Protecting infants during the second lockdown

We know that families struggle to cope more with their children at times of financial hardship, stress and isolation. Now Covid-19 has brought all those things to many families’ front doors.

‘ICON: babies cry, you can cope’ is a programme designed to help parents cope with a crying baby and, by doing so, to help prevent Abusive Head Trauma. Crying is often the trigger for a parent or carer to lose control and shake their baby, potentially causing brain injury, blindness, bone injuries and sometimes death.

ICON stands for:

• I: infant crying is normal and the crying will stop. Babies start to cry more frequently from around two weeks of age, when the crying may get more frequent and last longer. After about eight weeks of age, babies start to cry less each week.
• C: comfort methods will sometimes help and the crying will stop. Think about the baby’s needs - is it hungry, tired or in need of a nappy change? Try simple calming techniques such as singing to the baby or going for a walk.
• O: it is ok to walk away if the baby is safe and the crying is getting to you. After a few minutes when you are feeling calm, go back and check on the baby.
• N: never ever shake or hurt a baby. It can cause lasting brain damage or death. If you are worried that your baby is unwell contact your GP or call NHS 111.

This simple message is delivered to parents and carers within the first eight weeks of a baby’s life, via professionals, including midwives, health visitors and GPs.

The ICON programme was developed following my 2016 Churchill Fellowship, when I travelled to the USA and Canada to explore programmes that are successfully reducing the level of Abusive Head Trauma in infants. The learnings I gathered have directly supported ICON, which is the first co-ordinated UK programme aimed at helping parents and carers to cope with a crying baby.

ICON was first piloted in 2018 and has been taken up by Clinical Commissioning Groups and Local Authorities throughout England. More recently, NHS England and NHS Improvement for the North and for the Midlands have commissioned ICON for all of their respective regions.

In March 2020, at the beginning of the first lockdown, ICON launched an intensive social media campaign recognising the likelihood of increased pressures in families and the increased risk to babies under the age of one. In June I was awarded an Activate Fund grant by the Churchill Fellowship to support this campaign, which has had a significant impact on our ability to undertake this work.

NHS England/Improvement included ICON as part of its Covid-19 emergency planning arrangements. All maternity units throughout the country were asked to implement the hospital-based element of ICON, as this is the best time to capture men, even with restricted visiting arrangements. A recent evaluation of these arrangements has found that about half of maternity units managed to implement ICON and deliver the message and leaflet to both parents in less than 10 minutes.

For many families, the second lockdown will bring more of the toxic combination of stress, hardship and isolation. Thankfully, vital resources like health visiting are not being redeployed this time. Now, more than ever, families with babies will need the help and support of professionals. ICON is a fundamental part of that support and is helping parents to cope. We must ensure babies do not become hidden during this time, that parents are allowed to say they are struggling and to be reassured that babies cry and they can cope.

ICON resources