So what is the point of Health Visitors?

[wonderstuff]

I've seen 3 so far, they all seem very nice, but really not very useful.

Today lovely lady came by, did PND questionnaire, weighed my baby. Talked about weaning - advised that some babies (especially boys) are ready for weaning at 4 months, to be aware of him taking interest in us eating couldn't give any advise about BLW as no reseach has been done and she doesn't want to get sued - fair enough, but seemed strange that on the weaning age she was willing to contradict research evidence. She also warned of 'missing weaning window at 6 months' I didn't ask what would happen - will I end up bfeeding forever, Little Britain style? Told me breastfeeding was tiring (there was me thinking it was the lack of sleep that was knackering but presumbably if I bottle fed I'd have much more energy?) She stayed for half an hour.

Really what is the point - could money be better spend on Midwifery or Social care?

Mine have been fabulous :)

Please do not kid yourselves all we do is weigh babies and carry out development checks.

That's true, we have a nursery nurse to do that at our clinic now I'm told, so somebody with an NVQ will be patronising new mothers instead of a qualified nurse
I'm sure you do work your socks off Jolly, but you can surely understand the publics perception when you read these experiences ?
So many HPC are coming across as nothing short of idiots, the HV who gave my son his immunisation could answer none of my questions and was determined she was the one he wanted to go to for comfort rather than his mother afterwards, told me he didn't want the breast feed he wanted to cry, honestly I came out thinking what a prat.

My HV was great.

Please don't bash them all.

I have mixed feelings about HVs. I have had good experiences with both of them when the DCs were small. My current HV has been really good with my PND, organised respite for us etc.

But we moved to this area a couple of years ago and the lack of interest in DS (then 2), despite me getting in contact, was truly shocking. Anything could've been going on in our house and nobody would have known. Then I found out that the HV for our current house, who came to see DD, didn't even have DS on her books - the records had never been transferred.

I was quite surprised to hear that babies here go from 4 months to 1 year without being seen at all. Isn't it the case that those who need help the most might be the least likely to ask for it?

I can't help feeling though that a great deal of what they do is a complete waste of time. The cringeworthy contraception chats, the 4 month weaning chat, the mediocre feeding advice. Some of the time they are preaching to the converted and the others will ignore them anyway. And don't get me started on Bookbug or the Childsmile programme. But for moral support on an individual they can be very good.

on an individual level

I've had three in 17 years, and they've all been wonderful women. All very different styles but oodles of calm and experience. The one time I had to put up with a not so good one was a very upsetting experience, considering my daughters' weight "issues" (not an issue for them as they were disgustingly healthy, but clearly too much for the not-so-good HV to compute). All the other three have had the breadth of experience to know a failing to thrive child from a small but healthy child.

They are first point of contact for signs of neglect, depression or abuse - and its important they see you / us early on in case there is a problem to report / help / solve...apart from the weighing and answering questions to do with feeding and sleeping etc. I would say its worth tolerating what you feel is a bit of a waste of time for 30 mins when it might save a baby's or a mother's life somewhere else down the line.

Mine is great. She has

• weighed the baby- yes, it's basic but her coming round means I dont have to haul him to the well baby clinic once a week/ fortnight.

• massaged the lumps out of my boobs

• been v supportive re bf (she's also a lactation consultant), watched me feed the baby and answered all my questions re timings of feeds/ demand vs wake and feed etc

• Helped me with expressing- advised re pumps as mine wasnt working for me

• Correctly diagnosed what I thought was wind as reflux and showed me how to tilt the mattress etc.

• Given me advice on treating cradlecap

• Reassured me that the fact my 5 wk old baby still sleeps pretty much all the time does not mean he's a bit slow

I think it's an important role for First time mums, however many books you've read.

Don't get me started on HVs! The various ones I saw completely missed my PND and PTSD for 15 months, didn't bother to contact me for months and gave crap, contradictory advice (any question I asked about my DD resulted in one of the following answers - all babies are different, that's just babies for you. you'll be fine/you're doing fine/you are fine).

I ended up complaining about the HV provision at my surgery on the advice of my GP.

I think the HV could potentially provide a very important and useful service but ime they need to be better trained and better informed

Jolly Pirate - if that's what you do, that's brilliant BUT don't you agree there needs to be some more honesty about the manner in which the service is delivered. My HV could not have done what you do. The only time I went to the dreadful clinic when I was commanded I had to wait in an unhygienic environment adjacent to the sick people needing the doctor. The HV had stains down her front, and she was a registered HV because later I checked, and when she weighed my baby I noticed the scales were registering a minus. She noted a weight 6oz less than when the HV had visited me the previous week without comment. She then got arsy when I said I wanted the scale to be reset, the baby weighed again and the record amended. This was 15 years ago admittedly. It was my last interraction with the HV service as a mother. This followed two visits from my allocated HV who was completely and utterly useless and unable to provide any help whatsoever with feeding or about immunisation although very happy to dictate what I would do.

Surely there is a need for a separation between the social work/child protection issues in which you are involved and the service provided to families who do not present such risks.

As far as checks go, I was left with so little faith in the HV service I refused to have them carried out by an HV. I refusted the service completely when dd was born.

It's very interesting that the HV's on here by and large are not supportive of the difficulties women have faced with the service provided. I really do believe that a full review is required urgently to ensure resources are directed towards those who need them most.

I agree that the normal families receive a shit service but that's because we are stretched to breaking point. I do not dismiss what women experience at the hands of some so called health professionals and I include many HVs in that too. Some of the "advice" I have read as posted here by people's HVs is truly shocking and when I see it I don't hesitate to say so. Complain complain complain because only then do we stand a chance of getting those people OUT.

FWIW I do tell families that after 6 weeks their only contact with me is likely to be in clinic but I also DO tell them that they can access me by phone and email if needed and I make a point of ensuring I return calls. I do my best with limited time and resources. I thank the powers that be every day for Children's Centres and Outreach Workers who do a bloody fantastic job of filling in the gaps and in some cases providing the support I would like to provide but do not have time for.

I am constantly amazed that there are not more threads like this one on MN because HVs are not providing the service they should be due to constant cutbacks. Plus of course there are some utter shite HVs out there - had one with DS who dismissed his lack of speech at 2 completely (he is ASD).

On a more positive note our PCT now employs a specialised agency (Little Angels) who provide brilliant breastfeeding support. A full time psychiatric nurse to support mental health issues as well as a very good nursery nurse (who does not do development checks as she feels unqualified to do them).
It's not brilliant but better than it was.

Locally talk is afoot which might well see us moved in with the local social services. Higher up talk is afoot which will see us removed from so called normal families completely and targeted at the most vulnerable. I am not happy about this as one of the reasons so called difficult families let me in is because there is no stigma attached to my presence.

..... and there are some truly lazy HVs out there too. I have worked with them - pristine little duchesses sitting at their computers going "bloody hell Jolly look at the state of your desk" . Needless to say they are always "busy" dispensing crap advice "if the crying irritates you could always put the baby in the garden for a while if the weather is nice" (No word of a lie that one folks). Er yeah because fresh air will really sort out a colicky baby

i have had the same health visitr with all 3dcs, i rally dont like her..
she is more interested in my sexlife then anything else...
there was one comment she made which i thought took the p@@s

after 1 of my caseareans she asked

"have you had sex with dh since the section" i was mortified but answeresd "yes"
she then asked "did you enjoy it ?" before i could answer she then said "did your dh enjoy, it, thats the main thing"

i was [shocked] and at this....

if she is reading this she will know who i mean

I think the problem with confining HVs to the 'needy' would lead to two problems. First of all, the crap ones would not get complained about and continue to distribute terrible advice. Secondly, HVs would rapidly start to forget what 'normal' families look like.

Sounds to me like there is something to be said for giving them lactation consultant type training and refreshing the whole provision.

I don't think the hv bashers have a clue what the role actually involves and the level of responsibilty they have- perhaps all those people who don't want them and thnk they are rubbish should advise their nhs trust acordingly and let the HVS/PHNS get on ith their work targeted at people who want their input and the vunerables who need it
Keep up the good work Jolly Pirate and others.

I think YABU. I'm sorry that so many of you have had less than brilliant experiences with your HVs, but to generalise to the whole profession is foolish.

All of our HVs have been fantastic, very helpful, knowledgeable, approachable and not at all judgemental. The first time we were visited, I offered her tea, she told me to stay sat down and went and made us both a cup. :)

More recently, DD had been poorly, I was trying to get her seen by our GP, but the scary receptionist wouldn't offer me an appointment before 2 and a half weeks(!) and told me that I couldn't stay for the walk-in clinic as "the wait would be too long for a little one" After arguing with the receptionist (ending with me stalking off muttering that the place was a joke ) I called our HV who got me seen elsewhere, and DD got diagnosed with a chest infection. So if you're reading this Karen in Southampton, thank you, we love you!

Lucy - no one disputes that there are fabulous HVs out there, but the fact is that many women have had somewhat less than fabulous ones. Our experiences are as valid as those who've had good, helpful HVs.

Reading the link earlier in the thread to AIMS, it appears that if you refuse the HV 'service' that acts as a 'red flag' and parents can find themselves referred to SS on the strength of this alone. This hardly reinforces the idea that this service is optional and might explain why people don't opt out and leave it to those that need it.

... and just OMFG at what thiswhatalove's HV has said to her. Weird weird weird.

MY first HV was brilliant, she called into see us regularly and was a mine of information and support. If we saw her in the street she always asked if we were ok and talked to the dc's
Our current HV is good enough. She is encouraging me to bf dc3(2) and dc4(2months) as she feels not enough people do in our area. She is great with feeding advice and easy to talk to which is a great plus. She does however keep pushing us on vaccinations, everytime saying it's my job to remind you. She knows our views and I wish she would respect them a bit more.
She is up to date on current trends like BLW so doesn't think i'm odd for not giving baby pureed foods.

I think HVs should have regular psychological testing to see if they are mentally OK themselves. They are visiting very vulnerable people, and are in a position of power over them, able to initiate child protection procedures, and certainly more than able to use that as a threat. Is there any mechanism to ensure that they are not suffering from a personality disorder or other mental illness themselves?

One HV told me to stop eating fibre to help DS's colic. He was no better, I had constipation.

Another wrote in the red book that I'd "failed to attend" a check up, even though the date stipulated in the letter was when I was on holiday, I had rung up straightaway to request an alternative date (never forthcoming) and then resorted to just going in to a weekly clinic.

I never waited less than an hour at a baby weighing clinic. Such a lack of respect for parents.

I would never bother with a HV again. I just go to see the GP if there are any problems.

So, do they actually visit? We got two visits when DS was 1 and 2 weeks old, and since then we go to the clinic but hardly ever see the same person. Of the ones we have seen, the one who came home was brilliant- but unfortunately never to be seen again. I wonder if she is the boss and therefore does not do clinics. Of the others, one is good and two indifferent.

From reading this it sounds like there should be a person to follow us- how does one find out who it is? And what do they actually do, other than weigh the baby and telling me off for having him weighed too often (once a month)?

Im 37 and a bit weeks pregnant and had a letter last week saying a HV would come round on a certain day and to phone if I had any queries. I rang to see why she wanted to come (thought it would be post birth, not before?) and if she wanted to see just me or DH as well. Not had any answer, does anyone else know?

In my area there's one great HV and one slightly bonkers but generally supportive one.

The big problem is the unqualified assistants who weigh babies and do other checks and spout all manner of crap without making it clear they aren't HVs. Ds was 10 months old before I found out two local 'HVs' weren't actually HVs at all!

I do think it's great that all new mothers and their babies get seen at home at least once, and if you don't want to let them in that should be OK but I can understand them checking to see if you and baby have seen a GP or clinic to confirm you are both OK.

Agree with JollyPirate, some of the advice that you have received from your HV's is shocking and like she said I have also worked with appalling HV's. Even when I was training as a HV I complained about a member of staff as she was advising all mums to wean their babies onto jars of food at 8 weeks old!!

However, there are some good ones, admittedly often overstretched which can make it seem difficult to access us at times. I do make sure that all my families are told that although we don't do the number of routine visits that used to happen we are always there and will return phone messages and make appointments if needed. I suspect for most of you you will just experience the "routine" aspect of our service rather than the support for families enduring domestic abuse, parents that need support when their children have been abused by paedophiles, terminally ill children and babies, court appearances to testify re child abuse cases, and supporting families so that they can remain out of the social services arena.