Tuesday, 28 July 2015

SPHPM researchers take the lead on the important public health dialogue about unsettled infant behaviour

Professor Jane Fisher, Director of the Jean Hailes Research Unit within SPHPM, recently gave the keynote address at a one-day public seminar convened at the University of Melbourne’s Hawthorn campus, ‘Unsettled Infant Sleep – a Discussion Forum’.

A range of esteemed speakers were invited to the Forum to present different research, insights and points of view on this often contentious topic that up to one in three families will experience when parenting an infant.

Professor Fisher’s research career has focused on gender-based risks to women’s mental health and psychological functioning from adolescence to mid-life, particularly related to fertility, conception, pregnancy, the perinatal period and chronic non-communicable diseases; and on parenting capabilities and early childhood development in low- and high-income settings.

In 2012, she and Dr Heather Rowe from the Jean Hailes Research Unit, together with other experts in the field, wrote a discussion paper for the Australian Research Alliance for Children and Youth (ARACY) titled Understanding and Responding to Unsettled Infant Behaviour

This paper formed the basis for Professor Fisher’s keynote address and her participation in panels that asked ‘When parents seek assistance, what is appropriate care and guidance?’ and ‘Why is this such a divisive issue? Do you agree or disagree that guidelines are needed?’.

The Understanding and Responding to Unsettled Infant Behaviour report concluded that responses to unsettled infant behaviour can be grouped broadly into two positions on a spectrum. The ‘Intuitive Parenting position’ draws predominantly on personal and clinical experiences whereby parents are encouraged to trust their instincts and respond to all unsettled behaviours with active comforting. For example rocking, ‘wearing’ the baby in a sling or pouch, holding and suckling.

The other position on the proposed spectrum, ‘Infant Behaviour Management’, stems predominantly from published research evidence, which concludes that unsettled infant behaviour causes significant problems for many families; is not usually attributable to organic illness or always readily explainable. In this approach, parents are given active strategies of care-giving behaviours to reduce unsustainable sleep associations and ways for the baby to learn to settle to sleep, from which reductions in crying and fussing usually follow.

The management of unsettled infants is an area rife with opinions and controversy – the seminar wanted to combat this with logical and informed debate to provide greater insight to the community, healthcare workers and researchers alike. In fact, the seminar was born out of public opposition to a session that was planned to take part in the 2014 Parenting, Babies and Children Expo, that had to be cancelled due to escalating threats from some advocates. It is therefore very positive to see the successful mounting of the Discussion Forum a year on, and SPHPM researchers at the forefront of this important public health dialogue.

Participants in the discussion group agreed with the findings from the 2012 ARACY paper, concluding that there is a definite need for clinical practice guidelines in this field to reduce the conflicting advice (and its uncertain evidence base) that is still provided by health professionals.

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