EIF updates evidence for vital maternity and postnatal support and highlights critical gaps in evidence on what works to reduce the impact of parents’ drug and alcohol misuse

Press release: embargo for 00:01, Thursday 28 June

New research published by the Early Intervention Foundation (EIF) shows how maternity and postnatal support for parents and children could be improved by wider take-up of evidence-based practices and programmes. For example, EIF’s report highlights the importance of mental health screening for women during pregnancy, and of the use of infant sleep routines for both children’s development and parents’ wellbeing. 

EIF identifies common, light-touch activities for which there is not good evidence. It also highlights worrying gaps in what is known about how children benefit from many mental health treatments commonly offered to their parents, including those made available to parents who misuse drugs and alcohol.

EIF’s review focuses on the latest evidence for early childhood support commissioned and delivered locally as part of the Healthy Child Programme, an evidence-based framework for supporting pregnant women, new parents and infants set out by Public Health England. There is good evidence underpinning many of the activities already delivered through the Healthy Child Programme. EIF’s findings suggest that, while there are some notable gaps in the evidence, there are several areas of practice that could be enhanced by increasing the use of evidence-based activities.

Dr Jo Casebourne, Chief Executive at EIF, says:

“This review adds significantly to what we know about what works to support mothers through pregnancy and infants in their crucial first 12 months of life. Just as importantly, it casts light on those common practices which haven’t been tested for mothers or very young children, as well as those which have been tested and shown not to work.

“Early years professionals, such as health visitors, are such a vital link between families and other public services, and provide essential and valued support right there in the home. That is why it is so important that these lessons about the evidence of effective practice are heard and acted upon both by the policymakers who continue to shape this vital programme, and those hard at work on the frontline.”

When the Healthy Child Programme was introduced in 2009, it was based on the best available evidence. EIF’s evidence update captures findings published in the decade since the Healthy Child Programme was launched, and uses the evidence to set out when and how effective interventions might be delivered.

EIF concludes that the Healthy Child Programme is a good delivery mechanism for many of the evidence-based interventions identified in this update, and that the majority of these interventions can be delivered as part of the Healthy Child Programme with minimal additional training for midwives, nurses and health visitors.

Viv Bennett, Chief Nurse at Public Health England (PHE), says:

“This Early Intervention Foundation publication sets out the continued case for early intervention, and strengthens the evidence of what works within the Healthy Child Programme to improve outcomes for children and their families, and is a welcome addition to a growing suite of ‘what works’ resources published by EIF.

“As the evidence for early intervention continues to grow, we gain a greater understanding of the individual factors that influence why certain interventions work for some people in some circumstances and not others. This publication will help policy-makers, commissioners, providers and practitioners use high-quality evidence for decision-making, which in turn contributes to our ultimate ambition for every child to have the best start in life.”

EIF’s review highlights a significant lack of good evidence of what works to reduce drug and alcohol misuse among parents, and its impact on infants in the home. The small number of good quality studies which exist have failed to demonstrate meaningful benefits from available interventions for either the parent or the child.

Kirsten Asmussen, co-author of the report and Head of What Works Child Development, at EIF, says:

“Parental drug and alcohol misuse and dependency is strongly associated with a range of negative outcomes for children, and is a primary reason for child protection referrals for infants up to the age of 12 months. We know that tackling the problem is tough: the effectiveness of many commonly used practices remains unclear, improvement is often gradual and relapse is common.

“Given the significant risks to children’s wellbeing associated with parental substance misuse, it is imperative that more is done to develop and test interventions which reduce drug and alcohol misuse and improve outcomes for children.”

A variety of light-touch interventions commonly delivered through early years services have been found through rigorously conducted evaluations or systematic reviews not to be effective in terms of improving outcomes for children, including:

• Infant massage, when offered universally to mothers and healthy, full-term infants – while this may be enjoyable for parents and children, there is no evidence that it improves attachment or other child outcomes.
• Parent management training for child behavioural problems, when offered to parents during pregnancy or during a child’s first 12 months – although there is good evidence to support its use for children over the age of 2.
• Book gifting and other light-touch interventions designed to support children’s language development.

*ENDS

Notes:

• The report is available at: http://www.eif.org.uk/publication/what-works-to-enhance-the-effectiveness-of-the-healthy-child-programme-an-evidence-update (from 00:01 Thursday 28 June). Copies are available in advance, on request.

• The Early Intervention Foundation (EIF) is an independent charity that champions and supports the use of effective early intervention to improve the lives of children and young people at risk of experiencing negative outcomes. For more information, see: http://www.eif.org.uk/
• The Healthy Child Programme 0–5 is a Public Health England (PHE) programme intended to support healthy pregnancy, ensure children’s early development and readiness for school, and reduce health inequalities in young children. It is one part of the overall Healthy Child Programme for children between birth and the age of 19, which is delivered primarily via health visitors (for children up to the age of 5) and school nurses (ages 5–19).