Professor Kevin Nugent:

If it is not a bit self-promoting, one of the things I did with some of my colleagues was to develop an approach to working with new mothers and fathers in the perinatal period. Even though I have spoken of the importance of the first three years, we have found that the first three months are critical in the formation of a family. If we intervene at that point, we can help parents to understand their own child as an individual and to realise that their baby can be a therapeutic agent in their own recovery in, for example, the case of a single mother who is on drugs. There is a chance for a psychological rebirth and the baby becomes the key person.

My research over the years is that one is giving the baby a voice through reading the baby's cues as a way of getting an assessment of who this baby is.

Prenatally, we have had many groups and I felt my contribution was actually minimal. People want to talk to each other and to normalise the experience of pregnancy. Isolation is very often the enemy. In the first three months, for example, the goal is to be there with them through home visiting, such as the visiting nurse Deputy Mitchell O'Connor talked about, and being there with them over the first three months to develop the foundation during this huge family transition when, in all cultures, the boundaries are quite permeable. People can enter and one can be part of the family story, as a nurse, professional, a home visitor or early intervention provider, by being there to support the parents at that time. That is just one example, but it is very strength based. There is never an attempt, even in the case of the 15 year old single mother on drugs, to label her, but to try to give her the support she needs to become a mother for this child. As I said, often the baby becomes the catalyst for change.

The same applies to the high risk infant, the baby who was born prematurely and the expectation that a high risk baby brings. How do we support parents with that? One of the initiatives we have, and I am happy we developed it, was to have an infant focused but family centred model of care that is embedded within the community. Again, understanding the inner life of the baby becomes the catalyst for change and then there is fostering the relationship along the way. The basic belief is that there must be a secure relationship, whether it is the mother per seor any alternative care giver. The key thing is the child must feel valued, worthy of trust and worthy of love, so that by the end of the second year of life the child has that individual sense of self and a sense of being valued as a person. That would be our goal, to create a sense of trust and a secure attachment relationship over the first two years of life.

Our approach has been, and there are many ways one can do it, to begin in pregnancy but around the perinatal time of transition to becoming a parent to be available there, supporting that and having the baby as our catalyst for change.

I hope that was helpful.