Minister questioned about the inclusion of infant formula in Healthy Start

Lynne Jones MP this week questioned the Secretary of State for Health about why the NHS Healthy Start Scheme includes entitlement to free infant formula and under what circumstances it is provided. Minister of State, Dawn Primarolo responded stating that Healthy Start provides a nutritional safety net for pregnant women and children under four years old in low income and disadvantaged families.

 

She noted that the scheme provides vouchers that can be put towards the cost of cow’s milk, fresh fruit, fresh vegetables, and infant formula milk at participating retailers. “We recommend exclusive breastfeeding for the first six months of life, and the scheme encourages this. However, if mothers choose not to breastfeed, formula is the only safe alternative for children under one year of age, as the use of cow’s milk is not recommended.”  She said that this was why infant formula is included in the scheme.  She also noted that follow-on formula is not included because scientific advice is that follow-on formula has no additional nutritional benefits for healthy babies over six months old.

New network to tackle child poverty in London

London Councils and the Government Office for London launched the country’s first Child Poverty Network this week.  It will help local authorities and their partners work more closely together to tackle child poverty across the capital. The network’s purpose is to help local authorities and their partners share good practice, discuss local issues and to support pan-London approaches to tackling child poverty.

 

Designed for senior staff from local authorities and their partner organisations such as Primary Care Trusts (PCTs), Jobcentre Plus and housing associations, the network will link up staff tasked with developing policies to combat child poverty with those in charge of implementing policies on the frontline. It will not only help raise awareness of child poverty, but also help policy-makers work more closely with those charged with delivering services to identify the barriers to making their policies a success.

 

The network will meet quarterly to allow members to discuss what works in their local area, explore new approaches and to talk with colleagues from across the capital. The network is also supported by an online resource for members.

 

View more information on the London Child Poverty Network

View Government Office for London website

Concern over midwife numbers raised

Mr. Stewart Jackson, MP for Peterborough this week highlighted concerns about the increase in the number of live births outstripping the increase in the number of midwives by a ratio of 3:1 in the period since 2001.  He noted the Royal College of Midwives (RCM) call for 3,600 midwives and emphasised that the current problems are particularly acute in areas of high population growth, such as Peterborough where six expectant mothers were recently turned away by the maternity unit at the district hospital and forced to travel 35 miles to King’s Lynn.

 

The Parliamentary Under-Secretary of State for Health, Ann Keen, responded noting that the Government is actively recruiting midwives, and working very closely with the RCM. She also stated that if an expectant mother were turned away from a unit it would be for reasons of safety—for the mother and the birth—because there was not enough capacity. She noted that there is an escalating birth rate and an active recruitment programme of midwives as well as efforts to encourage midwives to return to practise. She said “It is unfortunate when a woman has to travel further to give birth, but it is a matter of safe practice.”

Minister questioned about the accuracy of maternity data

Ann Keen this week responded to a question from Anne Milton, Shadow Minister for Health, about what steps the government is taking to improve the accuracy in the recording of (a) gestational age and (b) birth weight. The Parliamentary Under Secretary of State stated that a number of measures are in hand which should improve the accuracy of data. She noted that one of the aims of Public Service Agreement 19: “Ensure Better Care for All” (2007) is to “increase the percentage of women who have seen a midwife or a maternity health care professional for a health and social care assessment of needs, risks and choices by 12 weeks of completed pregnancy”.

 

This assessment is to include a dating scan that will be used to calculate the gestational age of the foetus during pregnancy and at birth. She noted that as more women benefit from these assessments the accuracy of recorded information on gestational age should improve and together with this the plausibility of weight for age data.  She also highlighted the maternity data quality dashboard which was published by the NHS Information Centre for health and social care (IC) in February 2009 for use by NHS trusts and commissioners, enabling them to better monitor progress using the data they have submitted. The dashboard specifically identifies gestation length and birth weight as data fields. Increased local scrutiny of this data should also encourage improvements in data quality.

 

She also stated the additional steps the NHS IC is taking to improve the accuracy of maternity data in hospital episode statistics (HES). She said that this should have a positive effect on other information in this area such as that used by the Office for National Statistics to link to registration data.

 

The IC now contacts NHS trusts directly when they submit data for HES which contains a high proportion of blank or unknown values in key maternity fields. The IC encourages trusts to investigate why these fields are not being populated and to resubmit data with correct values. The IC has also begun introducing improvements to the annual NHS Maternity Services publication, which includes data on gestational age and birth weight, while ensuring that data problems are transparent so that there is an incentive to improve data quality.

New study suggests breastfeeding may help to offset early disadvantages

A new study from the Institute of Education, London, has suggested that breastfeeding may be particularly important to the educational and emotional development of children from single-parent and low-income families. The study, which involved 1,136 mothers and was funded by the Department for Children, Schools and Families, strengthens the argument that breastfeeding is also associated with more positive parenting practices that can continue beyond infancy. Previous studies have reported that the high nutritional content of breast milk can increase a baby’s IQ. Other research has found that breastfed children are at an advantage because their mothers are, on average, better-off and more articulate.
 
Researchers who analysed the behaviour of mothers reading a storybook to their one-year-old children found that, on average, those who breastfed made more effort to engage their infants in the book than mothers who bottle-fed. In general, mothers with more positive attitudes towards breastfeeding also appeared to have a warmer relationship with their babies.
 
The study found that the greatest differences in behaviour were between two groups of single and low-income mothers – those who breastfed for between 6 and 12 months, and those who bottle-fed. Poorer women who breastfed interacted with their babies during the book-reading exercise almost as well as more advantaged mothers did. However, low-income mothers who bottle-fed their babies tended to communicate with them much less well than other mothers, the researchers say. It also found that marital status had no effect on the quality of a mother’s interaction with her child, provided she had breastfed for 6 to 12 months. In fact, single mothers who had breastfed for this period made slightly more effort than other mothers to explain the storybook to their child.
 
A repeat experiment four years later found that mothers who had been on a low income when their child was one, but had breastfed for more than six months, had a higher quality of interaction with their five-year-old than other mothers. They also made more effort to engage their child in the book-reading exercise than mothers who had not breastfed. By contrast, breastfeeding appeared to have no lasting effect on the parenting behaviours of married and higher-income mothers.
 
The report’s principal author, Dr Leslie Gutman, research director of the Institute’s Centre for Research on the Wider Benefits of Learning, says that the age five findings underscore the “protective” influence of breastfeeding for lone parent and low-income families.  Future studies should investigate the processes behind the findings, she suggests. Researchers should attempt to establish, for example, whether skin-to-skin contact forms stronger bonds between breastfed infants and their mothers which, in turn, lead to more positive parenting practices.
 
Dr Gutman also says that the findings provide support for government policies that encourage breastfeeding, particularly for more disadvantaged mothers. If a mother works on a short-term casual basis, or is an agency worker, she may not qualify for maternity leave, and if she earns less than £90 per week, on average, she does not qualify for Statutory Maternity Pay. This may act as an incentive to stop breastfeeding and return to work as soon as possible, the study says.
 
“New mothers, particularly in deprived communities, may therefore require more than information leaflets,” the researchers comment. “Rather, interventions that offer early and ongoing support and encouragement to manage breastfeeding may be needed: this may come from financial support in order to enable a delay in return to work and/or workplace nurseries where mothers can visit and breastfeed their babies during the day. Meanwhile, campaigns such as ‘Be a star’, run by Blackpool Primary Care Trust (PCT) and North Lancashire Teaching PCT to provide role models for young mothers, may be a way of highlighting the issue.”
 
Dr Gutman and her colleagues also found that mothers with extensive social networks interacted with their infants more positively, on average, than mothers with more limited social circles. “At a community level, the finding implies that the networking and social interactions that go on between parents in children’s centres, early-years settings, community groups and many other community venues,  such as libraries, and health and leisure centres, are of great value,” they say.
 
Efforts to improve maternal health could also help to build parenting capabilities as post-natal depression impairs communication between mother and child, the researchers add.
 
Nurturing parenting capability: the early years, by Leslie Gutman, John Brown and Rodie Akerman, is available here. 

Minister launches joint agreement to tackle child poverty

Social Justice Minister Dr Brian Gibbons this week launched a joint agreement on child poverty and called on public and voluntary sector organisations in Wales to sign up. The joint agreement sets out the Welsh Assembly Government’s commitment to reducing child poverty and outlines ways in which other organisations can make their own contributions. It supports the proposed Children and Families Measure which was laid before the National Assembly on March 2nd. If passed, it will place a duty on specific Welsh public bodies to identify and take action to assist in the goal of eradicating child poverty by 2020.

 

The agreement will allow public agencies in Wales, who will not be affected by the legislation, to sign up to demonstrate that they too are prepared to work with the Assembly Government to tackle child poverty. The Minister joined representatives from organisations from across Wales at Tonyrefail School to see a project that provides sporting opportunities to all children and to sign the agreement. The following organisations signed the agreement today:

 

One Voice Wales
Welsh Local Government Association
Wales Council for Voluntary Action
NHS Confederation
Save the Children
Sports Council for Wales
Greenhouse
Mid & West Wales Fire and Rescue Service

Welsh Assembly lays out commitments for children and parents

The Minister for Social Justice and Local Government in the Welsh Assembly, Brian Gibbons, this week noted that tackling child poverty is a top priority for the third Assembly Government term and that they are committed to using every policy lever available to them as they work towards reaching the challenging child poverty targets.

 

He said that the proposed Children and Families (Wales) Measure demonstrates the Welsh Assembly Government’s commitment to improve the lives of vulnerable children and families in Wales and the lives of those disadvantaged by child poverty. He said that it would enable them to provide support to those families and children in greatest need, who without additional support would be unfairly disadvantaged within our society.

 

The Measure makes statutory provision, through a legislative framework, to take forward the Welsh Assembly Government’s commitment in terms of child poverty and the early development of its strategy for vulnerable children. This is achieved by bringing forward legislation to provide greater support to families where children may be at risk and strengthening regulatory enforcement in children settings.

 

This is in addition to the wide range of Assembly Government policies and programmes operating across Wales aimed at tackling child poverty. These include employment support programmes, childcare initiatives, education and health programmes, Communities First interventions and income maximisation initiatives. The Assembly Government’s policy response to child poverty includes a mix of universal and targeted provision all of which are designed to complement and add value to UK Government interventions through the tax and benefits system.

 

An analysis of the Labour Force Survey found that around half of the children in Wales living in low income households are in lone parent households. The latest ‘Monitoring Poverty and Social Exclusion report’ (Palmer et al, 2006), also found that lone parent families have a high risk of poverty and that worklessness puts those families at a particularly risk. The Assembly Government is therefore making significant investments in programmes like Want to work2 and Genesis 2.  One of the main ways that Genesis 2 supports the child poverty agenda is by improving the prospects of increased income into the family by moving people closer and/or into work, and also providing free childcare for parents who wish to access learning, training etc where no other funds are available. Genesis 2 targets give priority to women/lone parents that have been economically inactive or unemployed for a considerable amount of time; helping them move closer to the labour market by providing childcare where that is identified as being a barrier for participants.

 

He noted that funding and support for parents is also being made available through a wide range of policies and initiatives that contribute towards tackling child poverty, such as the Flying Start and Cymorth.

 

Flying Start provides support to parents through the requirement that parenting courses must be available to each family accessing the scheme. Families within Flying Start areas are also entitled to additional Health Visiting support, free-part time quality childcare for 2 to 3 year olds and language and play courses through the Basic Skills programme. This package of support benefits the whole family. Flying Start requires that the bulk of the parenting courses offered should have been evaluated to demonstrate their effectiveness. Guidance has been provided by the Assembly Government as to which parenting programmes can be offered as part of Flying Start.

 

One of the themes within Cymorth, the Children and Youth Support Fund, is Family Support. This aims to ensure that families have access to support that will foster positive relationships between parents and children. Parenting Programmes are also funded through this strand.

 

Through the Parenting Action Plan published in November 2005, there is increased support and information available to all parents in Wales, from early years provision through to the teenage years. Support to parents is embedded across a number of portfolios and parenting is being mainstreamed across a range of policies and programmes. The Parenting Action Plan has been a catalyst for this.

 

He also highlighted that in 2008-9, £266k was given through direct grants to organisations to fund the training of trainers in parenting programmes, and to provide funding for the evaluation of parenting programmes. This evaluation will enable an evidence base to be built which can inform future policy direction.

Local councils must be awarded greater freedoms to end child poverty

London Councils this week warned that London’s boroughs must be given greater flexibility if they are to eliminate child poverty in the capital. The organisation’s response to the Child Poverty Bill consultation argues that the government’s proposed new statutory duties for local authorities and their partners to tackle child poverty will only be successful if boroughs are provided with sufficient freedoms to respond. It also warns that in the current economic climate, extra effort will be required to keep child poverty at the top of the policy agenda. 
 
The organisation is calling for boroughs to be given greater freedoms from government control around housing benefit, tackling worklessness and childcare to respond to their residents’ specific needs and thus tackle child poverty at a local level. It also supports the London Child Poverty Commission’s proposal to extend the housing benefit payment period once an individual moves into employment from four weeks to six months – which would increase the likelihood of them staying in work. Increased training opportunities should also be made available to those in receipt of housing benefit.
 
London Councils also wants to see successful pilots from the government’s Childcare Affordability Programme rolled out on a large scale in partnership with the boroughs to help more parents into work, and for councils to have greater control over back to work programmes. Child poverty is reflected in the National Indicator Set (Indicator 116—Numbers of children in households dependent on out of work benefits). Local authorities can choose to select child poverty as a target in their local area agreement and 45 have already done so. Kitty Usher, Minister at the Department for Work and Pensions confirmed that the Government is committed to refining this indicator to ensure that low income families are included in this measure.  However she also said ‘we need to do more to ensure that all delivery partners prioritise child poverty and take action.’

Despite advances in tackling child poverty nationally, London’s child poverty rate remains high. 41 per cent of London children live in households with an income below 60 per cent of the national median income after housing costs (compared to 30 per cent nationally). However, London local authorities have a long track record of successfully delivering a range of services to tackle the causes and impact of child poverty. This activity has increased in recent years and includes:

• Nine boroughs (Croydon, Enfield, Harrow, Islington, Kingston, Lambeth, Lewisham, Southwark and Westminster) signing up to the London Child Poverty Pledge, with another eight London boroughs (Barking and Dagenham, Hackney, Haringey, Merton, Newham, Tower Hamlets, Waltham Forest, Wandsworth) making a commitment to doing so
• 11 London boroughs (Ealing, Enfield, Hackney, Haringey, Islington, Kensington and Chelsea, Lambeth, Newham, Tower Hamlets, Waltham Forest and Westminster) have committed to include the child poverty indicator (NI 116) as a priority in their Local Area Agreements (LAAs)
• A number of London boroughs are now working more pro-actively and effectively across departments to develop coordinated corporate responses to reduce child poverty, including Enfield, Islington and Waltham Forest
• Four London boroughs (Hammersmith and Fulham, Islington, Waltham Forest and Westminster) have also been selected to run government funded Local Authority Innovation pilots (out of a total of 10 nationally), demonstrating the enthusiasm, knowledge and expertise that exists amongst London boroughs.

 

The London Councils’ response to the Department for Children, Schools and Families’ (DCSF) consultation on the Child Poverty Bill can be found at:
 
http://www.londoncouncils.gov.uk/children/childpoverty/briefings/2009childpovertyconsultation.htm

Rheumatoid arthritis risk ‘may be associated with weight at birth’

High birthweight may be associated with an increased risk of developing rheumatoid arthritis later in life, according to new research published in the Annals of the Rheumatic Diseases.

 

Rheumatoid arthritis (RA) is a disease in which joints become inflamed, causing swelling, pain and stiffness for patients. More than 350,000 people in the UK have the condition, which can occur at any time from childhood to old age. Women are three times more likely to develop RA than men. Although it is not known what causes the initial inflammation to occur in RA, there are a number of risk factors for the condition including lifestyle (smoking, drinking) and genetic factors.

 

In the latest study, researchers led by Dr LA Mandl from Weill Cornell Medical College in New York have attempted to establish a connection between birthweight and the risk of developing RA. They analysed data gathered from 87,077 women and found that 619 cases of RA were diagnosed between 1976 and 2002. Information on age, socioeconomic status during childhood, history of diabetes on the maternal side and parental smoking was noted. In addition, the researchers gathered data on the women’s own smoking, age at which they started menstruating, whether they used oral contraceptives and/or hormones following menopause, lifetime breastfeeding and body mass index at age 18.

 

Results of the analysis showed that women who weighed more than 4.54 kg at birth were twice as likely to develop RA compared to those who weighed between 3.2 kg and 3.85 kg when they were born. “In this large prospective cohort, birthweight of more than 4.54 kg was associated with a two-fold increased risk of adult onset RA, compared with those of average birthweight,” the researchers concluded.

 

A spokesman for the Arthritis Research Campaign, which has established that smoking, low intake of fruit and vegetables and high intake of red meat were all contributory risk factors to developing RA, said the new results were of great interest.  

Ten year anniversary of Labour promise to end child poverty

March 18th saw the tenth anniversary of the historic promise to end child poverty. To mark the occasion a ‘keep the promise petition’ was handed to Government to encourage them to keep their promise.

Organisations involved with the campaign noted that ‘as the recession bites, an investment of at least £3 billion would provide a vital, timely and targeted injection into families in our poorest communities who are hardest hit. Without this £3bn in the forthcoming budget the Government will be 700,000 children short of its target to halve child poverty by 2010.’
                
Click here to view full details of the campaign.