Star Babies: Evaluation of a health visiting initiative for first-time parents in Northern Ireland

Star Babies is an enhancement of the universal Child Health Promotion Programme in Northern Ireland, where first-time parents are offered additional regular health visiting support from the antenatal period until the baby is 12 months of age. This study was carried out to evaluate outcomes of first-time parents who received the core Child Health Programme or the enhanced Star Babies programme to identify the areas where the programmes are successful and to quantitatively assess the magnitude of their impact. First-time parents were invited to participate in the study and were divided into two groups: those in the Star Babies programme (n=189) and those in the core Child Health Promotion Programme (n=125). The study found differences between the two groupings of first-time parents and the evaluation of the health visiting services received in terms of infant feeding, knowledge of preventing home accidents and overall satisfaction varied across the two groups. The findings highlight the positive outcomes from an enhanced health visitor-led programme such as Star Babies, with implications for policy, practice and service development.

Woman, Mother, Wet Nurse: Engine of Child Health Promotion in the Spanish Monarchy (1850–1910)

In Spain, the wet nurse increased the survival of children through care and breastfeeding of other women’s children. They had a great development together with the Spanish monarchy between 1850 and 1910. The aim is to identify the role of wet nurses in the Spanish monarchy and the survival of the royal infants (s. XIX–XX). A scoping review is presented to study documents about the wet nurse in the Spanish monarchy. Applying the dialectical structural model of care (DSMC). Recognizing five thematic blocks that shape the historical-cultural model. Books, decrees and databases were analyzed: Scopus, Scielo, Dialnet, Cuiden, Medline/Pubmed, CINAHL, Science Direct and Google Scholar, from January to July 2020. The selection process was rigorous because it was difficult to choose. They had to overcome medical and moral exams. The selected rural northern wet nurses emigrated to Madrid. The contract was regulated by laws and paid. Wet nurses were hired by the monarchy due to health problems of the biological mother and a need for greater offspring. The wet nurse wore a typical costume, a symbol of wealth. The northern wet nurses hired by the monarchists have been the engine that has promoted the health of infants through the breastfeeding process.

Child public health part 3: promoting healthy childhood

Child health promotion focuses on individuals and communities adopting healthy behaviours. This article, the third part of four on child public health, explores health promotion strategy and theory, as well as the areas in which paramedics can contribute to improving their own health promotion beyond the clinical setting.

Child health

This chapter in the Oxford Handbook of General Practice explores child health in general practice. It covers child health promotion from birth, including the neonatal and 6-week check, neonatal bloodspot screening, screening for hip dysplasia, vision and hearing screening tests, birth trauma, genetic disorders, common problems of small babies, prematurity, and neonatal jaundice. It examines feeding babies, weaning, and developmental milestones. It discusses fever and acute illness in the under 5s, childhood infection, urinary tract infection, congenital heart disease, asthma, constipation, malabsorption, gut atresia, hernias, and intussusception. It explores growth disorders, endocrine problems, funny turns, febrile convulsions, epilepsy, hydrocephalus, neural tube defect, arthritis, dermatology, and cancer. It also discusses behaviour problems, sleep problems, toilet training, poor progress at school, autism, learning disability, adolescence, chronic illness, disability, safeguarding children, and child death.

The equity impact of a universal child health promotion programme

BackgroundReal-world evaluations of complex interventions are scarce. We evaluated the effect of the Salut Programme, a universal child health promotion intervention in northern Sweden, on income-related inequalities in positive birth outcomes and healthcare utilisation up to 2 years after delivery.MethodsUsing the mother’s place of residence at delivery, the child and the mother were classified as belonging to either the control area (received care-as-usual) or the intervention area (where the intervention was implemented from 2006) and either the premeasure (children born between 2002 and 2004) or the postmeasure (children born between 2006 and 2008) period. Parents’ earned income was used as the socioeconomic ranking variable. The Relative Concentration Index was computed for six binary birth outcome indicators and for inpatient and day patient care for children and their mothers. Changes in inequality over time were compared using a difference-in-difference approach.ResultsIncome-related inequalities in birth outcomes and child healthcare utilisation were absent, except that full-term pregnancies were concentrated among the poor at premeasure in the intervention area. In contrast, mothers’ healthcare utilisation was significantly pro-poor in the control area. The extent of inequality changed differentially between premeasure and postmeasure for two birth outcomes: full-term pregnancies and infants with normal birth weight. Inequalities in healthcare utilisation did not change significantly in either area over time.ConclusionIn northern Sweden, income-related inequalities in birth outcomes and child healthcare utilisation are largely absent. However, relative inequalities in mothers’ healthcare utilisation are large. We found no evidence that the Salut Programme affected changes in inequality over time.

0973 Maternal Depression And Infant Sleep Duration Trajectory In The First 3 Years: A Prospective Cohort Study

Introduction The study was to investigate trajectories of infant sleep duration and associations with trajectories of maternal depression status during 3 years post-partum. Methods Data were from the Child Health Promotion Project in Shanghai (CHPPS). Mothers were recruited at the third trimester of pregnancy and followed up together with the infants until 36 months postpartum. Between 2012 and 2013, 262 women (Mage=29.5, SDage=3.2, range: 22-39 years old) were recruited and were followed from June 2012 to August 2015. Sleep duration of the children was assessed using Brief Infant Sleep Questionnaire (BISQ) at 42 days, 3 months, 6 months, 9 months, 12 months, 18 months, 24 months, and 36 months postpartum. Center for Epidemiological Survey-Depression Scale (CESD), Edinburgh Postnatal Depression Scale (EPDS), and the Profile of Mood States (POMS) were used to measure the mother’s depression status at late pregnancy, 42 days postpartum, and 12-36 months postpartum, respectively. The group-based trajectory models (GBTM) were used to estimate patterns of infant sleep duration development and maternal depression status. Results Two trajectories of infant day sleep duration were identified, defined as “initial short sleepers” (54.8%) and “initial long sleepers” (45.2%). Three trajectories of infant night sleep duration were identified, labeled as “increasing” (8.5%), “stable” (61.7%), and “mild declining” (29.8%). Two trajectories infant total sleep duration were identified, defined as “initial short sleepers” (51.5%) and “initial long sleepers” (48.5%). Two trajectories of maternal depression status were identified, labeled as “low” (74.2%) and “high” (25.8%). After controlling for covariates, women who have higher depression status had infants of shorter day sleep duration. There was no significant association with infant night sleep duration. Conclusion Our study suggests that maternal postpartum depression is associated with short infant day sleep duration, but not with infant night sleep duration. Support Supported by the Chinese National Natural Science Foundation of China (81773443, 81728017, 81602870, 81601162, 81602868)

The equity impact of a universal child health promotion programme

Background We aimed to evaluate whether the Salut Programme, a universal child health promotion intervention, aimed to strengthen healthy lifestyles in northern Sweden, had any effect on income-related inequalities in positive birth outcomes for children and on healthcare use for children and their mothers. Methods Mother’s residence and child’s date of birth determined whether the child and the mother belonged to the control group (areas that received care-as-usual) or the intervention group (areas with the intervention implemented from 2005), during the pre-measure period (children born 2002-2004) and the post-measure period (children born 2006-2008). The sum of parents’ taxable income was used for socioeconomic ranking. We computed the standard concentration index for six binary indicators of positive birth outcomes, and for inpatient and day patient care for children and mothers during the two years after delivery. Using a difference-in-difference approach, we assessed whether the extent of inequality changed over time between areas. Results Income-related inequalities in child health status at birth and in child healthcare use were absent, except that full-term pregnancies were concentrated among the poor at pre-measure in the intervention group. However, mothers’ healthcare use was significantly pro-poor in the control group. The extent of inequality changed between pre- and post-measure periods for two outcomes: the pro-poor concentration of full-term pregnancies in the intervention group at pre-measure disappeared at post-measure; and an increase in pro-poor concentration of normal birth weight in the control group was not matched by a similar increase in the intervention group. Inequalities in healthcare use did not change significantly. Conclusions Birth outcomes and child healthcare use seemed to be equitably distributed. However, the results raise concerns whether the intervention may have reduced the pro-poor concentration of positive birth outcomes. Key messages There are concerns that participation in universal health promotion programmes differs by socioeconomic status, although few public health interventions have been evaluated from an equity perspective. Birth outcomes and child healthcare use in Northern Sweden seemed to be equitably distributed across different socioeconomic groups.