The Nuffield foundation’s latest publication in The Changing Face of Early Childhood in Britain series is an evidence review which draws on research funded by the Foundation and a collaboration with the Nuffield Trust. The review provides the first ever comprehensive analysis of the health of children under five over the last 20 years.

The review focuses on seven key indicators of young children’s health which are infant mortality, immunisations, breastfeeding, obesity and overweight, oral health, mental health and emotional well-being, respiratory health.

Overall, young children are healthier than they were 20 years ago and more children are receiving a better start in life. Infant mortality rates have fallen. Vaccination uptake rates have increased. Breastfeeding has increased. Tooth decay has declined.

But this progress has stalled in the last five years and we are now seeing a reversal of some of these long-term improvements. The last five years have seen small but unprecedented increases in rates of infant mortality. The UK’s infant mortality rate is 30% higher than the median rate across EU countries.

Until the COVID-19 pandemic, rates of obesity and overweight in four- and five-year-olds had remained broadly static since 2005 but have soared in the last year. In England, the proportion of four- and five-year-olds classified as obese increased from 9.9% in 2019/20 to 14.4% in 2020/21s.

While data has not historically been collected on young children’s mental health, parental mental health has worsened over time, which in some cases can negatively affect young children, including their own mental health. Perinatal mental health problems affect up to 20% of mothers, only about half of whom are identified and even fewer receive adequate treatment. In England, an estimated 11.5% of children under five live in a household with a parent suffering from a severe mental health problem.

Vaccination uptake rates have increased in the last 20 years but have been falling since 2014. Only Scotland and Wales meet the 95% coverage recommended by the World Health Organisation for herd immunity. There have been improvements in the proportion of mothers who breastfeed immediately after birth, but rates for those who continue to breastfeed exclusively remain far below recommended levels and are amongst the lowest in high income countries. There have been significant declines in dental decay in young children over the last 20 years but the pace of improvement has slowed since 2014/15. There is some evidence to suggest young children’s respiratory health is worsening – recent research found that three of the top five reasons for admissions for young children in England were for respiratory conditions.

The Nuffield Founcation summary  is available here and the full report here.

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