I'm a health visitor, AMA

[KittyMcAllister]

Just as it says really!

I know we're not exactly the most well liked group on here but happy to answer any of your questions...

[FromAtoBin21months]

Why does my 2 year old keep hitting/pinching/biting his 10 month old brother. Nothing works and it's so frustrating.

[Lmj25]

I'm pregnant with my 2nd and my 4 yr old has been really pushing the boundaries not listening etc is this because of the new baby on the way?

[motortroll]

I'm not a health visitor but I can tell you that's typical 4 year old behaviour and yes changes in the air definitely makes it worse!!

My question for the thread is: do you really think the questionnaire thingy for PND is actually useful and have you ever missed signs because of a low test score?

[Lmj25]

Thankyou @motortroll he's been a nightmare! At least I know it's normal now

[KittyMcAllister]

*FromAtobBin21months
*
Biting is a really common behaviour at age 2- often accompanied by other "boundary-pushing" behaviour. A firm, brief indication from you that this is not acceptable is what's needed and plenty of praise for good behaviour helps too. Consistency is the watchword in these matters!

[KittyMcAllister]

Agree with PP that that 4 year old behaviour is pretty typical!

As to PND, yes I would agree that screening does not always highlight when there are issues. Sometimes it may be because the mother is not ready to admit to these feelings, sometimes the screening can be a bit of a blunt tool. In my trust we also screen for postnatal anxiety which is I believe under-diagnosed.

[hodgeheg92]

Do you have to go upstairs and see where the baby is sleeping at night as part of the 6 week check? Or did my HV (rightly) not believe me when I said the baby slept in a crib and definitely not my bed (following co-sleeping guidelines)

[MorrisDancingViv]

What training do you have in relation to breastfeeding? There are so many threads on here which mention HV either shaming mothers for not breastfeeding or, alternatively, actively encouraging formula at the newborn stage at the slightest sign of discomfort?

[KittyMcAllister]

No we don't check where the baby sleeps! Unless you want to show us- some people do!

If we saw the baby in an unsafe sleeping position whilst we were on a visit- e.g. on a settee or with lots of potential hazards in a cot we would of course point this out.

[FromAtoBin21months]

Thanks kitty I’ll keep at it.

[Thissameearth]

Hi not a question but a thank you. I had my first baby last year and the HV were a big relief compared with midwives, both community and in hospital. Made appointments, had a bit of time to sit and chat (I couldn’t get anyone really to help with breastfeeding in hospital: Some were kind but just rushed off their feet and some seemed purposefully spiteful which I found hard to understand but didn’t say anything as just felt timid and not myself at that time. Community midwives we’re nicer but ran in and out and had no time). I found HV really encouraging, told me to call whenever, came out same day when breastfeeding issue resurfaced. A big part of it for me was simply moral support. One lady just said repeatedly to me you’re doing amazingly, baby looks fantastic and I’m actually welling up just now thinking about it as I was post-natal, blue, self doubting, in pain and worried about my baby’s weight with ebf and she just made me feel confident and relaxed. She even timed a visit for my husband’s first day back at work.

[KittyMcAllister]

Re: Breastfeeding

My trust is "baby friendly" WHO accredited so we have two days' training initially & attend yearly one day updates as well as regular auditing of practice etc.

We are taught to promote breastfeeding and to encourage women to do it as long as they want to- which means giving support through common issues that might arise and ensuring that their efforts to breastfeed are not undermined by unnecessary formula supplementation. Often I find that this can be undermined by midwives before we visit the family (which is usually around 10 days post partum).

[hodgeheg92]

Haha, clearly I just gave a bad impression then as my HV came upstairs .

How much is the monthly weighing of babies about the weight compared to seeing the baby naked/with mum?

[Pumkinfailure]

Do you advocate controlled crying?

[KittyMcAllister]

Aww thanks thissameearth! That's really lovely to hear.

Empathy and listening skills are hugely important in my job and when we are able to have such a positive impact on people's experience of having a baby, it gives us great job satisfaction

[dinosaurkisses]

What kind of schedule do you work off for visits? Is it different for every family?

I've seen posts on MN about people seeing their HV every month or so- DD is 9 months and I've had to chase my HV to arrange our red book appointments never mind any extras!

[ThisMustBeMyDream]

Hodgeheg, it is done in some areas. I'm a midwife and we do a safer sleep assessment on our first postnatal home visit. We check both upstairs and downstairs sleeping arrangements and advice on any potential risks we see.

[ThisMustBeMyDream]

^advise

[KittyMcAllister]

*Hodgeheg92
*
Where I work we encourage parents to follow their own instincts re: weighing. If there are no health problems, monthly is fine for the first 6 months but if someone chose not to come to clinic as they are happy their baby's growing/developing normally that's fine as well. It's not really seen as a surveillance tool unless we have very specific concerns.

[Summersun111]

I really wish I became a health visitor =( regret my career choice! Looked in to it but you have to become a nurse before hand and I don't have the time or money to go back to university =(

So questions....

What is the highlight of your job?

What is the worst element of your job?

Have you ever been under threat or danger during any of your visits?

[KittyMcAllister]

*Pumkinfailure
*
No we don't really advocate controlled crying. It can be quite detrimental especially to small babies. With older ones we might suggest a "graduated withdrawal" but it has to be something the family is happy to do.

Dinosaurkisses

The nationally mandated HV contacts are home visits at antenatal, birth (10-14 days) and 6-8 weeks. Development reviews at 8-12 months and 2.5 years are usually done by nursery nurses in a clinic or children's centre.

We may visit monthly if the family requires more support eg for postnatal depression but I would be surprised if any areas have the staff to do this routinely for every family. We also support families with safeguarding concerns which takes up a considerable amount of our time in terms of meetings, report writing and extra support that those families need.

[Pumkinfailure]

I’m so so pleased you don’t advocate controlled crying. I like you a lot! I’ve heard so many HV tell mums (often young mums who can’t stand up for themselves) to do it! My friend was given written instructions!!

[KittyMcAllister]

*Summersun11
*
It sounds corny but I feel really privileged being present at the start of a family's journey to becoming a family and seeing them blossom into confident parents. Also knowing you've created a valuable therapeutic relationship with a family.

The worst aspect is the lack of outside agencies to which we can refer families for support - these are ever-shrinking or there are huge waiting lists or criteria which prevent families from getting the help they need until they are at crisis point.

I have never personally felt in danger but I do know of a colleague who was "kidnapped" by an irate parent! She got out ok as her OH is police but it was very scary. Another has had death threats and needed to get a restraining order!

[KittyMcAllister]

@pumkinfailure

Aw no, that's sad to hear
I try never to tell people to do things, it has to be a collaborative approach and often the parents have the solution, it's just giving them the confidence to implement it. Although sometimes people do ask you to be more directive!

[OhTheRoses]

The thread's been done.

Perhaps some of us were confident in our parenting to begin with and didn't need a patronising nurse to watch us blossom. Rather to be cpurtepus, respectful and provide accurate evidenced based research to back up her mantras
You know if she was responsible for my dc's immunisation (which in the absence of a court order she clearly wasn't) being able to answer quesrions that might have been posed by a mother with more intellectual thoughts than painting her toenails.

Having the basic courtesy to actually make the first appointment with me ratjer than tipping up on the step at 9.15 after I received a letter telling me she was coming at 9.

HV's are obliged to offer a service. Families are not obliged to accept it.

Blossomong under your care my backside. Mg DH and I were professionally qualifoed professionals. We didn't need to blossom under the oversight of a nurse. If we needed advice we apught it from a doctor, referral to paediatrician if required. Sadly because the HV couldn't answer anything not printed in a leaflet designedbfor the lowest common denominator.

My first ever . And DFOD. The arrogance beggars belief!

My DC are 20 and 23. I saw an HV twoce and then discovered I could refuse because they had nothing of intellectual merit to bring to the party