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...

Thanks for your reassurance!

Is it normal for a HV to recommend stopping breastfeeding at 1 year as there is no evidence to support its efficacy?
And should they be recommending controlled crying and night weaning at 9 months old?

If I request another health visitor do I have to explain why and will they tell her? She is lovely but totally useless, she forgot two referrals for my ds and still hasn't done them when she was supposed to do it in April, forgot red book for dc2 and forgot to visit me. My first health visitor was lovely, efficient and competent but she left so I have been assigned a new one.

Just catching up on the rest of the posts!

Re: male HVs, we have a couple in our service but I've never actually worked with one. I certainly think talking to another woman can help some women open up, especially those from certain ethnic minority backgrounds who might feel uncomfortable discussing childbirth or domestic violence (for example) with a man.

Changing health visitor can be tricky and it really depends on the trust. They're not particularly keen on it where I work but I guess asking to raise a complaint with management would be a place to start.

Sorry DD2017, missed your post!

I would never tell anyone to stop breastfeeding unless they wanted to! The WHO guidelines actually recommend breastfeeding till age 2 anyway so the evidence & guidelines are there but obviously it's an individual choice and some people BF longer than that.

Sleep training is quite controversial and not something I advocate for young babies, but if families are really struggling I might recommend a "staggered soothing" or gradual withdrawal approach. Some children need a little help learning to self soothe and the impact of sleep deprivation can be huge on the entire family (again I've been there!). Nothing's black and white when it comes to parenting.

*Nuttynutjob
*
Yes child protection makes up a fair chunk of our workload. It can be very upsetting and difficult work, those families often have a lot of complex issues which in some cases are ingrained over time (substance misuse, mental health problems, domestic violence).

It's a shame that the preventative work that can stop families getting to crisis point has been cut by austerity in a lot of areas.

Thanking you

Loved this thread, thank you. I had good HV support on mine (now 21 and 20). I’m now a (apparently very mature) student nurse doing adult nursing and this has definitely made me think about HV once I’ve qualified. I will ask about a spoke placement tomorrow.

@OhTheRoses
You seem really bitter

Thanks Lolimax

It was my student nurse placement with health visiting that first got me interested in it! We have lots of student nurses (different branches) sometimes on long placements.

You sound a lot like my first HVs who used to say they don't come in people's houses to tell them off, but to see if there's anything they can help with.

Their office/ branch whatever where also the ones that actually did something about my PND when my GP was dragging his feet and got me extra help so very grateful to them

Did have a patronising arse show up once, but she wasn't actually unkind TBF and I only had to see her for 10 minutes or so .

If you knew a mother of a 2 & 4 yr old, quite isolated was taking non prescription opiate type med, and had deliberately OD'd, was suffering from ongoing depression & kept making 'panic' calls to family saying she couldn't look after the children, what would you do as a health visitor?
Just wondering as this recently happened in our family & the health visitor did nothing. Is that normal?

That would worry me a lot, Chocolate50. I'd certainly be concerned about the mother's ability to cope with the children and would probably explore my concerns with others involved (GP, other family members etc). If I wasn't satisfied that there was a protective factor in the immediate family (eg a partner or grandparent) who could safeguard the children, I would raise concerns with my safeguarding nurses in the first instance before escalating it further if that was thought necessary.

Are younger mothers judged more by the HV?
I felt very judged and looked down on by my first HV she insisted on visiting me regularly and talked to me like a child. When I moved the new HV came once and said I was doing a fantastic job and that there were no actual concerns and was unsure as to why I’d been visited so much.
Are some just more judgey or are there rules that younger parents must be visited more? (I was 19 when pregnant with DC1)

No there are no rules why a younger parent would be visited more and I'm sorry you felt patronised. In some areas there is a scheme for teenage parents called Family Nurse Partnership which is a very intensive (weekly) visiting programme but even then it's voluntary and based on the idea that those parents may need more support, be more isolated and not be as likely to ask for help.

I've just realised that my ds was supposed to have a year check up with a health visitor. He's 15 months now. We moved from London when he was 8 months. Registered with new GP etc. Do I need to do anything? Have we missed anything crucial?

Re weighing clinics, do you find some parents of healthy babies focus too much on getting them weighed regularly?

our local health visitor baby weighing clinics are PACKED and parents v frustrated by the long waits. But some parents of healthy babies who are feeding and growing well come every month for them to the weighed on schedule. Is this necessary? I think it creates quite a lot of anxiety for the mums.

How often do you pick up a significant growth problem when the mum has no concerns and has just attended for a 'routine' weight?

My local health visitors take quite a 'traditional' view of parenting e.g. what my mum might have recommended (although the HVs are younger). So importance of self-settling from a few months old, not using the breast for comfort "like a dummy", getting into a routine early on, sleep training, no co sleeping.

Is this something that is taught during health visitor training? Or are they using their own personal beliefs?

I know quite a few mums who felt they had to lie to their health visitor to avoid being given advice about things the mum didn't perceive as a problem.

Is there anything in HV training about respecting different parenting choices (as long as safe obviously) and identifying whether the parent perceives something as a problem in need of advice?

Thanks for answering my question about the nursery biter.

Can I ask another, please? How long do HVs continue home visits? My son has a couple of health problems and I struggled with PND, and both HVs I have had have been happy to do home visits quite frequently for quite a while - I think the last one I had was when DS was about 2 (this was with the second HV when we'd moved house to a new area, and I was concerned about DS's speech).

Fluffybat

When you move area your new health visiting team is supposed to contact you to inform you of clinics, community resources etc and some do a movement in visit depending on capacity. Sometimes it's not always communicated to us when families move into the area though! If you google the name of your area+health visitors you should get their contact details (or the GP should have them).

Unless you have any specific concerns you won't have missed anything vital, but if you need anything in the future it's good to be on their books.

HopelesslydevotedtoGu

Very interesting what you say about younger HVs following v traditional ways of parenting. Rather than being taught in university, I think these things are quite area-specific and I'm lucky to work somewhere which has instilled the importance of the attachment relationship, responsive parenting etc** in all its staff. Funnily enough as a parent I'm quite routine based as that works for me but unless the parenting choices are dangerous or the parent/child is unhappy, I would never judge anyone for their choices and certainly would never impose my ideas on families.

Having the "worried well" attending clinic is a big issue. Sometimes families will come every fortnight which is really unnecessary for well babies. We have moved to appointment only clinics in a lot of ours so the people that need it can access it rather than people just popping on the way to the shops which does happen! I agree that over-attendance at clinic is anxiety provoking for some families, I really encourage people to trust their own instincts but the pull of knowing the "pounds & ounces" is too great for some.

Geekyblinders

Regular home visits are usually offered at 10-14 days and 6-8 weeks postpartum. Home visits after this point are based on our assessment of the clients' needs. We would certainly continue to visit if postnatal depression or anxiety was identified for example.