After birth, health visitors provide much of the early screening and advice, and a proposed increase in their numbers in Scotland is welcomed by Mullin. Both they and the GP signpost to other services and third sector organisations at the Govan SHIP project, helped by link workers. However, outwith the family nurse partnership, health visitors have a much higher caseload. Unless she is flagged up as specifically vulnerable, they, like the GP, will have less time available for Caley. “What the Govan project has taught us is if you
Te University of Edinburgh’s Centre for Research “The first
child is a often a shocking experience in lots of ways”
give us more time we’re much better at dealing with vulnerability, in terms of bringing it to wider services,” she says. “Because you need time to do that work. You need longer appointments with complex families. Tere are lots of issues you have to deal with.” Mullin says that despite the pressures of demography and budget,
‘deep-end’ GPs make time to know the family situation and ascertain other factors such as diet, quality of housing, levels of family support and mental health. “You need to spend time writing down the narrative that will deter- mine which services and input you need for that family, so you definitely need more GPs, but that’s across the board. In areas of deprivation you need to acknowledge that,” she adds. For Mullin, the relationship is key. “At the centre of this is patients
knowing where to go for help and having trusted professional support. Te importance of relationships can't be overestimated.”
on Families and Relationships (CRFR) is a partner in the Growing Up in Scotland study, which is tracking 10,000 real children across the country in two cohorts. Te work is carried out by ScotCen Social Research in collaboration with the CRFR and the MRC Social and Public Health Sciences Unit at Glasgow University. Comparing the two cohorts born in 2004 and 2010, the study has produced some interesting results. Improvements include the number of mothers abstain- ing from alcohol in pregnancy, the number engaging
with books with children at 10 months and mothers with three-year-olds not smoking. Tere are some declines, though. Te number of longstanding illnesses at age three had increased, as has the number of mothers in “excellent health” at the same point. CRFR co-director Professor Lynn Jamieson says trust that those provid- ing services won’t be judgemental is an issue, but all relationships are key to Kirsty’s development, not just those with services. It is likely the maternal grandmother will play an important role, accord- ing to the findings of the Growing Up in Scotland study. “Most infants in Scotland benefit from grandparents contributing to their family life and, for some struggling parents, a grandparent may be keeping chaos at bay, plugging gaps in care or holes in budgets,” says Jamieson. Te relationships with peer groups are also vital, she says. Caley’s social network may help or hinder her chances of breast feeding, for example.
23 May 2016
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