Trudi Seneviratne: Collaborative support from healthcare professionals is vital in helping parents with the early years

New report highlights importance of early years for children’s physical and mental wellbeing—we must listen

We’ve all heard it before—being a parent can be the most rewarding, not to mention challenging, job in the world. Clinical studies into the early years have provided invaluable insights into just how crucial the period from conception through to the first five years is, and the impact of this developmental period in determining our emotional and psychological wellbeing for the rest of our lives should not be underestimated. 

What is missing is a wider conversation on how the public sees the importance of the early years, and the people who guide children through them, in shaping the society of tomorrow. Without an open dialogue between the health and social care sectors, and the wider public, it’s not possible to identify the key areas where support is needed most, or to provide the tools that would make the most difference. 

A new report from The Royal Foundation of The Duke and Duchess of Cambridge, conducted by Ipsos MORI, has asked important questions about attitudes to and perceptions of the early years. The findings represent an essential piece of the puzzle—listening to the public’s lived experience of parenting. The work gives us the unique opportunity to identify the gaps in awareness of the importance of the early years, and trigger a shift in how we support those in our care through those first five years of parenthood and beyond. An online survey launched by The Duchess of Cambridge received over 500,000 responses, demonstrating the enormous appetite for this conversation—and it can’t start soon enough.

One of the key findings of The Royal Foundation’s study is that the majority of people—three in four—don’t fully understand the specific importance of the early years. While 98% of people believe nurture has a significant role in a child’s progress, there remains a strong emphasis on a baby’s physical development, and although efforts have been made to widen the focus into the psychological sphere, there’s more to be done. Society has made great strides in terms of placing physical and mental health on an equal footing, but this progress has yet to translate to the early years.

We need a collaborative, concerted effort between all health and social care professionals to empower parents in their understanding that a baby’s social, emotional and cognitive evolution starts—and can be affected—in utero. Teaching parents how much development takes place from birth to the age of five is a crucial step in ensuring they are equipped to give their children the best possible start in life.

At the heart of development during the early years is parents’ wellbeing, and the new research found that 90% of people recognise their mental health has an impact on their child—a hugely significant acknowledgement. 

But it’s no secret that taking a moment for yourself as a parent, both during and following pregnancy, is easier said than done. The research shows that only 10% of parents cited taking the time to look after themselves as a way of getting ready to welcome a baby, and the notion that mentally preparing for a new arrival is just as important as something like buying a cot is a conversation that, although central to work in the early years and longer term wellbeing, isn’t being had. 

A mother’s mental health directly affects the baby, and untreated perinatal mental health issues can have a devastating impact on a child’s development. While services have increased in England in recent years, The Royal Foundation’s findings prove what those of us who practice in this area have long known to be true—support for the mental health of parents, during pregnancy and after birth, needs to become a greater priority when it comes to raising the next generation.   

And something that has a considerable impact on a parent’s mental health is a sense of inadequacy, and the new research tells us that 70% of parents feel judged by others. The environment around parents and social attitudes feed directly into issues of parenting—especially during the early years. It often seems that there is a never-ending list of reasons to feel like you’ve failed in your role as a parent. Anything from the type of delivery a mother chooses, to the rate at which their child is reaching key milestones, can cause parents to feel insecure and anxious. The reality is that low self-esteem of parents—whether they feel judged, or are judging themselves—can influence how they interact with their children, and set off negative behaviour patterns that have a detrimental effect during the early years.

Concerningly, fear of judgement can prevent parents from seeking help when they need it, and the Ipsos Mori research shows that during the pandemic, the number of parents who feel uncomfortable asking for help for how they’re feeling has risen from 18% to 34%. It is crucial that, as a sector and as a society, we tackle these feelings of judgement so that parents don’t suffer in silence and intervention can come at the right time.

We must take this opportunity to consider how these findings influence the way in which we care for expectant and new parents, and how we can normalise seeking support. The task falls under so many practices—primary care, midwifery, obstetrics, paediatrics, mental health services and more—and it’s vital that a clear message is communicated to the public if we are to effect real, positive change. Crucially, this study adds the public voice to decades of clinical research, and for the sake of generations to come, we need to listen.

Trudi Seneviratne is a consultant adult and perinatal psychiatrist, and Registrar at the Royal College of Psychiatrists.

Competing interests: none declared.