michelle phillipsWhen I saw the job advert for a nurse practitioner for Minding the Baby on the NSPCC website, it just grabbed me. As a health visitor, I’d worked with a lot of teenagers over the years. The idea of working with young first-time mums over a two year period felt like a dream! We work with the mums from their third trimester of pregnancy all the way to the child’s second birthday, and building that relationship – while not always easy at first – is what makes it so rewarding and effective.

Minding the Baby is an early intervention programme developed by Yale University, which the NSPCC is running in Glasgow, Sheffield and York. It is based on attachment theory and aims to enhance the mother’s relationship with her child, helping her develop better awareness of her baby’s physical and mental states and improve her reflective functioning by continuously voicing the baby’s emotions and intentions.

Practical parenting support
I work alongside a children’s services practitioner to spend time with mums and babies in their home: weekly in the baby’s first year, then fortnightly. As a nurse, my focus is on helping mums with health matters and care-giving. My social worker partner provides infant and parent mental health and social care support.

As a team, we provide first time mums aged 14-25 with child developmental guidance, crisis intervention, parenting support and practical support.

One of the huge benefits – and challenges – of my work on Minding the Baby is building a strong relationship with mums who are often wary of professionals, particularly coming into their home. We use texts to keep in touch, reminders about appointments and checking in to see how they are if appointments are missed. Sometimes this is the way you really see you’ve turned a corner with a mum. One mum I worked with texted me a short time after a baby development session about infants learning to move with a text to say: “Michelle, she’s learnt to roll over!” It’s really special being the person who mums share these developmental milestones with – and sometimes the only person for that mother.

Child development is a really key part of the learning for mums. For instance, when infants become more active and start to reach out for things. Mums can often see this as naughty behaviour. But we vocalise what the baby might be thinking, or speak out loud, wondering what makes the child reach out for the object, getting the mum to reflect on what the infant is thinking and feeling. By doing this we can help shift mothers’ perception and ensure they understand that what might feel like naughty behaviour is natural child development. This helps them respond and bond better with their child.

Reminder and reassurance
As part of the programme, we work through ‘ages and stages’ questionnaires with mums every other month. It’s a great way to help mums see how their child is developing and understand what a baby can see or do at different ages. It’s a reminder and a reassurance that they can help their child’s development. And if we every have concerns, or a child is not meeting a developmental milestone, we can identify it and make a referral if needed.

It’s a completely different way of working here at the NSPCC and there’s been a culture shift, moving over from the NHS. I have to stay on top of my professional registration, and l have been supported by the NSPCC as time, funding and training have been given to enable me to do this. I have definitely developed stronger safeguarding skills through training and on the job. I’m much more at ease with sharing information in case conferences. And when I feel like I have a concern, which isn’t a direct risk, I feel much more confident about holding it with my manager and my children’s services practitioner and addressing it as a concern through my work with the family.

Ultimately, we’ll learn so much from delivering this programme. Not just for ourselves as nurse practitioners, but also through the randmoimsed controlled trial evaluation the NSPCC is funding as part of the delivering in all three sites, working with University College London and the University of Leeds. I’m really pleased and proud to be part of it, and I hope our evaluation of this programme in a UK setting will help persuade people that this way of working is really beneficial for first-time young mums.

Michelle will be speaking at next week's free to attend, RCN accredited study day: Current issues in infant health - click here for more information or to book your place