This generation: Bradford, UK

I'm not very good at quickly referring interesting tv/radio and before you know it, the iplayer has stopped making it available.... one worth mentioning is an update on the Born in Bradford study that I heard on radio four last week, tracking babies from in the womb and beyond. Those children are now entering primary school. I found the study into bed sharing/co sleeping particularly interesting (as I am co sleeping and did with my first child too), although there were also sad discoveries about children's lives in more deprived parts of the city. I've tried to summarise below. There's plenty more besides too though, so worth the 30 minutes it takes to listen. 

Born in Bradford

Study outline, from BBC iplayer page (click here to listen):  

"Winifred Robinson tracks researchers on one of the world's largest child health studies, which has gathered statistics on 17,000 babies born in Bradford since 2007. Families have given blood samples, medical histories, details of their educational attainment, eating and parenting habits, family structures and incomes. As the first children to join the study start school, Winifred finds out how they have fared.

The research team is based at the Bradford Royal Infirmary and its work will provide solid evidence to help answer some of the great medical puzzles of our time: everything from why some people have heart disease and depression to what is driving the rises in incidence of diabetes, asthma and obesity. The findings on cot death are just about to be released, with results that will significantly modify the guidance to parents. Other studies soon to be released with assess how far a pregnant mother's diet affects her baby's health.

The city is ethnically diverse - more than half of the 6,000 babies born each year have a mother of Pakistani origin. Bradford also has the highest rate of genetic illness in Britain and this is due to genetic disorders passed on in cousin marriages. The research has demonstrated that two thirds of mothers of Pakistani origin in Bradford have husbands who are their first or second cousins - which significantly increases the risk of autosomal recessive conditions.

According to the Head of the study, Professor John Wright - an epidemiologist based at Bradford Royal Infirmary - the aim is to find out more about the causes of childhood illness in children from all cultures and classes as their lives unfold: "It's like a medical detective story really - trying to piece together the clues in people's lifestyles, their environments and their genetic make-up, as we try to determine whether someone falls sick or someone doesn't."."

I recommend finding time to yourself, cup of tea and a good listen. I've summarised some findings, and my interpretations of them, below too.

Study into bed sharing and cot death

One investigation sampled 2000 babies, half of asian origin, half of white origin. Four babies in the study died of cot death. The deaths were in the white families. Babies in asian families were less likely to die of cot death, even though they tended to bed share (or co-sleeping, see nice blog describing this approach). Current NHS guidelines say safest place for newborn is in your room, in a cot, advice is not to sleep with your baby - this is a strongly dealt message by health visitors too (I've received it enough already).

Bed sharing is a common practise in the Bradford Pakistani community. Pakistani mums in the study described that when you bed share, the Mum is by her baby all of the time, that there is no delay in getting to the baby or noticing they need anything, compared to if they were in a cot.  The paediatrician leading the study, Dr. Moya, finds this a positive, safe behaviour, and found no need to change it. The study also found that "educated white women who were breastfeeding" also tended to bed share with their babies, and that it has a protective effect (no details on what these were). The danger arises when parents who drink/smoke fall asleep with their baby on the sofa, perhaps even in response to health advice: they are perhaps so scared of bed sharing that they move outside of the bedroom and onto the sofa, leading to them taking more dangerous actions. The study's researcher's recommend that there is a new, more sophisticated discussion surrounding cosleeping, that not all cosleeping is the same. Also, they mention the unintended consequences of warning off against cosleeping, for instance, it may put mothers off breastfeeding.

The finished paper is available here: Ball et al. (2012) Infant care practices related to sudden infant death syndrome in South Asian and White British families in the UK. Paediatric and Perinatal Epidemiology, 26 (1), 3–12.

Last paragraph: "This study identifies maternal smoking, non-breast feeding, sofa-sharing and alcohol consumption as clear targets for SIDS risk reduction among White British families. The study also shows that South Asian families prioritise close proximity, breast feeding and maternal behaviours congruent with infant health and low SIDS risk as normal cultural practice. This study therefore calls into question the unproven value of applying SIDS risk reduction advice developed for White British families to those of other ethnicities. In groups where mothers breast feed, do not drink alcohol or smoke, sleep their infants supine and in close proximity to a parent at night, SIDS rates are so low we speculate that alterations in other infant care practices are poor targets for achieving further SIDS reduction."

Study into children in poor white families known to have an educational disadvantage

The headteacher at a nursery and primary school in an area she says is known for high social, economic and emotional disadvantage summarises the pupil intake: When children come into nursery, at age 3, they may have problems with little/no speech; when children come into primary school, teachers are toilet training children either because carers find easier to put nappy on child or for medical reasons. A lack of communication between children and parents (e.g., talking to them as they spend time together) is thought to be the major reason for speech delays: parents wearing headphones, using mobiles, not facing their children in buggies, children being left for long periods watching TV / playing computer games etc. Furthermore, many children suffer from general health problems that include asthma, autism, obesity, mental health problems (emotional instability: not resilient, able to cope with change). They are working to improve children's attainment in school based on theories that gross motor skills in physical education, translate to fine motor skills (e.g., tracing a shape on paper) that are linked to literacy. They are also providing speech therapy for children whose parents unable/ unwilling to take them to speech therapy elsewhere.

The description of children entering primary school from such a disadvantaged background sends all sorts of questions into the air. The major point for me is the emotional impact the children are being pounded with. The benefit system maybe providing support for these families financially, but it cannot replace the love and attention that these children need in order to truly prosper - that is what can help social mobility, not just job availability, but employability, the capacity to be educated. Why are the parents/ carers of these children not providing the one thing that is freely available? Why is this problem specific to this particular section of society - are there lessons to be learned from the other groups in the Bradford cohort that do not show this socio-economic-emotionally disadvantaged profile, e.g., as found by comparing communities in the bed sharing study above?

Bringing children up to know that they are loved and wanted, that there will always be somebody there to support them is what is needed so that the children can enter school more psychologically equipped for education and to make the most of the world that they are growing up into. Not taking time to talk to their children, to potty train them, and more besides, must leave those children feeling lonely and ignored, to say the least.

Advances in technology too have contributed to the impeded relationships between children and their parents, (and it isn't limited to one social group, e.g. recent book by MIT Professor, Sherry Turkle, "Alone Together: Why We Expect More From Technology and Less From Each Other." US President Obama also recommended parents switch off their phones when spending time with their children at a speech last September). [She preaches... in her online blog - there are great things about technology, but only if it doesn't remove our attention from those that deserve or require our attention more].  


The lower socio-economic groups are receiving the greatest impact of these negative parenting behaviours, when they need the reverse to happen. How can the culture change? What happens when the children brought up in such an emotionally-damaging environment go on to have their children? (Probably already happening now). It is perhaps not enough to look at the children once they are NEETs or long-term unemployed, and to blame them for not going out and getting a job - early intervention before they even enter primary school is needed, so that children don't get institutionalised into this unproductive, unmotivated, and unhappy way of life. I think this needs alot more discussion than what I have provided here, I hope that the Bradford Study, and those similar, will help to find interventions for these families.
 
Also:
For a programme summary, download one here.
For a list of publications from the research programme so far, click here.