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How the NSPCC Helpline protects babies

Helpline HigHligHt:

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“She is leaving the baby on his own. He’s only a few weeks old.”

“The children are not getting fed properly. They’re not getting looked after. Sometimes, the mother and the father just go out and leave the kids on their own. The youngest is three months old.”

“The baby’s about nine weeks old and he nearly fell out the pushchair. So I said to her, you can’t look after the baby. She was so drunk.”

“It just looks like someone bit the baby’s face.”Callers to the NSPCC Helpline

Key findings

Between April and June 2011, 851 people contacted the NSPCC Helpline with concerns about a baby.

Almost three quarters (74 per cent) of all calls about children under one led to a referral to the police or children’s services.

44 per cent of people who contacted the Helpline about a child under one, were worried the child was being neglected.

In over half (55 per cent) of all calls that resulted in a referral, the caller said they had heard or seen the child in distress.

Nearly two thirds (60 per cent) of referrals involved either parental substance misuse, domestic abuse or concerns about the parent’s mental health.

One in three referrals for neglect also featured some form of emotional abuse, physical abuse, or both.

This Helpline highlight is the second of a series that provides evidence of some of the issues and risks facing children and young people today, and evidence of how adults are playing their part in protecting children from harm.

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“Abusive or neglectful care, growing up in a dangerous environment, and related conditions are manifest risks for healthy brain development.”

(Shonkoff and Phillips 2000)

“If somebody’s ringing up and telling us that a 10-year-old has not been fed for a day then that is serious. But for a baby, that’s life threatening”.NSPCC Helpline counsellor

Abuse and neglect can have severe and long lasting impact on a child’s health, development and behaviour (Dobson and Perry 2009; Whitaker et al 2006). The abuse of any child is serious but babies are particularly vulnerable:

• Babies are unable to move away from adults who pose a risk to them.

• They are unable to tell anyone about the treatment they experience.

• They are physically very vulnerable and can sustain permanent injuries (including severe brain damage) from being shaken or roughly handled.

• Babies spend most of their time with their carer and may not have daily contact with other adults who can monitor their welfare.

The NSPCC Helpline is crucial. It’s thanks to the people who contact us that babies at risk are given a voice.

There is a disproportionately high number of children under one within the UK’s child protection system. 45 per cent of serious case reviews (undertaken when a child dies or is seriously injured as a result of abuse) include a child under one (Brandon et al 2009; NSPCC 2011).

This is one of the reasons why the NSPCC has made children under one a priority group, developing services aimed specifically at protecting babies.

Calls to the NSPCC Helpline about children under one

“I would hate to think that if something was a problem, I’d ignored it and I didn’t do anything. It’s better to be safe and sorry. That’s why I’m doing this, so I can protect the children.”A caller to the NSPCC Helpline

The NSPCC Helpline received 11,806 calls, emails, online reporting forms and text messages (henceforth referred to just as “calls”) from April to June 2011. Of these, 851 calls (7 per cent) related to children under one.

Calls to the NSPCC Helpline are responded to in one of two ways:

• Where counsellors believe a child is at risk and where identifying details are given, the Helpline makes a referral by passing details on to children’s services or, in an emergency, the police, so that action can be taken to safeguard the child.

• In the other cases, counsellors talk the caller through their concerns and provide them with advice and information.

The Helpline refers 74 per cent of the calls it receives about children under one to police or children’s services. This compares to 51 per cent of the calls it receives about children of any other age.

The vulnerability of babies

Advice calls Referrals Referrals

Children under one 225 26% 626 74% 851 100%

All children 5,818 49% 5,988 51% 11,806 100%

Calls received from April to June 2011

The vulnerability of a baby means the NSPCC Helpline is more likely to identify them as high risk so a larger proportion of calls result in referrals. After making a referral about a child under one, the NSPCC follows up and asks the statutory agency what action was taken. This means the NSPCC is able to liaise with children’s services to make certain the baby is safe, and to be sure that the appropriate action has been taken.

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People who call about children under one

“We are rarely called by babies’ parents, but looking after a baby can be very stressful. If parents feel like they are struggling to cope, they should know that they can call us for advice and support and we are always here to help.” NSPCC Helpline counsellor

74 per cent of calls about children under one come from the public. These people, who do not live with the child and who have no direct caring responsibility for the child, are more likely to call the NSPCC Helpline to express concerns than parents, carers or other relatives.

The NSPCC Helpline is more than twice as likely to receive a call from the parent of an older child than it is a child under one. 23 per cent of calls about all children come from parents compared to 9 per cent of calls about children under one.

Parents call most often with concerns about bullying, child behaviour, family relationships and sexual abuse – all issues that tend to be associated with older children.

Why people call

“Many of our calls about babies are about constant crying. The tone of the crying is often described as ‘not normal’. I’ve heard somebody describe a cry as ‘blood curdling’”NSPCC Helpline counsellor

“I’m just concerned about the baby because I’ve heard him crying all afternoon. He’s still crying now.”A caller to the NSPCC Helpline

Making the decision to contact the NSPCC Helpline can be difficult but by doing so the caller is helping to protect a child from harm.

Of the calls we get from the public, most are from neighbours concerned about seeing or hearing a baby in distress.

For babies, crying is their only means of communication and is normal behaviour. Some babies do cry a lot, even though they are being cared for well. However, many callers felt the crying they heard was a sign that something else was wrong. They thought something was different or “not right” about the child’s cries and this is what prompted the call.

80%

70%

60%

50%

40%

30%

20%

10%

0%

Public Parent/Care Relative Not know All professionals Child

Figure 1: All calls April - June 2011 Children under one All children

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The counsellors ask a range of questions to assess why the baby might be crying. This might include:

• how long the baby has been crying

• whether it is constant or intermittent

• if the caller has heard anyone attempting to soothe the baby

• what they know about the circumstances within the household

• how the baby’s cries compare to the caller’s experience with their own children.

These questions help the counsellor make a more informed decision about whether a referral needs to be made. In over half (55 per cent) of the referrals we make, child distress was mentioned as a significant factor.

“If mum and dad are screaming, the baby is often screaming as well.”A caller to the NSPCC Helpline

“The parents are fighting now andI don’t know what to do. I’m concerned about the baby in there.”A caller to the NSPCC Helpline

Many people call because they’re concerned about the behaviour of a child’s parents. They may be worried because there is alcohol misuse or domestic abuse in the home.

Although some signs of abuse are visible (such as bruises, child distress) a lot of abuse is hidden from view and babies are unable to tell anyone what is happening to them.

With babies in particular, it is necessary to look for other signs that indicate they might be at risk. Some parental behaviour (such as substance misuse) may not be abusive in itself, but could be putting the child at risk by the effect it has on the parent’s ability to care for their child. It is important that issues such as parental substance misuse and domestic abuse are identified as risk factors and reported (Kroll and Taylor 2000).

What people talk about 44 per cent of calls about children under one relate to concerns that the child is being neglected. This is significantly higher than the proportion of calls about neglect that relate to children of all ages (29 per cent).

The other concerns where people are more likely to call about children under one are:

• physical abuse (where the caller believed the child was at risk from physical harm)

• adult behaviour (where an adult, generally with direct caring responsibility displays behaviour that places the child at risk, through things such as alcohol misuse).

50%

45%

40%

35%

30%

25%

20%

15%

10%

5%

0%

Neglect Physicalabuse

Emotionalabuse

Sexualabuse

Adult health/behaviour

Familyrelationships

Other Childbehaviour

Childhealth

Figure 2: All calls April – June 2011 Children under one All children

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Janice’s story

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The following case study shows what happens when someone contacts the NSPCC Helpline with serious concerns for a young child but does not want to identify the family.

Janice, a concerned grandmother, rang the NSPCC Helpline with serious concerns about her three-month old granddaughter. She was worried about how her daughter, Leanne, was caring for the child but didn’t want her to know she’d phoned the Helpline. Janice just wanted advice – she was scared about what might happen to her granddaughter.

Leanne, who was 21 years old, was living on her own with Amy, although Amy’s father, Dan, would visit the flat a couple of times a week.

When Janice had visited her daughter, she had seen Amy being left in a buggy for most of the day, being given feeds with the wrong amount of powdered milk to water, and her nappies and clothing being changed infrequently. Janice was also shocked that Amy’s unfinished bottles were left open and unwashed before being given to Amy again later in the day.

Janice finally called the Helpline when she found out that Leanne had left Amy alone, propped up on cushions, while she had gone to the shop. Anything could have happened to Amy, but Leanne wouldn’t listen to her mother’s advice and warnings.

Worried, Janice explained that although Amy’s father would help care for her, he would often drink excessive amounts of alcohol with Leanne when visiting, and Amy would be neglected. Dirty nappies were left on the floor, and ash trays were left overflowing.

It was clear this neglect could seriously harm Amy’s health and development. After talking to the Helpline counsellor, Janice acknowledged that while she was helping to look after Amy and keep the flat clean, she wasn’t helping Leanne to change her behaviour.

Janice knew Leanne needed more help than she could provide. However, she worried that passing the details to children’s services would cause a rift and mean that Leanne might stop her from seeing her granddaughter.

The Helpline counsellor understood Janice’s worries, but knew that Amy needed help. The counsellor discussed the different ways Janice could share her concerns with an appropriate person who could contact children’s services to ensure the family received the right support. Janice had previously met Amy’s health visitor but hadn’t said anything about her concerns as she felt she could support Leanne herself at that stage. When the Helpline counsellor suggested that she could contact the health visitor to share her worries, Janice agreed to do this immediately.

The health visitor visited Leanne and Amy after speaking to Janice, and contacted children’s services having decided that Leanne and Dan needed further support. Children’s services worked with Leanne and Dan to support them with their parenting, and to ensure that Amy would be safe and cared for appropriately.

This sample case draws on what people tell the Helpline, but it does not describe a specific case.

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Kai and Milly’s story

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This case study shows how multiple factors can place a child at risk and the ways in which the NSPCC Helpline works with children’s services and the police to protect children who are unable to protect themselves.

After hearing shouting and screaming most evenings for a couple of months, an anxious neighbour contacted the NSPCC Helpline using the online reporting form on the NSPCC website.

The neighbour wrote that every night between 9pm and 2am, he would hear the mother and father shouting and screaming at each other, as well as hearing thuds and crashes during these arguments.

He had seen the mother with a bruise on her cheek in the past and had seen the father with scratches down the side of his face. The neighbour stated that the police had gone to the house before but the couple had denied anything had happened and the neighbour was unsure whether it had been taken further.

Recently, the neighbour had become more worried about the children, 10-month-old Kai and four-year-old Milly. They were both crying more often and the neighbour had heard both the mother and father screaming at them.

Earlier in the week, the neighbour heard Kai crying for a long time and the father was heard running up the stairs and screaming at Kai to “shut his mouth”. Kai had screamed louder and Milly joined in, at which time the father swore and slammed doors. The mother and father could then be heard screaming at each other whilst the children continued to cry.

From the information provided on the online reporting form, the Helpline counsellor was gathered details about the concerns, the children’s wellbeing, and the parents’ capacity to be good parents. All of this helped the counsellor make an assessment of the possible risk to the children, and the support that may be needed.

The neighbour had provided the family’s details and so the Helpline counsellor contacted children’s services to share the concerns for the children and request that an assessment be undertaken.

Children’s services carried out an initial assessment which raised concerns about domestic abuse between the parents. A further core assessment was undertaken and a child protection plan put in place, to ensure the family received support around domestic abuse. The family was visited regularly by a social worker to ensure the children were not put at further risk.

This sample case draws on what people tell the Helpline, but it does not describe a specific case.

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Risk Factors

Many of the people who contact the NSPCC Helpline have identified adult behaviour that they think puts a child at risk. The three most common of these are parental or carer substance misuse, domestic abuse and mental health issues. These factors are recognised as key child protection risks for babies.

substance misuse “One’s a baby. She’s not growing at all, which I’m most concerned about. And the mother seems to be drinking a hell of a lot of vodka. How can she look after a baby?”A caller to the NSPCC Helpline

“They leave the three-month-old baby in a bouncer, and they go out the back to drink and smoke drugs.”A caller to the NSPCC Helpline

“Parental substance misuse can impact on a baby’s health if the parents aren’t getting up in the morning or if they’re leaving the baby for long periods of time without giving them food or changing them. Sometimes they don’t buy things the baby needs, like nappies, so the child has to sit in a wet and dirty nappy for hours.”NSPCC Helpline counsellor

Drug and alcohol abuse was a common reason for people calling the Helpline and was often central to their worries about a child’s safety. Parental or carer substance misuse was a factor in half of all referrals (50 per cent) for children under one and was mentioned in 54 per cent of neglect referrals.

Research by the National Scientific Council on the Developing Child shows that alcohol is the most damaging substance to the unborn child’s development. High levels of alcohol exposure during pregnancy affect the development of the cardiovascular, digestive, musculo-skeletal and neurological systems. These effects are not simply confined to alcohol however; most illegal and recreational substances (such as cocaine or nicotine) have adverse effects on the health of an unborn baby (NSCDC 2006; Eiden et al 2007).

Substance misuse can continue to cause damage after birth because of the effect it can have on the parent’s ability to properly care for their child.

It is important to note that parental or carer substance misuse alone does not result in child abuse but it does significantly increase the risk of the child being harmed or neglected (Smarsh Hogan et al 2006).

domestic abuse“I just would like someone to look into it. I don’t know what their past history is or anything, but I was just quite concerned seeing a lady bleeding and the baby crying.” A caller to the NSPCC Helpline

“Sometimes you are told that one parent was holding the baby to protect him but that child is still being caught in the cross fire. The child can be in the same room, screaming and crying while mum and dad are carrying on at each other. We know that the risk for a young child in that situation is very significant.” NSPCC Helpline counsellor

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Domestic abuse affects children physically and emotionally. There is the danger that parental fighting could involve a baby and the aggressor may physically abuse that child as well as their partner. There is also the damage that is done to the emotional wellbeing of the child from witnessing domestic abuse. Evidence suggests that early and repeated exposure to domestic abuse causes serious behavioural problems and trauma in the first few years of a child’s life (Bogat et al 2006; Whitaker et al 2006). There is also the emotional impact of domestic abuse on the parent and the effect this can have on their ability to care for a child.

Domestic abuse was a factor in 15 per cent of the referrals made about children under one.

Mental health issue“She’s out tonight, she’s out every night. She’s just completely changed as a person. So I don’t know whether she had post natal depression.”A parent, calling the NSPCC Helpline about their daughter

“She’s had a baby and she’s talking a lot about wanting to harm herself. Then she says that she’s going to harm the baby. But the way that she is acting, is kind of like mania.” A caller to the NSPCC Helpline

The presence of a mental health problem within a household does not mean that a child will be abused. However, studies have shown that some mental health conditions can severely affect a parent’s ability to care for their child (Conroy etal 2009). In some cases the stress of being a child’s carer could trigger a mental health issue or condition (Hobson et al 2005).

Mental health issues are more difficult for Helpline callers to pick up on than domestic abuse orsubstance misuse. Identifying someone’s behaviour as a mental health problem requires specific knowledge and so it is probable that some of the cases that are reported to the Helpline do include mental health issues, but they are not recognised by the caller.

Helpline counsellors do not try to establish a clear‘diagnosis’ on the phone, but are trained to recognise and probe for specific signs that may indicate a problem. They might ask about the caller’s experience of the person’s behaviour, including any changes in behaviour, or if they seem different from their ‘normal’ self. The answers to these questions can then be included if a referral is made, enabling specialist workers to start with the fullest picture possible for their more detailed assessments.

Mental health concerns are twice as likely to be mentioned as a factor in referrals relating to babies (14 per cent) compared to referrals for all children (7 per cent). However, these figures are likely to be an under-representation of the number of cases where mental health issues are actually a factor.

Some parents or carers called the NSPCC Helpline because they were worried about their own mental health and the impact that may have on their ability to care for their child.

One parent said: “I’ve been feeling really, really down and I’ve got a two month old baby and because of how down I’ve been feeling, I’ve been finding it quite difficult with him.”

Another told a counsellor: “I just keep screaming at her. I can’t seem to control it.”

In these situations many parents don’t want to give their details to the NSPCC Helpline, so the counsellors look at the impact their behaviour may have on the child and assess the support network – such as friends or family – that may be able to help.

By offering this kind of support, the counsellor may be able to help parents understand the potential implications of their behaviour as well as reassuring them and helping them to see the benefits of seeking further help.

The counsellor gives the caller details of any local or national services that can offer them more help and support. The most important message is that the NSPCC is always there to offer support and to keep the child safe.

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neglect“She leaves the child because he’s asleep. She will leave him asleep and she will go across the road to her friend’s house.”A caller to the NSPCC Helpline

Over 50 per cent of the referrals that included a child under one were for neglect. A baby’s complete reliance on their parents or carers means that any reduction in their care has serious implications. Malnutrition, poor hygiene, and an absence of love and communication can have severe effects on the development of a baby (Jordan et al 2009; Ward et al 2010).

physical abuse“She was shaking the baby and he started screaming and going red in the face.”A caller to the NSPCC Helpline

Physically abusing a baby is unimaginable to most people but it accounts for a quarter (25 per cent) of all the referrals of under ones made by the Helpline to children’s services.

One of the most dangerous types of physical abuse for babies is being shaken. Babies’ fragile bones and muscles are easily damaged. Even the smallest shake can have a devastating impact.

A survey of studies of Non Accidental Head Injuries in babies (Dias et al, 2005) found mortality rates varying between 13 and 30% amongst babies whose injuries came to the attention of medical professionals.

A separate study found that of babies surviving brain injury, at least half sustained significant neurological impairment.

Multiple abuse“We get a lot of calls where the risk factors are quite complex. There might be concerns around child neglect, the father is taking drugs, the mother is drinking too much and they often have screaming rows. And the baby gets caught up in the middle of it all.”NSPCC Helpline counsellor

One third of all the cases of neglect for under ones also involved aspects of emotional or physical abuse, or both. Similarly, half of all cases of emotional abuse also mentioned either physical abuse or neglect.

60%

50%

40%

30%

20%

10%

0%

Figure 3: Top five reasons for all referrals April – June 2011 Children under one All children

Neglect Physicalabuse

Emotionalabuse

Sexualabuse

Adult health/behaviour

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This pattern is mirrored in referrals for all children, with at least one of these factors being mentioned in 53 per cent of referrals.

overlapping risk factorsSubstance misuse, domestic abuse and mental health problems are three key factors that place a baby at an increased risk of abuse. One or more of these factors was present in 60 per cent of the referrals for children under one. Whilst any of these factors is a significant indicator of risk, a combination of two or three hugely increases the risk of abuse to the child (Whitaker et al 2006).

Figure 4 illustrates how often the three risk factors overlap.

Figure 4: percentage of referrals of under ones mentioning substance misuse, mental health issue or domestic abuse April – June 2011

33%

10% 6%

1%

1%3% 6%

Domestic abuse(a factor in 15% of referrals)

Mental health issues(a factor in 14% of referrals)

Substance misuse(a factor in 50% of referrals)

Substance misuse is a factor in 50 percent of referrals. This includes:

• 10 per cent of referrals that mention both substance misuse and domestic abuse

• 6 per cent that mention both substance misuse and mental health concerns.

This pattern is mirrored in referrals for all children, with at least one of these factors being mentioned in 53 per cent of referrals.

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“It’s often in the night where people are more anxious. If they’re hearing these babies screaming, then we’re the people that they call.” NSPCC Helpline counsellor

“People who live locally are anxious about getting involved with the police and children’s services directly. But they can talk to us about their concerns and be reassured that, if there is something that needs investigating and that needs to be taken further, we will do that.” NSPCC Helpline counsellor

The NSPCC Helpline is available 24 hours a day, seven days a week with experienced child protection professionals answering the calls. The counsellors have the knowledge and experience to know when a family needs more help and when a referral needs to be made to keep a child safe. When they do not make a referral, they provide counselling and safeguarding strategies and help the callers talk through their worries.

The Helpline counsellors are able to give advice for all the cases they receive and anyone contacting the Helpline can be assured that their concerns will be dealt with appropriately.

Conclusion

Babies depend completely on their carers to meet their physical and emotional needs, as well as to keep them safe from harm. Unfortunately sometimes a baby’s carers find it difficult to meet these needs. Where families have other problems such as substance misuse or domestic abuse, the risks to a baby increase. The calls made to the NSPCC illustrate how helpless babies are and why the Helpline is vital in protecting these children. Babies are unable to ask for help so a call or an email to the NSPCC from a concerned adult could be their only hope.

Practitioners who work with adults, children, and families have the opportunity to make a difference to the lives of babies. The NSPCC Helpline encourages professionals to trust their instincts and seek advice if they are concerned about a baby.

Many professionals working with children will be in organisations where there are established child protection procedures. In these cases the Helpline can be a helpful addition to organisational procedures, allowing anyone to talk through their concerns with an experienced child protection professional.

How we help

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Bibliography

Bogat, A; Dejonghe, E; Levendosky, A; Davidson, W; von Eye, A (2006). Trauma symptoms among infants exposed to intimate partner violence. Child Abuse and Neglect 30(2) pp: 109-125.

Brandon, M; Bailey, S; Belderson, P; Gardner, R; Sidebotham, P; Dodsworth, J; Warren, C and Black, J (2009). Serious Case reviews and their impact: A biennial analysis of serious case reviews 2005/07. DCSF Research Report 129.

Conroy, S; Marks, M; Schacht, R; Davies, H and Moran, P (2010). The impact of maternal depression and personality disorder on early infant care. Social Psychiatry and Psychiatric Epidemiology 45(3) pp: 285-92.

Dias MS; Smith K; de Guehery K; Mazur P; Li V, and Shaffer ML (2005). Preventing Abusive Head Trauma Among Infants and Young Children: A Hospital-Based, Parent Education Program. Paediatrics 115(4) pp: 470-477.

Perry, B and Dobson, C (2009). Shayna, Ty and trauma survival. Counselling Children and Young People March pp: 28-31.

Kroll, B and Taylor, A (2000). Invisible Children? Parental substance abuse and child protection: dilemmas for practice. Probation Journal 47(2) pp: 91-100.

Hobson, P; Patrick, M; Crandell, L; Garcia Perez, R and Lee, A (2005). Personal relatedness andattachment in infants of mothers with borderline personality disorder. Development and Psychopathology; 17(2) pp: 329-347.

Jordan, B and Sketchley, R (2009). A stitch in time saves nine: preventing and responding to the abuse and neglect of infants. Child Abuse Prevention, 30 pp:1-26.

National Scientific Council on the Developing Child (2006). Early Exposure to Toxic Substances Damages Brain Architecture. NSCDC Working Paper No. 4. Centre on the Developing Child, Harvard University.

NSPCC (2011). Statistics on children under one. http://www.nspcc.org.uk/Inform/resourcesforprofessionals/children_under_one_statistics_wda79305.html

Eiden, R; Foote, A; Schuetze, P (2007). Maternal cocaine use and care giving status: Group differences in caregiver and infant risk variables. Addictive Behaviours, 32(3) pp: 465-476.

Smarsh Hogan, T; Myers, B and Elswick Jr, R.K. (2006). ‘Child abuse potential among mothers of substance-exposed and non-exposed infants and toddlers’. Child Abuse and Neglect, 30(2) pp: 145-156.

Ward, H; Brown, R; Westlake, D and Munro, E(2010) Infants suffering, or likely to suffer, significant harm: a prospective longitudinal study. London: Department for Education.

Whitaker, R; Orzol, S and Kahn, R (2006). Maternal mental health, substance use and domestic violence in the year after delivery and subsequent behaviour problems in children at age 3 years. Archives of General Psychiatry 63(5) pp: 551- 560.

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Appendix

Children under one - NSPCC Helpline: April - June 2011 (calls, emails, texts)

Advice Referrals Total

Public 113 50% 516 82% 629 74%

Relative 41 18% 59 9% 100 12%

Parent/ Carer 51 23% 26 4% 77 9%

Not Known 10 4% 24 4% 34 4%

All professionals 8 4% 1 0% 9 1%

Child 2 1% 0 0% 2 0%

Total 225 100% 626 100% 851 100%

All children - NSPCC Helpline: April - June 2011 (calls, emails, texts)

Advice Referrals Total

Public 1,863 32% 4,840 81% 6,703 57%

Relative 973 17% 403 7% 1,376 12%

Parent/ Carer 2,297 39% 400 7% 2,697 23%

Not Known 187 3% 250 4% 437 4%

All professionals 327 6% 50 1% 377 3%

Child 171 3% 45 1% 216 2%

Total 5,818 100% 5,988 100% 11,806 100%

Table for Figure 1: All calls April - June 2011

Children under one All children

Neglect 374 44% 3,380 29%

Physical abuse 174 20% 2,277 19%

Emotional abuse 112 13% 1,614 14%

Sexual abuse 49 6% 1,462 12%

Adult health / behaviour 69 8% 647 5%

Family relationships 17 2% 707 6%

Other 37 4% 683 6%

Child behaviour 13 2% 866 7%

Child health 6 1% 170 1%

Total 851 100% 11,806 100%

Table for figure 2: All contacts to the Helpline: April – June 2011

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Children under one Substance misuse Mental health issues Domestic abuse

Substance misuse 33% 6% 10%

Mental health issues 6% 6% 1%

Domestic abuse 10% 1% 3%

All 3 factors 1% 1% 1%

Total 50% 14% 15%

Table for figure 4: Overlapping risk factors for children under one April – June 2011

At least one factor mentioned in 60 per cent of referrals.

Children under one Substance misuse Mental health issues Domestic abuse

Substance misuse 31% 3% 10%

Mental health issues 3% 4% 0%

Domestic abuse 10% 0% 6%

All 3 factors 0% 0% 0%

Total 43% 7% 16%

Overlapping risk factors for all children April – June 2011

At least one factor mentioned in 53 per cent of referrals. The sample size, whilst representative, is small. We are not implying that the Helpline doesn’t refer cases where all three factors occur but that the numbers are low and were not picked up in this sample.

Children under one All children

Neglect 319 51% 2504 42%

Physical abuse 157 25% 1605 27%

Emotional abuse 89 14% 972 16%

Adult health / behaviour 24 4% 149 2%

Sexual abuse 30 5% 565 9%

Other 7 1% 193 3%

Total 626 100% 5988 100%

Table for figure 3: reasons for referrals April – June 2011

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All of the data used in this paper has come from the NSPCC Helpline records between April and June 2011.

Contacts to the Helpline are categorised either as “advice” or “referral”. Referrals are where concerns are serious enough to be passed on to the children’s services and/or police and where identifying details for the child/family have been provided by the caller.

Contacts are categorised as “advice” in three circumstances: the caller is only seeking guidance, there is insufficient information to make a referral, or the concerns do not meet the thresholds of seriousness.

A proportion of the advice calls should be referrals due to the children being identified as at risk, but the caller is unable or unwilling to provide identifying details, therefore the call is categorised as advice.

The qualitative analysis was done using the software package NVivo and all the cases for this came from two samples taken from referrals between April and June 2011. The two samples each consisted of 144 referrals (one for children under one and the other for all children) and were weighted by type of concern (neglect, family relationships, child behaviour, etc) and by caller (parent/carer, member of public etc). From each of these sub-sets a representative numbers of calls or emails were chosen at random. The age categories are based on the youngest child present in the household concerned. This means that in some cases whilst there was a child under one present they may not have been the focus of the call.

All quotes are from real calls to the Helpline but they have been edited to remove any potentially identifying factors and to increase clarity. The two case studies reflect real calls to the NSPCC Helpline but have been created for the purpose of this report.

To gain the invaluable insight of the Helpline counsellors a focus group was conducted as part of the research for this report.

Methodology Information

For more information, please contact the NSPCC Information Service: 020 7825 2775 or email: info@nspcc.org.uk

All names and potentially identifying details have been changed to protect the identity of callers.

Researched and written by Richard Woods, NSPCC

Quotes and case studies by Annabelle Whitlock, NSPCC

Adult Advice and Information Service, NSPCC 2011

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Anyone with concerns about a baby should contact the NSPCC immediately. We’re here 24/7. It’s free and you don’t have to say who you are.

call: 0808 800 5000 email: help@nspcc.org.uk

text: 88858

Visit: www.nspcc.org.uk/helpline

For further materials about babies and the NSPCC visit: www.nspcc.org.uk/underones

Registered charity numbers 216401 and SC037717. Photography by Jon Challicom, posed by models. 0077/11.