Growing Up In Southampton From Conception to 4 years. Fairness Commission January 2015

Live Births 2009/ /15 Maternity bookings declined from 2010/11 to 2013/14 but have increased in 2014/15 by 5.9%, it is likely births will increase.

Ethnicity In the first 6 months of 2014/15: White British births were 63% of all births compared to 65% last year Other White births were the same as last year at 16%. BME births were 21% of all births compared to 20% last year.

Overall 28.2% (13,101) of children are estimated as living in poverty and against the child poverty measure The city is ranked 26th out of 326 local authorities (where 1 is highest), this is worse than the most of Southampton’s comparator authorities. Variations between wards range from 17.5% of all children living in poverty in Sholing to 40.9% in Bitterne ward.

Inequalities Gap by Deprivation: Smoking at time of midwifery booking Children who breathe in secondhand smoke have an increased risk of: Cot death (Sudden Infant Death) – twice as likely. Asthma Serious respiratory conditions such as bronchitis and pneumonia. Meningitis. Coughs and colds. Middle ear infections with risk of hearing loss Children who grow up with a family member who smokes are 3x as likely to start smoking themselves. In 2009/10, the inequalities gap was 65.0% and has reduced to 31.3% White British mothers from areas of deprivation are more likely to smoke than other groups.

Inequalities Gap by Deprivation: Normal Births and Caesarean Sections The rate for normal births has been consistently better in the most deprived areas compared to the rest of the city since the inception of case- loading midwifery in the original Sure Start areas. But this gap is narrowing. The difference in rates are: Caesarean births: 17.6 percentage difference in 2009/10 to 10.3 in first 2 quarters of 2014/15 Normal births: 16.7 percentage difference in 2009/10 to 5.8 in first 2 quarters of 2014/15

Inequalities Gap by Deprivation: Singleton Low Birth Weight Babies “Lower birth weight babies have worse outcomes, both short- run in terms of one-year mortality rates and longer run in terms of educational attainment and earnings” Black et al The inequalities gap for singleton low birth weight babies has increased from 20.1% in 2011/12 to 32.4% in 2014/15. Babies from new communities including Asia are more likely to be low birth weight babies.

Inequalities Gap by Deprivation: Breastfeeding “Emerging evidence suggests that breastfeeding has a positive impact on mother-baby relationships: breastfeeding releases certain hormones which promote maternal feelings and behaviour. …and oxytocin acts like a fertiliser for the brain, promoting the growth of neurons (brain cells) and the connections between them, enabling babies to grow into secure, happy children”. UNICEF The inequalities gap for initiating breastfeeding has worsened since 2011/12 from 8.4% to 16.3%. White British mothers from areas of deprivation are less likely to breastfeed than mothers from other groups.

Inequalities Gap: Teenage Mothers There have been 52 live births to teenage mothers aged under 18 (at birth) over the past 12 months, this is higher than 44 the previous year. The Family Nurse Partnership is offered to 100% of first time mothers who conceive before they are 17 years and 3 months. Older teenage mothers have access to some additional support but finances are not currently available to extend the FNP.

Inequalities Gap – Lone Parents In 2011 census identified 6,918 lone parent families in Southampton with dependent children; Of these, 46.8% were not in employment (compared with 40.5% nationally) The vast majority was female (over 91%). Increasingly evidence suggests that the quality of family networks, interactions and income are more important features than just family type.

Accessing the Healthy Child Programme Includes contacts offered by health visiting service to all families in the ante-natal period, when the baby is days old, 6weeks, 4, 12 and 24 months. Southampton rates of take – up are generally good, the immunisation rate is excellent. Engagement with the HCP reduces inequalities through: Promotion of attachment and child development Health promotion Identification of risk factors and support needs Children that are not given the opportunity to access the HCP are often those most at need. They are often the same children that do not access funded child care places and who have poor school attendance. Families from new communities particularly asylum seekers may need time to trust official sources of support, including midwives and health visitors. Mothers where there is domestic violence may not have the freedom to access the HCP or to speak freely to professionals.

Accessing Parent and Toddler Groups

Accessing Children’s Centres 14 children’s centres managed in 4 clusters aligned with Early Help and HV teams Services and activities offered according to individual and community needs Reducing reach but increasing emphasis on targeted services to vulnerable families. Continued emphasis on enabling families to access training and employment Coordinating function across agencies and within communities.

Accessing Funded Child Care Currently we have over 80% of children accessing both the targetted places for 2 year olds (income, LAC and DLA) and the universal places for 3 and 4 year olds. We have just over 100 child care providers offering nursery/pre-school places and over 200 childminders. There are sufficient places across the city but some areas have fewer places available such as Thornhill. “Much is made of the importance of parenting for children’s cognitive development, and our study supports these claims … But importantly, our analysis shows that low income has a two-fold effect on children’s ability: it has an effect on children regardless of anything their parents do, but it also has an impact on parenting itself.” Institute of Education

Foundation Stage Profile West Cluster55.35%65.07% South Cluster47.55%60.38% North Cluster53.40%63.70% East Cluster47.48%57.65% % mixed econ53.13%63.41% 0-30% Deprived48.46%60.08% Citywide50.79%61.65% Nationwide52%60%

Joint Strategic Needs Assessment Since 2003 there has been a 40% rise in the level of new births, equivalent to an increase of more than 1,000 children being born every year. … Coping with this increase in service population within the current service resources and infrastructure alone would demand a system wide efficiency improvement of 40%. In practice, services are likely to need to meet this demand with less resource than they have in their current baseline. This rise in birth rate will make the effective use of resources critical to ensuring that support is available for those who need it throughout childhood and into early adulthood. Southampton JSNA

There are currently over 16,500 under 5s in the city. They represent a great future, our future. Building on our strengths and working together we can ensure that every child gets the best start in life.