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?

@Hardbackwriter those brain pictures were probably Romanian orphans from the 80's/90's. A very extreme thing to compare those mothers to! Must have been very stressful to see.

1. In Wales we have flying start based on postcodes.

This does not work. I'm in a flying start area and I'm also a primary school teacher specialising in the early years. I don't need the extra support but I lap it up anyway. The next steer over there are families who desperately need support but can't access it as their postcode is wrong.

1. During Covid antenatal support has been done alone. I was told by a midwife that this has allowed them to talk about domestic violence more openly without the partner sat in the same room. If everything ever does go back to normal I think there should be some appointments that have to be done without partners present so that women can openly disclose their circumstances where necessary.

@jakeyboy1 I agree stop pushing women out of hospital so soon after birth.

Overworked midwives with little investment in breastfeeding offering formula at the first opportunity is not going to help our breastfeeding rates either.

One thing was the amount of baby and toddler groups , my health visitor didn't tell me about a single one I could attend with my 1st, after my second child I found one at a local church, I made some great friends and it kept me sane having something to look forward to and to vent my issues, get advice etc. These are so essential as it really did help me and prevented my PND !!!

Also the rules have changed every year that iv had a baby 2016,2017,2019 , they shouldn't change so frequently their so confusing and I hear a lot of people saying they don't know what to do for the best anymore. Example 2016 co sleeping with baby BIG NO NO ..... 2019 I got asked if I was going to an that it was okay?? Doesn't make sence at all!

I appreciate your considered responses Andrea.
With the Online versus in person, I think HV need to physically be in people's homes, from a safeguarding perspective it is a much more thorough assessment if they can see a person's living conditions even if just one room, from a physical health perspective seeing a baby and assessing them undressed to weigh allows you to properly notice signs of poor physical health. Very hard to assess hydration from example on a screen, and hard to assess work of breathing on a dressed baby on a screen.
From a mental health/DV perspective for mums I think most people want to see the same person at least for the antenatal visit, the newborn visit and the mood visit which is the around 8 weeks bit. I feel like I'd be much more likely to open up to someone who is met q couple of times before and was in my home rather than on a screen. I had my daughter's 2 year check remotely and it was so awkward.
With breastfeeding support to properly assess latch and effective mill transfer it needs to be in person. Great if there is also the option to access phone or online support but this shouldn't replace the face to face support. Also again if this person is able to visit the mum at home, they can be another safeguard in noticing is this family coping? Do they need support? Is this baby physically well?
The Thrive approach which is used in some areas talks about brain development for parents in the early years.

@Peasbewithyou

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

Absolutely this.

Sure start, sure start, sure start, SURE START.

The Most Amazing lactation consultant who ran fantastic fb peer groups and meetings with others, and also ran an nhs bf support service lost that job through cuts and had to become private.

Wonderful support. But now only for those who can afford it as groups have had to stop.

The groups weren't just about bf, they were about parenting. And a lot of them ran at surestarts.

With post-natal hospital care, perhaps there needs to be an element of patient choice. I was desperate to come home to be comfortable. I don't think GPs are the right person for the 8 week check following caesarean or any other complex procedure, they don't have the experience nor an ability to resolve issues. A medical service could be trained to do all the physical and mental health checks thoroughly, ideally using an ultrasound as well as prodding vaguely at the stomach.

Involve fathers more. Fathers should be able to stay at the the hospital for longer following birth, how can you effectively parent as a team if only half the team is there?

Make a labour "debrief" standard. My first labour was horrible and effected my mental health for years to come. It wasn't until six years later when pregnant again that many of the issues were explained to me.

A complete overhaul of the health visiting process. Never has one group of medical professionals left so many women in tears. You could speak to five HV in the same day about the same issue yet the advice would vary wildly. A 111 type telephone line for parents?

It sounds like support is really varied geographically - I'm in the Derbyshire Dales, and my postnatal experience was fab - breastfeeding support a phone call away, great health visitor, plenty of contact. It's so sad that others are missing out.

Completely 100% bring back Sure Start!
I’m an early years teacher the number of children that come to us not being able to speak or use the toilet is chronically high, and getting worse!
Parents need help way before their children get to us. Many aren’t seen by HV after their children are babies, esp if the parents are disorganised and unlikely to follow up the 2yr check letter. These are exactly the children who need help.

@IHateCoronavirus, I know a primary school teacher, who told me recently that many children start Reception before they’re toilet-trained, and that this makes her job really difficult.

She seemed impressed that my 2.5 year old was out of nappies, but surely this is about average?

Hello all

Thanks again for all your thoughtful contributions so far. Andrea will be back on the thread at 2.45pm today if you'd like to chat to her in real time.

Thanks
MNHQ

@Solasum

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

@Solasum it’s really good to hear about the value you took from being with other mums, and the sharing of views and sense of community. Have you found anything online that can compare during the pandemic, or do you think it’s only face to face that provides the right amount of friendship and support?

@footprintsintheslow

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.

@footprintsintheslow. You are totally right that support for breastfeeding is really lacking in some places. I agree with you that it should only be those who really don’t want to breastfeed who don’t do it - everyone else should get the help they need. Many people have observed that more training is needed for those volunteers and/or professional staff who provide breast feeding advice. Do you think peer support or professional support is better? Could breast feeding support also be given online?

@PowerslidePanda

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?

Hi Andrea - I'm a mum of twin babies and just wanted to add a couple of points from my own experience. While I also received excellent care during my pregnancy, I was shocked at the lack of knowledge the midwives and sonographers had asbout multiple births. For example, several of them told me that because my twins did not share a placenta, this meant they were non-identical. The consultant was the only person who told me that 30% of identical twins also have separate placentas (and a DNA test after birth revealed that mine were indeed identical). This is important to know for any health issues that might arise in future.

You also asked about impacts of the COVID pandemic. The biggest one for us was supermarkets introducing item limits. Our twins were consuming 4 tins of formula per week between them, but we were only allowed to buy 3 tins at a time and I was very worried about being able to feed them. I offered to show the supermarkets the birth certificates which proved I had twins, but they didn't care. I contacted the Twins Trust charity about it and they wrote to all the major supermarkets, but still nothing changed. Hopefully item limits are now a thing of the past anyway, but who knows what the future holds - if such a situation arises again, it's so important that parents of multiples are able to feed their babies just as easily as anyone else.

@PowerslidePanda. I’m really sorry to hear about the supermarket situation. How extraordinary and awful for you! I agree it is unlikely such a thing would happen again, but I will make sure your feedback goes to the Health department.

@MrsBobDylan

My main important point - my HV was the single most important person when it came to getting an early diagnosis for my middle child. She was brilliant and I think the HV role is absolutely crucial.

I rang HV when ds was 15months. He wasn't developing in the way I would have expected. HV did a home observation and referred ds to the Child Development Centre for a developmental check and pre-autism assessment, a hearing test and speech therapy.

He got his ASD diagnosis at 2.5yrs, EHCP at 3yrs and was able to start special school just after his 4th birthday.

This was all thanks to this wonderful HV.

Ironically I saw the GP once ds has been referred on another unrelated matter and she saw the referrals on the system and told me that there was nothing wrong with ds.

More than anything else we tried and did, those early referrals and being listened by our HV made the difference between sinking and swimming.

@MrsBobDylan. You are in good company thinking that Health Visitors are critical in that period between pre-birth and pre-school! Lots of the feedback we have had says that HVs who have the time and a manageable workload have made a huge positive difference to families 😊

@NeurotrashWarrior

The Most Amazing lactation consultant who ran fantastic fb peer groups and meetings with others, and also ran an nhs bf support service lost that job through cuts and had to become private.

Wonderful support. But now only for those who can afford it as groups have had to stop.

The groups weren't just about bf, they were about parenting. And a lot of them ran at surestarts.

@NeurotrashWarrior. Really interesting to hear about a lactation consultant running FB groups. Was the online support as useful as face to face? Would you say that for those who are nervous about the idea of breastfeeding, online support might encourage them?

@superhauntedvagina

Involve fathers more. Fathers should be able to stay at the the hospital for longer following birth, how can you effectively parent as a team if only half the team is there?

Make a labour "debrief" standard. My first labour was horrible and effected my mental health for years to come. It wasn't until six years later when pregnant again that many of the issues were explained to me.

A complete overhaul of the health visiting process. Never has one group of medical professionals left so many women in tears. You could speak to five HV in the same day about the same issue yet the advice would vary wildly. A 111 type telephone line for parents?

@superhauntedvagina. Totally agree Dads need to be included - MPs have run a big campaign calling for NHS trusts to make sure Dads can accompany scans/delivery etc. Also a labour debrief is a really good idea to have as standard. On the NHS 111 idea - improving digital and online support is something we are looking at alongside face to face. Do you think it would be better if 111 was the place you call first as a sort of ‘parents helpline’, or would it be better if it was only for out of hours needs?

@AndreaLeadsomMP thanks for taking the time to reply. I think some sort of out of hours set up would be brilliant for the times when you can't get through to a HV.

@AndreaLeadsomMP

Really interesting to hear about a lactation consultant running FB groups. Was the online support as useful as face to face? Would you say that for those who are nervous about the idea of breastfeeding, online support might encourage them?

It was extremely helpful in the early days for support, and signposting where to get more support, and actually longer term too, as after a year there is a 'toddler' group to graduate to! I feel face to face and the online support worked to complement each other. Eg how to continue feeding when back at work.

I don't know if it's helpful before you start (Might depend on the individual?) unless you are absolutely certain you do want to - I knew I did. But it's extremely helpful to know where to ask for help and receive some support or reassurance on what is normal very quickly. Phoning helplines (LLL, NCT, breastfeeding network) or asking in a fb group when you're sleep deprived or coping with a screaming breast refusing baby is extremely helpful in the moment.

Posters sometimes posted about pressure from partners or grandparents to stop breastfeeding and there were helpful conversations around how to talk about this.

I found it really confidence boosting to read in the group that not everyone found it as straight forward as it looks! That some can only feed from one side or need to use shields. I personally had some difficulties that led to face to face meetings and some really good positioning advice, as well as tongue tie being picked up, led to a referral to cut it and a huge improvement in latch and pain.

Face to face experiences with supporters in hospital and hvs and meeting other mums breastfeeding is possibly more helpful prior to starting (?) and definitely important longer term. It's especially important to get really good support in the first few hours and days. The fb group backed that up further with an opportunity to ask questions when needed.

A wider local parenting fb group might support expecting mothers, alongside signposting to baby/ play groups or classes etc. Sure start was an excellent base for things like that. I believe that an antenatal group was set up locally to support expecting mothers at the start of the first lockdown.

My experience was (and still is) that it's a wonderful network of support and many have made good friends through it.

In the context of Covid, fb groups could be invaluable for ongoing online peer support.

They rely on a lot of expert volunteers and moderators.

There needs to be clarity around what face to face support is possible though.

As someone who desperately wanted to breastfeed but has 'failed' twice, I think you need to look more closely at breastfeeding support. Technical / practical ongoing support is what is needed rather than all the campaigns focusing solely on motivation/reasons for breastfeeding. I think we all know breast is best now but it makes you feel bloody awful if you couldn't breastfeed because although everyone encouraged you to do it, nobody could help you do it successfully.

Linked to that- tongue tie clinics with fast referral. No point telling me my daughter's tongue tie can be snipped in 6 weeks. By that point I've given up because of the pain.

Sure Start centres were amazing. I am fortunate enough to be able to pay for baby classes should I choose but still went to SS centres with my first daughter as I found their informal groups suited my child better. Heaven knows what you do these days if you have a child and can't pay for baby classes. Where do you even go for support and a friendly face?

I think the NHS info is only there if you look for it. For example I am about to wean my second child into solids. I know how to do this from my own reading and experience and know how to provide her with healthy balanced meals as she progresses but I haven't received any contact from a health visitor or even a leaflet through the post to guide me on this if I didn't know.

Finally reading to children in the first 1001 days has proven impact (Scotland has done studies on this) so expanding Bookstart. Members of my own family would never consider buying my children a book or reading to them. I grew up in a house with hardly a book to be seen and Bookstart could help with this.

Oh and more inclusion of fathers. Some sort of antenatal preparation for fathers. NHS classes spend bloody ages making you draw mind maps of pain relief options and hardly any time on what it is like to have a baby practically and emotionally. It's like planning for your wedding day obsessively and neglecting to think of the actual marriage. If a child can be raised by two parents who are equally competent at care (none of this 'I've never changed a nappy nonsense') then the impact on the whole family is huge and has wider impacts too such as keeping women in the workforce. Obviously this point stands whether or not the baby's parents remain a couple or not.

@AndreaLeadsomMP many thanks for replying.

I am happy to hear HV are recognised for the crucial role they can play beyond sleeping/feeding advice.

I found GPs (male & female) didn't take me seriously once I had a baby (it felt a bit like they were afraid I would become hysterical if they spoke to me as a thinking, rational human being).

They just didn't listen to me, which is why the first person I turned to when we hit a serious problem was my HV.

Great thread btw, I think you are getting some interesting stuff!