Wednesday, 5 December 2007

Ofcom response to Bringing Up Baby

Ofcom Broadcast Bulletin, Issue 98

3 December 2007

Not in Breach

Bringing Up Baby

Channel 4, 25 September to 16 October 2007, 21:00


This was a short four-part series aimed at exploring three of the most popular childcare methods of the twentieth century. These were the 1950s Truby King method, the 1960s Dr Spock method and the 1970s Continuum method.

Five couples and one single mother, all with newborn babies, had decided to raise their babies using one of these three methods. The relative success or failure of the various aspects (e.g. where a baby should sleep, or when a baby should be fed, etc) were shown by the programme. Each method had a mentor who would support and take the parents through the method. The mentors were strong supporters of one of the three childcare methods.

From time to time during the course of the series, the parents were encouraged to adopt certain different approaches to childcare. For instance, the approaches included: leaving a week-old infant wrapped up in a blanket in a pram in the garden to get 'fresh air', so as to sleep better at night time (the Truby King method); "trusting your instincts" and not having a set routine (the Dr Spock method); constantly carrying and being always available to feed the newborn (the Continuum method).

Ofcom received 752 complaints from viewers. In summary, the principal concerns raised were that the programmes:
  • employed techniques that were unethical, abusive, or neglectful and/or went against current UK government or other agency (such as the World Health Organisation) guidelines in respect of childcare
  • employed as mentors people who were not necessarily properly qualified to practise as childcare professionals
  • put children at risk of harm; and
  • did not sufficiently highlight to viewers the potentially harmful effects of some of the practices featured, and therefore put the safety of infants in viewers' care at risk.

Ofcom recognises the sensitivities relating to such issues as appropriate and safe child care, and understands the offence that may be caused to viewers who witness approaches and methods that do not accord with their own views and practices.

Under the Communications Act 2003, Ofcom has a statutory duty to set standards for the content of television programmes with which broadcasters must comply. These standards are set to secure certain objectives set out in the Act including the protection of under eighteens and that generally accepted standards are applied to content so as to provide adequate protection for members of the public from the inclusion of offensive and harmful material.

Ofcom considers the standards it has set for the protection of children to be amongst the most important in the Code. These rules are aimed at preventing children suffering any unnecessary distress or anxiety as a result of being involved in a programme or by its broadcast; requiring that broadcasters take due care over the physical and emotional welfare of children who take part or are otherwise involved in programmes. However, it should be noted that Ofcom's role does not extend to investigating allegations of child abuse, which is the role of the relevant authorities.

The Communications Act 2003 requires Ofcom to have regard to certain matters when setting the standards in its Code; particularly when applying generally accepted standards so that the public is adequately protected from offensive or harmful material, Ofcom must have regard to the need for standards to be applied in a manner that best guarantees an appropriate level of freedom of expression. This is in terms of both the broadcaster's right to impart information and ideas and the right of the audience to receive them. These rights are enshrined in the European Convention of Human Rights incorporated within the Human Rights Act 1998. Accordingly, Ofcom must exercise its duties in light of these rights and not interfere with the exercise of these rights in broadcast services unless it is satisfied that the restrictions it seeks to apply are required by law and necessary to achieve a legitimate aim.

In the case of this series, Ofcom considered the complaints against the following Code Rules:

1.26: "Due care must be taken over the physical and emotional welfare and the dignity of people under eighteen who take part or are otherwise involved in programmes. This is irrespective of any consent given by the participant or by a parent, guardian or other person over the age of eighteen in loco parentis".

1.27: "People under eighteen must not be caused unnecessary distress or anxiety by their involvement in programmes or by the broadcast of those programmes".

2.1: "Generally accepted standards must be applied to the contents of so as to provide adequate protection for members of the public from the inclusion of harmful...material".

2.2: "Factual programmes or items or portrayals of factual matters must not
materially mislead the audience".

2.4: "Programmes must not include material...which, taking into account the context, condones...dangerous... behaviour and is likely to encourage others to copy such behaviour".

In the course of our investigation, we contacted Channel 4 with regard to these matters seeking all relevant background information. It supplied us with further details. Much of the information it provided was also publicly available on the broadcaster's website, which accompanied the series.

It is important to note that the programme was based on three different approaches to childcare. The methods themselves are all based on previously published and well-known books and theories:
  • Truby King's "Feeding and Care of Baby";
  • Dr Spock's "Baby and Childcare"; and
  • Jean Liedloff "The Continuum Concept".

These methods and approaches to raising a baby are all in the public domain. As the programmes stated, these were three of the most influential childcare methods of the 20th century. Although some of the methods are highly controversial, many parents today do debate these techniques, and they are all used to a greater or lesser extent within the UK. Therefore, Ofcom's starting point must be that a programme which explores and discusses these approaches cannot in itself be problematic, so long as the broadcaster ensures that the material is put in context and that the audience is fully informed; for instance by being made aware of government guidelines, where appropriate. Ofcom would not expect, and it would be a breach of the Code for, a broadcaster to promote or encourage practices which were overall considered to be dangerous or harmful.

Possibility of harm to the children involved in the series: Rules 1.26 and 1.27

The childcare methods used were sometimes controversial (for example: where a baby should sleep; whether a baby should be left to cry; or when a baby should be weaned). Ofcom therefore considered the steps taken by the broadcaster and the programme makers to ensure that no harm would be caused to the children involved. Ofcom understands from Channel 4 that a range of relevant experts was consulted on current medical opinion with regard to the methods used before filming began.

These were:

a senior psychologist, who advised that following the routines proposed would cause no harm to the babies;

a neurologist, specialising in brain development issues, who said that there was nothing in the books to suggest brain development would be impaired by a baby being put in any form of routine; and

a GP who was of the view that none of the particular routines/methods was damaging to a baby's well-being.

A senior consultant paediatrician (currently an honorary senior clinical lecturer at a leading UK university and an associate member of the General Medical Council) also viewed all the programmes in the series, after editing and before their transmission. He was of the view that the babies had not been put at any risk.

Ofcom is also aware that all the families, whilst participating in the series, followed the standard practice (after leaving hospital with a new baby) of consulting with their GP, attending clinics and receiving visits from qualified health care professionals.

In our view, the broadcaster therefore gave careful and appropriate consideration to the potential impact of the methods used on the infants, and sought relevant independent advice. We have seen no evidence to suggest that due care was not taken over the physical and emotional welfare of the children, or that they were caused unnecessary distress or anxiety.

Ofcom also took into account concerns over the professional experience and qualifications of some of the mentors involved with the series. It is not Ofcom's duty to regulate such qualifications, or lack of them, except insofar as it might contribute to a breach of the Code through materially increasing the risk of harm to the children (see also "Claire Verity's Qualifications: Rule 2.2" below). However, in Ofcom's view, a material increase in the risk of harm to the children did not happen here for a number of reasons, including: the fact that the books (Truby King, Spock and Continuum methods, written by acknowledged experts) were essentially the 'providers of the advice' to parents; the appropriate levels of protection from harm provided for the young children throughout the series; the fact that objective independent information from healthcare professionals was available to the parents through the standard medical routes during filming; and the guidance followed by the programme-makers, on the advice of the relevant medical experts consulted. With regard to the matter of consent, Channel 4 had made it clear that the families involved had been given detailed information on the principles and techniques of the methods being used to ensure that they were able to make an informed choice as to whether to continue with the method they had themselves chosen. It was made clear to the families that they were free to change their minds, and cease using the method in question, at any time they chose to do so during filming.

It should be noted that Ofcom has not received a complaint from the parents who participated in the programmes. Neither has Ofcom received any complaint from the healthcare professionals involved in the independent provision of the standard care to the participating families, as mentioned above. For all of the reasons set out above, the programmes were not in breach of Rules 1.26 and 1.27.

Possibility of harm being caused, in general, by the broadcast of the programmes: Rules 2.1 and 2.4

In considering this matter, Ofcom sought to establish whether the broadcaster had applied generally accepted standards to the programmes to ensure adequate protection from material that could be harmful. In other words, did Channel 4 encourage or condone harmful methods which could endanger babies?

In Ofcom's view, Bringing Up Baby was a programme which explored different methods of raising a baby which have been, and are still, popular in the UK. The methods adopted were put into context and the pros and cons of each method were explored. In particular, the more controversial approaches were all challenged within the programme, either via the commentary or by the mentors themselves. Further, where the approach differed from current public health advice, this was made clear to the viewers and explained. For instance, having the newborn baby sleeping next to the parents in their bedroom was described as "the safest place to be according to government guidelines". When the mentor for the Truby King method encouraged the weaning of young babies at the age of 16 weeks, the programme clearly stated that the current World Health Organisation advice is for weaning to take place at 6 months because of the risk of allergies. In discussion about formula milk, the programme was unequivocal, stating that "breast milk is known to be much better for babies than bottled formula". The broadcasting of views which challenge current medical advice may not, in itself, breach the Code. Programmes should be permitted to explore such issues so long as such views are appropriately explained and put in context.

In Ofcom's view, the programme ensured that the viewer would be left in no doubt, what the pros and cons were of each method, and how each mentor felt about the others' view. According to the Dr Spock mentor, the Truby King method was "...cruel, hard, awful... when what a baby actually needs love, touch and cuddles". The Truby King method was itself described by its own mentor as "quite mean".

The programmes themselves frequently made it clear that the methods used were controversial, and consequently were not offering universally accepted approaches to childcare. For example, important issues such as leaving a baby to cry, or allowing a baby to sleep in the same bed as the parents, were both regularly fiercely debated by the three mentors on screen and/or questioned by the participating parents themselves. Therefore there were frequent discussions between the mentors (and the parents) about the appropriateness of the approaches and the viewer would be left in no doubt about which ones would be considered, by many, as problematic.

Further areas of controversy or risk were regularly highlighted in the commentary throughout the series, e.g.:
  • "...some people criticise the 1950s routine...";
  • ", some experts also believe that having your baby in the same room can help prevent cot death...";
  • "...although co-sleeping [in the parent's bed] is the norm in some countries, it's a contentious issue in Britain and should only be done if proper safety guidelines are followed" (the safety guidelines were then outlined by the Continuum mentor and re-stated in the commentary); and
  • "...but having no rules isn't always a blessing...".

It is also important to note that all the babies, when shown asleep in their cots or prams, were shown lying on their backs and placed at the end of the bed - both positions recommended by today's practitioners; and that there was an extensive website providing a wide range of information related to the programmes, childcare advice (including reference to currently accepted practices) and debate; the address of which was announced at the end of every programme.

Overall, Bringing Up Baby was not a programme that advocated or promoted any one method or particular practice. It gave the viewers the facts about different approaches adopted today and in the past. The methods were put in an historical perspective. Where appropriate, it gave the government or other health guidelines. In our view, it was clear that the parents that featured in the programme had different priorities and chose their method accordingly.

Taking all the above into account, we consider that the broadcaster took the necessary steps to ensure that there was adequate protection for viewers from harm. The programmes were therefore not in breach of Rules 2.1 and 2.4.

Claire Verity's Qualifications: Rule 2.2

Concerns were also raised over the qualifications of Claire Verity (who advocated the Truby King theory). In terms of whether the audience was materially misled, Ofcom's remit, in this case, extended only to what was broadcast (as opposed to what may or may not have been claimed off-air). The programme almost exclusively referred to Claire Verity as a "mentor" (and on one occasion as a "1950s guru"). Such descriptions did not attribute to her any qualifications or expertise beyond what she may or may not have. The broadcaster stated that she had been working with babies and children for over 20 years.

However, the broadcaster did also refer in the introductory sequences to Claire Verity as "a maternity nurse". Some complainants were concerned that the use of this term implied Claire Verity had qualifications which they believed she did not in fact have. In our view, there is no evidence to suggest that a maternity nurse must have a qualification or belong to any professional body. While some maternity nurses may have a medical background, others do not but are experienced nannies or carers. Therefore, in our view, the description can refer to someone who is "experienced" in post-birth care both for the baby and the mother, and the programme was not necessarily intending to imply that Ms Verity had medical qualifications.

As it was therefore unclear whether or not Ms Verity had professional qualifications, we went on to consider whether by labelling her as a maternity nurse, there was a risk that some viewers might have assumed that her opinions were backed by professional training, and that she was accountable to a professional body.

On the very few occasions she was referred to as a "maternity nurse", it was always
qualified and limited. For example: she was referred to as a "controversial maternity nurse", "1950s style maternity nurse" and "1950s inspired maternity nurse". On these occasions, she was also introduced as a "mentor" immediately before.

Taking into account all of the above, it is our view that whether Ms Verity has professional qualifications or not, the programmes were not materially misleading to viewers about her professional status, so as to cause harm. Nevertheless, it is clear that in cases such as these, where there is the potential for harm, broadcasters should be careful when using terms which may imply participants have medical qualifications or other professional status. They need to take into account the potential risk of viewers giving more weight to the opinions of such people. It would therefore have been preferable for the programme not to have used this term (even if only sparingly).

Not in Breach