Cliffe 766

CLINICAL PRACTICE Immune thrombocytopaenia in pregnancy: Key principles for the midwife Carol Hindley 768

Ltd

Healthcare

MA

2016

©

www.markallengroup.com

The British Journal of Midwifery is published by MA Healthcare Ltd, St Jude’s Church, Dulwich Road, London SE24 0PB, UK Tel: +44 (0)20 7738 5454 Website: www.britishjournalofmidwifery.com

© MA Healthcare Ltd, 2016. All rights reserved. No part of British Journal of Midwifery may be reproduced, stored in a retrieval system, or transmitted in any form or by any means electronic, mechanical, photocopying, recording, or otherwise without prior written permission of the Publishing Director. The views expressed do not necessarily represent those of the editor or the British Journal of Midwifery. Advertisements in the journal do not imply endorsement of the products or services advertised. The journal accepts advertising from all companies operating ethically and in accordance with UK law and regulations. Editorial content in the journal is entirely separate from advertising and, unless clearly stated, commercial companies have no influence over the content of articles. ISSN 0969 – 4900 Printed by Pensord Press Ltd, Blackwood, NP12 2YA Cover picture: Adobe/MAK

EDUCATION Heightening levels of compassion towards self and others through use of compassionate mind tr aining Elaine Beaumont and Caroline J Hollins Martin 777

University midwifery societies: Support for student midwives, by s tudent midwives Alison Power and Ilaria Grzelak 787

Navigating the midwifery undergraduate programme: Is resilience the key? Jacqui Williams 790

British Journal of Midwifery • November 2016 • Vol 24, No 11

Volume 24 Number 11 November 2016

A D O B E /

D O M F O R S T O C K

Factors influencing postnatal weight management 806

RESEARCH The case for developing an online intervention to support midwives in work-related psychological distress Sally Pezaro 799

Factors influencing engagement in postnatal weight management and weight and wellbeing out comes Amanda Avery, Sarah Hillier, Carolyn Pallister, Jenny Barber and Jacquie Lavin 806

LEGAL Midwives must do more to comply with health car e sharps regulations Richard Griffith 814

CLASSIFIED

816

MIDWIFE BLOG Acting up as the labour ward matron Sophie Windsor 818

755

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