All health professionals know they have a duty not just to treat disease but to promote health. They do this partly by preventive measures such as vaccination and immunisation programmes. They also promote health by encouraging a healthy lifestyle, by giving advice on diet and exercise. As mental health problems contribute greatly to the total amount of ill health in the population, it makes sense for health professionals to be active in promoting mental health as well as encouraging good parenting (see Chapter 15).

Preventing intellectual disability

Intellectual disability has a permanent effect on an individual's quality of life. Although it cannot be entirely prevented, much can be done to help reduce the number of people who suffer from it. Health professionals have an important part to play.

Before the child is born

• • Make sure mothers have enough to eat and get sufficient rest.

• • Monitor the progress of the pregnancy regularly: refer to a gynaecologist if there is cause for concern about the health of the fetus or the mother.

• • Discourage pregnancy before the age of 18.

• • Discourage smoking, use of illicit drugs or drinking of alcohol in pregnancy, as it may harm the fetus.

• • Treat as an emergency, high blood pressure or fits in pregnancy.

• • Do not give pregnant mothers drugs or X-rays unless absolutely necessary.

• • Advise pregnant women against carrying heavy loads or walking on slippery ground.

• • Immunise mothers against measles and tetanus – do not let them come in contact with people with German measles, mumps or chicken pox.

• • If there is a genetic counselling service available, refer all pregnant women over 40 as well as those with close relatives with intellectual disability.

At the time of childbirth

• • Avoid premature childbirth if at all possible – if the mother enters labour too early, advise bed rest and refer.

• • Ensure only skilled people conduct deliveries.

• • If before delivery the baby is in an abnormal position, refer to a specialist.

After childbirth

• • Ensure all babies are breastfed at least for the first 4 months of life; this prevents infection and ensures babies are adequately nourished.