Agenda item

The Committee considered a report of the Director of Public Health which provided an overview of the progress made in addressing the best start in life framework and action plan and highlighted the importance of early intervention and prevention in the first 1001 critical days (for copy see file of minutes).

The Committee received a presentation from L Vasey, Specialist Public Health Nurse BSIL (for copy see file of minutes).

The committee were provided with information on the BSIL key outcomes that included reducing tobacco dependency with an ambition to reduce tobacco dependency to 6%.  Members were advised that historically there were greater levels of tobacco dependency in the Durham Dales and Easington Clinical Commissioning Group (DDES CCG) area rather than the North Durham CCG area, but the gap was reducing.  Work had been carried out by local maternity clinics and focus groups.  The service was providing dual treatment for tobacco replacement and had support in place for 12 months after the birth of the baby using the Smoke Free Home initiative through the Health Visitor contact.

In relation to breastfeeding statistics, Members were advised that take up was low with variations throughout the county.  Work had been conducted locally to improve rates, including the setup of a breastfeeding accreditation scheme and a peer support programme and of the County Durham Health Visiting Service had received a UNICEF UK Gold award for the baby friendly initiative.

Members were advised that Newborn Behaviour Observation (NBO) and Neonatal Behavioural Assessment Scale (NBAS) had helped parents to understand the ways in which babies communicate.  To help the bonding process parents were asked to communicate with their baby inside the womb as this assisted in recognition of their parents’ voice.

Members learned that development of speech and language was another key priority .  Evidence suggested that children did not have access to books and members were advised of campaigns and action plans to help children’s vocabulary through the Book Trust and Bookstart Corner programme for two year olds.

The report confirmed that 18% of boys and 21% of girls aged 2-4 years were overweight or obese and an early year’s framework had been developed to support the early years settings and provide nutritional standards within childcare settings.  Portion control was a key message to get out to parents and babies did not need to be weaned as early as 4 months old and it was advisable to start weaning at 6 months of age.  One of the major areas of concern is the impact of universal credit on the healthy start vouchers.  Members were advised that parents should take up the healthy vitamins which included a voucher of £3.10 that could be used to purchase food.

In relation to oral health members were informed that oral health was worse in County Durham than in other areas and affected 57% of 12 year olds.  Oral health was being promoted in Early Years settings through a supervised tooth brushing scheme.  The scheme was being rolled out in 64 settings within the top 30% of deprived areas in the county.  The scope of the work is being considered to be widened to include 5 year olds.

Councillor Charlton asked a question with regards to encouraging breastfeeding in malnourished mothers and the Specialist Public Health Nurse BSIL confirmed that research showed that there would be no negative impact to breastfed babies or their mothers.  As well as more nutritious benefits, breastfeeding also had attachment and bonding benefits.

Councillor Hopper commented that amongst the health benefits for both mother and child, breastfeeding assisted with emotional bonding and was good for mental wellbeing, but a major benefit was that breastmilk was free.

The Chair added that breastmilk supported brain development and had immunological benefits.

Councillor Bainbridge commented on the data with regards to only 43% of children who had visited a dentist being free from decay.  She asked if there was any data to confirm how many children had never visited a dentist.  The Specialist Public Health Nurse BSIL confirmed that some data would be recorded following visits to a walk-in centres or A&E on presenting with symptoms of pain and resulting in tooth extractions.

Councillor Bainbridge advised that she had heard a newsflash on the radio that morning that child cruelty had increased in the North East and M Baldwin, Public Health Strategic Manager, confirmed that she would look into it.

Councillor Jopling commented on postnatal depression in young mothers which was often undiagnosed and felt that it was prevalent that services were identifying symptoms early enough to treat this condition. She said that postnatal depression could damage the relationship between mother and child. The Public Health Strategic Manager confirmed that the Health Visiting Service did assessments on all new mothers and had been subject to a lot of training to assist in identifying the symptoms.

Councillor Charlton suggested with regards to health weight and nutrition, finding out what was on the curriculum with regards to cookery as people were unable to make simple dishes from scratch.  The Public Health Strategic Manager confirmed that it was challenging to know but information from a school survey had been collated to confirm how many portions of fruit children were consuming per day and she commented on the availability of convenience foods, being relied upon by many families.  Courses were offered to families in family centres and One Point Centres to learn cooking skills.

Councillor Temple referred to deteriorating performance indicators for smoking in pregnancy and breastfeeding and Durham having scored worse than the regional and national average.  He suggested that this could be the subject of a joint review between the Adult, Wellbeing and Health Overview and Scrutiny Committee and this Committee.

T Smith, Public Health Advanced Practitioner, confirmed that the figure went up and down slightly but had been relatively static for a number of years.  There had been some improvement in tobacco dependency in pregnancy and improvements in recording information may have led to the changes in performance that had been reported.

Resolved:

That the report and presentation be noted.