I’ve heard it said that the best time to intervene to change a child’s life chances is 100 years before their birth. This may be taking the concept of early intervention to its extreme, but it is undoubtedly true that work with prospective parents can, and should, start before their children are born.
The NSPCC is well-known for the great work that we do with children who are, or have been, subject to neglect and abuse: providing therapeutic support for children in care; campaigning for justice for survivors of abuse, or counselling children through our ChildLine service. This work is critically important but in an ideal world it wouldn’t be needed in the first place.
Prevention is literally in our name at the NSPCC and is at the heart of what we do. We aim not just to stop abuse once it is happening, but to prevent it from ever happening at all. And this work starts from the earliest possible moment – from conception.
Pregnancy and the postnatal period are an important time and an opportune moment to engage with parents. Evidence shows us that parents’ emotional wellbeing during this period, and the care that they provide to their baby, greatly influences their child’s cognitive, social and emotional development. What happens in the year after conception does not predetermine a child’s life chances, but it does set the foundation for what happens next. Pregnancy can also be a golden opportunity when families are receptive to support and motivated to change; when parents want to ensure their babies lead a better life than they may have experienced. This is why at the NSPCC we are currently piloting a number of evidence-based programmes to help parents during pregnancy and their transition to parenthood.
Providing antenatal education
One of these programmes, Baby Steps, is an innovative antenatal education programme, which helps parents during the transition to parenthood, and supports them to care for their baby. It was developed by the NSPCC with experts at Warwick University using the latest evidence about how to promote sensitive parenting, reduce the stresses of early parenthood, prevent abuse and neglect, and improve outcomes for babies. The programme helps parents to nurture healthy relationships, and to understand and respond to their babies’ cues. It is delivered in a participative and engaging way, which build’s parents’ engagement, confidence and communication skills.
An early evaluation was very encouraging: Parents told us that the programme had a positive impact on their relationships with each other and with their babies, and helped them to cope better with the pressures of parenthood. We are now undertaking a quantitative evaluation to measure changes made during the programme.
Supporting parents to care for a crying baby
Another new service, Coping with Crying, is a simple intervention to help parents to care for a crying baby and to cope with the stress and frustration that this may trigger. It centres around a powerful new film, created with experts at Warwick Medical School and Great Ormond Street hospital, and is based on a successful programme in the USA.
We know that parents can sometimes struggle to care for a crying baby and may find this upsetting or frustrating. Research shows that excessive crying can disrupt parents’ developing bonds with their babies, and in extreme cases, can cause parents to get angry and harm their babies. Evidence from America shows that helping parents to understand how to cope with this stress, together with educating them about the dangers of shaking a baby, can reduce the number of serious head injuries in babies by nearly half.
Over 30,000 new parents have now seen the Coping with Crying film in the UK and our evaluation shows that it is helping mums and dads to cope with the pressures of new parenthood and keeping babies safe. 99% of parents remembered the film at least six months after watching it and 82% said they used advice from the film when caring for their baby. Parents who watched the film were significantly more likely to agree with the message that you shouldn't handle your baby roughly, and reported lower rates of injuries among babies with feeding, sleeping or crying difficulties.
The future of prevention
Our goal is that these programmes, and others like them, can one day be offered to any new parent in the UK who needs them. The next stages of our work involve developing the evidence base further and understanding how we can support high quality delivery of these programmes at scale. We are already working with four local authorities and health trusts to understand how we can support NHS midwives, health visitors and children’s centre managers to deliver the Baby Steps programme.
The NSPCC might seem large compared to other charities, but our direct services are just a tiny proportion of all the services available for children and families in the UK. We know that even if we entirely devoted all our resources to local services, we would not be able to keep all children safe. Therefore we aim to help children and to prevent abuse, not simply by offering these services ourselves, but by influencing and supporting others to change what they do and adopt ‘what works’. The NSPCC cannot prevent abuse to all children on our own but we can be a driver to help others in the system to work towards this goal.