Mental health services for marginalised women
By Geraldine Esdaille,
Abusive Head Trauma (AHT), also known as Shaken Baby Syndrome, is a devastating form of child abuse. As a registered nurse and health visitor specialising in child protection for the past 23 years, I’ve witnessed the catastrophic injuries it often causes - including intracranial injuries, retinal haemorrhage, and long bone and spinal fractures that can lead to brain damage, blindness, learning difficulties and death.
"Inspired by my trip, I have designed an AHT prevention programme, now known as ICON."
The trigger for shaking an infant is frequently a parent’s inability to cope with persistent or excessive crying. In 70% of cases, it is men who are responsible for causing AHT. Ways of helping parents to cope with a crying baby have been pioneered successfully by projects in Canada and the USA. In 2016 my Churchill Fellowship gave me the opportunity to see these programmes first-hand.
I saw many outstanding practices during my travels, but I was particularly impressed with 'The Period of PURPLE crying' programme in Canada. Their emphasis on interventions in the hospital, as well as in the community, is vital, as research has shown that the best time to reach men is while they are still in a hospital during or after their child’s birth.
Typically, babies’ crying starts to increase at two weeks, reaching a peak at six to eight weeks and then starting to decrease. We need to get the message out to parents that it is normal for their baby to cry more during this period. It doesn't mean they are a bad parent or that they have a bad baby.
It's important for parents to check there is nothing wrong with their baby - but once they have established this, they should feel they have permission to 'walk away' and calm down if they feel themselves getting wound up.
Inspired by my trip, I have designed an AHT prevention programme, now known as ICON, with the aim of getting these messages out there. ICON is a mnemonic: Infant crying is normal, Comfort methods can help, it’s Ok to walk away, Never shake a baby. Our slogan is ‘Babies cry, you can cope’.
Our team of professionals and families have developed several initiatives, including animated videos like the one above, materials for a lesson to be delivered in secondary schools, a leaflet to give to parents before post-natal discharge, a ‘script’ to support midwives to deliver our message, and a questionnaire for use by GPs at their routine six-to-eight week check with mothers and babies.
ICON are currently running three pilot programmes in Manchester, Oldham and Hampshire. We will be launching a further pilot in Gloucestershire this week (2 October) and we are talking to three other counties who are interested in the programme. I am delighted to say that the Gloucestershire pilot will be launched by Churchill Fellowship Chairman Jeremy Soames, in recognition of the role of the Churchill Fellowship in making all this possible.
So far, these pilot programmes are proving a great success. In Hampshire, 70% of parents said they would change their behaviour in relation to their baby's crying after receiving the ICON message, and 100% said they would feel confident to share the ICON message with other care-givers.
My deepest desire is that the ICON message is delivered as consistently and as widely as possible. If parents understand that increased crying is a normal developmental phase in infancy, they will feel better able to cope with it and, ultimately, we will see less babies suffering as a result of the terrible consequences of AHT.
The views and opinions expressed by any Fellow are those of the Fellow and not of the Churchill Fellowship or its partners, which have no responsibility or liability for any part of them.
By Geraldine Esdaille,
By Lorraine George,
By Sophie Redlin,