“Don’t Stop Believing” Ethna M. Dillon Manager, Vulnerable Baby Service Summit for Preventing Infant Death LSE 15 th June 2011.
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“Don’t Stop Believing”
Ethna M. DillonManager, Vulnerable Baby Service
Summit for Preventing Infant Death LSE
15th June 2011
Greater Manchester
Manchester4th in Index of Multiple Deprivation
England (2010)
Population 483,830 (2009)24% aged 0-19 years
35% primary school children: English a 2nd language (2010)
13,285 births in M/C hospitals(2010)7,552 births to residents
IMR 6.3 per 1000 births (2006-08, Nat av 4.8)
Increased Vulnerability and Hard to Reach
Exposure to nicotinePremature babiesAlcohol UsersDrug UsersMobile FamiliesVictims of violence and abuseTeenagers
Why?
Environmental factors that cause stress to either the baby or their carer are potential risks ie.
Fear
WorryLack of sleep
Lack of alertness
Change in routine
Resistant to change
Relationship problems
Bonding issues
Poor concentration
Who are the babies with increased risk of SUDI in Manchester?
Analysis of deaths in Manchester shows that there were environmental factors which could have influenced the outcome for these babies;
Eg. Alcohol/Substance misuse,
Violent criminal history against child or partner,
A previous child not living with parent,
Late booking for ante natal care,
Homelessness with mental health issues/domestic
Abuse/probation. Hearing impaired parents
Referral Criteria
Targeted Specialist Case Planning led and chaired by Vulnerable Baby Service
-Family offered opportunity to have a meeting with agencies who can help them to address their needs-Referrals from health or muti- agency partners to VBS if family meet criteria. -Multi agency case planning meeting arranged, chaired and minuted by VBS -Since 2004, 983 families have been referred to VBS (1 of those babies has been SUDI; moved out of area before meeting took pace)
Early Intervention is a national strategy
Graham Allen and Eileen Munro
Meeting eg.
Midwife
Health Visitor
Chair
Social WorkerEducatio
n
Mental Health Worker
Police
Parents
ReferrerSure Start
Multi agency Partners
Housing
Universal Services
Connexions
Voluntary Services
Sure Start
Drug Services
Community Alcohol
Team
Probation
Police
Children’s Social
Care
Family
Population approach
Safe Sleeping Practice Guidance
- Every family is given consistent advice by all agencies
- All multi agency partners are stakeholders in embedding
practice
“The attitudes and behaviour of individual practitioners have a major effect on whether families engage”
Safeguarding Knowledge Review 2010
Centre for Excellence and Outcomes in Children and Young People’s Services (C4EO)
Target Staff Groups
Specialist Services, often involved with high risk families ; Foster parents and social workersHousing staff; refuges ,temporary accommodation, prisonsProbationConnexionsCommunity Alcohol TeamDrug ServicesPolice
Health
Midwives
Neonatal teams
Health Visitors
GPs
Obstetricians
Paediatricians Appoint a champion to lead in each group
Campaigns; targeted message to the population
Evaluation Reasons for co sleeping in Manchester
Midwife opinion:Breastfeeding (46%)
TirednessTo settle baby
CulturalConvenience
No cotAccidental
Public opinion:I get more sleep (53%)
I like to sleep with my babyHelps when illWon’t go in cot
No space for cot in bedroomBreastfeeding (12%)
Mum didI don’t have a cot
Learning led to 3 point process 1. Verbal explanation, reduce the risk advice
2. The wrong picture test
3. Given bib
Graph to show comparative rate of unexpected deaths of infants in United Kingdom, and Manchester (Birth - 1 year)
UK figures are from the Foundation for the Study of Infant Deaths where data include deaths that remain unexplained after post mortem examination and may be registered as sudden infant death syndrome, SIDS, sudden infant death, sudden unexpected death in infancy, unascertained or cot death. Manchester figures are locally collected unexplained deaths.
Rate of Sudden Unexpected Death in Infants
0
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
1.8
2
2002 2003 2004 2005 2006 2007 2008 2009 2010
Year
Rate
(p
er1
000 liv
e b
irth
s)
Manchester
UK
Summary- Know your demographic, analyse the local SUDI, speak to front line staff- Safe Sleep Practice Guidance - Evaluate, keep looking for gaps or themes and address them- Staff change, training and updates are a way of life- Target specialist staff groups- Keep safety of baby the priority- There is no quick fix, but there is always more that can be done
Don’t Stop BelievingThat you can make a difference
Vulnerable Baby ServiceSafeguarding Children’s TeamWalmer StreetRusholmeManchesterM14 4NB
Ethna.dillon@cmft.nhs.uk
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