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Worcestershire Health and Care NHS Trust
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The Healthy Child Programme

Child Eating Melon Picture

Health Visitors offer services on four levels;

 Community

Health Visitors have a broad knowledge of your community needs and resources available through Children Centres and self-help groups and work to develop these and make sure you know about them. Health visitors can also assist you develop your own groups if you feel there is a need for it in your local area.

 Universal

Health Visitors and their teams lead and provide the Healthy Child Programme to ensure a healthy start for your children and families. They ensure that every new mother will have access to a health visitor and will receive good information about healthy start issues such as parenting and immunisations.

Each family will receive 5 key visits;

·         A visit when you are around 28 weeks pregnant, including fathers.

·         10-14 days following the birth of your baby.

·         When your baby is 6-8 weeks old.

·         A 9 month health and child development review.

·         A 27 month review of your child’s development.

• Universal Plus

Gives families a rapid response when specific expert help is needed.

For example: With issues such as Postnatal Depression, Weaning, Sleepless baby or answering any concerns about parenting

• Universal Partnership Plus

Health Visitors provide on-going support, playing a key role in bringing together relevant local services, to help families with continuing complex needs.

For example: On-going medical issues, Disabilities - early support, Mental health issues, Drug & alcohol related issues, Learning disabilities, School Readiness.

Local services include Children’s Centres, community services and where appropriate Local Authority Children’s Services. 

 

New Baby Review

A member of your Health Visiting team will visit you and your family at home, usually when your new baby is between 10 – 14 days.

This first visit gives you the chance to discuss any issues about the health and well being of yourself, your new baby and the rest of the family and is a chance to ask for any or information and to discuss any worries you have. 

During this visit your Health Visitors will observe your baby and take growth measurements, and will conduct a ‘Newborn Hearing Screen’ to test your baby’s hearing. You will also be offered parenting support and advice and will be given some guidance on managing your new baby in the early days.

Here are some of the things you may want to discuss with your Health Visitor at this visit:

  • Contacting your Health Visitor in the future
  • Child Health Clinics
  • Feeding
  • Advice on reducing the risks of Sudden Infant Death
  • Immunisations
  • Family Health
  • Registering the birth of your baby
  • Child Benefit / Healthy Start Vouchers
  • Home and Car Safety 

 

6 – 8 Week Review

This review is chance to talk to your Health Visitor about your baby, their health and general behaviour. It is also a chance to discuss any worries you may have, despite how minor you may feel they are! 

Your Health Visitor will also been keen to discuss with parents how they are feeling about becoming a new parent and will offer on-going support and advice if necessary.

During this visit your Health Visitor will also assess how baby is generally progressing and will offer the opportunity to provide further growth measurements to review your baby so far.

Here are some of the things you may want to talk about when you see your Health Visitor;

  • Do you feel yourself?
  • Is all going well with your baby?
  • Are you pleased with your baby’s weight gain?
  • Does your baby watch your face and follow with his/her eyes?
  • Does your baby turn towards the light?
  • Does your baby smile at you?
  • Do you think your baby can hear you?
  • Is your baby startled by loud noises?
  • Is your baby easy to look after?
  • Do you have any worries about your baby?

 

Please contact your Health Visitor at any timeif you are you are worried about your child’s health, growth or development.

At this age your doctor will invite you and your baby into the surgery, it is at this review your baby will receive a full physical examination with an emphasis on eyes, heart, hips and (testes for boys).

At 8 weeks your baby will also receive his/her first set of immunisations.

If at any time you should have any concerns or would like any further advice on immunisation, speak to your doctor, practice nurse, Health Visitor or pharmacist, or call the NHS helpline 111.

For more information visit:www.nhs.uk/vaccinations

 9 month Health and Development Review

Your baby is now 9 months old and is learning many new skills, such as:

  • Turning to his/her name
  • Now making lots of new sounds and babbling
  • Enjoying pat-a-cake games and toys that make noises like rattles
  • Almost walking alone but preferring to crawl at times
  • Picking up small things and exploring them so you need to keep him/her safe
  • Being more demanding and pointing to things
  • Holding a spoon and needing more practice to feed him/herself

 

During this time your Health Visitor will contact you and ask to book an appointment to conduct a development review. This will be an assessment of baby’s development progress by using the Ages and Stages or SOGS II assessment tools.

NHS Choices gives information about children are generally doing at this age. www.nhs.uk      

At this stage your Health Visitor will support and promote developmental activities that you and your child can get involved with, such as reading, accessing groups for songs, music play and interactive activities, and will offer information regarding local services and how to access them.

These activities can also be accessed via your local Children’s Centres www.worcestershire.gov.uk/childrenscentres

Your Health Visitor will also review your child’s growth measurements and will discuss any concerns you may have. Your Health Visitor will also assess and raise awareness of the physical signs suggestive of developmental dysplasia of the hip, www.rcph.ac.uk.

Your Health Visitor will also offer guidance on encouraging your child to be physically active for at least 180 minutes (3 hours), spread throughout the day.

Your child may now have their first tooth and guidance will be given regarding future dental care, and she/he will be preparing to have their next immunisations.                                          

Things you may wish to discuss with your Health Visitor at this review are:

  • Your child’s growth or weight
  • Vision or hearing
  • Sleeping and routines
  • Behaviour
  • Safety in the home www.capt.uk or www.rospa.com
  • Your child’s development
  • Returning back to work
  • Your health

 

 

27 months Health and Development Review

The Service you can expect from your Health Visitor at this visit includes;

  • Your Health Visitor will offer information regarding local services and resources and how to access these.
  • Assessment of baby’s development progress by routinely using the Ages and Stages or SOGS II assessment tools, focusing specifically on;
  • speech and language progress
  • social and emotional development
  • parenting
  • toilet training, if support is required,
  • Referral to specialist agencies if required

 


There are leaflets available that give useful information to parents about their children these are;

1.     Your speech and language development 2-4 years

2.     Talking Walk-In – Speech and Language Therapy early years service at your local Children’s Centre

3.     Temper Tantrums – tips for children aged 2-4 years

4.     Sleep – tips for children aged 2 to 4 years

5.     Stress - tips for children aged 2 to 4 years

6.     Why give your child choice? - tips for children aged 2 to 4 years

7.     Routines - tips for children aged 2 to 4 years


These leaflets can be found at any of your Children Centres or online at: 
www.worcestershire.gov.uk/childrenscentres

During this visit your Health visitor will:

  • Review your child’s weight and height.
  • Discuss issues important to the parents such as pre-school plans, what they enjoy doing with their child
  • Provide information for child and family on healthy eating and physical activity according to age;
  • Advise on minimising the amount of time spent being sedentary, restrained, or sitting for long periods of time (expect for sleeping)
  • Promote dental hygiene and discuss the use of toothpaste.
  • Promote immunisation programme and identification of any missed appointment
  • Advice to help parents think and understand individual infant’s temperament and the use of individualised strategies relating to healthy sleep practices, managing crying.
  • Promote hazards in the home and outside, and to encourage access to sites such as the Child Accident Prevention Trust www.capt.uk
  • To encourage smoke free environment by identifying those who smoke.
  • For more information please visit, www.nhs.uk/start4life or www.dh.gov.uk

 

 Other things you might want to talk about at this review with your Health Visitor are;

  • Speech and language
  • Learning
  • Diet
  • Behaviour
  • Safety
  • Your own health 

 

The Ages and Stages Assessment Tool

The Department of Health have asked Health Visitors to use the Ages and Stages Questionnaires (ASQ) with all families to routinely review a child’s development. The ASQ is a screening tool that asks about a child’s development in different areas. As a parent or carer you know your child best. That’s why ASQ questionnaires are designed to be filled in by you. This is an opportunity for you to tell us what your child can and cannot yet do.  Your answers will show your child's strengths and any areas in which your child may need more help or practice. The information you provide will be helpful to decide whether your child needs further assessment. You will need to play with your child, watch what they do and then spend 10 – 15 minutes completing the questionnaire. Here’s how it works:

1. Read each question

2. Try each activity with your child. Your child may be able to do some but not all of the items. 

3. Mark a response to each question: 

  • YES / Most of the time – If your child is doing the skill
  • Sometimes – If your child is doing the skill but doesn’t do it all the time
  • Not yet / rarely – If your child does not do the skill yet

 

 4. Have the questionnaire with you for your appointment with the Health Visiting team (please see appointment letter attached).

Tips!

  • Make completing this questionnaire into a game that is fun for you and your child!
  • Make sure your child is not tired or hungry and is ready to play before trying the activities.
  • The activities do not need to be completed on the same day.                                                      

 

Finally; Please remember to have your child’s “Red Book” as well as the completed questionnaire with you for your appointment with the Health Visiting team and we will look forward to discussing the questionnaire with you. By completing ASQ questionnaires and activities, you are making sure your child is off to the best possible start and this will give us a good understanding of your opinion as well as help you keep track of your child’s development.

We hope you have fun completing the activities with your child. However if you have any difficulty completing the questionnaire, please still keep the appointment with your Health Visiting team and we will complete the questionnaire with you.