Welcome to the twelfth A Better Start Southend Research Bulletin, bringing you the latest on early years’ policy, practice and evidence around Diet and Nutrition, Social and Emotional Development and Communications and Language.

Your regular update, produced by Rachel Wood, also shows how we are using these findings to influence our work in Southend as well as inviting you to help shape our work through your input!

If you would like to sign up to receive these updates, or have a question, please email abetterstart@pre-school.org.uk.

Contents:

Breastfeeding and Food Preference

Title: Ventura, AK (2017), Does Breastfeeding shape food preferences? Annals of Nutrition and Metabolism, vol.70 (3), pp8-15

Research source: https://www.ncbi.nlm.nih.gov/pubmed/28903109

Publication date: September 2017

Our Summary: The article argues that the first two years of life are a critical window in terms of the development of food preferences and flavours. In a time of rapid growth, and in a relatively short time – children transition to solid foods. Its focus is on the unique role that breastfeeding can play in later food preferences. This is on the basis of evidence that those who are breastfed tend to have healthier diets than those who do not. This is also seen as contributing to the leading of infants being more accepting of a wider range of flavours during weaning. The authors argue that this is due to the transmission (resulting in a ‘kick start’) of the mother’s variety of dietary flavours through the womb and breastmilk. Breastfeeding is therefore seen as an important method for prevention efforts, along with healthy maternal and childhood eating. Importantly in terms of obesity (which has multiple risk factors) the study also argues that breastfed infants gain healthier amounts of weight in their first year and are less likely to show patterns of rapid weight gain than those who are fed with formula.

How were applying this in Southend

  • We are currently in the process of designing ‘test and learns’ for breastfeeding support as we recognise the importance of this in terms of outcomes for children.

Help us help Southend

  • What other factors do you think are important in childhood obesity? What other prevention activities could we test in order to prevent this?

Let us know what you think by e-mailing abetterstart@pre-school.org.uk

Workforce Development and Breastfeeding

Title: Haile, ZT. MPH, Elmasry, M. Chavan, B. Azulay Chertok, IR (2017), Association Between Type of Health Professional at Birth and Exclusive Breastfeeding, Journal of Midwifery and Women’s Health

Research source: https://www.ncbi.nlm.nih.gov/pubmed/28940707

Publication date: September 2017

Our summary: The article argues that as well socio-demographic, behavioural and health related factors, maternal decision is an important contextual factor in exclusive breastfeeding. In a previous study Infant Feeding Practices II (A US long-term study) showed that 74.6% of women were breastfeeding at discharge and 27.7% at 3 months post birth. The study found that those who had a midwife (as opposed to an obstetrician or other professional) at the birth had higher rates of exclusive breastfeeding. It also found that all clinicians working with women after birth should have further development in supporting breastfeeding, as this has been found to have a significant effect.

Help us help Southend

  • What additional breastfeeding workforce development do you feel that we need?

Let us know what you think by e-mailing abetterstart@pre-school.org.uk

Pregnancy, Breastfeeding and Food Allergies

Title: Wanga, Y. Allena, KJ., and Koplin, JJ. (2017), Dietary intervention for preventing food allergy in children, Current Opinion in Paediatrics, vol 29

Research source: https://www.ncbi.nlm.nih.gov/pubmed/28914636

Publication date: December 2017

Our summary: The report argues that over the past decade food allergies have increasingly become an issue for public health. Despite this the influence of maternal diet during pregnancy and breastfeeding on children’s food allergies is relatively unclear. In addition, vitamin D, pre-biotic and pro-biotic status also need further examination. However, the early introduction (using phone reminders) of peanuts (and eggs) has been shown to be evidenced as a protective factor in terms of those found to be at high risk. However, it is argued that more evidence is needed in this window of opportunity for such an introduction or in those that are not identified as high risk. As well as peanuts and eggs it is also argued that dietary exposure to cow’s milk should be considered. The authors also recommend that cross-cultural studies be undertaken in relation to countries where low levels of food allergies have found to be present.

Help us help Southend

  • How important is it that we include content about food allergies in the design of tests and learns that look at introducing nutritious foods?

Let us know what you think by e-mailing abetterstart@pre-school.org.uk

Mobile Technology and Parent-Infant Interaction

Title: Myrucki, S. Gulyayeva, O. Birk, S. Perez-Edgar, K. Buss, KA. and Dennis-Tiwary, TA. (2017), Digital disruption? Maternal mobile device use is related to infant social-emotional functioning, Developmental Science

Research source: https://www.ncbi.nlm.nih.gov/pubmed/28944600

Publication date: September 2017

Our Summary: Although there is wide usage of mobile devices, there is little know about the impact that this may have on infant development. It has indeed been observed that parents may be physically present, they may also be distracted and not responsive to their infant. Previous research has shown that this can lead to socio-emotional difficulties. The still face procedure (An observation method in which the mother does not react to the infant’s behaviours) was used for the study. The results of the study with fifty infants and their mothers seemed to show that the presence of a mobile device did indeed affect the quality of the parent-infant interaction (and less room exploration). However, the authors argue that more research is needed in terms of technology and infant socio-emotional development.

Help us help Southend

  • What messages if any do you think that we should take from this study?

Let us know what you think by e-mailing abetterstart@pre-school.org.uk

Pathways and Speech and Language Therapy

Title: Ebbels, SH. McCartney, E. Slonims, V. Dockrell, JE. And Norbury, CP. (2017), Evidence-based pathways to intervention for children with language disorders, PeerJ Preprints, https://doi.org/10.7287/peerj.preprints.295v1

Research source: https://peerj.com/preprints/2951/

Publication date: April 2017

Our summary: This article argues that in the current funding environment that speech and language services are increasingly becoming specialised and targeted at those most in need. This is despite the recommendation that a tiered approach be taken. This is on the basis of a review of peer reviewed journals, and meta and systematic analysis.

It concludes that speech and language therapy is making a contribution in all tiers. However, where prioritisation is needed it is essential that the cost-effectiveness of this is looked at. It is also stated that there is evidence to show that individualised interventions are essential for children who are identified as having a need for additional support. It also recommends that at the universal level (Tier 1 Prevention) that high quality language education be undertaken. There is currently relatively little evidence of outcomes where speech and language therapy support has been provided at the universal level as to date such studies have been seen as of low quality. On the other hand, where workforce development has been provided this has shown to be effective, but is time consuming and has been seen to be lacking in evaluation.

How we are applying the research in Southend

  • We are currently testing and learning through our “Let’s Talk” activities, developing the use of a universal screening tool, as well as improving the availability of workforce development.

Help us help Southend

  • How can we continue to ensure that speech and language therapy is available at all tiers?

Let us know what you think by e-mailing abetterstart@pre-school.org.uk

Systems Change and Public Health

Title: Rutter, H. Savona, N. Glonti, K. Bibby, J. Cummins, S. Finegood, DT. Greaves, F. Harper, L. Hawe, P. Moore, L. Petticrew, M. Re- hfuess, E. Shiell, A. Thomas, J. and White, M. (2017) The need for a complex systems model of evidence for public health, Lancet. DOI: 10.1016/S0140-6736(17)31267-9

Research source: http://researchonline.lshtm.ac.uk/3962417/

Publication date: June 2017

Our summary: This study examines the possible reasons why despite much investment in research and policy, many public health challenges still remain. It is argued that this is due to tools and methods examining the effectiveness of interventions that look at cause and effect. Such complexity is seen to require additional methods in terms of service design, implementation, and evaluation of the way that systems change. Such complexity is seen to be defined as:

  • Emergence – The properties of the system are greater than the sum of their parts, and cannot be predicted from the elements within it;
  • Feedback – A change reinforces or balances further change; and
  • Adaptation – Adjustments in behaviour in response to interventions.

This shift in thinking will support policy makers with robust evidence that takes account of the real way in which people live their lives. It will also help with the mistaken judgements that can be made in terms of believing that interventions are ineffective because the wrong questions have been asked or they have been delivered over the wrong timeline.

In addition, it argues that new research skills will need to be developed in terms of the art and science of system level evaluation (e.g. concept mapping, natural experimental evaluations and simulation approaches). It will also require changes in the way that research is funded and valued and how policy is formulated. The authors argue that this is the only way that oversimplification will be overcome, and that population level interventions and their systems effects will be generated and disseminated.

Help us help Southend

  • How could our learning from systems change support outcomes for children and families?

Let us know what you think by e-mailing abetterstart@pre-school.org.uk

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