Pre-Birth to Three: - Health and Wellbeing
Narrator:Within the United Nations convention on the Rights of the Child, is the declaration that all children have the right to experience a healthy start in life, and be offered a standard of living that meets their physical and mental health needs.
Scientific evidence shows us how health and wellbeing is determined to some extent by the way in which children’s brains develop in terms of the relationships and the responsive care that they receive. Children’s early experiences of a caring environment have a direct influence on their self-esteem and sense of wellbeing as they develop and grow.
Paula Dudgeon:There is a huge link between relationships and children’s mental wellbeing. The very first experience is about how you develop your sense of yourself; what their self-esteem is, who I am as a person, do people value me, through all the responses they get and the feedback. So fro staff it is really important that they know that that’s a key bit in how they help those young people develop, particularly young children who don’t have that perhaps from elsewhere.
Narrator:Staff working with young children should provide the kind of support and guidance that helps families to build capacity to work towards achieving the most positive outcomes.
Jacky Gillan:I think it’s really paramount that practitioners are always looking at the emotional wellbeing of the whole family. And certainly in their direct work with parents there is a three-way relationship which is about looking at the wellbeing, the level of confidence, how they feel about themselves and can practitioners look at any opportunity to harness that? So it’s not just about having parents in helping at one specific area, it is starting where the parents are at and looking at how can we actually best support the parents.
Yvonne Hall:A lot of our families that come to Hand-in-Hand could be attending because they are isolated; they have just moved to the area and they don’t know anybody, or it could be a bit more serious where they might have post-natal depression. In the centre we appreciate that it is very difficult for the parents to walk through our front door even, so can we incorporate home visits and we can come and visit and encourage the parents to come into the centre where they can have group support. There are other mum’s, there are other people out there that are having the same problem, so we encourage the mums to come in and discuss their issues, and we can help with that. We do courses about self-confidence, we do baby massage to help with bonding with your child, and we do lots of arts and crafts that can encourage mums to not feel stigmatised, not have a label, they are individuals and we like to help them see that they are individuals.
Ali Ferguson:The big thing behind what I do really is about raising self-esteem, raising confidence through creative work. And also through helping parents express themselves. At the moment we have been looking at parents aspirations for their families, so we have been relating that and doing wish books with the families, where we get parents to think about what their aspirations are for their children, what their wishes are, and then putting them down in a book. Which works on all different levels; they are learning new skills, they are using new materials. There is a lot of discussion going on that people don’t necessarily even notice. For example, one of the wishes is that people wish their child to be confident, comfortable with themselves, so that creates all sorts of discussions about how the parents feel, and maybe they find difficulties with confidence and so on, so how do we bring that out in children, it really just starts up all sorts of conversations about confidence.
Lisa Brown:I feel it’s helped me in confidence, because I was employed and then I got paid off from my job, and it’s given me confidence in being able to go out and actually find another job, and get back out into the workforce. And just confidence within myself as being a parent; it has boosted my confidence in doing that.
Narrator:Scottish government policy frameworks, including the Early Years Framework, Equally Well, and Achieving our Potential, all seek to address disadvantage and improve the life chances of our youngest children, by tackling social, health and educational inequalities through prevention and early intervention. The frameworks represent a strong commitment to a partnership approach, where their promotion of health and wellbeing relies on staff, parents and agencies working together to achieve the best start for all children.
The policy frameworks offer a consistent approach, and Equally Well makes clear that staff working with young children and families must not only respond to the consequences of health inequalities, but also where possible tackle its causes. Through primary care services Health for All Children 4, commonly referred to as Hall 4, supports the delivery of preventative healthcare and health promotion. Health visitors have a key role to play in supporting and promoting the health of children and families, and it is important that staff use this pivotal service.
Parents play a central role in supporting children to develop physically, emotionally, socially and cognitively. Staff working in early years settings are in a strong position to be significant and positive role models for children and parents, and they should be aware of the responsibilities in the promotion of health and wellbeing. By promoting healthy living messages, such as tooth brushing, healthy eating, physically activity, and hand washing, staff help children and families to achieve the most positive health and wellbeing outcomes.
Liz Hutcheson:It’s extremely important to promote children’s health and wellbeing at this early stage. We encourage outdoor play, we constantly encourage children to be energetic; every day the children are out playing. We encourage children to wash their hands, be independent at toileting. Their snack time is very healthy, and of course with parents we encourage parents to look at our snack board, what’s on offer today, so that they constantly are being reinforced as well, that children have to have very good food to encourage their growth.
Narrator:A key person who knows and understands the child and family best is well placed to contribute meaningfully to this partnership approach.
Narrator:A prevention and early intervention partnership approach, with parents staff and other agencies, is key if babies and young children are to develop lifelong healthy eating habits.
Steve Halkett:Health and wellbeing is a critical part of the curriculum for all our children. We would look at the nutritional aspects of that for the child, both in terms of snacks and meals. It is about rewarding, it’s about praise, it’s about encouraging children in a very positive way. We would encourage the families to support that in terms of what they would do with the child, and extend learning away from the nursery to home. And we would work very closely with our colleagues in health and social work to ensure we give the parent the best chance, and obviously then that child the best chance in life.
Narrator:The Scottish government promotes breast feeding as the optimum way of ensuring that babies have the best start in life, and receive all the nutrients they need. Staff can support parents who are seeking guidance about breast feeding, by signposting them to useful publications, help lines or to the health visitor.
Robin Balbernie:We know that secure attachment actually, and left handed feeding, roughly correlates, because if you are feeding on the left side you have got left eye to left eye contact, and the left eye communicates to the right brain, so that’s why I mentioned the left side, there is a reason for that. The baby is getting nice physical contact, the mother is relaxed, so the baby is relaxed, because of course the baby will pick up all the mother’s subliminal signals. The mother is enjoying the feed, she is able to focus her attention on the task at hand and not be distracted; so she hasn’t got other things on her mind which a more stressed mother might have; she has only got the baby on her mind. The baby is enjoying the feed, it gradually gets through, finishes when he or she feels like it, and it’s a complete experience with a beginning and a middle and an end, and that baby has a good experience. And in terms of the brain wiring up what’s happened is, neurons that fire together wire together, in that baby’s internal representation of the mother is mum’s – or relationships as it will be – make you feel good, they care for you, you can feel safe, you can relax.
Now next door we could have a mother who, for whatever reason, can’t keep the baby in her mind, she can’t hold the baby in her head, because she is overstressed and she is vulnerable, She is struggling with a multiplicity of risk factors, which are impacting the relationship; and these can be social like poverty or racial intolerance, they can be immediate, like an inability to tune into the child because of her own background, or trouble with a violent partner, or they can be in her own past, such as being in care or coming from a background of maltreatment or poor parenting herself. But for whatever reason she can’t hold the baby in mind, and maybe she can’t even tolerate, unconsciously, giving the baby a good experience because she did not have it herself. And so therefore you get the paradox of mothers sometimes being jealous of their own children because they are being asked to do something for their child that nobody did to them, and these mums of course need even more understanding and support, they certainly don’t need blaming.
And perhaps it’s important to do an aside here, and say that there is no such thing as a bad parent; all parents do the best for their babies that they possibly can. No parent sets out to be a bad parent, or a difficult parent, but all parents bring different resources, and all of us who have been a parent know there is nothing more stressful and exhausting than being a mum or a dad. But this poor mum, and this poor baby are getting a completely negative experience; the baby doesn’t feel settled, the baby may be being prop fed, the mother isn’t making eye contact, so there is excitation of the right brain. The baby is just doing a mechanical task; gulping it down, it is probably going to get colic, so that will make it again a more difficult baby to settle, which is make the baby even less satisfying from the mum, and you can see the whole thing going off into that predictable negative spiral. And yet they are both having the same experience these two babies, they are having a feeding experience. But what’s been wired up in each babies head, the structure of their mind that’s being put in there could not be more opposite.
Narrator:Staff may also wish to promote, for example, the baby café initiative, by providing a dedicated area for breast feeding mums and displaying relevant materials.
Lee Davies:I got the breast feeding group every Wednesday, I also attend another one on a Thursday, and it has been a fantastic help. I have breastfed two boys already and used the facilities right through, and wouldn’t know where I would be without it, to be honest, it’s really, really good; the girls are fantastic, the friends that I have made through the group have been fantastic, and the information that you can get just through talking to other mums as opposed to just looking in a book is just out of this world.
Narrator:Babies and young children need a healthy balances diet to support brain function, as well as other aspects of physical development. As soon as babies have been weaned onto solid foods at around six months they can choose from a range of healthy foods and drinks supported by adults who encourage them to try out new tastes and textures.
From the earliest days children can experience the joy of physical activity through play, both indoors and outdoors, and in all weathers. These experiences offer important opportunities for the development of fine motors, gross motor, and social skills. Opportunities to experience planed risk and challenge through play encourage children to gain confidence in their abilities and in making decisions.
Dr Rosemary Roberts:We are really clear now that health and wellbeing are absolutely crucial for very young children’s development and nurture. The research now tells us that the things that happen to babies and young children in their first three years are absolutely fundamental foundations for what happens later. We have got our good old structure that we have had for decades and decades about children’s mental, emotional, social, physical wellbeing chunked up into four things, and it seems to be that it’s become incredibly unhelpful to think about those four things separately. We need to acknowledge and think about the integration of children’s development, and how it all works together. But the most important for people’s wellbeing, for very young children and for adults, especially mothers with children under five, is all about feeling that you can both make a difference for yourself; in other words to look after yourself, to care for yourself, but crucially also to care for other people. So it’s about caring.
Narrator:One of the principles of getting it right for every child is keeping children and young people safe. Emotional and physical safety is fundamental, and is wider than child protection.
Prevention of infection is crucial as babies have an immune system which is not fully developed, making them particularly vulnerable to infection. In early years settings, where adults and children are in close contact, infections can spread very quickly. These risks can be reduced by ensuring good hand washing practice, high standards of personal hygiene, and maintaining a clean environment. Frequent hand washing is one of the single most important ways of reducing the spread of infections and preventing ill health.
Children are particularly affected by second hand smoke, as their bodies are still developing. It is important that parents understand that the only way to protect children from second hand smoke is to have a smoke free home and car.
Staff can provide relevant information for parents on matters relating to prevention, safe environments and avoiding unintentional injury.
Narrator:How does your current practice ensure that you remain up to date in relation to key health improvement messages?
How can you further develop partnership working in your setting to promote healthy lifestyles?