Share your thoughts about how to give babies the best start in life, and chat to Andrea Leadsom MP about the government’s Early Years Healthy Development review

[BojanaMumsnet]

Hello

As some of you will remember, last year we hosted a thread with the Rt. Hon. Andrea Leadsom MP about the support that parents receive antenatally and in the early years, and the kinds of help that parents on Mumsnet found most useful when their children are very young.

Now Andrea is leading a Review within the Department of Health and Social Care to investigate how to ensure every baby has the best start in life. (Please note that the Review is focussed on England because this policy is devolved - although thoughts from parents outside England would still be interesting.)

The focus here is squarely on health and development (not childcare) in the period of time between conception and a child’s second birthday - what some specialists call ‘the first 1001 days’.

This period sees huge changes for families and has ramifications for a wide range of issues. From differences in birth weight to social and emotional development; from adverse childhood experiences in infancy to domestic abuse during pregnancy; and from mental health impacts for parents to how the COVID pandemic and lockdown have changed family life - Andrea would like to hear from Mumsnet users about your thoughts and your experiences.

The Department of Health and Social Care says: ‘We know the period from conception to the age of 2 is critical, with the potential to provide a solid foundation as babies grow and develop. We are committed to ensuring that every baby and young child has the best start in life, and that they are supported and nurtured to be school ready and to progress in life, no matter what their circumstances. The Government will work with academics, health professionals and other experts to identify policies and services that will improve the outcomes for vulnerable babies, children and their families.’

Andrea says: ‘I’m really looking forward to taking part in the Mumsnet early years thread and talking with parents about their experiences. I am keen to hear about the real life experiences of Mums, Dads, carers and health professionals and their ideas about what can be done to improve early years provision.’

‘The Early Years Healthy Development Review is focused on conception to the age of two, known as the first 1001 Critical Days. This is where the building blocks for good emotional and physical health are laid down, and these thoughts and experiences will be essential in helping shape the Review’s recommendations to ensure that every baby gets the best start in life.’

The Review is set to report in early 2021 - so this is a chance to directly influence government policy in this crucial area.

Andrea will have a Mumsnet log-in for this thread and will be reading your comments and responding to them directly over the next couple of weeks. Her first check in will be on Tuesday 3 November at 1pm, so if you’d like to talk to her ‘live’ we’d love to see you then - but if you can’t make it at that time please just post on the thread to add your thoughts.

Andrea’s keen to focus on the first 1001 days, so while you may be bursting to know what she thinks about other political issues, we’d appreciate it if you could remain on-topic as much as possible given how critical this issue is for so many Mumsnet users.

Some starters for ten:
What is (or was) important for you in the early years, including antenatally?
What would you have liked to have access to, but didn’t? What’s missing?
What would you like to say about your experience of the period from your child’s conception to their second birthday? What were the high points and low points when it came to health, development and support?

Proper, financially supported, highly trained expert breastfeeding support on the NHS.

I find it strange that if an older child is away from school for one day the school must follow it up for safeguarding if you haven't let them know - but young children can go a year or longer without being "seen" by anyone in terms of safeguarding. Children this age are hugely vulnerable to abuse and neglect because of this potential isolation. Covid - with baby groups and classes closed or people not wanting to mix and additional financial pressures will make this group (the under 2s) more vulnerable.

More health visitor visits or clinic drop ins with a statutory duty for children to be "seen" every 6 months or so and a duty for parents to facilitate? Would require vastly more resources for the service though as the existing health visitors wouldn't have time.

The sure start centres that were around about 15 years ago were absolutely brilliant for this and making a real difference. They were mostly defunded during austerity cuts. There is no need to reinvent the wheel. Just bring sure start back. It was brilliant. Free groups where you could get advice and meet people and (in the worst cases) had a safe, warm place to go where you knew you could get a cup of tea and your child could have some fruit and toast. They had links to education and support as well. One mum I met through there had left school after GCSEs but due to her experience decided to pursue midwifery training. Another mum I met there was living in a refuge with her two young children. She couldn't afford to go to soft play and coffee shops and baby classes. I couldn't afford that either. We had a clothing swap, toy library, breastfeeding support groups running. I'm so so sad that these places are gone.

Yes. Sure start was an outstanding initiative. Groups every day of the week and helpful, compassionate staff providing a hot drink, a listening ear and practical solutions all day every day.

Ours are mostly shuttered up now. Children's centres gone, breastfeeding support decommissioned. It's not difficult. Care for the PARENTS so that they can care for their children.

I second the breastfeeding support. In desperation I paid for a lactation consultant to help me and I'm so lucky I could do that though it wasn't easy to afford. It changed everything and saved my mental health. Still breastfeeding at age 2 now. This should be available to everyone just like a midwife is available to attend your birth.

I gave birth in February. From March all health visitor, breastfeeding support etc have stopped. Now a health visitor appointment can be booked but there is a 6 week lead time as just one clinic is open. I have had to work hard to get vaccination appointments. It would be very, very easy for a mother/ baby to fall through the cracks. Stopping these vital services shouldn't be acceptable, for any reason. If some can be booked, why can't they all be booked? Why can't breastfeeding groups continue at a distance (as meeting in cafes was fine)? Why can't video support happen? A dereliction of care by local authorities, and first time mothers just put up with it because they don't know different and no-one is listening.

I have had to purchase privately:
Physio for me
Breastfeeding consultations
Baby vaccinations

All of these things should be covered and available to new mothers who cannot self fund

As a mum to two year old triplets this is relevant to me currently. From my scan, through to health visitor post natal visits the staff were outstanding. There was however a huge lack of knowledge of triplet pregnancy and early years. From sonographers not understanding triplets, breastfeeding consultants assuming I wouldn’t want to breast feed or even pump, to unrealistic advice from the health visitor.

Properly trained breastfeeding support is patchy within the NHS. Health visitors and community midwives seem to have limited knowledge- they can show a mother how to latch in one way but don't know what to do when the mother can't replicate this herself. Knowledge of holds seems limited to cradle and rugby ball and little is known about oversupply and how to manage it- my baby was diagnosed with colic when really an oversupply was causing her gastrointestinal discomfort. No one in the NHS spotted it and I eventually worked it out myself, but by then DD had become accustomed to it. I've prevented the issue with second-born DS by using techniques advised by la leche league.

I was readmitted to hospital for breastfeeding support in the immediate postpartum period with DD and this is what saved my breastfeeding journey. I was sleep deprived and miserable, terrified I was starving my baby, and the hospital stay supported me to become properly confident with breastfeeding. At present, midwives tick a box to say baby has latched and fed and can then send new mums home. This is not enough and mums often struggle once home. Not enough is shared about what normal is- no one tells you about the prolonged nursing and crying on days two and three and that it's normal. They don't tell you that your breasts will become like leaky rocks, or that this can prevent baby latching and that a pump might be necessary to get rid of enough that baby can latch. A bank of online resources with troubleshooting would be helpful (as would cessation of the 'if it hurts, you're doing it wrong' fallacy). Some volunteer groups do absolutely amazing work- this time around I received support at midnight from a local peer support group which was invaluable. These should be signposted to. Tongue tie cutting should be more widely available very quickly- I've seen breastfeeding journeys end because tongue tie couldn't be resolved promptly and the baby needed feeding.

It's not enough to encourage women to try breastfeeding- support is needed for when it goes wrong. Otherwise, women are being set up to fail and this does not start their journey into parenthood positively.

Children’s centres are now missing. Mothers need social support to have the best outcomes for themselves and their families. Funding the services we used to have is a vital start.

Funding community breastfeeding groups properly is another priority. Again, reinstating funding that was cut would be a start.

We also need support with infant sleep as an urgent priority. Look at Sleep Scotland for a helpline example. But proper work is needed to establish what support should look like as infant sleep is currently a tribal war ground and there is no one way that works for everybody.

Agree with all these comments.

Also, action needs to be taken on women’s experiences of giving birth and being in hospital.

I left hospital already broken from an entire 48 hours with no sleep following major surgery and heavy blood loss. The wards were impossible to recover on - noisy, hot, I couldn’t have my partner to hold my baby overnight so I could sleep.

She cried constantly so I had to carry her pacing the area outside the ward so other women could sleep and I wouldn’t fall asleep holding her.

My experience is common!

I was fortunate geographically and had outstanding bf support ante and post-natally. That isn't universal though.
We also had my son's tongue tie sorted within a week, whereas my brother (completely different part of England) has had to pay privately to have both his children's tongue ties dealt with. Considering what an effect tongue tie has on how much a baby can take in through bf it is not on that this isn't diagnosed and sorted whilst the mother and baby are still in hospital from the birth.
I only knew there was a problem with my son because I had already successfully bf my older child. I didn't know he wasn't gaining weight. My SIL hadn't bf before so only knew as her baby continued to lose weight, which isn't the best start for a child.
There's absolutely no reason why this can't be picked up in the first couple of days.
Being told that the wait to have the snipping procedure on the NHS was months was just devastating when their baby was being readmitted for failure to thrive!

Bring back Sure Start centres. Breastfeeding support. Practical advice for bottle and mixed feeding. Support for new Mother’s with PTSD. A social services team to check up on the education and well being of ‘home schooled’ children.

I found there was zero support for formula and mixed feeding - no information given out at all antenatally but loads about breastfeeding and HCPs refused to talk about it. There was loads of support for breastfeeding but none if you were also using formula (whether that was through choice or necessity). There was huge pressure to breastfeed but no information about the risks of it and the downsides. I think families need clearer information about all methods of infant feeding and not be denied access to it.

Mental health support - very patchy for my PND as the HV wouldn't provide support and yet that has a big impact on caring for your baby.

The local children's centre was a lifeline - non-judgmental baby group that was free/cheap to access. That was closed last year. We need more of these centres not less!

I'm also concerned about lack of checks on babies/toddlers. I had mine several years before Covid and we saw HV at six weeks, then not at all. I eventually got the two year check after writing to my MP. There wasn't a one year check. That was pre-Covid so there must be more missed now. There must be so many babies/toddlers with problems missed because checks aren't happening. So they're missing out on early support which can make a difference over a lifetime. As a first time parent with perhaps little experience of children, it's really hard to know what is 'normal' and what isn't and when to get help.

Also far more support in postnatal and the early days. Postnatal wards are a noisy hell - women need to recover from the birth and rest not be kept awake all night. Once you get home there's no support at all - I thought I'd be getting frequent visits from midwives/HV etc and that they'd be helpful but they rarely came and when they did they were awful (pressure to breastfeed, didn't recognise baby having problems feeding, made assumptions about my personal circs).

@Peasbewithyou

Proper, financially supported, highly trained expert breastfeeding support on the NHS.

I totally agree with you that breastfeeding support is vital. Have you ever come across a ‘breastfeeding support group’ where volunteers are trained up by professionals to provide peer to peer support? Do you think this might be helpful to Mums who feel more comfortable with someone who has been through it all themselves? Or do you think it should only be delivered by NHS expert professionals?

@Winter2020

I find it strange that if an older child is away from school for one day the school must follow it up for safeguarding if you haven't let them know - but young children can go a year or longer without being "seen" by anyone in terms of safeguarding. Children this age are hugely vulnerable to abuse and neglect because of this potential isolation. Covid - with baby groups and classes closed or people not wanting to mix and additional financial pressures will make this group (the under 2s) more vulnerable.

More health visitor visits or clinic drop ins with a statutory duty for children to be "seen" every 6 months or so and a duty for parents to facilitate? Would require vastly more resources for the service though as the existing health visitors wouldn't have time.

@winter2020 Can I ask how many visits you had from health visitor or other early years professionals when your children were pre-schoolers? Would you have preferred someone to come to your home, or do you think a place that you can visit with different facilities for different age groups and advice for parents on site would be better?

@BertieBotts

The sure start centres that were around about 15 years ago were absolutely brilliant for this and making a real difference. They were mostly defunded during austerity cuts. There is no need to reinvent the wheel. Just bring sure start back. It was brilliant. Free groups where you could get advice and meet people and (in the worst cases) had a safe, warm place to go where you knew you could get a cup of tea and your child could have some fruit and toast. They had links to education and support as well. One mum I met through there had left school after GCSEs but due to her experience decided to pursue midwifery training. Another mum I met there was living in a refuge with her two young children. She couldn't afford to go to soft play and coffee shops and baby classes. I couldn't afford that either. We had a clothing swap, toy library, breastfeeding support groups running. I'm so so sad that these places are gone.

Thanks for such a clear message of support for Sure Starts. I agree they have been incredibly helpful for some parents, and there are many hundreds still providing excellent support in their communities. Do you have thoughts on what would have made your family’s experience even better? E.g. support for Dads, Health visitor checkups, birth registration, debt advice, childcare advice etc.

@xtinak

I second the breastfeeding support. In desperation I paid for a lactation consultant to help me and I'm so lucky I could do that though it wasn't easy to afford. It changed everything and saved my mental health. Still breastfeeding at age 2 now. This should be available to everyone just like a midwife is available to attend your birth.

Very happy to hear you are still breastfeeding with your child now 2. There’s no doubt it is fantastic for parent and baby health and bonding when it goes well. Were you able to access any breastfeeding support free of charge, and if so, what was it that didn’t work, causing you to pay privately?

@prisscalledwanda

I gave birth in February. From March all health visitor, breastfeeding support etc have stopped. Now a health visitor appointment can be booked but there is a 6 week lead time as just one clinic is open. I have had to work hard to get vaccination appointments. It would be very, very easy for a mother/ baby to fall through the cracks. Stopping these vital services shouldn't be acceptable, for any reason. If some can be booked, why can't they all be booked? Why can't breastfeeding groups continue at a distance (as meeting in cafes was fine)? Why can't video support happen? A dereliction of care by local authorities, and first time mothers just put up with it because they don't know different and no-one is listening.

@prisscalledwanda I’m really sorry to hear what a battle you have had during the lockdown with accessing services. On the review project we’ve heard about how some areas have continued to run services successfully via digital means, including video, so it would be helpful to know if you would have found this useful, and what in particular you would have liked to see.

I’ve noticed a lot of calls for more breastfeeding support but I think there needs to be a change in the quality of support offered- at the moment the support tends to be offered by those who are either very privileged (volunteer BF peer support for example), or those for whom breastfeeding is life. This leads to women being pressured to breastfeed as soon as they get pregnant and the support available is usually quite poor, with no consideration of different forms of infant feeding or support for these (eg combi feeding). This can have a real impact on maternal mental health- especially for those who decide not to breastfeed or are unable to. Action is needed to ensure that the quality of infant feeding support moves from being based in woo and pseudoscience, to being rigorous and evidence based.

Women also deserve higher quality antenatal and postnatal support. Groups such as NCT and the Positive Birth Movement dominate the area and this is resulting in an unrealistic, damaging portrayal of pregnancy, birth & the early days. There needs to be a more realistic antenatal/postnatal offering which focuses on truly caring for maternal mental health.

The field also needs a focus on infant mental health and how parents can support this. This is completely missing at the moment and if new parents were more aware of how to support infant mental health we might not see the same high numbers of new parents experiencing mental health difficulties due to shame/guilt around their birth/feeding experiences.

Food for thought.

The policy of promoting exclusive breastfeeding does not meet the needs of families and may cause harm. When I arrived on the postnatal ward, I was strongly encouraged and supported to exclusively breastfeed, though I hadn't slept in days and was very low in mood. I continued not to sleep, meanwhile I knew my baby wasn't feeding well. Staff kept supporting me to breastfeed round the clock. Less than 24 hours after initial hospital discharge, a home visit revealed my daughter had not been feeding, had lost excessive weight and was jaundiced and a readmission was needed. Once formula feeding, she thrived and I got to sleep as my husband could share care. Sharing care would have been our plan all along but policy and practiced steered us off course and down a path that had nearly disastrous outcomes for us. I urge any review of early years care to look at the impact of exclusive breastfeeding promotion on mental health and the safety of the Baby Friendly Initiative (BFI). Vicky Fallon's 2019 review of the BFI has shown mothers experience it as pressure and that it impacts mental health. She also showed that BFI does not increased breastfeeding rates beyond the first few weeks. BFI has been introduced to hospitals with no safety data. A Nuffield Trust report showed that newborn readmissions for feeding complications more than doubled in the last decade. We need to start putting families, not breastfeeding rates at the centre of their care and base infant feeding policy around compassion, autonomy and safety.

@cataclysmiclife

As a mum to two year old triplets this is relevant to me currently. From my scan, through to health visitor post natal visits the staff were outstanding. There was however a huge lack of knowledge of triplet pregnancy and early years. From sonographers not understanding triplets, breastfeeding consultants assuming I wouldn’t want to breast feed or even pump, to unrealistic advice from the health visitor.

Huge congratulations on your triplets! I’m sure it can’t be easy to manage with three tiny babies, and I’m so glad to hear the support was outstanding. I wonder if you could give the project a bit more info on what you felt was a lack of understanding about the particular issues for triplets? What kind of advice and support would you have liked to see?

another vote for Sure start and breastfeeding support.
I was a breastfeeding peer supporter at a sure start centre. This support is vital and we helped so many families who were in desperate urgent need. We were lucky that we had paid breastfeeding counsellors and lactation consultants running the clinics we helped at but later it was handed over to the health visiting team and run just by volunteers which is just not good enough