Health visitor and community health nurse perspectives of supporting parents caring for unsettled babies: a qualitative interview study
Health visitor and community health nurse perspectives of supporting parents caring for unsettled babies: a qualitative interview study
Objectives: the aims of this study were to explore how health visitors (HVs) and community health nurses (CHNs) assess unsettled baby behaviours, how their perceptions of these behaviours influence decisions about support offered, and how able they feel to deliver support to families of unsettled babies.
Design: qualitative semi-structured interviews were conducted, recorded and transcribed. Data were analysed using Reflexive Thematic Analysis.
Setting: potential participants were invited nationally via social media and via Health Visiting Service managers from an NHS Trust. Interviews took place remotely.
Participants: 17 health visitors (HVs) and three community health nurses (CHNs) were purposively selected to include a wide range of perspectives.
Results: three themes were developed, 1) HVs’ perceptions of parents’ sense-making which explains how HVs/CHNs understand parents’ beliefs around unsettled babies; 2) care pathway which highlights the importance HVs place on creating emotional space for the baby, the parent and the health visitor within the pathway (containment); and 3) service delivery decline, which outlines the impact of funding cuts to the services on the HVs’ ability to provide support for families. Lastly, a new concept – the Tipping Point model - was created to holistically conceptualise the experiences of HVs providing support for unsettled babies in the UK.
Conclusions: policy makers need to organise services to value and support the role of the health visiting team in ‘containment’. HVs identified a training need around assessing and advising about unsettled babies to place them in a stronger position to support families. Further research is needed into different models of support for families of unsettled babies from the wider primary care team, and/or from digital services.
Clinical Decision-Making, Community child health, EDUCATION & TRAINING (see Medical Education & Training), Health Services, Health Workforce, Nurses
e101051
Smith, Lucy
835f8b9b-b6e0-4f5f-b6b4-a48c7913b463
Hornsey, Sam
ae4537b0-04fd-4c1a-a859-e7863fab5055
Latter, Sue
83f100a4-95ec-4f2e-99a5-186095de2f3b
Dobson, Amy
ed6f36e0-55ce-48a7-b33a-59f3231b5ee9
Miller, Sascha
448d724f-ce7d-4e8e-9ff1-e0255e995c77
Henaghan-Sykes, Kate
cabaf937-2270-42c3-838c-6921a27415b8
Adams, Sue
f974678d-5a26-4a75-9762-3ed8b67093c7
Santer, Miriam
3ce7e832-31eb-4d27-9876-3a1cd7f381dc
Muller, Ingrid
2569bf42-51bd-40da-bbfd-dd4dbbd62cad
12 February 2026
Smith, Lucy
835f8b9b-b6e0-4f5f-b6b4-a48c7913b463
Hornsey, Sam
ae4537b0-04fd-4c1a-a859-e7863fab5055
Latter, Sue
83f100a4-95ec-4f2e-99a5-186095de2f3b
Dobson, Amy
ed6f36e0-55ce-48a7-b33a-59f3231b5ee9
Miller, Sascha
448d724f-ce7d-4e8e-9ff1-e0255e995c77
Henaghan-Sykes, Kate
cabaf937-2270-42c3-838c-6921a27415b8
Adams, Sue
f974678d-5a26-4a75-9762-3ed8b67093c7
Santer, Miriam
3ce7e832-31eb-4d27-9876-3a1cd7f381dc
Muller, Ingrid
2569bf42-51bd-40da-bbfd-dd4dbbd62cad
Smith, Lucy, Hornsey, Sam, Latter, Sue, Dobson, Amy, Miller, Sascha, Henaghan-Sykes, Kate, Adams, Sue, Santer, Miriam and Muller, Ingrid
(2026)
Health visitor and community health nurse perspectives of supporting parents caring for unsettled babies: a qualitative interview study.
BMJ Open, 16 (2), , [e101051].
(doi:10.1136/bmjopen-2025-101051).
Abstract
Objectives: the aims of this study were to explore how health visitors (HVs) and community health nurses (CHNs) assess unsettled baby behaviours, how their perceptions of these behaviours influence decisions about support offered, and how able they feel to deliver support to families of unsettled babies.
Design: qualitative semi-structured interviews were conducted, recorded and transcribed. Data were analysed using Reflexive Thematic Analysis.
Setting: potential participants were invited nationally via social media and via Health Visiting Service managers from an NHS Trust. Interviews took place remotely.
Participants: 17 health visitors (HVs) and three community health nurses (CHNs) were purposively selected to include a wide range of perspectives.
Results: three themes were developed, 1) HVs’ perceptions of parents’ sense-making which explains how HVs/CHNs understand parents’ beliefs around unsettled babies; 2) care pathway which highlights the importance HVs place on creating emotional space for the baby, the parent and the health visitor within the pathway (containment); and 3) service delivery decline, which outlines the impact of funding cuts to the services on the HVs’ ability to provide support for families. Lastly, a new concept – the Tipping Point model - was created to holistically conceptualise the experiences of HVs providing support for unsettled babies in the UK.
Conclusions: policy makers need to organise services to value and support the role of the health visiting team in ‘containment’. HVs identified a training need around assessing and advising about unsettled babies to place them in a stronger position to support families. Further research is needed into different models of support for families of unsettled babies from the wider primary care team, and/or from digital services.
Text
e101051.full
- Version of Record
Text
Accepted BMJ Open_Smith et al_CUBs paper
More information
Accepted/In Press date: 28 January 2026
Published date: 12 February 2026
Additional Information:
Publisher Copyright:
© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY. Published by BMJ Group.
Keywords:
Clinical Decision-Making, Community child health, EDUCATION & TRAINING (see Medical Education & Training), Health Services, Health Workforce, Nurses
Identifiers
Local EPrints ID: 510112
URI: http://eprints.soton.ac.uk/id/eprint/510112
ISSN: 2044-6055
PURE UUID: a4d63d90-ebbb-4156-a5eb-d3ca604cd1be
Catalogue record
Date deposited: 17 Mar 2026 18:07
Last modified: 18 Mar 2026 03:10
Export record
Altmetrics
Contributors
Author:
Lucy Smith
Author:
Sam Hornsey
Author:
Amy Dobson
Author:
Kate Henaghan-Sykes
Author:
Sue Adams
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics