New mothers desperately need more support by Clare Floges - Our response In the 13th May edition of The Times Newspaper, Clare Foges authored a thought provoking piece on what she refers to as the “early years parenting crisis”. Reflecting on the birth of the new royal baby, Foges laments the lack of support available to mothers in the UK. Compared to societies where support for new mothers is embedded in tradition or given priority in health care services, the UK crisis, Foges explains, begins with mothers being discharged hastily from maternity units. Their partners have often returned to work and their families or support networks may be far afield. Infrequent home visits from practitioners can leave mothers feeling unsupported, overwhelmed and isolated as evidenced by post-natal mental health problems. A lack of proper support, Foges argues, limits parenting skills and ripples to impact on the health and development of children, citing troubling statistics on child oral health and nutrition. Recognising that an investment in the early years is the most effective one we can make, Foges’ proposed solutions to the crisis include: longer stays on the maternity ward, a ‘Mary Poppins’ practitioner to provide live-in parental support for the first couple of weeks and a reinvestment in the UK’s Sure Start centres. Best Beginnings has long recognised the unacceptable inequalities and intergenerational cycles of poor outcomes: that children born into disadvantage are at significantly greater risk of chronic mental and physical problems across the life course; these not only cause suffering to individuals but also negatively impact society, putting pressure on all services including hospitals, schools and prisons. We are also starkly aware of the inequities in care provision that drive these inequalities: those who need health and social care the most are the least likely to receive it. We therefore agree with Foges that it is crucial to invest in early years and parenting and are committed to providing content and tools to support a child’s first 1001 days of life – the critical window of opportunity for laying good foundations. However, a call for increased services is not nearly enough. Nor does it take into account the reality of budget shortfalls or the immediacy of these issues: we simply cannot wait for more resources to be allocated to these areas; nor can we be assured that in doing so, we won’t pay a price by reducing spending elsewhere. Under these constraints, health and social care services are struggling to adapt to the changing demands of a growing population and the rise of non-communicable diseases and comorbidities. These challenges call for more innovative and sustainable solutions than a reallocation of funding. We applaud the impressive policy reforms in maternity provision, with the Maternity Transformation Programme and Better Birth Initiatives as well as the NHS's new long term plan, which focus due attention on prevention and wider determinants of health through a population health lens and with plans for integrated care. Health leadership is waking up to the brewing crisis and recognises the need for creative and new approaches to resolving them with a focus on the critical early years, including the use of cost effective, digital solutions. Indeed, the NHS is steadily moving towards a digital future, with digitization, including mobile apps, playing a central role in the new long-term plan. Digital resources offer an opportunity for improvement in the face of tight budgets, through optimizing the delivery of services and by equipping and empowering individuals to look after their own and their family’s health and wellbeing. This serves to both enhance services and reduce pressure. Baby Buddy is not the only pregnancy and parenting app in the market but it is unique in its recognition of diversity and its accessibility to those whose first language is not English or who may not be in education, training or employment. It has also been designed to address determinants of health such as breastfeeding, weight gain and mental health and reflecting these in terms of a wider socio-economic and cultural experience. We are passionate that the advent of digital health innovations can broaden access to support and reduce health inequalities but without adequate embedding at a professional level in conjunction with integration at a community level, these interventions could further isolate those who are most excluded. As an organisation that as long been fighting in the corner of those at greater risk of poorer outcomes, using digital resources, and an effective embedding and training model based on a principle of universal proportionalism and an asset-based approach to meet families’ actual needs, there two key issues to consider: Digital health organisations responding to the opportunities across the NHS to supply resources, must understand the obligation to address inequity through development and design that prioritises communities whose needs are greatest. Parenting resources are often exclusive; lacking in representation and a true understanding of the needs of marginalised groups, including for instance well communicated information for women that do not speak English as their first language or an understanding of the barriers faced by BAME women in accessing mental health services. There is a risk that costly projects within the health system are, ‘reinventing the wheel’, duplicating existing resources at considerable expense rather than adapting and customising the flexible digital tools that already available. When it comes to delivering cost effective, impactful and equitable interventions we advocate for pooling resources through collaboration and consultation. Maintaining digital resources and managing data is expensive: we are stronger working together. Broader awareness of the disparity in provision and outcomes is the first step. Supporting organisations working to reduce inequalities in the face of constrained budgets is next. Our model recognises the picture painted by Foges and seeks to address this by not only integrating our resources into health and early years’ services but by working in community with grassroots organisations. As part of our new Parent Leaders programme we are aiming to empower BAME parents to represent the experiences of their communities at key decision making meetings in the maternity and early years’ field to ensure that their needs are met by services. To read more see: https://www.bestbeginnings.org.uk/news/best-beginnings-set-to-help-6500-newcomers-to-newham.