Abstract

BackgroundThe risk of entry to state care during infancy is increasing, both here in England and abroad, with most entering within a week of birth (‘newborns’). However, little is known about these infants or of their pathways through care over early childhood. ObjectiveTo characterize infant entries to care in England. Participants and settingAll children in England who first entered care during infancy, between April 2006 and March 2014 (n = 42,000). MethodsWe compared sociodemographic and care characteristics for infants entering care over the study period by age at first entry (newborn: <1wks, older infant 1-51wks). Among those who entered before April 2010, we further characterized care over follow-up (i.e. 4 years from first entry) and employed latent class analysis to uncover any common pathways through care. ResultsAlmost 40 % of infants first entered care as a newborn. Most infants first entered care under s 20 arrangements (i.e. out-of-court, 60 % of newborns vs 47 % of older infants). Among infants entering before April 2010, most were adopted over follow-up (60 % vs 37 %), though many were restored to parental care (20 % vs 32 %) or exited care to live with extended family (13 % vs 19 %). One in six infants (17.7 %) had particularly unstable care trajectories over early childhood, typified by three or more placements or failed reunification. ConclusionsEvidence-based strengthening of pre-birth social work support is needed to improve preventive interventions before birth, to more effectively target infant placement into care. Linkages between child protection records and information on parents are needed to inform preventive strategies.

Highlights

  • Half of newborn entrants were later placed for adoption, while 35 % exited care to live with extended family

  • The annual rates of entry into care rose in all six infant age groups over the study period, though increases were steepest among newborns (Fig. 2)

  • Among countries with available data, the US had the largest rates of infant entry into care (Fig. 3, top)

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Summary

Introduction

Child maltreatment (i.e. abuse and neglect) during infancy (

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