MatCH
Newsletter

Diet and development

Women are usually told to start focusing on their health three months before trying for a baby. New research is showing that health and lifestyle choices many years before conception can impact women’s wellbeing during pregnancy and their children’s health and development. The MatCH substudy is unique because it allows us to link information on children's outcomes with a decade or more of pre-pregnancy health information from their mothers.

What it means

Meeting the Australian Dietary Guidelines is important at every stage of life. Not all children are planned, which is why it is important that we form healthy eating habits as early as possible.
 
Policymakers and clinicians can help by educating young women about the importance of pre-pregnancy health. And by changing the pre-pregnancy timeline to include the entire reproductive phase of women’s lives, not just the three months before conception.

Visit www.eatforhealth.gov.au for more information about the Australian Dietary Guidelines.

Depression during pregnancy

About 20% of mothers experience depressive symptoms during pregnancy (the antenatal period) or after pregnancy (the postnatal period). We know children are at greater risk of cognitive, social, and academic difficulties if their mothers experience depressive symptoms during pregnancy and early childhood.

Pregnancy is obviously a critical time for the developing baby. But mum’s health and wellbeing during the pre-pregnancy period, and even infancy can also impact children’s physical and mental development.

Up until now, we weren’t sure which factor mattered more; when mum was depressed, or for how long. Knowing if pregnancy is a critical time for exposure can help determine the best time to provide women with intervention and support services.

What we found

Research from MatCH has shown that it didn’t matter when women experienced depression. Exposure to maternal depressive symptoms before pregnancy, during pregnancy, in early childhood, or more recently were all associated with an increase in children’s behaviour problems.

What mattered was how often children were exposed. Children whose mothers had depressive symptoms at more than one point in time had poorer outcomes than other children.

What it means

What this tells us is that there’s no critical point where being depressed could be more harmful to children’s development than at other times. The earlier women seek support for depressive symptoms the better.
 
The antenatal period presents clinicians with an opportunity to check in on women’s general health and wellbeing. We know that mental health screening during pregnancy and after birth has more than tripled since 2000. However, one in five women still don’t receive the recommended mental health screening.
 
If you or a loved are feeling depressed you can reach out to PANDA – Perinatal Anxiety and Depression Australia on 1300 706 326 or Beyond Blue on 1300 22 4636

First foods

We are born with a preference for sweet and salty foods. Many vegetables have a bitter taste, so we have to learn to like them. If we want children to eat fruit and vegetables, it makes sense that a ‘vegetables first’ approach to weaning might be key. Another theory suggests that breastfeeding gives children a ‘flavour bridge’ because the taste of breast milk varies depending on mum’s diet.

What we found

Babies' first semi-solid food was a better predictor of their fruit and vegetable intake than whether or not they were breastfed.
 
Babies from the MatCH substudy who ate vegetables as their first food went on to eat a wider variety of vegetables in childhood (age 2-12 years). They also ate fruit and vegetables more frequently than children who were weaned on cereals first.
 
Breastfeeding did play a part. The children who received six months of breast milk ate a wider variety of vegetables than those who were breastfed for less than six months. There was no difference between children who were exclusively breastfed and those who had breastmilk supplemented with formula.

What it means

Only 5% of Australian children meet the Australian guidelines for fruit and vegetable consumption. The guidelines currently recommend iron-fortified rice-based cereals as a first food for babies. Recommending vegetables as a first food instead has the potential to improve the eating habits of an entire generation. Not to mention reducing meal-time stress for parents struggling to get their kids to eat vegetables.

Read more at https://www.alswh.org.au/vegies-are-best-for-babys-first-solids/

Apgar scores

At one and five minutes after birth, a doctor or midwife scores every newborn on their Appearance (skin colour), Pulse (heart rate), Grimace response (reflexes), Activity (muscle tone), and Respiration (breathing rate and effort). An Apgar score of 7-10 shows the baby is adapting well to their new environment. A score below seven indicates complications. Otherwise healthy babies may have low scores due to a high-risk pregnancy, complicated delivery, C-section, or premature birth.

The Apgar score was never intended to measure long-term health, intelligence, or developmental outcomes. However, recent research from Canada and Sweden suggests a link between Apgar scores and neurodevelopmental outcomes.

What we found

Children who had an Apgar score of 7-8, traditionally considered in the ‘normal’ range, were at an increased risk of gross motor delays compared to those with a score of 10. Gross motor skills use large muscle groups to control our whole body and include activities like running, jumping, sitting and climbing. The risk of communication delays was not significant.

The 809 boys and girls included in this study ranged in age from eight months to five and half years old. In this group, 7.1% of children had a gross motor delay, and 4.2% had a communications delay. The Australian state-based Perinatal Data Collections linked data from the ALSWH and MatCH studies to provide Apgar scores for the MatCH children: 16.1% scored 10, 75.9% scored 9, 6.2% scored 7-8, and 1.9% scored 0-6.

What it means

The Apgar test is fast, non-invasive, and very easy to administer. However, the Apgar score is currently not recommended as a tool for predicting an individual child’s developmental outcomes in Australia or elsewhere. This research adds to a growing body of evidence that shows that the Apgar score should be considered as a useful tool to support referral for ongoing assessment and early intervention.

Read more at https://alswh.org.au/resources/can-the-5-minute-apgar-score-be-used-to-predict-developmental-outcomes/

Allergies

Two out of five children in the MatCH study had one or more allergies. The prevalence of allergies, and their severity has been on the increase for the past 30 years. This increase suggests that our allergies are not just due to genetics, there are changing environmental factors at play. We’re looking for clues in children’s dietary patterns.

What we found

Children aged 5-12 who consumed sweet and savoury snacks (biscuits, chips, processed meats, lollies and spreads) twice a day were 1.2 times more likely to have food allergies than those with lower snack intakes.

What it means

Foods like these are lunchbox staples for many families – they’re convenient, children eat them, and (with the exception of meats) they mostly don’t go off in unrefrigerated lunchboxes. However, the Australian dietary guidelines recommend only one serving of non-core foods per day. Setting healthy diet patterns as early as possible will fuel children’s physical and mental development and set lifelong healthy habits. Australian parents could be supported to provide healthy meal options through:
· Increased education on the dietary guidelines and practical ways to implement them
· Limiting or banning junk food advertising to children
· A free school lunch program for all children

Read more at https://alswh.org.au/resources/is-junk-food-contributing-to-childhood-allergies/