Don's diary: low birth weight - the legacy

Winter 2001
On the crest of a wave. My study of low birth weight (LBW) in North Wales is complete, finding rates as high as 9.9 per cent in some areas. I want to discover why there are no funded strategies specifically to redress infant LBW in the UK, considering that the incidences in Wales (7.7 per cent) and England (7 per cent) are the highest in Europe.

The effects of LBW are huge: obesity, delayed development, poor speech, behaviour problems and poor scholastic outcome. Evidence also supports links between LBW and high blood pressure in childhood and coronary heart disease in adulthood. The long-term implications point to a need for public-health policy changes. Must work on report to submit to funding bodies in January.

Spring 2002
Really pleased by responses to my report: director of Foyer (a national organisation providing sheltered accommodation for young homeless people) wants to use it as evidence for funding; the National Assembly for Wales may quote it in a national report; and the local MP, Chris Ruane, wants to set up meeting with agency leads in the area.

The issues desperately need flagging up. Professionals I interviewed talked so much about the causes: poor nutrition, eating disorders, drug abuse, depression, and isolation among teenage mums. Evidence also suggests that this last group is 50 per cent more likely to have a LBW baby and, saddest of all, that LBW babies are 50 per cent more likely to die in the first year of life.

Summer 2002
Pleased with meeting of executive leads of agencies. They appear keen to develop something positive out of the findings. In close contact with Chris Ruane and Ann Jones, national assembly minister, who will raise parliamentary questions, if I work on framing them.

I am due to present findings in Montreal and Washington DC - as luck would have it, the two places in the developed world with tested systems to reduce LBW. Nutritional support programmes have been found successful in improving maternal and infant health, actually reducing costs to health services.

Return to find my study reported on TV news and in local papers. My friendly MP has been busy again, I suspect.

Autumn 2002
Must apply for funding and get properly trained in the nutrition programmes found in operation abroad. My study is on the BBC Wales website and I am invited to do BBC radio and TV interviews - excellent for the cause.

Decide to name project "Focusing: Foetal Origins: Creating a United Strategy, Investing in the New Generation". Well received at executive leads meeting, resulting in formation of a local workgroup. Positive response at council meeting: subgroup formed.

Winter 2002
Work with local council subgroup is ongoing. Questions have been raised in both the national assembly and House of Commons.

This week has been inspiring. Learn I have obtained my doctorate, and meet with Jane Hutt, assembly minister for health and social services, and Ann Jones. The minister listens with interest to a precis of the study. Discuss methods of using the findings. Many decisions to be made, but it is apparent that issues of LBW are considered serious health concerns and will be driven forward vigorously in the near future.

Joan Ashdown-Lambert is senior researcher, Centre for Health Policy and Practice, Staffordshire University.