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Background and Objective: Germany is only moderately breastfeeding-friendly, according to a systematic inventory from 2019. Based on a reference study, a survey on the acceptance of breastfeeding in public was conducted. The aim of the work is to capture perceptions and attitudes towards public breastfeeding in a periodic comparison. In addition, differences between the general population and mothers of young children as well as between mothers with different levels of education are considered., Materials and Methods: In 2020, 1007 people aged 16 and older and 307 mothers with children up to 24 months were surveyed online about public breastfeeding. The results were compared with a previous survey from 2016., Results: In 2020, a larger percentage of mothers breastfeed in public than in 2016; it is avoided less often. Mothers with lower levels of education are less likely to breastfeed, also in public, and more likely to report mixed reactions. Among the general population, acceptance of public breastfeeding has declined, for example, in gastronomy. About one in six (17%) explicitly rejects breastfeeding in public. Knowledge about the health effects of breastfeeding is lower among the general public than among mothers. As in 2016, knowledge about the positive effects of breastfeeding is associated with greater acceptance of public breastfeeding., Conclusions: The results underline the importance of measures, for example, to communicate knowledge to the population, show breastfeeding more frequently in mass media and through positive role models, and make the settings in which families live more breastfeeding-friendly. Measures should pay special attention to women with lower levels of education., (© 2022. The Author(s).)

Aims Obesity is an increasing problem, even in young women of reproductive age. Obesity has a negative impact on conception, the course of pregnancy, and neonatal outcomes. Caring for obese pregnant women is becoming an increasingly important aspect of standard prenatal care. This guideline aims to improve the care offered to obese pregnant women. Methods This S3-guideline was compiled following a systemic search for evidence and a structured process to achieve consensus. Recommendations Evidence-based recommendations for the care of obese pregnant women were developed, which cover such as areas as preconception counselling, identification of risks, special aspects of prenatal care and prenatal diagnostic procedures, intrapartum management, and long-term effects on mother and child., Competing Interests: Conflict of Interest/Interessenkonflikt The conflicts of interest of all of the authors are listed in the long version of this guideline./Die Interessenkonflikte der Autoren sind in der Langfassung der Leitlinie aufgelistet., (Thieme. All rights reserved.)

Diet and exercise before and during pregnancy affect the course of the pregnancy, the child's development and the short- and long-term health of mother and child. The Healthy Start - Young Family Network has updated the recommendations on nutrition in pregnancy that first appeared in 2012 and supplemented them with recommendations on a preconception lifestyle. The recommendations address body weight before conception, weight gain in pregnancy, energy and nutritional requirements and diet (including a vegetarian/vegan diet), the supplements folic acid/folate, iodine, iron and docosahexaenoic acid (DHA), protection against food-borne illnesses, physical activity before and during pregnancy, alcohol, smoking, caffeinated drinks, oral and dental hygiene and the use of medicinal products. Preparation for breast-feeding is recommended already during pregnancy. Vaccination recommendations for women planning a pregnancy are also included. These practical recommendations of the Germany-wide Healthy Start - Young Family Network are intended to assist all professional groups that counsel women and couples wishing to have children and during pregnancy with uniform, scientifically-based and practical information.

Despite known positive effects for breastfed children and their mothers, only one third of children under four months of age are breastfed exclusively. In addition, an overview of structures, actors, and measures to promote breastfeeding in Germany is missing. In a two-year international research project entitled Becoming Breastfeeding Friendly (BBF), the current status of German breastfeeding support is systematically evaluated on the basis of the Breastfeeding Gear Model (BFGM) which was developed by the Yale School of Public Health. Therefore, committee members with expertise in the healthcare sector, science, policy, and communication evaluate 54 benchmarks of the eight relevant gears: advocacy, political will, legislation & policies, funding & resources, training & program delivery, promotion, research & evaluation, coordination, and goals & monitoring. Based on the identified strengths and needs, concrete calls to action for scaling up breastfeeding promotion are derived and prioritized. BBF started in September 2017 and is conducted in cooperation with the Yale School of Public Health by the Healthy Start - Young Family Network as well as the National Breastfeeding Committee as an initiative of the Federal Ministry of Nutrition and Agriculture. The project assesses the framework conditions for breastfeeding and thus makes a valuable contribution to the health promotion of mother and child and to breastfeeding protection in Germany.

Study Aim: This study aims to measure the level of acceptance of the recommendations of the "Healthy Start - Young Family Network" on infant nutrition and nutrition for breastfeeding mothers among different professional groups., Methods: A standardised online questionnaire was used to investigate the level of acceptance (dichotomised response mode: accept vs. not accept). The first survey was of midwives, gynaecologists and paediatricians among others, the second survey was of paediatricians. The level of acceptance was categorised as low (<75%), moderate (75-89%), strong (90-94%), very strong (95-99%) and absolute (100%)., Results: 1 311 health professionals participated in the first survey (n=908 midwives) and 77.6% reported having knowledge of the recommendations. The average level of acceptance was lowest among midwives (67.5%). 119 paediatricians participated in the second survey and 86.5% of this group said they had knowledge of the recommendations. A low acceptance level was mainly found with regard to recommendations on supplementation (fluoride and iodine). A focus on the individual situation of young families, an orientation towards other recommendations and subjective assessment were the main reasons for non-acceptance., Conclusion: Recommendations have not been successfully implemented in midwives' practices. Due to overrepresentation of midwives, the observed results do not necessarily apply to other occupational groups. However, the implementation of the recommendations into training and education of health professionals, revision of ambiguous statements as well as the communication of the scientific background of the recommendations are meaningful measures to raise acceptance levels., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Nutrition, physical activity and lifestyle in pregnancy influence maternal and child health. The "Healthy start - Young Family Network" supported by the German Government with the national action plan IN FORM developed recommendations on nutrition in pregnancy. Energy needs increase by only ≈10 % by the end of pregnancy whereas micronutrient needs increase much more. Normal weight should preferably be achieved before pregnancy. Dietary recommendations follow those for the general population. Folic acid supplements (400 µg/day) should be started before pregnancy and continue for at least the first trimester. Iodine rich foods and salt and an iodine supplement (100-150 µg/day) are recommended. Long-chain omega-3 fatty acids should be provided with ≥ 1 weekly portion of oily sea fish, or a DHA-supplement if regular fish consumption is avoided. Vitamin D supplementation is advisable unless there is regular exposure to sunlight. Health care professions should lead parents to health-promoting lifestyles. Subjects of part 2 of the article are practice recommendations on nutrition in pregnancy, especially vegetarian diets, recommendations on micronutrient supplementation, risk reduction of listeriosis and toxoplasmosis, alcohol, tobacco, caffeine and physical activity in pregnancy., (© Georg Thieme Verlag KG Stuttgart · New York.)