Guidance

A practitioner’s guide to starting conversations about parent-infant relationships: summary

Published 21 March 2024

Applies to England

Prompt questions

The prompt questions are intended to support practitioners to have conversations with parents and carers about the relationship they have with their baby. This summary document sets out the prompt questions and some principles that should be kept in mind when applying them. The full guidance document sets out these in more detail as well as further context around the purpose of the prompts and their application.

The prompts form just one step of a 3-step framework. The full guidance document covers each step of the framework in more detail and the considerations you may wish to take when implementing each step.

The prompt questions are derived from the Leeds Early Attachment Observation (EAO) tool which is used in the routine 6 to 8-week postnatal health visitor contact. The tool is comprised of 3 questions and a 2-minute observation.

Question 1

What 3 words or phrases would you use to describe your relationship with your baby?

This is a neutral question to encourage the parent or carer to think about their baby and how they relate to one another. It helps you as a practitioner get a sense of their feelings towards the baby.

When you want to find out more information and delve deeper

The way a caregiver responds to this question may give an indication as to how they are feeling generally about the relationship they have with their baby. You may wish to try and find out a little bit more about why they picked those particular words.

You could follow up by asking:

Can you tell me a little more about why you chose those words or sentences?

Question 2

What brings you the most joy in the relationship with your baby?

This question brings out the positive side of being a parent or carer. As part of a strengths-based approach, it can be a helpful reminder for the parent of what is going well.

When you want to find out more information and delve deeper

The caregiver may find it easy to reference positive things about the relationship they have with their baby. They may also struggle to point to a positive and instead bring the conversation towards things they are worried about.

You could follow up by asking:

What is it about that part of the relationship that makes it your favourite?

You may wish to provide a tailored example here, such as:

How do you feel when you are feeding your baby?

Question 3

What is your biggest fear about your relationship with your baby?

This question focuses on aspects of the relationship that a parent or carer may be struggling with.

As part of a strengths-based approach, it can be useful to remind parents of some of the positives they have talked about and how it could be applied here.

It is also important to acknowledge any worries or fears the parent has shared, thank them for their honesty and recognise that this might be something they might like to change and have some support with.

When you want to find out more information and delve deeper

You may want to consider the role of observation when implementing the prompt questions.

Sharing something that parents and carers are afraid of may be daunting. Take the opportunity to build your relationship with the parent or carer by empathising with their position:

Thank you for sharing that with me. It’s understandable that you feel worried about that. Lots of people caring for a small baby have a similar fear.

After empathising with this fear, you could follow up by asking:

Is this similar or different to your relationship with your other children?

or:

How long have you been worried about this?

Giving the baby a voice: the role of observation

‘Stepping back’ and allowing interactions between the infant and caregiver to unfold without interruptions will help you to gauge the emotional responses of both the infant and carer and to get a general feeling for how those interactions develop.

The use of observations will help to tune into the baby’s ‘voice’ and bring a strengths-based approach to support. The full guidance document sets out more detail on carrying out an observation and how you may wish to do this alongside the prompts.

Moving through the framework

For most parents and carers, a conversation with you about their parent-infant relationship will be all they need.

You may decide, however, that it’s appropriate to move onto the next step in this framework to identify potential areas of need so you can determine if further support is required.

Further details on applying steps 2 and 3 of the framework can be found in the full guidance document.