Health visitors’ management of excessive infant crying

Background: Parents commonly report that they have unsettled babies in the first year of life For example, they report that they cry excessively and/or experience other common symptoms such as vomiting. This has been linked to negative outcomes for families such as poor parent mental health.

Often this leads to health professional or parent misdiagnosis of milk allergy or reflux. This has been linked to increased costs to the NHS (such as unnecessary prescribing of medication or specialist formula). It has also been linked to negative outcomes for families such as decreased parental confidence and early stopping of breastfeeding.

Research with parents suggest that their experiences with health professionals such as health visitors are important to how they assess, experience, and manage unsettled babies. Specifically, how they access health professional support, how health professionals assess their babies and the advice they give 

Health visitors are the first point of contact for most families, but are currently extremely under-funded and under-staffed. It is important to understand their experiences of supporting families with issues related to crying, breastfeeding, weight gain and healthy nutrition. Currently there is a lack of research on health visitor experiences of managing unsettled babies. Research into health visitors’ experiences, along with the findings of parent research, will help to design further support for health visitors and parents to manage unsettled babies together in the future.

Aims of this research: We aim to explore health visiting team members’ views, experience and knowledge/training for the management of unsettled infants.

Design and methods: We aim to interview 20-25 health visiting team members. The interviews will be 30-60 minutes long and will take place over videocall or telephone. The interviews will be recorded and transcribed to written text and they will be analysed within the research team.

Patient and public involvement (PPI): We will run this study with the involvement of a parent who has key public contributor experience in the department and similar child health research. The study will also be informed by learnings from a series of four listening groups with parents of unsettled infants. We will include other parents throughout the research process to check that how we are doing the research is appropriate and relevant to someone with lived experience of unsettled babies and common baby symptoms.

Sharing our findings: The findings will be used to inform future research to support parents/carers and health professionals such as health visitors in the assessment and management of these symptoms, whilst reducing the use of unnecessary medication.

Impact: Findings will inform future research to support health professionals and families to manage unsettled babies.

Amount awarded: £51,868