Revised standards of proficiencies for midwives: an opportunity to influence childhood health?

The first 1 000 days of life, from conception until a child's second birthday, are significant in terms of influencing childhood health (Black et al, 2016; Cusick and Georgieff, 2018; House of Commons Health and Social Care Committee, 2019). This period of time sets out the crucial foundations on which future growth and neurological development are determined, and ensure a child's optimal future health, well into adulthood (Victora et al, 2016). The early days of life are initially dependant on factors such as maternal health status, nutrition and the environment. It is hypothesised that the fetal genome undergoes a process of remodelling during the antenatal and intrapartum periods by means of epigenetic responses by the fetus to stress, intervention or particular birth practices such as the use of antibiotics or oxytocics (Dahlen et al, 2013). Following birth, this genetic remodelling continues; and practices such as breastfeeding help to establish infant gut health and normal function (Parigi et al, 2015). Nutrition and responsive stimulation from parents and caregivers are postnatal epigenetic factors that can permanently influence a child's future long-term health, helping to shape the newborn brain to reach its full potential via accelerated tissue growth and the development of millions of connecting neural pathways (Centre on the Developing Child, 2017). The importance of breastfeeding during early life stems far beyond a simple source of infant nutrition; it is a form of nurturing for the developing newborn baby (Britto et al, 2017)