Low benefit levels threaten babies’ health

29th April, 2003

Most pregnant teenagers are not eating a healthy diet during their pregnancy, with many reporting that they cannot afford to do so, according to a new survey published by the Food Commission and the Maternity Alliance.

For the survey, 46 pregnant teenagers were interviewed and their diets was analysed for nutritional content. Interviews with the young women revealed that pregnant teenagers, particularly those living away from their parents, face huge obstacles to eating an adequate diet, including a lack of cash to spend on healthy food.

Pregnant teenagers are penalised under the state welfare benefits system as they receive much lower payments than older pregnant women. Two thirds of the teenagers taking part in the survey said that they found it a struggle to get by. The majority of teenagers living away from home said that they had less than £20.25 to spend on food each week – the bare minimum required for a ‘modest but adequate’ diet. Many reported that when money was tight, they filled up with cheap fatty or sugary calories such as chips, biscuits and sweet breakfast cereals.

Babies born to teenagers tend to have lower birthweights, with increased risk of infant mortality and an increased risk of health problems in childhood and later life. The Food Commission and the Maternity Alliance are calling on the government to ensure that pregnant teenagers receive better support. Women of all ages should have the right to eat healthily during pregnancy, for the good of their health and for the good of their unborn babies.

Is this enough to feed a mother and her growing baby?
Meal	Food
Breakfast	Crunchy nut cornflakes with whole milk Milky tea with two sugars Glass of whole milk
Lunch	Packet of crisps 4 gingernut biscuits 2 chocolate digestives Milky tea with two sugars
Supper	2 sausages (fried), chips, peas and gravy Ice-cream
Snack	Smoky bacon flavour crisps Milky tea with two sugars
Typical daily diet of reported by a pregnant teenager containing eleven portions of fatty, salty and/or sugary foods, no fruit, and only one portion of vegetables.

 

The UK has the highest rate of teenage pregnancy in Western Europe. In the year 2000, 23,000 babies were born to women under the age of 18.1

The diets eaten by teenagers are among the worst recorded in national surveys of the British population’s nutritional status. Teenage girls in lower income groups are prone to skip meals and to deprive themselves of food to prevent weight gain. Their diets are typically deficient in essential minerals such as iron, calcium, zinc and magnesium, and vitamin A and folic acid.

Partly as a result of this unhealthy pattern of food consumption, babies born to teenagers tend to have lower birthweights, increased risk of infant mortality and an increased risk of health problems in childhood and later life.

When a teenager becomes pregnant she needs all the help and support she can find. An adequate income is essential if she is to eat properly for herself and the growing foetus. It is estimated that the minimum amount a pregnant women needs to spend on food is just over £20 per week, assuming she has local access to a wide range of foods at current average prices, and that she knows what she should buy to obtain a nutrient-rich diet. In such circumstances, an estimated £20.25 would be just enough to buy a ‘modest but adequate’ diet.

To find out what foods pregnant teenagers are eating, how they make food choices and what factors influence their eating behaviours the Food Commission, in partnership with the Maternity Alliance, undertook a survey of 46 pregnant women aged under 18. We wanted to find out if pregnant teenagers were eating healthily, or whether their diets were cause for concern.

The research found that most teenagers who shopped and cooked for themselves are not able to afford even the modest amount of money needed to buy an adequate diet.

Benefits for 16-17 year olds are complex and depend on the young woman's circumstances. For a pregnant 16-17 year old in full time education living at home, her parents can claim £38.50. If she is eligible to claim benefit in her own right she can get £32.90 a week, or in some circumstances, including where she can show she is estranged from her parents, £43.25. Some young women of 16 and 17 may not be eligible for any benefit, even if they are pregnant and living independently. The benefit rate for a woman aged 18-24 is £43.25, and for a woman aged 25 or over, £54.65. For most pregnant teenagers, this money is only available after the 29th week of pregnancy, beyond the time when her growing foetus has the maximum need for essential nutrients. The payments are meant to cover all costs except housing.

Money and diet
A wealth of evidence shows that when money is tight, one of the easiest items to cut is food, as it is one of the few areas of people’s budgets that is not fixed (unlike fuel bills and rent, for example). The easiest ways to reduce food costs are to buy cheaper foods and to eat less. The research found evidence that many pregnant teenagers did both. Previous research by the Food Commission also shows that healthier options tend to cost more than their less healthy alternatives (e.g. wholemeal bread compared to white). The differences are shown below.
Additional costs of healthier food options
	Regular basket	Healthier basket	Average extra cost of healthier foods
1988	£9.78	£11.56	18%
1995	£11.04	£15.11	37%
2001	£12.72	£19.19	51%

 

If these young women are failing to eat healthily, both they and their growing foetuses are at risk of malnourishment. Inadequate nutrition during pregnancy will affect the mother’s long-term health, as the growing foetus draws on her nutrient reserves, and it will affect the foetus which, deprived of an adequate range of nutrients, will be at risk of stunting and early symptoms of heart disease and diabetes.

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Of the 46 young women interviewed, dietary patterns were characterised by:

• many portions of fatty foods
• many portions of foods with high levels of saturated fats
• many portions of foods high in salt
• many portions of sugar-rich foods and
  beverages
• few portions of fruit or vegetables
• low levels of dietary fibre
• deficiency in vitamin A and folic acid
• deficiency in the minerals zinc, iron and calcium
• missed meals every day or two.

The young women were generally aware of what a healthy diet should be and knew that they should be improving their diet during pregnancy. Nonetheless, it was not easy for them to eat well. The majority of those who had to buy their own food did not have enough money to ensure their diet was adequate.

Frequency of foods eaten by pregnant teenagers during the previous day
Type of food	Number eating this food out of 46 women	Average number of portions
Milk	40	2-3
Bread/toast/rolls	35	3-4
Squashes and soft drinks	34	2-3
Crisps/bagged snacks/pot snacks	31	2
Breakfast cereals	29	1
Low sugar breakfast cereals	13	1
High sugar breakfast cereals	16	1
Vegetable/salad (excluding potatoes)	27	1-2
Processed meat products	26	1-2
Confectionery	25	1-2
Sweet tea/coffee	18	2-3
Chips/French fries	18	1-2
Fresh/lean meat	18	1
Fruit and fruit juice	17	1
Biscuit/cake/dessert	16	4-5
Cheese	15	1-2
Potatoes (not chips/crisps)	12	1
Pastry	9	1-2
Pasta/rice	7	1
Eggs	6	1
White fish and processed fish products	7	1
Seeds/nuts/pulses	3	1
Yoghurt	3	1
Alcohol	2	1-2
Oily fish	0	0

 

Over half of the 46 women surveyed said they had made some healthy changes to their diet since finding out they were pregnant, such as drinking milk or eating vegetables. They could all recall at least one person who had given them dietary advice during their pregnancy and most had tried to follow this advice. Almost all of those who were not able to follow the advice said this was because it was too expensive. Three quarters said that if they had an extra £5 a week to spend on food they would buy fruit and/or vegetables.

Without sufficient cash, any amount of nutrition information and knowledge, and any amount of skill in food preparation, will be wasted. With less than £5 per day to pay for all their needs, it is not surprising that typically less than £3 could be afforded for food. To eat healthily on less than £3 is virtually impossible: a bag of salad leaves at Sainsbury’s might be £1.49, three tomatoes 35p, a tin of sardines at Tesco 49p and a small wholemeal loaf at the corner shop 65p. That’s it. The money is spent and you have not bought enough to survive on (see box: Money and diet). Cheaper ways to fill up can be easily managed: a packet of custard creams is 39p, a big bag of chips 70p, sausages, sweet tea, white bread, margarine and jam – you can buy enough calorie-dense food to keep you going two days for less than £5.

The dilemma between not enough healthy food and too many fatty, sugary calories cannot be resolved on a low income. For teenage women living alone, especially for those with no support from parents, partner or friends, the risk of a seriously inadequate diet is high. In the present survey, a detailed analysis of the diets of six young pregnant women found that four had diets that were seriously deficient in calories (less than 1,700 per day) yet all six were eating more than the recommended maximum amount of saturated fat, and five were eating more than the recommended maximum amount of sugar. None were eating the recommended minimum five portions of fruit and vegetables per day – indeed none had eaten more than two portions on the day surveyed.

Most of the 46 young women surveyed survived by depending heavily on their parents, their partners or partners’ parents, or their friends. This puts a strain on relationships at an age when these women are least able to cope, adding to their difficulties and the likelihood of ill health. To exhort them to improve their diets without offering them the means to do so is worse than futile, for it encourages resentment and distrust.

The solution lies in providing the means for these women to obtain the diets they need, and which they are well aware that they need. Assessment of the costs of a ‘modest but adequate’ diet should be undertaken routinely, with allowances made for specific dietary requirements and local price variations. Benefit levels then need to be upgraded to cover this minimum entitlement, and the benefit made available automatically to all pregnant women from the moment the pregnancy is confirmed.

Additional measures should also be considered to improve the health status of teenagers so that pre- and post-conceptual periods are not nutritionally jeopardised. This requires better school-based food policies and closer attention being paid to the food culture and food marketing environments which surround children and teenagers in modern society. Previous research has shown that nutrition education programs are not always effective at improving pregnant teenagers’ diets. More research is needed to understand the factors affecting these women’s food choices and to identify what works to help improve their diet.

This survey was conducted by Helen Burchett and Annie Seeley and funded by the kind donations of friends and colleagues of the nutrition campaigner Arthur Wynne, who passed away in 2002.

Reference 1. Summerfield C, Babb P (eds), 2003, Social Trends No 33, The Stationery Office, London

Useful resources

The full report is available in pdf format, 40 pages Click here to view Good enough to eat? The diet of pregnant teenagers

The Food Magazine reports on children's food and drink and other food issues in the UK. An annual subscription costs £25.00 (individuals/non-profit) or £50.00 (corporate). Published every three months.

The Maternity Alliance is a national charity, working to end inequality and promote the health and wellbeing of all pregnant women, new parents and their babies.

The Maternity Alliance
2 - 6 Northburgh Street
London EC1V 0AY
Tel: 020 7490 7639. Fax: 020 7014 1350
Email: info@maternityalliance.org.uk
Web: http://www.maternityalliance.org.uk/