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?

Sure starts centre are a must, it is so sad that the majority of these aren't a Sharon on what they used to be, if you are lucky to have them still in your area. Also more early identification of SEN so by the time they get into school, support is already there. Rather than get to school and wait another 2/3 years of diagnosis and support.

I had excellent breastfeeding support in hospital but the postnatal Ward was horrendous. Overheated, under ventilated, too many guests, waking up every time any baby cried.

The single most important thing to me in babyhood was being able to go to the local children’s centre several times a week. It was nothing high tech or expensive to deliver (we even all sat on the floor!) a warm comfortable room, cup of tea, and a very motherly coordinator available who could offer advice on anything baby related, then just space to feed and chat to other new mums in the same position. Having a baby is probably the single most life altering thing that most women do. Especially now when many people do not have family nearby, having help on hand is so very important. It has now mostly shut, and the only group still going nearby is for vulnerable mums. Which is all very well, but ALL mums deserve support, and I bet almost all of the people I met at groups would have been prepared to donate a little each week to fund the sessions had there been a mechanism to do so. Supporting new mothers is such a basic, human thing to do. The buildings are still there mostly, so reopen Children’s Centres for all mums

@timestep I'm sorry for your experience, it shouldn't be happening. Have a read of this:

https://www.theguardian.com/lifeandstyle/2020/oct/04/fears-for-mothers-and-babies-covid-19-health-visitor-crisis-mental-health-breastfeeding-england?CMP=ShareAndroidApppOther&fbclid=IwAR3WaXTj3kiKodhNwKxxhvciwl8PC5RD9CQ7IJr1qkvh6MGCv7ihGKEcB8 you get the idea in the first paragraph alone.

It breaks my heart, I love this service, love my job, but we just can't do it properly under these conditions. I've been in the position before where I've had to choose whether to stop seeing a family like yours, to prioritise a family with children facing severe neglect and domestic violence, I'm sorry for having to do that. I would have always followed up with you once I had time, but I'm now at the point where I just never have the time to do that follow up.

What do you even do with that? It's scary. We have no support, our managers can't help. The level of stress I am currently under as a human being trying to do a job I love, just isn't manageable long term. We need more health visitors.

Proper post natal physio therapy. Women are left struggling with back and pelvis problems which make looking after the baby harder. Similarly, the number of women who end up with continence issues.
I had an unstable pelvis during pregnancy and had some physio but there was no follow up after the baby was born. I still have issues years later which I suspect could have been reduced with prompt intervention.

Having unaddressed physical issues after giving birth makes looking after a baby more difficult and has a negative effect on your mood.

@hvnamechange2000 I really appreciate that and can see the workload isn't manageable. It must be very hard to work under those conditions.
I did get the support I needed in other ways but am fearful for other families with more need, especially now other support services have closed.

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.
Andrea
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

It's a long time since I had my dc now, but I found the complete lack of support for parents who went back to work worrying and disheartening. So maybe a clinic or support group even if it were once a month on a Saturday, between areas even - not expecting it at every clinic.

What we definitely need - and this would cover nearly all of the issue raised - is a quadrupling of the numbers of HVs. HVs in my area are now so stretched it is all they can do to cover the children on Child Protection work. The majority of parents just don't get the support, and even when they do see a HV the HV is so pushed for time it might not be the experience they hope for, and there is certainly no chance of building a relationship with them. they don't have time to update themselves on the latest research or the individual syndromes or conditions children on their caseload might have. They don't have time to run groups or to liaise with other Early Years Professionals (as was the aim with the 2 yr checks??). I feel incredibly sorry for HVs who are fighting to keep their heads above water and who are not able to do the job they trained to do, because of caseload.

Plus, it is all interlinked with all other public funded services having been slashed over the last 10 years.

• There is a two year waiting list list for Speech therapy where I work, and that is for the small minority of children who actually meet the criteria after being assessed due to the SaLTs being understaffed and then setting the threshold at which they are able to offer therapy to anyone so very high.
• There is a two year plus waiting list for an autism assessment - and then the parents are given a diagnosis and no follow up support like they used to get
• The Home visitors / Portage and the Area Inclusion Officers are on their knees due to caseload and demands being put on them from above

-There are nowhere near enough special schools to support the families that want them, nor enough support in mainstream schools for children with additional needs for the families that want that provision

Yes, most of this impacts on children aged 2 - 5 BUT it impacts on the HVs time and caseload, which then impacts on the care they are / aren't able to offer 0 - 2 yr olds and their parents.

Midwife training for breastfeeding seems lacking. The UK's breastfeeding rates is disgusting and we are letting children down by not giving them this opportunity. It has life long consequences.

The only reason women shouldn't breastfeed is because they don't want to. Not because there's lack of support, lack of education and a toxic culture surrounding it.

Definitely bring back surestart centres. I've felt like the mum who's slipped through the net. I've had severe PND and there is literally no help or support out there. I've had to put private therapy sessions on a credit card to see me through the days I felt I couldn't go on. My children are 2 and 10 months. I can't go it alone- I need some support from local, trained professionals (who just don't answer the phone/reply to emails).

Echo what others have said about surestart centres. I also struggle to understand why children’s centre sessions for babies are still not running universally when I understand the government have agreed for these to continue.

Separately I found the baby to be very much the focus of the postnatal gp check and little time given to me to discuss my ailments which remain months on. I felt dismissed and as though I should put up and shut up. I understand physio is offered as standard in places like France and surely this is preventing more costly issues further down the line. Thanks for your time

What is (or was) important for you in the early years, including antenatally?
Breastfeeding support which has unfortunately had huge cuts in the last few years, and reintroduction of the infant feeding survey, which unfortunately the gov refused to fund..meaning there is no evidence based data around the impact of cutting those services.
What would you have liked to have access to, but didn’t? What’s missing?
With my first daughter I could access a myriad of sure start services and had help from a health coach to loose weight, and free play groups, and many weighbin clinics I could go to for support and advice. 5 years later having my second daughter these services had been completely decimated...and now she is two they have reduced even further...pre Covid there was one fortnightly weigh in I could access, and self weigh and self plot now promoted...So a HV wouldn't be seeing and assessing babies wellness which I think is dangerous. The new parents cpurse run by surestart has gone, the under ones group has gone, there are much fewer centres to access. The 2 year check has stopped being funded in the neighbouring county...and even pre Covid they moved the 6 week check online...I beleive these things make babied and toddlers who are already very vulnerable at greater risk...There has been a text line introduced with the HV service which is good.
What would you like to say about your experience of the period from your child’s conception to their second birthday?
-Grossly underfunded maternity care, which was delivered by amazing midwives who were under too much pressure and working in a very stressful anxiety culture.

• Breastfeeding support was best accessed through the breastfeeding network..I had to travel to the neighbouring city because locally the BFN funding had been cut. These people were so helpful to me. The phoneline was also good, crazy that it's staffed by volunteers and not paid for properly! But they are brilliant and well trained.
• Saw HV at home once...then phone call at 8 weeks (despite this being the mood visit and having suffered PND with my first)..underfunded and unsafe. But staffed by brilliant people trying to do their best.
• lucky to have good family support.
• lucky to have friendship support.
• Play groups mostly expensive...now sure start groups have been cut so much.

What were the high points and low points when it came to health, development and support?

• Th low point is seeing the difference of how poorly services are funded now and the difference from having my first, I am lucky to have a lot of support from friends and family but many people with young children don't have this. It feels to me like the preventative supportive aspect has been majoritively lost and now these professionals spend their time having to fire fight rather than being able to do the gentle supportive interventions that would reduce the fires in the first place..like the HV supported new parents course.

-Breastfeeding has such a huge impact on both early and long term health..the mind boggles as to why this is so poorly funded. If there is one area that needs investment and research this is it. I also have to ask why on earth the government decided to stop funding the infant feeding survey of they have interest in the first 1001 days?? This isn't about forcing women to do something they d9nt want to do, but WHO suggest in the UK 8/10 women say they stopped breastfeeding before they actually wanted to...there isn't the support there for them. -High points The professionals I met where on the whole hugely motivated and dedicate people working in touch systems but doing their best for us. There was good access to IAPT support when I needed it.

I think all pregnant women (and maybe their partners) should be offered moving and handling training. It is so easy to hurt wrists, backs etc and to make mistakes and have accidents when you are sleep deprived etc. When I used to work for the NHS this was offered annually to all staff. Physio should also be much more accessible generally in the UK and it should be possible to see a paediatrician more easily. Our DD was recently diagnosed with ADHD and ASD at the age of 7. We have had years of awful sleep and behavioural issues. There were signs there much earlier. We have had to do all the investigating ourselves and pay for everything privately. This is completely normal in the UK unfortunately.

So many developmental issues in children that could be ameliorated with early intervention are not identified. For example, speech difficulties, which my dc struggled with, are often not picked up on the nhs at all. Children who aren’t saying words and pointing at 18/19 months are already delayed.

We need to get better at monitoring child speech and there needs to be speech therapy available for the under 3s. Speech therapy budgets have been dramatically reduced over the last decade and many toddlers with speech delay don’t get any help at all or are offered a drop in or group therapy.

My own dc failed their two year check in almost every category and there was absolutely no follow up. No referral to speech therapy, no referral to physio for gross motor and no appointment either to come back to see the health visiting team. I felt very alone.

This is the consequence of hv having been refocused on to families with particular vulnerabilities (eg social services involvement etc). Because I was seen to be parenting well and dc was well fed and happy we got no help at all.

This then means children like my dc are hugely delayed when they start school. We need to invest in early intervention centres where children developmentally behind in toddlerhood are referred. Outcomes will be so much better, not only improving children’s life chances, but supporting parents, keeping families together and reducing costs to schools of dealing with special needs in the school years.

More mental health support for new mums.Postnatal depression is something very common yet many mums do not get the help needed or are scared speaking up will mean their child is taken away from them.
Make sure they have support services available not just go to the dr for antidepressants as many women may not do this.

So many of the things being raised could be, and used to be supported by the Children's Centres.
My LA has dropped from having 75 CCs to just 10.
It is such short term thinking. The whole point of CCs and Triple E funding was to give children who didn't have a great start, a boost, so there weren't quite such massive gaps when the dc start school. But sadly "austerity" means everything has gone - even the shiny new buildings they must have spent millions building.

It is the hardest job in the world, the most vital and important, the vast majority are motivated to get this right ( who doesn't want the best for the child that they love?), yet this is something that we know so little about and are so unprepared for.
Education about parenting, child development, how to cook and perhaps how to 'grow your own' is a necessity. Bring back support for parents through Sure Start Centres or similar parent education centres.

Invest in programmes with a multi focus that impact more widely on young children and their families. Child education specialists leading a growing project linked to cooking ,allotment/community garden based. This would impact on adult mental health, physical health, healthy eating, knowledge of food and basic cookery, poverty and effective learning characteristics. Carried out by the adult with their own children, this would impact on all of the above for the child and on their language development and social interaction.

Teach parents about 'play' and language and the characteristics for effective learning, teach about use of flexible resources that cost little, rather than electronic gadgets and plastic toys.

Even better develop a KS4 curriculum which includes the above in order to break the cycle of low aspiration for children by educating teenagers.

Dental care is a huge early identifier of poor care, poverty and poor behaviour/routine management at home, yet access to NHS dentists is so limited. Improve access to NHS dental care.

Picking up one of once upons points, the lack of support for parents of young DC (and parents of DC with SEN as they grow up) has an effect on the divorce rate I am sure. We had some marriage guidance when we were at a real low point a year ago. The therapist said 'do you realise you've spent all the sessions talking about your daughter?'. And this is in a situation where we have had money to throw at the problems...

Picking up one of once upons points, the lack of support for parents of young DC (and parents of DC with SEN as they grow up) has an effect on the divorce rate I am sure.

Without a doubt. Lack of services, lack of respite, lack of school places, lack of support, all added on to lack of sleep, lack of 'normal life' means the breakdown of adults relationships are shockingly high.

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.

I completely agree with this. In my area the HV just gave you the details of the local La Leche League meeting - that seemed to be the full extent of what was offered. And I think they do some great work and I really admire the passion and dedication of the women I met there, who devoted a huge amount of time to it, but it was not really designed to be appealing or feel welcoming to a broad demographic. It was very, very middle-class and dominated by self-described attachment parents, many of whom also home schooled - and there's nothing at all wrong with that, but it represents a tiny minority of parents. I went to ask for some practical advice on continuing breastfeeding when I went back to work at six months and I did get some useful advice, but what I remember more was that the first suggestion was that I just didn't go back to work, and sad faces about 'if I really had to'. Inherently volunteers are going to be people who are atypically invested and there's absolutely a place for their work but it shouldn't be as the one and only option.

Professionally I train foster carers in attachment, child development, trauma informed and behaviour support. As a parent I wasn't informed of attachment parenting, empathic parenting or research on brain development and behaviour support strategies. In fact parents/families are only offered evidence based advice when they are struggling and accessing Early Help. We can support the early intervention strategy far better by highlighting the research on parenting in preparation of becoming a parent e.g. when pregnant. I even created my own blog to share evidence based research to parents because I couldn't find anything. https://raising2children.com.

Many of my friends who are parents don't know how playing and interacting with their baby supports attachment - which fundamentally impacts how you behave throughout childhood and into adulthood.

I think if you're going to do this you have to be incredibly careful about how. I actually posted on another thread about my experience of going to a postnatal group at my local children's centre, which was sort of loosely aimed at women who were a bit anxious or isolated - which was generally a godsend, by the way, I'm so grateful it was running; it was part of a service that was pretty stripped back then and now is essentially non-existent. The group leader gave a presentation on the impact of early parenting, complete with slides of shrunken brains from infants who weren't interacted with 'enough' (which meant who were severely neglected, but she didn't say that) - and I watched as a room full of women who had been interacting naturally with their babies suddenly became stilted and began to make a conscious effort to do interaction 'right'. It probably wasn't the right place for that message, and it certainly wasn't the right way to do it. From what I see there are actually a lot more mothers who need to be told that good enough is good enough than who need to be told to make more effort with their babies - and does something like that really reach the latter? Do your friends really not play and interact with their children because they don't know attachment theory - and, if not, do you think a short video on it would really change that?

I agree @Hardbackwriter

@Onceuponatimethen as per my pp, this is not universal. In my area we are huge in early intervention and pick the majority of our SALT referrals up at either the 9-12 month check, the development review of that check a few weeks/months later if the initial wasn't satisfactory, or at 18 months or 2 years.

What annoys me is all the research and importance that has been put on early intervention... it's brilliant that we are identifying developmental concerns early, but we then refer to other agencies for support for children to sit on a waiting list for a year or more for the intervention!!

The service differs dramatically depending on area and that is just not ok. It's widening the gap of health and education in equalities. It's appalling and needs to be changed. HV services need to be reviewed and standardised across the country with agreed additional/different approaches for areas of high deprivation.

Breastfeeding support could be given remotely i think

Health visitor apps need to be in person for weighing sadly

Hi my little one is 28 weeks old , he is undergoing tests as he is not meeting development milestones such as sitting without support , ( doctor told me he had reduced tone and gross motor skills delay ) he’s head is fixed to the left side and is Very wobbly.Feels like tests are taking a lifetime so any advice from other parents who’s children might of done similar or had similar experiences

Houses, please, not much is of use if a pregnant woman fleeing domestic abuse or otherwise made homeless is stuck in emergency accommodation for months or years at a time, with no end in sight, at enormous cost to local authorities, children in overcrowded conditions, whole family in one or two rooms and often losing all their possessions in the process!