2yr developmental check

[Fuschia]

Mumto3girlies I think we can sympathise with hvs who are very stretched and there are stories about very good ones offering great help to a friend of mine who had pnd but I do think they should be able to properly explain govt weaning policy... Saying it keePs chSnging, if a bAby isn't sleeping through it needs solids, Babies should sleep through by 6m etc etc are all bad Advice

I suspect a particular problem I'm this area with some weak hvs and well informed mums

[Belle]

mumof3girlies - how awful that you were attacked. You sound like one of the good ones, and they clearly are out there. It does sound like maybe the role needs to change.

[helena handbasket]

Fuschia that's not really fair, a lot of what we call being well informed is actually flavour of the day or a local trend. It must be incredibly hard to be giving advice of any kind in the google age. Especially since the information online is changing daily while government policy moves slowly.

We had a wonderful HV (eventually) who made up for the neglect of our awful GP surgeries, and I hate to think that the good ones like mine and mumof3girlies will eventually move on because why would you stay? That's part of why the service is bad; there just aren't enough of them and the ones who care burn out. Then you are left with the rifraf. You see in health care, social services, education.

I realize people have been given bad advice, but my GP's have been no better frankly and actually worse. It seems like the problem is that there is a black hole in infant care; the midwives aren't around long enough maybe? And then mothers are passed off to HV's who are generalists and are basically agents for social services. There's no continuity of care (at least not in my experience). It reminds me of the frenzy from Baby P, when social workers were dragged through the mud and the faults of a massively broken system were blamed on the demoralized humans at the bottom of the chain. Obviously the HV system needs to be improved but when it does work (ie when they are able to properly do their jobs) it's a great resource. It's like the NHS in general; when it works it really works well but when it doesn't it's a gong show.

[helena handbasket]

Sorry I just wanted to add a conversation I had with my HV:

When I first met her I expressed my frustration with a system that seemed to let people fall through the cracks. As someone who moved to the UK with a baby I found it incredibly hard to get my son noticed by the system, no red book or HV for two years even though I expressed my concern many times. What kind of doctor isn't interested in notes/base lines in a new patient, especially a baby? That's wrong.

Anyway what we talked about was her concern and sadness that if someone who is middle-class, professional and speaks the language is having trouble getting care what is the situation with the many many mothers who do not understand the system, are not educated and don't speak the language? My hope is that in Southwark the limited resources are going to this group. That does still leaves the question of care for the hopelessly average mum who still needs care. Some of us just aren't ill "enough", or needy "enough", and that doesn't seem right.

[Fuschia]

helena handbasket Wrote:

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> Fuschia that's not really fair, a lot of what we

> call being well informed is actually flavour of

> the day or a local trend. It must be incredibly

> hard to be giving advice of any kind in the google

> age. Especially since the information online is

> changing daily while government policy moves

> slowly.

>

Not at all. I am thinking of things like weight gain slowing from 4-5 m in bf babies, about policy being to wean at 6m and never before 4 m, about being on a low centile line consistently not being a problem, about the old live polio vaccine not being a threat to unvaccinated babies swimming

These things are not

> We had a wonderful HV (eventually) who made up for

> the neglect of our awful GP surgeries, and I hate

> to think that the good ones like mine and

> mumof3girlies will eventually move on because why

> would you stay? That's part of why the service is

> bad; there just aren't enough of them and the ones

> who care burn out. Then you are left with the

> rifraf. You see in health care, social services,

> education.

>

> I realize people have been given bad advice, but

> my GP's have been no better frankly and actually

> worse. It seems like the problem is that there is

> a black hole in infant care; the midwives aren't

> around long enough maybe? And then mothers are

> passed off to HV's who are generalists and are

> basically agents for social services. There's no

> continuity of care (at least not in my

> experience). It reminds me of the frenzy from

> Baby P, when social workers were dragged through

> the mud and the faults of a massively broken

> system were blamed on the demoralized humans at

> the bottom of the chain. Obviously the HV system

> needs to be improved but when it does work (ie

> when they are able to properly do their jobs) it's

> a great resource. It's like the NHS in general;

> when it works it really works well but when it

> doesn't it's a gong show.

[Fuschia]

Hmm iPhone not being very cooperative

None of the things I have listed are local trends, but well established facts that, surely any health professional working in the field of child health should have in their basic knowledge base !

[helena handbasket]

My point is that the NHS is where the problem lies if there is not consistent information (and some of your points I've not heard before so far from general knowledge), including and especially the GP's.

Alas, no point arguing the finer points of interpreting NHS policy because neither of us are experts in that area I don't think. I just feel that something is broken but it's dangerous to always blame the front line.

I have nothing to add to that.

[Fuschia]

helena handbasket Wrote:

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> My point is that the NHS is where the problem lies

> if there is not consistent information (and some

> of your points I've not heard before so far from

> general knowledge), including and especially the

> GP's.

>

The feeding stuff is fairly well known I think

The vaccine issue is in the vaccine booklet ... That's the issue I made my complaint about on 2003 after checking it out with my gp before taking my baby swimming at 8w I the

Had a hv tell me I had put him at risk and she wS going to hVe to make a note in his file ... And gave me the booklet and made ms sign for it

Then Shen I read it it said swimming before vacs was fine!

I could have accepted the hv being ignorant but she didn't have an inkling that she was bullying on totally spurious grounds !

[mumof3girlies]

Thank you Belle for your support and Helena HB you very succintly described what I also feel is wrong with the service, Fuschia I am not sure you read my second post where I addressed the issues of inconsistent advice and training, I didn't mention anything about staffing levels in my second post. I guess it's a bit like any profession - you get good staff and not so good staff, I have come across some awful solicitors while buying houses, awful GPs, terrible builders and some shocking estate agents to name but a few, but I wouldn't write off an entire profession as a bad job because of limited experience with one particular practitioner. East Dulwich is quite a small part of London/UK so I think it's hard to judge the entire health visiting profession on the basis of probably 5 HVs who cover the area.

edited to add that I have just come across the other thread on HVs (I missed it - that house move and the building site)and it seems all of this has been discussed and done and pretty much duplicated there - bad experiences and good experiences, so I guess all done on the role of the HV now ...;-)

[Fuschia]

It is a shame so many of us have had bad experiences locally and the service doesn't have a good reputation on here as a result. Maybe it is just a local issue, certainly my friend in Kent with pnd had huge support.

Maybe there should be more complaints locally to try to improve things

[flocker spotter]

I am very surprised that the administrators of this site are allowing posts with disparaging remarks about local professionals and their services. If these kind of comments were made about local traders, the posts would be pulled and the posters banned - such as happened to Mr Snorky who kep us so amused with his scorn.

We should be supporting our health service professionals who often have to deal with very challenging situations. Things like the 2 year check are there to catch potential problems and allay concerns. Well informed mothers of healthy toddlers may find it is just a form filling tick box exercise - but for others it can be so much more. Just because it is not for you, does not give you a right to slag off health visitors.

[Moos]

Flocked spotter, people make disparaging comments on this forum about local services: restaurants, plumbers, service in shops, all the time.

I don't think anyone has suggested they "don't need" HVs. There is a variety of opinion on the service that is provided, but if it wasn't wanted or used it wouldn't have provoked so much comment.

[Ruth_Baldock]

Personally, I've (unfortunately) never had a good experience with a HV; mainly through shockingly bad/incorrect advice. I was told to stop breastfeeding IMMEDIATELY and exclusively FF my son when he lost a bit of weight, even after he regained it and started to, slowly, put weight back on. A friend was told to give her 4wk old baby 1 oz of orange juice to relieve constipation. I was told to begin solids at 17w, and was also told to bring my son back for his second MMR shot 8 weeks after his first one; surely this can't be right????

[zeban]

My Mum started weaning all of us 5 children from 4 months, together with breastfeeding. Some people don't start doing that until 6. Surely there are going to be mixed messages because there isn't always a right or wrong answer.

[Fuschia]

zeban Wrote:

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> My Mum started weaning all of us 5 children from 4

> months, together with breastfeeding. Some people

> don't start doing that until 6. Surely there are

> going to be mixed messages because there isn't

> always a right or wrong answer.

Well no, because there is very clear nhs policy based on evidence, and a hv should present that information just as any other health professional should do, not depending on their personal opinion

[zeban]

What about their professional opinion?

[Fuschia]

zeban Wrote:

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> What about their professional opinion?

Their professional opinion will be the one backed by evidence, surely and in line with guidance otherwise what's the point of a hv? Cuts to the core of this discussion?

[zeban]

Flocker Spocker already explained that:

'Things like the 2 year check are there to catch potential problems and allay concerns. Well informed mothers of healthy toddlers may find it is just a form filling tick box exercise - but for others it can be so much more. Just because it is not for you, does not give you a right to slag off health visitors.'

It sounds to me like health visitors do have an important role, and if you already know it all and see yourselves as experts then why are you using them at all only to then slag them off.

And guidelines change and are often confusing- only recently it was decided that babies shouldn't be exclusively breastfed up to 6 months- that solids/normal food should be introduced earlier- to which my Mum replied, 'duh!'- she has 5 grown up children and introduced food for all of us at 4 months and they've only just discovered this. In fact aren't you all always saying on here 'every baby is different'? So the HV's I'm sure are trying their best dealing with such conflicting advice and pushy mothers!

[Fuschia]

The policy on weaning hasnt changed at all , it was just an article picked up on by the press suggesting more research into some issues

That's exactly my point, hvs are supposed to know more than your next door neighbour or a baby mag but often they don't seem to

Friend of mine in west London has had trouble with hers just the lady few weeks with wrong interpretation of baby weight gain

I am afraid I judge the service on what I hear from friends and my own experience and far too much of it is not very reassuring

Anyway we can disagree

But in answer to the original post , I didn't take my twins to their 2.y check because I have little confidence in the hvs ... And I am entitled to my view!

[Mrs TP]

Thought I would add the perspective of our recent 2yr development check. Us at Melbourne Grove Medical Practice and had a letter from them giving me the contact details of 5 diff HVs all working diff days so I could pick one to suit my availability. Arranged a home visit for following week. I didn't have any concerns but as in a busy household with two older children and not a health care professional myself it crossed my mind that there may be something I had not picked up on / forgotten / health advice changes etc and so no harm in it. HV arrived 20mins early and caught us finishing off a late breakfast as school hols. Visit went v. well. HV chatted to me more fully about child's behaviour and development, how child fits in within the family and relationships with sibblings etc. Child is normally v. chatty but of course clammed up when HV started to speak to her. So HV left her for a while but gave her the fab free satchel of books and crayons etc that you get at these checks. As the visit progressed HV then pulled out her little bag of toys for child to play with, identify etc. She did play with them but still refused to speak to HV so HV offered the answers to identifying the toys and child nodded, shook her head, laughed etc. HV said she could see child knew what was what and seemed v. happy. HV was v. polite, well turned out, organised, relaxed, easy to talk to and extremely professional. There were no concerns and I was pleased to have this confirmed by a professional person.

As the HV was getting ready to leave I said to my daughter 'shall we go to the park now?' and she asked 'is the lady coming to the park?' so at least the HV did get to hear her speak and my daughter wanted her to come and play with us so had obviously enjoyed the check too.

[Belle]

Wow Mrs TP that sounds like a v positive experience - but interesting as my HVs don't do home visits, or at least it's never been offered and I have never ever heard from mine directly apart from the first visit at 10 or so days old, when they dropped off the red book and a leaflet about PND, and some vitamin drops. I don't really understand the inconsistency of the service.

[Polly D]

Mrs TP: that's a lovely anecdote, and am impressed HV came to your house!

Intention in original post was not to knock HV's, tho along the way I've felt frustrated by some of them, but to consider the merits of the 2 yr check, possibly simply 'cos I knew/thought my son would not play ball. I remember sitting in the waiting room at hospital for 2yr check which never happened, thinking:'if only they could observe him from a distance', as he stuck stickers in a colouring book and made loud observations about other peole in waiting room.

When son was tiny I initially held on to every word the HV said. I met some amazing ones, and some truly frustrating ones but I learnt that like with most things: we hear what we want to hear and get annoyed when we don't.

[Saffron]

Belle Wrote:

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> I don't really

> understand the inconsistency of the service.

For me that is the real problem -- the inconsistency. I have no problem with HV as a profession, and one very nice HV did come to our home. Unfortunately, we saw three other rubbish HVs at two baby clinics. When you've been given wrong or incorrect advice, it knocks your confidence. So even if I wanted a professional opinion of someone to say that Little Saff is developmentally fine at 2 years old, how do I trust that the same place which gave me bad advice is the one I'll go to for a good assessment?

It's opinion masquerading as fact that really disturbs. And it's not just HVs that have this problem sometimes.

Are HVs a worthless service? No certainly not. But could their services be improved? In my experience, YES.

[budur]

Probably not very helpful but i have no faith in HVs and this is not because they are overloaded. One of them wrote "Olbas"(oil) and "Menthol" for me as an advice to use as I and the baby had a bad cold, both words spelled with mistakes. Another one weighteed well over 100 kg, how can she be called an HV? the third one when I asked how to get my child off thumb sucking said "I thumb sucked until 15 years old myself" and then talking to my daughter "Tasty, isn't it?" What sort of opinion am I supposed to have about HVs after encounters like that? thankfully my daughter was healthy so I just went for occasional weight check-up and once I was confident she was fine I stopped going. I then took my daughter to a private paediatrician, nothing wrong with her, but just to make sure that she was fine since under NHS she wasn't seen by a doctor except for 6 week check. Back where I'm from babies are seen by a variety of doctors regularly: neurologist, ophtalmologist, cardiologist, besides the paediatricians of course. I find it unbelievable that kids are only seen by nurses here, obviously due to constraints on the system but they simply don't have the necessary knowledge.

[minder]

It seems like things have changed since had my three children (first 18 years ago).

The HV seemed a natural and regular person to visit at the Health Clinic - I used to attend weigh-ins, etc. to reassure myself I was doing a good job in a way!

I knew and expected when the HV was due to turn up, 8 months, 2 years, pre-school etc. I received letters as well saying when they were due to come along.

I used to look forward to going to the clinic or for them to come to me - around 1999 they used to come to your home to make it better for baby/toddler/preschooler in own environment.

Still have their red books with details!