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Parenting - the first twelve months

11 Jul 2002

We have known for a long time that children's early years can have a major impact on their later life chances. New research suggests that the first year of life, including the months before birth, may be particularly important.

There is now clear evidence linking low birth weight with later outcomes in childhood and adult life. The Medical Research Council has shown that low birth weight babies are more likely to grow up with a low cognitive ability compared to babies born at a higher birth weight. Research from other countries has linked low birth weight with adult ill-health, such as coronary heart disease. Birth weight is determined by a number of factors, including a mother's health and diet before and during pregnancy. Income has a major role to play here: studies show that mothers who are reliant state benefits may not be able to afford a healthy diet for themselves or their children.

Research on the beneficial impact of breast feeding has been growing over recent years. Breast feeding has been shown to reduce the likelihood of infant mortality and to decrease the incidence and severity of childhood infections. It has also been shown to protect against adult diseases. For example, babies fed with breast milk are less likely to suffer from high blood pressure than those who are not. Cognitive development also appears to be linked to breast feeding. A Scandinavian study found that children who were breast fed for less than three months were more likely to achieve lower scores for cognitive development at thirteen months old than children who were breast fed for six months or more. However, despite considerable efforts to encourage breast feeding in the UK, rates have remained static for the past 20 years with a strong disparity between social classes and ethnic groups.

New research from the US indicates that pregnancy and the first year of life are critical to brain development. During this period, a child's brain is 'wired' to match his or her daily experiences. The amount of stimulation babies get - how much they are talked and read to, played with and encouraged - can influence language development and later reading ability and numeracy skills. Again, socio-economic factors play a significant role. Studies have found significant differences in the amount of vocabulary that children of more affluent parents are exposed to compared to those on benefit by the time they are one years old. Reasons for these differences include parents own reading abilities, and the amount of money they have to spend on books in the home.

Two key factors underlie the new evidence into this early period of life. The first is that poverty and disadvantage can harm early child development and that the effects can persist into adult life and across the generations. However, it is important to stress that the associations between poverty, disadvantage and later outcomes are in no sense determinist: risk is not destiny.

Which leads to the second factor: the importance of parents' roles. Parents can clearly help protect their children against the risks of poverty and disadvantage. However, whilst much has been written about what constitutes 'good' or 'bad' parenting, it is extremely difficult to isolate what makes a 'good parent' let alone develop interventions which alter parenting in ways that are sufficient to affect children's subsequent development. Too often policy makers and the media seek to find simple answers to difficult questions about parenting when the reality is far more complex.

One such question is the impact of mothers working during their child's early years. Some studies suggest that maternal employment while children are under one year old may have a detrimental effect on child development. Others claim that good quality childcare during the first year life actually benefits child development, leading to higher scores in tests of cognitive and language development. Most of the evidence on this issue comes from the US: we know very little about the sort of childcare UK parents want or use during the first year of life, or the impact it has on child development and later outcomes. This gap in research must be urgently addressed.

There is no doubting the Government's commitment to tackling these issues. A range of policies are being implemented to help meet the Government's target of abolishing child poverty by 2020 such as the New Deal, increases in child benefit, the minimum wage and tax credits, including the child and baby tax credits. In addition, programmes like Sure Start are seeking to more effectively co-ordinate services for toddlers in deprived areas.

Yet major challenges still remain. The first is to reach parents much sooner. Programmes which intervene earlier and more intensively have stronger effects than those which intervene later and less intensively. However, there are still serious gaps in the provision of early preventive services, despite the Government's efforts in this area to date.

The second is to improve information and support for parents. Surveys show parents think services are too often focused on the process of giving birth or on the baby and fail to give families the information they really want about what its like to become a parent. This presents a major challenge, particularly to the traditional roles of midwives and health visitors.

Thirdly, whilst public policy should be guided by what's best for children, it also needs to support parents whatever the situation they are in. Not every mother is able or chooses to breast feed. Not every mother wants or can stay at home during their child's early years. Policy makers and practitioners need to recognise this reality and develop appropriate responses to support parents, whatever decisions they take.

Finally, the Government should consider shifting the focus of its child poverty strategy specifically to pregnancy and the first year of life. This is not to say that the government should stop funding interventions further down the line, rather that the earlier the intervention the more effective and cost-effective it may be and that, over time, this may require a significant shift in resources 'upstream'.

(From The first twelve months, Liz Kendall, 0-19 Magazine, July 2002)

Tags: Talk To Your Baby