Minding the Baby
Note on provider involvement: This provider has not agreed to EIF’s terms of reference, and the assessment has not been conducted and published with the full cooperation of the programme provider. Some or all information on this programme has been obtained from publicly available sources, and so assessments may not include all relevant evidence and published information may contain inaccuracies on programme details.
Minding the baby (MTB) is a home-visiting programme. It is a targeted selective programme for young first-time mothers. It is delivered during the mother’s second or third trimester until the infant is two years of age and aims to improve child and maternal socioemotional outcomes.
Minding the Baby (MTB) is a home-based interdisciplinary parenting intervention. Nurse practitioners and social workers work together to deliver weekly sessions to young first-time mothers. Practitioners aim to promote sensitive caregiving and improve child-infant attachment through developing the mother’s ability to reflect on her own and her child’s mental state, and to be more reflective when interacting with the child.
EIF Programme Assessment
Minding the Baby has evidence of a short-term positive impact on child outcomes from at least one rigorous evaluation.
What does the evidence rating mean?
Level 3 indicates evidence of efficacy. This means the programme can be described as evidence-based: it has evidence from at least one rigorously conducted RCT or QED demonstrating a statistically significant positive impact on at least one child outcome.
This programme does not receive a rating of 4 as it has not yet replicated its results in another rigorously conducted study, where at least one study indicates long-term impacts, and at least one uses measures independent of study participants.
Child outcomes
According to the best available evidence for this programme's impact, it can achieve the following positive outcomes for children:
Supporting children's mental health and wellbeing
Minding the Baby
Key programme characteristics
Who is it for?
The best available evidence for this programme relates to the following age-groups:
- Perinatal
How is it delivered?
The best available evidence for this programme relates to implementation through these delivery models:
- Home visiting
Where is it delivered?
The best available evidence for this programme relates to its implementation in these settings:
- Home
How is it targeted?
The best available evidence for this programme relates to its implementation as:
- Targeted selective
Where has it been implemented?
United Kingdom, United States
UK provision
This programme has been implemented in the UK.
UK evaluation
This programme’s best evidence includes evaluation conducted in the UK.
Spotlight sets
EIF does not currently include this programme within any Spotlight set.
Minding the Baby
About the programme
What happens during delivery?
How is it delivered?
- Minding the Baby is delivered as weekly sessions beginning in the mother’s second or third trimester until the child’s first birthday, then fortnightly until the child’s second birthday.
- Sessions are 1 hour duration on average and are delivered by two practitioners who alternate visits to individual families.
What happens during the intervention?
- Sessions are delivered by social workers and nurse practitioners who alternate weekly visits. Nurse practitioners provide prenatal care and health education, while social workers monitor and support the mother’s psychological well-being, as well as support with social system.
- Both the nurse practitioner and the social worker work with the mother to improve the mother’s ability to reflect on their own and their child’s needs and mental states, and to be more reflective in their interactions with the child.
- Clinicians building a supportive, therapeutic relationships with the mother is also a key element to the programme.
What are the implementation requirements?
Who can deliver it?
The practitioners who deliver this programme are social workers and public health nurses with QCF-7 qualifications.
What are the training requirements?
Not available
How are the practitioners supervised?
Practitioners receive weekly discipline-focused supervision, alongside speciality-specific MTB supervision from the programme team.
What are the systems for maintaining fidelity?
Programme fidelity is maintained through the following processes:
- Training manual
- Face-to-face training.
Is there a licensing requirement?
Not available
How does it work? (Theory of Change)
How does it work?
- Young parents are more at risk of facing various challenges during parenthood which can affect their ability to respond sensitively, and effectively support the needs of the child.
- The Minding the Baby programme aims to provide health support and increase parental sensitivity through developing the mother's reflective functioning capabilities.
- The development of the mother’s ability to reflect on her own and the child’s mental states helps the mother to be more attuned to and cater to the needs of the child.
- Better meeting the needs of the child increases the number of positive interactions between the parent and infant, leading to improved infant attachment security.
Intended outcomes
Supporting children's mental health and wellbeing
Preventing obesity and promoting healthy physical development
Contact details
Minding the Baby
About the evidence
Minding the Baby’s most rigorous evidence comes from a RCT which was conducted in the UK.
This study identified statistically significant positive impact on a number of child outcomes.
A programme receives the same rating as its most robust study, which in this case is the Longhi et al., (2020) study, and so the programme receives a Level 3 rating overall.
Study 1
| Citation: | Longhi et al., 2020 |
|---|---|
| Design: | RCT |
| Country: | United Kingdom |
| Sample: | 148 mothers below the age of 26 and expecting their first child. |
| Timing: | post-test |
| Child outcomes: | Reduced child behavioural problems |
| Other outcomes: | None measured |
| Study rating: | 3 |
Longhi, E., Murray, L., Wellsted, D., Hunter, R., MacKenzie, K., Taylor-Colls, S., & Fearon, P. (2020). “Minding the baby® home-visiting programme for vulnerable young mothers. NSPCC.
Study design and sample
The first study is a rigorously conducted RCT. This study involved random assignment of first-time mothers to a Minding the Baby treatment group and a treatment-as-usual group. This study was conducted in the UK, with a sample of young first-time mothers. At the time of enrolment, just over half of the participants were 20 years of age or below. The majority of participants were White European (86.39%.)
Measures
Child outcomes
- Child behaviour problems was measured using the Child Behaviour Checklist (CBCL) (parent report).
- Child attachment security was measured using the attachment Q-set (expert observation of behaviour).
- Child cognitive development was measured using the Bayley Scales of Infant and Toddler Development scales, third addition (Bayley-III) (parent report).
- Maternal sensitivity was measured through direct observation of mother-child interactions and was coded according to the NICHD Study of Early childcare protocol.
- Postponed childbearing was measured by asking mothers about their pregnancy status.
- Maternal mental health was measured using the Edinburgh Postnatal Depression Scale (EPDS).
- Parenting stress was measured using the Parenting Stress Inventory (PSI).
- Maternal sense of mastery was measured using the Pearlin and Schooler 7-item scale.
- State and trait anxiety was measured using the State-Trait Anxiety Inventory (STAI).
Findings
This study identified statistically significant positive impact on a number of child outcomes. This includes child behavioural problems.
Other studies
The following studies were identified for this programme but did not count towards the programme's overall evidence rating. A programme receives the same rating as its most robust study or studies.
RCT with high sample attrition, conducted in the US.
Sadler, L. S., Slade, A., Close, N., Webb, D. L., Simpson, T., Fennie, K., & Mayes, L. C. (2013). Minding the baby: Enhancing reflectiveness to improve early health and relationship outcomes in an interdisciplinary home‐visiting program. Infant mental health journal, 34(5), 391-405.
RCT with high sample attrition, conducted in the US.
Slade, A., Holland, M. L., Ordway, M. R., Carlson, E. A., Jeon, S., Close, N., ... & Sadler, L. S. (2020). Minding the Baby®: Enhancing parental reflective functioning and infant attachment in an attachment-based, interdisciplinary home visiting program. Development and psychopathology, 32(1), 123-137.
RCT with high sample attrition, conducted in the US.
Sadler, L. S., Slade, A., Close, N., Webb, D. L., Simpson, T., Fennie, K., & Mayes, L. C. (2013). Minding the baby: Enhancing reflectiveness to improve early health and relationship outcomes in an interdisciplinary home‐visiting program. Infant mental health journal, 34(5), 391-405.
Follow-up of Sadler et al., 2013
Ordway, M. R., Sadler, L. S., Dixon, J., Close, N., Mayes, L., & Slade, A. (2014). Lasting effects of an interdisciplinary home visiting program on child behavior: Preliminary follow-up results of a randomized trial. Journal of pediatric nursing, 29(1), 3-13.
Ordway, M. R., Sadler, L. S., Holland, M. L., Slade, A., Close, N., & Mayes, L. C. (2018). A home visiting parenting program and child obesity: A randomized trial. Pediatrics, 141(2).
Follow-up of an RCT, conducted in the US
Londono Tobon, A., Condon, E., Sadler, L., Holland, M., Mayes, L., & Slade, A. (2022). School age effects of Minding The Baby—An attachment-based home-visiting intervention—On parenting and child behaviors. Development and Psychopathology, 34(1), 55-67.
Secondary analysis of Sadler et al., 2013 and Slade et al., 2020
Condon, E. M., Tobon, A. L., Holland, M. L., Slade, A., Mayes, L., & Sadler, L. S. (2022). Examining Mothers’ Childhood Maltreatment History, Parental Reflective Functioning, and the Long-Term Effects of the Minding the Baby® Home Visiting Intervention. Child Maltreatment, 27(3), 378–388.
Secondary analysis of an RCT conducted in the US (Sadler et al., 2013)
Albertson, J. G. (2017). Minding the Baby®: Maternal adverse childhood experiences and treatment outcomes in a mother-infant home visiting program. City University of New York.
RCT which is currently underway in Denmark
Pontoppidan, M., Thorsager, M., Friis-Hansen, M., Slade, A., & Sadler, L. S. (2022). Minding the Baby versus usual care: study protocol for a quasi-cluster-randomized controlled study in Denmark of an early interdisciplinary home-visiting intervention for families at increased risk for adversity. Trials, 23(1), 529.
Published May 2024