Tobacco dependency
Around 3330 babies are born to mothers who are tobacco dependent each year in the North East & North Cumbria. Tobacco dependency is main modifiable risk factor for a range of poor pregnancy outcome it is strongly correlated to high neonatal admissions, still births, sudden infant deaths and low birth weight in the region.
Smoking in pregnancy imposes a considerable economic burden on society. Health care costs are imposed on the NHS, during pregnancy and in the year following birth, as a result of mothers continuing to smoke during pregnancy.
Costs to the NENC NHS related to maternal increased risk of miscarriage, ectopic pregnancy, placenta previa, abruption of the placenta, preterm premature rupture of membranes and decreased risk of pre-eclampsia are estimated to be £10.2 million per year. In addition, costs related to infants’ increased risk of preterm delivery, low birth weight, Sudden Infant Death Syndrome, perinatal mortality, asthma, otitis media, and upper and lower respiratory infections are estimated to be between £12 million and £23.5 million per year based on different costing methodologies.
It is possible to generate positive economic cost savings by introducing low-cost smoking cessation interventions during pregnancy. It is estimated that spending between £13.60 and £37 per pregnant smoker would yield positive cost savings for the NHS. This is purely in economic terms and does not include the health benefits to mothers and children. These cost estimates are conservative and are limited to NHS costs during pregnancy and the first year of life.
Some women continue smoking during pregnancy despite the extensive information available on the dangers smoking poses to their unborn child. Moral judgements are commonly directed to mothers through reference health behavior in pregnancy. The reasons for mothers continuing to smoke during pregnancy are complex but the reality is that smoking in pregnancy is not a lifestyle choice. The Royal College of Physicians’ report on nicotine addiction states that “it is reasonable to conclude that nicotine delivered through tobacco smoke should be regarded as an addictive drug, and tobacco use as the means of self-administration”. They conclude that: “Cigarettes are highly efficient nicotine delivery devices and are as addictive as drugs such as heroin or cocaine.” It would therefore be more pertinent to refer to all smoking as tobacco dependency, a condition in which requires medicalised support.
All North East and North Cumbria Maternity services have trained support workers who can advise further, read more information here.
In addition to this, there is free access to all features in the Smoke Free App (RRP £90), view here.
Support information
Stop smoking in pregnancy here
Get help to stop smoking here
View the infographics and materials here.


Breastfeeding support
All Maternity, Neonatal Units and 0-19 services in the North East and North Cumbria have Infant feeding Leads, or Champions who can give 1:1 support and advice to both colleagues and families.
All localities have varying services through support groups and in some areas peer support, information can be accessed from 0-19 services.
Information on breastfeeding, bottle feeding, feeding a preterm baby, feeding twins and multiples, Expression and storage of breastmilk:
Unicef - support for parents
Breastfeeding Network
Association of breastfeeding mothers
Drugs in Breastmilk information
Breastfeeding Network - drugs in breastmilk
Special Pharmacy Services - Breastfeeding medicines advice service
Formula Milk and information on mother and infant nutrition:
First steps nutrition
First steps nutrition - infant milks
First steps nutrition - parents and carers
These helplines are all run by trained volunteers for breastfeeding people:
National Breastfeeding Helpline - 0300 100 0212 (available every day, 9:30am to 9:30pm).
In Bengali/Sylheti 0300 456 2421; in Tamil, Telugu and Hindi 0300 330 5469
NCT Breastfeeding Line - 0300 330 0771 (available 8am to midnight)
La Leche League 0345 120 2918 (This is open from 8am to 11pm, 365 days a year)
Better Health, Start for Life infant feeding hub resources here.
UNICEF Baby Friendly Initiative here.
For information in several different languages visit here.
Best Beginnings – films and app for parents to be and new parents here.
Perinatal mental health
Pregnancy, childbirth and the new-born period can be a stressful time and can trigger pre-existing or new mental health problems. The following resources from the NHS, professional bodies and national charities can be very helpful to provide information and support surrounding mental wellbeing, view them here.
Support for parents
Mind - Parenting and mental health
NCT - Emotions during pregnancy
Tommy's - Emotional changes in pregnancy
NHS - Mental health and pregnancy
Support for dads
Dads Matter UK - Getting support for yourself
The Book of Man - Postnatal depression in men
The Dad Pad
North East and North Cumbria local maternity and neonatal system - Emotional wellbeing and mental health
Support for young dads
North East Young Dads & Lads
Managed by the North East Young Dads and Lads Project (NEYDL), DigiDad is an online E-learning platform made by young dads for young dads and featuring father-friendly films, podcasts and training materials to support young men on their journey to fatherhood and beyond, see here.
The following link is a collection of Wellbeing and Mental Health Resources and Services in your local areas, see here.
Maternal healthy weight
Best Start in Life recognises that from preconception through to 6-8 weeks following the birth of a baby the healthier a mother is, the better outcomes for both them and the infant. Mothers who have overweight or obesity have significantly increased risks including difficulty conceiving, miscarriage, gestational diabetes, thromboembolism, pre-eclampsia, instrumental / Caesarean delivery. Whilst risk for babies include preterm birth, stillbirth, small or large-for gestational-age, congenital anomalies, perinatal death / sudden unexplained death in infancy and childhood obesity. Eating healthily and keeping active can help in maintaining and achieving a healthy weight.
Eat Well Guide (PHE 2016) see here.
Healthy eating in pregnancy (Better Health 2022) see here.
British Dietetic Association food portion guides can support balancing meal/plate quantity, see here.
Eating well in pregnancy see here.
Eating well for new Mums (including information for breastfeeding mothers) see here.
NHS - Healthy pregnancy diet
NHS Start4Life - Health eating pregnancy
Physical Activity
NHS - Exercise in pregnancy
NHS Start4Life - Exercising in pregnancy
Advice on activity and sport can be found here.
Infographics
Physical activity guidelines
Eat well guide



Reproductive health
Ensuring that families achieve and maintain good health throughout their reproductive years and beyond will not only impact their health, it will also influence the health of future generations
A planned pregnancy with effective preconception care improves health and reduces the risk of infants being born prematurely, having a low birth weight, reduces the incidence of birth defects and birth-related conditions that could negatively impact on a child’s optimal development.
By providing tailored care, education and appropriate support prior to, during and post pregnancies to individuals and their families who have conditions and behaviours that have been identified as having a negative impact on their health, their family’s health and their home environment we can positively influence lifelong health and wellbeing.
North East and North Cumbria Local Maternity and Neonatal System
NHS - Pregnancy
Royal College of Obstetricians and Gynaecologists
Pregnancy and Birth Choices - Before your baby is due
Alcohol in pregnancy
The Chief Medical Officers for the UK recommend that during pregnancy or when planning to become pregnant, the safest approach is not to drink alcohol at all to keep risks to unborn babies to a minimum. Drinking alcohol in pregnancy can lead to long-term harm to the baby.
Fetal Alcohol Spectrum Disorder (FASD) refers to the range of neurodevelopmental problems caused by pre-natal exposure to alcohol. The effects are diverse and impact on the individual throughout their life course.
Royal College of Obstetricians and Gynaecologists - Alcohol and pregnancy
General pregnancy information
Baby Buddy App here.
Screening information for pregnant people and babies here.
Pregnancy and Birth Choices in the North East and North Cumbria App here.
Information about COVID-19 and pregnancy, breastfeeding and vaccinations