Infant First Aid Training for Parents

Caroline Johnson Excerpts

Wednesday 3rd April 2019 Westminster Hall

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I congratulate my hon. Friend the Member for Truro and Falmouth (Sarah Newton) on securing this important debate. She has been a champion of raising awareness to reduce avoidable deaths through working with the UK Sepsis Trust—sepsis is also a major killer of adults and children—and I am delighted that she has now lent her voice to the cause of infant first aid training for parents. As a paediatric consultant, this is an issue close to my heart.

My hon. Friend highlighted the alarmingly high number of cases where something could have been done to prevent a child’s death: 21% according to the Royal College of Paediatrics and Child Health. I should declare my membership of that organisation. Working on a children’s ward for the last 15 years, sadly I have seen far too many of those 21%. However, I have also seen children whose lives were saved by passing members of the public, as was described earlier in the case of Rowena, by doctors or health professionals, or by visiting family members who just happened to spot something and were able to help.

My hon. Friend the Member for Truro and Falmouth powerfully described a case of a child choking. As we approach Easter and then summer, mini-eggs and grapes are particular culprits. Advice should include how to manage a choking child, as well as simple measures to prevent choking. Chopping up grapes into little pieces, sitting down while eating and not running about with things in the mouth are helpful in preventing choking, but it can still happen to anybody, young or old, at any time. We should all know some of the manoeuvres that can help, such as the one my hon. Friend described in the case of the baby choking. The baby should be held face down across the adult’s legs, so that the baby’s head is lower than the adult’s knee, and blows should be applied to the baby’s back, between the shoulder blades.

That sort of information does not take long to learn, but can have a huge impact and can be responsible for saving somebody’s life. The information is already provided to a number of parents. I have delivered infant first aid to parents whose children have been in hospital. Each of the neonatal units that I worked on in the midlands provided first aid training to parents before they left hospital, in part because pre-term babies are more vulnerable when they have just left hospital and in part to provide parents with the confidence to manage very small babies when they go home, as was described by my hon. Friend the Member for Moray (Douglas Ross). Training is also provided routinely to parents who have had a child die in the past, but obviously we want to look at prevention.

The hon. Member for Belfast South (Emma Little Pengelly) talked about contact with health visitors and midwives. Evidence shows that parents are particularly receptive to messages about healthcare and first aid when they have just had their baby or when they are expecting their baby, as my hon. Friend the Member for Moray mentioned. That is a time before life becomes really busy, when one can reflect on the joy that is to come and be well prepared for it.

There are lots of opportunities for first aid training to be provided. There are antenatal classes, where training can be signposted or provided, as well as nurseries. I strongly believe that the practical advice should not just include what to do when things have gone wrong, but how to stop them going wrong in the first place. My hon. Friend the Member for Moray mentioned burns. I remember the case of a child who walked past a lit candle; it caught her dress and she got severe burns to her whole front. In that case her mum knew what to do—drop her to the floor, roll her over and stop the burning—and treated the situation appropriately, but even so the injury was severe and could have been prevented if the candle had not been left on such a low table.

Using seatbelts and car seats are among other simple measures that we know we should to do. One major cause of preventable deaths in children is drowning, so there should be simple advice about making sure that children are not left unsupervised around open water. I have seen this particularly in situations where there has been open water and a group of people, often at a big family event, where everybody is looking after the child but there is not one specific person watching to see that they do not end up in the water. At one of my children’s christenings, I was upstairs in a bedroom on the other side of the house when I saw from the window that a friend’s little boy had gone towards the small pond we had in the garden and that he was on his own. I ran downstairs and was fortunate that he had not gone into the pond by the time I got there. My husband was out with a digger the following day getting rid of the pond. It was not worth the risk, but if people have such ponds they need to be carefully managed. I have certainly seen children drown in those situations.

[Jim Shannon]

One thing that can be neglected in homes is fluids in cupboards. Years ago, when we were younger, fluids were kept in lemonade bottles and similar containers, and children did not realise that. I well remember when my second boy was very young—he was the one who everything seemed to happen to—he managed to get a gulp or two of Brasso. He had the shiniest backside that any child ever had, but that is by the way. It can easily happen that a fluid can be drunk or absorbed by a youngster. We need to take steps in our own homes to ensure that all fluids are under lock and key, wherever they may be.

[Dr Johnson]

I take the hon. Gentleman’s point about fluids. I noticed when I bought some washing detergent last week that the lids now have a clasp that is especially difficult to open, so children cannot consume those little bubbles. No one is ever perfect; I know that if I looked for hazards to my three children in my own home they would be there. So far, thank God, I have been lucky and I hope that will continue, but we can all do things to reduce risk.

I am glad that the Government are committed to ensuring that all early learning staff have first aid training, but it is time that they did the same for parents. Since 2016, all newly qualified level 2 and 3 early years staff must hold a current paediatric first aid or emergency paediatric first aid certificate. The Millie’s Mark quality scheme, which was commended by my hon. Friend the Member for Cheadle (Mary Robinson), was also launched in 2016. It requires childcare providers to train 100% of their staff in paediatric first aid, not just to have one trained person on site at any one time. The 300th nursery gained Millie’s Mark last summer, which was a cause for celebration, and I am proud those nurseries include Dappledown House Nursery and Appletree Corner Daycare in my constituency. My son’s nursery has offered parents first aid training in the last couple of months, so the message is getting out there and that needs to continue.

The efforts to provide safety in schools should now be matched to provide safety in the home. The time and financial investment needed to provide that is small. It costs £30 for two and a half hours of invaluable training on some of the most common causes of avoidable death, including choking, and ways of providing resuscitation. Providing preventive medicine is one of the best investments we can make. As well as avoiding tragedy, it takes pressure off our NHS services, which are facing ever-increasing demand. It is the right thing to do for both our children and our country, and I am glad to lend my support to this cause today.

--- Later in debate ---

[Julie Cooper]

I am grateful to the hon. Gentleman for that important intervention. I shall certainly speak with a loud voice about the subject in my constituency, and I encourage all Members to do the same.

The other point made by the hon. Member for Moray was that access is not easy. In preparation for this debate I checked up on access to training courses for my constituents and found that, even though I represent an urban community, it involves a 60-mile drive or a long train journey on a slow, rickety train line. That presents a massive barrier to my constituents accessing such training. I totally take the point that the hon. Gentleman makes, and I agree with him entirely.

The safety of our children is and always should be paramount, and it is therefore important that, in the event of an obvious health emergency, parents have at least a basic knowledge of first aid so that they can take action before professional help arrives—actions that might save the child’s life. The hon. Member for Truro and Falmouth made a strong point about how it is important that parents are trained to recognise the symptoms of what can be serious diseases, such as sepsis and meningitis. It would be useful if parents were equipped to recognise the symptoms before they decide whether to call 999 or take their child to hospital, because knowing how to spot the symptoms really does save lives.

First aid, as the term suggests, is the first medical attention that a person receives after an accident or during a medical emergency. Despite what many people have been led to believe, first aid does not have to be delivered by medical professionals—we have established that. A person’s chances of surviving a medical emergency are increased dramatically if a member of the community can respond with first aid immediately. What happens in the crucial minutes after someone dials 999 or the NHS’s 111 and before professional help arrives can be the difference between life and death. The British Red Cross reported that close to a quarter of infant deaths could have been prevented had there been a qualified first aider on hand, and who better to be trained than the parent?

[Dr Caroline Johnson]

A few weeks ago I was walking to a parliamentary event across the square, and I came across a man who was unconscious and not very well. When I called 999 for an ambulance, I noticed that the ambulance operators who answer the phone provide detailed and step-by-step advice to callers about what to do. That is a beneficial thing to note.

[Julie Cooper]

That is an important point. I have been on the receiving end of that with a family member, waiting for an ambulance and listening to instructions. Nevertheless, I appreciate that having the confidence to follow those instructions, particularly with a young child, might go a little beyond that.

This is about re-teaching people about what they think they know. There is a lot of so-called knowledge out there among people who think they know first aid, but that is often based on what they have seen in the media, which sometimes puts style before substance. In fact, procedures shown for dramatic effect often bear little resemblance to safe first aid. Furthermore, carrying out procedures without proper training might do more harm than good. First aid for babies is also vastly different from first aid for adults and other young children. Such important matters should be regarded as key parenting skills.

All parents, irrespective of their ability to pay, should have access to high-quality first aid training as a priority. Access to first aid training is about more than skills; it is also about building confidence and resilience. The British Red Cross surveyed a group of people it had trained in first aid, and asked whether they felt the training had contributed to their personal wellbeing. Three quarters of the respondents said it had made them more capable and more reliable in an emergency, and half said it had made them more determined and better at finding their way out of difficult situations.

Ahead of this debate, the British Red Cross shared with me the case of Leanne, a young mum from Swindon. When her baby, Maia, was six months old, Leanne took a baby first aid course with the British Red Cross. When Maia was 18 months old, she had a febrile seizure. Using knowledge from her first aid course, Leanne was able to save Maia’s life by instantly recognising the signs, taking steps to cool her down by removing her blanket, and placing her on the floor so that she did not injure herself during the seizure. After the seizure was over, Leanne further reduced Maia’s temperature by stripping her down to her vest, and she placed her in the infant recovery position. Leanne’s quick thinking saved Maia’s life before the paramedics arrived, and Maia is back to her playful, happy self. Leanne was able to do that only because she recognised the signs of a febrile seizure from her baby and child first aid course.

A seizure can be a terrifying and violent event for a parent to witness, especially when they do not understand what is happening. Febrile seizures are not unusual in babies and children between the ages of six months and three years. However, the Red Cross reports that, when questioned, 66% of parents had not been taught to recognise a febrile seizure, and 65% did not even know what one was. The baby and first aid course gave Leanne the knowledge and skills to act, but most importantly it also gave her the confidence. She said:

“I’m grateful that I had attended a baby and child first aid course which meant I knew what to look out for and how to deal with a febrile seizure.”

Because of her first aid knowledge, she felt calm and able to act for her daughter.

We have heard many examples of such events, and we are grateful to the hon. Member for Sleaford and North Hykeham (Dr Johnson) for sharing her expertise. People in the wider public often talk about MPs living in a bubble or ivory tower, but the hon. Lady’s expert and practical knowledge demonstrates yet again that Members of Parliament are in touch and know what is happening out there. As the hon. Member for Henley (John Howell) said, it is right and proper to use our position to spread that knowledge and champion causes such as this.

In 2014, Mumsnet sponsored 20 mums to take part in British Red Cross baby and infant first aid training. All the mums rated the training highly, and one said:

“I really enjoyed the course as every single thing discussed could easily relate to me and my children. All the videos of real-life scenarios really brought it home how easily these things could happen, but now I feel confident and that I could make a real difference to the outcome, and would feel so much more knowledgeable on what to do in an emergency situation.”

As we have heard, there are many different providers of first aid training for parents of infants. I specifically mentioned the British Red Cross, and other hon. Members have mentioned St John Ambulance, which offers first aid courses designed specifically for babies and children. There are also local providers, such as the one championed by the hon. Member for Truro and Falmouth. In addition, the NHS provides an online app to support parents with first aid for their infants. One parent said:

“Although you could read everything on the app and watch the videos for free, I think doing it in a class environment really makes you take it all in. It will also make you feel more confident if you were ever to need to help someone or your own child.”

As the Secretary of State for Health and Social Care often reminds us, technology in the NHS is helpful, but it is not a substitute for services delivered by real people. In terms of first aid provision for parents, such apps can be useful to reinforce training given in a class setting, but they should not be seen as a substitute.

[Dr Caroline Johnson]

The hon. Lady is generous in giving way. Does she agree that both technology and face-to-face contact have their benefits and can be combined? A “sim” dolly is an electronic version of a resuscitation dolly, and when supervised resuscitation is provided to a baby, it provides electronic feedback on whether compressions are deep or fast enough, as that can be measured electronically by the dummy itself.

[Julie Cooper]

I am grateful to the hon. Lady for her expertise in that technology, and such things can be used in combination with a class setting and training to support existing knowledge. I agree that, on specific occasions, such technology has an important role.

In terms of treatment, we lack consistency of provision and access. We have already spoken about distances to, and charges for, courses being a barrier for some parents. Shockingly, research by the Red Cross showed that 95% of parents did not know what to do when shown three examples of life-threatening medical emergencies. Surely it is time to ensure that training is available for every parent in every region. I take the point that we ought not to be prescriptive, but in leaving things to local providers, we must ensure that no one falls through the gaps and no parent is missed.

The Royal College of Paediatrics and Child Health has warned that UK infant mortality levels are among the highest in the developed world. There are many reasons for that, but cuts to local child services, community health projects, and community midwives and health visitors have undoubtedly not helped. It is clearly desirable to ensure that this important provision is adequately funded, but a significant proportion of deaths could be prevented by ensuring that all parents are equipped with important first aid skills.

Of course, a parent first aider is no replacement for a health visitor or paramedic, but they can be the first line of defence when it comes to helping their children live longer and healthier lives. Informed parents can prevent unnecessary trips to the GP and inappropriate hospital admissions, and it is a shame that despite the support that community and parent first aiders provide to the NHS and families, they are barely mentioned in the NHS long-term plan. That is important because if the Secretary of State is serious about making the NHS the best health service in the world, and about having an NHS that promotes health and wellbeing through a focus on prevention, the Government must make first aid in the community a priority. Equipping parents to look after their infants is a good and important step.

Will the Minister take action to ensure that universal first aid training forms part of the antenatal care available to parents? This is about providing families and communities with the skills to step forward in an emergency so that tragedies can be avoided. Learning such skills can be the difference between a life saved and a life lost.