Globally midwives have an important role in supporting the attachment of parents to their new baby in the early weeks after birth. It is of concern that priority for postnatal services in recent years have continued to decline, with the latest Care Quality Commission maternity survey report highlighting decreased satisfaction with support given to new parents. In this article Ben Curran for the Parent-Infant Foundation, explains the importance of parent-infant relationships at the start of life and highlights their recent research calling for increased support for parents at this important stage of development.
INFANT MENTAL HEALTH: Focus on parent-infant relationships to give babies the best start in life
It is surprisingly common for a parent to struggle to bond with their new baby. For some, that resolves itself within a few weeks of birth or through the support of family members, a midwife, health visitor or other postnatal support. Sometimes more specialist support is needed, although sadly, it is not always available.
New research has provided further evidence to support the Parent-Infant Foundation’s call for all local authorities, integrated care systems and, in devolved nations, health boards to secure skilled and multidisciplinary support through specialised parent-infant relationship teams. These teams work to support and strengthen the relationship between a baby and their main carers in cases where there are severe, complex, and persistent problems in early parent-infant relationships. They are multidisciplinary in nature, always led by a mental health professional such as a psychotherapist or psychologist, and often including midwives and health visitors. They offer direct support to families as well as acting as expert advisors and champions for the parent-infant relationship to help the local workforce better understand and support these key relationships. Supporting parent-infant relationships during early life provides a solid foundation for a child’s future development.
Under this model of care, midwives who are concerned about potential issues in the relationship early on, such as ambivalence towards the baby or issues with bonding, can access support from specially trained therapists or make a referral if necessary. Interventions typically engage parents in order to strengthen their attachment with their baby.
Securing Healthy Lives
Secure relationships between babies and their parents have lifelong benefits for physical and mental health. To better understand how these vital relationships could be supported, the Parent-Infant Foundation gathered views from parents in the Cwm Taf Morgannwg area of Wales, where it is estimated that around 2000 local babies each year experience a less than optimal relationship with their main caregiver, putting them at greater risk of poor social, emotional, and educational outcomes later in life.
The research included a survey, thought to be the largest ever survey of parents in the UK on this topic, asking parents for their views on several issues relating to their baby’s development. They told an interesting story.
Parents rated the quality of parent-infant relationships with their baby as the third most important influence on child development, just below the impact of violence in the home and parental drug use.
Yet, parents were clear on the need for more support, including for dads. Nearly two thirds of parents (65%) said they had not been asked about their relationship with their baby and only 3% had been offered direct help and support. When parents had been offered help and support, 93% of those parents found that support to be beneficial.
Parents fears
Parents were also clear that they wanted local services where they could talk to someone about their relationship with their baby and get good advice. The biggest fears amongst parents were being made to feel like failure, of being judged or the notion of having their children taken away if they admitted to having difficulty.
Ceri, a mum who took part in the research, said:
“We are always shown ideals of a perfect family where parents don’t struggle, and things don’t go wrong. You worry about social services, losing your kids. So, you don’t always want to talk about mental health issues or other challenges you’re facing as a parent.”
These concerns are a barrier to parents accessing support. A public awareness campaign is needed to tackle the stigma many parents feel about asking for help. Our previous research with parents in Essex, found that once they have been able to speak to someone about their relationship with their baby, parents felt less worried because the process had been a positive one.
Lessons from Cwm Taf Morgannwg
Parents told us how important it is that support is welcoming and accessible to all parents, including dads/partners, young parents and LGBTQI+ parents. Parents said they were most likely to approach health visitors, family support services or a midwife first, with some saying they would also approach their GP. Staff training will be offered as part of a wider comprehensive workforce development strategy that upskills all professionals working with babies and their families to help support their relationship. One team, Baby in Mind, were able to demonstrate the positive impacts for families when parent-infant relationships were thought about and supported during pregnancy.
Call to action
There is still clearly more to do but their ambition and commitment to giving babies the best start in life places Cwm Taf Morgannwg well. We commend Cwm Taf Morgannwg’s approach to a detailed understanding of the local issues, including listening closely to parents. Governments, local authorities and health systems can learn a lot from their approach and the results of this research.
The findings from the report suggest that governments across the UK should take action across four key areas:
- Ensure specialist support for parent-infant relationships is available in every part of Wales
- Develop a workforce strategy so that there are skilled professionals to support parent-infant relationships
- Amend maternity guidance to ensure it includes support for parent-infant relationships
- Ensure assessment tools, such as those used by Midwives and Health Visitors, include prompts about the parent-infant relationship.
Campaigning for babies
This work is timely as the UK Government have announced £300 million dedicated to delivering the Government’s Best Start for Life vision. We are working with partners to try to ensure that specialised parent-infant relationship teams are part of the offer funded by this new investment. There are positive signals from the devolved administrations too. Infant mental health services feature in the Scottish Government’s programme for Government; Northern Ireland has included babies’ mental health in their Mental Health Strategy, and we have had positive engagement with the Minister in Wales.
Our work to improve the lives of babies will not stop there. Working with our partners in the First 1001 Days Movement, we regularly campaign and lobby Government to make changes in other legislation that has a lasting impact on babies and their families.
Infant mental health awareness week
Much progress has been made in raising awareness of mental health issues and breaking down the stigma around them thanks to some effective, high-profile campaigns led by people such as Prince William, Alastair Campbell and others. The understanding of infant mental health and the fact that a strong parent-infant relationship is central to it lags some way behind. This is why Infant Mental Health Awareness Week is so important. It started as a UK event but has become a truly global occurrence.
Taking place from the 13th – 19th June 2022, activity over the course of the week will focus on the theme ‘Understanding Early Trauma’. From a coffee morning to hosting a talk with a local expert, local events like this help to spread the message to people that would otherwise miss out. Could you organise a simple event or help to promote other activities taking place to help others learn about the impact of early trauma on an infants’ mental health? If so, visit our website for more information or email me on [email protected].
Ben Curran
Communications and Marketing manager, Parent-Infant Foundation