Agenda item

The Committee considered the report of the Director of Public Health that provided Members with an update of the progress made in addressing the Best Start in Life priorities and highlighted the importance of early intervention and prevention in the first 1001 critical days.

The report provided a brief update on the work undertaken to address some of the key priorities progress and challenges. It also outlined some of the next steps for improving the actions as outlined in the Best Starts in Life work plan (for copy of report, see file of minutes).

The Consultant in Public Health was in attendance to present the report.  She advised that it was a multi agency report and the challenges faced in County Durham were common to all North East local authorities.

Mrs Gunn referred to breastfeeding take up and asked if there was a certain demographic where low or high take up could be identified and asked how common tongue tie was among newborns as it was not talked about. Mrs Gunn then referred to health visitors supporting breast feeding and asked if they were trained in this area and if they made assumptions or if there was an unconscious bias towards breastfeeding. She then referred to speech and language and asked if hearing was part of the assessment. Mrs Gunn then referred to the National Child Measurement Programme and commented that she was concerned of the impact on young girls who may gain puppy fat throughout their adolescence and may develop eating disorders and how this was managed.

The Consultant in Public Health confirmed there was variation in the initiation of breastfeeding and that it was higher in affluent areas and lower in more deprived areas and this was seen regionally and nationally. Members were advised that there was detailed information on breastfeeding available on the County Durham Insight website, but the reasons for the variation were complex.

The General Manager 0-25 Family Health Service indicated that staff were trained to deal with tongue tie and commented that not all tongue tie cases required a release, but the health visitor would discuss the case with the specialist nurse.  Severe tongue tie would be dealt with by County Durham and Darlington Foundation Trust, however tongue tie doesn’t always require a procedure but when it does this is a simple one.

She then indicated that staff undertake a lot of training on breastfeeding and worked to the UNICEF standards. Staff did not promote formula milk but did support those who were bottle feeding and advised members that staff were audited.

With regard to hearing screening the General Manager 0-25 Family Health Service advised that the newborn screening programme had been running for a number of years, the school age screening was last run in 2021 and a minimal number of children were identified with hearing loss due to the success of the newborn programme. Development reviews took place that did not carry out tests, but discussion took place and referrals made to specialists if necessary. If picked up in the speech and language checks the child would be referred to audiology.

The Consultant in Public Health referred to the national child measurement programme and advised that the programme measured children’s weight and height. Parents would receive a letter advising of their child’s weight and height and offering support and advice if required.  She added that County Durham was participating in MAP2, which was a web-based research pilot programme that provided support and information to parents and carers.

Councillor Jopling commented that the aftercare now received following the birth of a child had reduced over the years and new mothers were not receiving the care to encourage you to breastfeed.

Councillor Hunt agreed with Councillor Jopling that more aftercare was needed as the encouragement to breastfeed was not there.

Councillor Gunn referred to Family Hubs and asked if government funding was for 3 years and commented that the figures sounded good overall.  She then asked how much funding would County Durham receive if the application to be a trailblazer was successful and would the Family Hubs be extended. Councillor Gunn then referred to paragraphs 56 – 58 of the report and highlighted the poor availability and take up of the healthy start vitamins and asked for further information and suggested that the service work with the voluntary sector as they were often at the heart of supporting children and families in communities, such as with childcare facilities.  With regard to breastfeeding, Councillor Gunn suggested that there may be cultural aspects and there was not enough focus on support, she added that those who had children during COVID who did breastfeed, support was provided by friends and family and peer support was crucial.

The Consultant in Public Health responded that in relation to Family Hubs there had been significant support and members had recently received a briefing on Family Hubs and that she would ensure this was shared with members.  If County Durham became a trail blazer it would attract a small amount of additional funding, but no figures were yet available. With regard to healthy start vitamins and vouchers they were developing a communications plan for eligible families, and she would feedback the member’s comments regarding the voluntary sector. In relation to breastfeeding there was lots of discussion, which was positive, but the issue was complex and multi-faceted, there was support for women and there was work planned to understand cultural norms including womens perceptions of breastfeeding. Breastfeeding was better for the child and the mother and cheaper.

Councillor Walton referred to unintentional injuries and that the figures for County Durham were higher than the national figures, but they did seem to come down prior to COVID and asked what the main driver was for those figures to come down.

The Consultant in Public Health indicated that these were quite complex and there was different factors at work, but the recent trend was narrowing the gap, their systematic approach to awareness training of staff was one of the impacting factors but was not definitive but it was encouraging that work was going in the right direction.

Councillor Reed referred to Family Hubs and asked if there was support available for those who spoke a different language.

The Consultant in Public Health indicated that educational services provided a lot of support in schools, she would take the question back in relation to family hubs.

Resolved: (i) That the contents of the report be noted.

(ii) That the opportunities to work collaboratively and further explore opportunities to meet the needs of children and young people as early as possible be promoted.