I think you’re stuck with recursive GetReferencesToContent if reference is a block.

I’m curious about the case here. Are you updating changed date on the page when a block or media file is changed?

Yes, that seems to be the issue, I get parent from child but when I get the references for the parent it gives me the child.

Not exactly but that would be a useful case. What we need to do is remove a page from a custom cache when anything used by the page is updated, block or media.

Any suggestions? I looked into getting parent items but for blocks this is the folder where the block 'lives' rather than the page.

I do something similar in my "BlockSearch" package. You can use something like this maybe?

List<ContentReference> referencingContentLinks = this.ContentSoftLinkRepository.Load(contentLink: contentLink, reversed: true)
                    .Where(
                        link =>
                        link.SoftLinkType == ReferenceType.PageLinkReference
                        && !ContentReference.IsNullOrEmpty(contentLink: link.OwnerContentLink))
                    .Select(link => link.OwnerContentLink)
.ToList();

For the complete code have a look at the complete helper on GitHub