'It is always difficult to balance the funding of preventative services against the demands of those services dealing with urgent or immediate need, but the work of WAVE has enabled us to argue that case more effectively.'
— Maura Appleby, Stockport Primary Care Trust
The health service is the most vital partner in supporting parents in the crucial period before and shortly after birth. These health-led interventions have proven successful in helping parents develop positive relationships with their young child.
Swedish Approach to Infancy
The Swedish approach to infancy and early childhood consciously puts a strong emphasis on prevention and ensuring the best possible support to parents at the beginning of a child’s life, from having 100% of hospitals qualify for UNICEF baby-friendly status, through 98% of mothers initiating breastfeeding, to high levels of parenting education and support in the early years. Sweden has among the lowest rates of infant mortality and teen pregnancy in Europe. Lifetime health outcomes on measures such as deaths from circulatory disease, liver, cancer and smoking-related illnesses are strikingly better than in the UK.
The study on the effect of early postnatal breastfeeding support from Denmark demonstrates that levels of breastfeeding can be increased significantly by a well-planned intervention. (We could have selected for recommendation a number of other examples which support the same conclusion.)
Nurse Family Partnership is the most thoroughly researched and recommended early intervention in the world and since WAVE worked with its originator, David Olds, between 2004 and 2006 to bring it to the UK, it now runs in this country as the Family Nurse Partnership.
The World Health Organisation recommends all infants be fed exclusively on breast milk from birth to six months of age. Breast-feeding rates in England are among the lowest in Europe. A 2008 report stated that less than a fifth of English mothers are still breast-feeding their babies after the recommended 6 months compared to over 70% in Sweden. Reasons cited include that fewer than 1 in 10 hospitals in England has achieved UNICEF Baby-Friendly Status compared to 100% in Sweden, 64% in Norway and 40% in Switzerland.
The Community Mothers Programme (CMP) in Dublin trains experienced, volunteer mothers from the local community to visit families to provide necessary child-rearing support from the birth of a child until its second birthday. Research on the children and families at age 8 showed superior parenting skills among the programme families, children who are more likely to read books regularly, visit the dentist and have better nutritional intake.
Centering Pregnancy is a model of group antenatal care developed at the Yale Schoolof Public Health that has since been widely replicated. Women are engaged as active participants (e.g. measuring each other’s blood pressure). With little added cost women receive 10 times more contact time. Suggested benefits include reduced preterm births, increased birth weight and increased breastfeeding initiation rate.
Kraamzorg is a unique Dutch system of universal support for mothers for 8-10 days after they return home following a birth. Help may cover health checks (e.g. stitches clean and healing), hygiene advice, support in breastfeeding, ensuring hygiene levels in the home are high and basic household chores such as cleaning the bathroom, nursery and mother’s room and taking care of meals for the mother.