We were interested to read the editorial by Saxena et al.1 We agree that GPs are in an ideal position to support expectant mothers through their pregnancy and the postnatal period. An important aspect of any GP’s role is of course health promotion and recently efforts have been made by local health authorities to encourage expectant mothers to consider vitamin D supplementation.
Symptomatic cases of vitamin D deficiency are on the rise in the UK and are especially common in young children from a South Asian, Middle Eastern, or African background. The Healthy Start programme entitles all pregnant women, new mothers, and young children from low income families to receive vouchers that can be exchanged for free vitamins. It is often believed that cultural, social, or language differences may explain the poor uptake of vitamin D supplementation in the above communities.
Between February–March 2012, we distributed a questionnaire to all mothers attending a health visitor clinic at a general practice in Glasgow to identify whether mothers with an adequate knowledge of English were aware of the Healthy Start programme and whether they administered vitamin supplements to their children. Out of 37 mothers approached, 34(92%) questionnaires were returned. Most mothers (n = 33, 97%) were of white, Scottish ethnic origin with English as their native language. The median age of the infant attending the clinic was 4 months (range 1–4). During the pregnancy, none of the mothers took Healthy Start vitamins, despite being eligible in terms of family income. Ten mothers (29%) paid for over-the-counter vitamins for pregnancy. Only three mothers (8%) could recall receiving written information about vitamin supplementation in infants and eight mothers (24%) recalled receiving verbal information. Of the 14 infants who were eligible for Healthy Start vitamins, four (29%) were taking vitamin supplements and only one of these was taking Healthy Start vitamins.
This audit highlights that there is poor uptake of the Healthy Start programme, even in groups whose native language is English. It is clear that new mothers are not sufficiently well informed of the availability of vitamin D supplementation during pregnancy and infancy. By improving awareness of vitamin supplementation, GPs could make a clear difference to the health of the mother and the young child.
- © British Journal of General Practice 2012
