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Simply someone to talk to


I found myself having breakfast last week with a woman who manages the early years services in her part of the world. We quickly fell into ‘work talk’ and from broad agreement that early intervention is definitely ‘a good thing’, we went on to talk about nutrition. This turned into a lengthy lament on her part about increasing obesity rates among young children and decreasing breastfeeding rates. We both acknowledged the link and moved on to discussing ‘what to do’.

I have been very struck by my recent reading which has comprised all the documents produced by the Scottish Government over the last four years detailing Scotland’s sexual and reproductive health strategy and national parenting strategy, and others which debate social justice for young families and what mothers and fathers feel they need in order to be able to bring up their children well.

To begin with:

These documents and especially the one reporting parents’ views, made me realise that I (along, I suspect, with other academics, and health and social care practitioners) may have underestimated parents’ understanding of the hazards of the internet. Parents in Scotland were very aware that there is a whole heap of rubbish ‘out there’ and that it’s important to be discriminating when surfing the net and to choose reliable sites. Dot gov (.gov) sites were trusted where many others were quickly dismissed.

In terms of receiving information, what parents overwhelmingly preferred was:

‘Personal, empathetic support from individuals dealing with their specific needs for information and support on child health and parenting. They were not opposed to technological resources but regarded them as a supplement to, not a substitute for, individualised information and two-way respectful communication’. (‘Bringing up Children: Your Views’ (2012) The Scottish Government: xi)

This is the same key message to come out of this year’s review of the English Maternity Services: women want continuity of carer across pregnancy, birth and the postnatal period because then they can build up a relationship with one or two midwives and both parties develop an understanding of each other’s points of view. The women are able to tell their stories and the midwives are able to put their advice, their health promotion messages, into the context of the woman’s and her family’s lives. Only by so doing is advice likely to be followed; if it’s totally out of touch with the realities of the woman’s day-to-day life, it’s likely to be dismissed.

So I think if we’re going to make a difference in a positive sense (and health promotion messages have a history of making a difference in a negative sense!) then it’s all about relationships. People’s lives are complicated and ‘purist’ messages (‘stop smoking NOW’; ‘breastfeed for SIX MONTHS’; ‘lose THREE STONES’) belong in the realm of the ivory tower but not the realm of people’s everyday messy circumstances (I’m not thinking of any particular group of parents here; I am presuming we’re all making the best of ‘messy circumstances’!) I think if I held the national purse strings, I’d stop spending millions on glossy leaflets (as the Editor of a Journal, I know exactly how much multi-colour printing costs) and even on evidence-based apps, and I’d fund another few thousand midwives, health visitors, and peer supporters to meet parents’ most commonly expressed need which is for ‘simply someone to talk to’ (Better Births, National Maternity Review’ (2016):37).

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