Building Blocks

A randomised controlled trial (RCT) to evaluate the Family Nurse Partnership in England.

Background

The Family Nurse Partnership programme (or FNP) offers young mothers having their first baby support from a Family Nurse. The nurse visits the woman at home during pregnancy and until the baby’s second birthday. As FNP has been shown to help young families in the USA the government have introduced it in England.

FNP aims to help young mums to:

• have a healthy pregnancy
• improve their child’s health and development
• plan their own future

A trial of home visits for first time mothers

Building Blocks was a study of how well FNP works in England. 1,645 pregnant teenagers joined the study between 2009 and 2010.

Women were split into two groups. One group was offered FNP and one group had usual care from Health Visitors. All women in the study also had maternity care and any other extra support available to young families in their area.

The study looked at how well the mothers and babies were doing up until the baby’s 2nd birthday.

Results

Our main findings

• FNP did not reduce the number of women that smoked in pregnancy. In both groups 56 women out of every 100 smoked late in pregnancy.
• FNP did not reduce the number of small or premature babies.  In both groups the average baby weighed 7lb 1oz.
• FNP did not reduce the number of women getting pregnant again within two years. In both groups 66 women out of every 100 were pregnant again within two years.
• In both groups nearly 80 out of every 100 children were seen in hospital as an emergency before their second birthday.
• We found that FNP is more expensive than usual care.

Other findings

• About four in every 10 mothers in both groups breastfed their baby.
• By two years of age around one in 10 children had needed a trip to A&E because of an accident or swallowing something they shouldn’t have.
• Social services had been involved with 14% of children allocated to FNP and 8% of children allocated to usual care.
• Children in the FNP group had better language skills than children who got usual care only.

Follow up study using routine data linkage

Finding out what happens to mothers and their children as they grow up will be important. It could be that having FNP helps mothers and children do better when they get older. We plan to keep following the children to see how they are getting on in the follow up trial: Building Blocks: 2-6.