Voice of the Infant: best practice guidelines and infant pledge

Key Messages for Best Practice: 2

Facilitating Infant Participation

Voice

Babies and young children have a voice that must be listened to. This voice is heard and seen in the noises and movements they make, their response to the environment and in their interactions with the people who are with them. Their silence may also represent a communication and it is important to understand this in the context of their history and relationships. Infant voice is present in how they make us feel. Eliciting the baby's voice requires close observation and facilitation. Observing and noting the baby's posture and movements, eye contact and other non-verbal communications is crucial, as is listening carefully to their vocalisations. In specialist services, it may be possible to ensure that two professionals are present, allowing one to focus entirely on the baby. Where this is not possible, space within a meeting dedicated to paying quiet attention to the baby can help to include their voice.

Assume that all children and young people have views and opinions about their own healthcare and actively encourage them to express what matters to them. NICE 204.1.5^[10]

Babies have things to tell us. It is our responsibility to create an environment that facilitates their communication and supports them to make a meaningful contribution. Giving information to adults and older children present about how babies communicate can help them to see and hear what is happening, leave a space for the baby and then respond. Back and forth communication with babies is called 'reciprocal' interaction and is essential for healthy brain development.

It is often helpful for professionals and caregivers to adopt an approach of shared curiosity to infant communication. Describing aloud what the infant is doing, wondering together about what it means and being open to different interpretations is supportive of infant expression, provides feedback to the infant, and offers insights to both caregivers and professionals. Interpretations of infant communication translate 'the language of the baby' into words but will not always capture infant experience fully or without error. When babies are sleeping or 'tuned out', it can be helpful also to notice out loud their different states of consciousness.

Depending on the setting and role of the professional, a range of training, tools and techniques may be relevant to supporting infant voice and helping parents or caregivers recognise and understand their infant's communication. Some are specifically used to help parents and caregivers see and appreciate their baby's strengths and their communications about their wellbeing and needs.