about HV reporting me to GP

[spectral]

I took DD to her 2-year development check last week. It was at 1pm, which I wasn't thrilled about as dd is normally asleep then and that's important work time for me, but I didn't have much faith in the possibility of rescheduling again, as we'd initially had a letter making an appointment for a date already in the past. I turned up on time with a completed copy of the development questionnaire and a very sleepy DD.

HV went through the questionnaire asking each question again, word-for-word. About five minutes in she said I seemed 'stressed' and asked why; I told her that DD really needed a sleep, that I really needed the time to work, and that I wasn't sure why I had bothered to fill out the questionnaire in advance if we were going to go through it again word-for-word. Appointment went a bit faster after that; I said that I would ask for help if I thought dd needed it, but that we had no concerns whatsoever about her development. HV agreed no concerns. DD didn't want to cooperate with being weighed and measured, but HV said she looked pretty 'in proportion' so it didn't really matter, and appointment ended by mutual agreement.

Six days later I get a phone call from DD's GP saying he's had an email from HV about me and is 'calling out of a duty of care to a child' -- so clearly not a friendly call just to check everything's ok. I told him about the conversation I had at HV appointment, explained again why I might have seemed stressed, but that that HV had not indicated to me that she might have grounds for passing anything on. I pressed him to say whether there was anything out of the ordinary going on, and he said no, and I decided to be honest with him and say that I was very unhappy (ok, I actually said furious) that HV had decided to report me to my daughter's GP.

I am utterly freaked out, though. I adore DD and do my best for her, as does DH, and I think we are doing ok. I did express a negative opinion about the way the appointment was organised, but I think that should be allowed! What on earth is going on?

And it's actually until children are 3 that this stress and anxiety can have an impact.

So, you were pissed off about the time of the appointment but didn't change it and the HV was supposed to know all about this? If I was the HV, and I'm being brutally honest here, I would think that was a bit odd too. It's not her fault you were annoyed, but you seem to want to blame her anyway, which in itself is a bit odd. Like the letter about the old appointment time...it's her fault you didn't rearrange a more suitable time. But can you see she would not have known anything about that until you told her?

And, why did you not expect her to go through the questions with you? That sounds like good practice to me, making sure there was nothing else you wanted to add.

I know this is not what you want to hear, but I think she had good reason to flag you up as you seem to have blamed her for something you should have rearranged and that was out of her control. And you didn't want to discuss anything with her as it was all too inconvenient.

You need to remember, she doesn't know you. She only sees you when you meet up regarding your daughter's welfare. If you look back on the appointment from her point of view, would you say your being defensive and didn't want to answer questions verbally about your child's health?

In which case, I think rather than seeing her as an interfering idiot, you might see her as a health care professional dealing with a parent who came into the appointment pissed off that she was there (remember, she did not know why until you told her) and then unwilling to talk through the questions.

Yanbu to be upset.
But the hv was nbu either. She was doing her job. She may have overstepped but when in doubt better to ask for another professional opinion instead of forget about it, specially regarding a child and his mother.

But it can hinder the developing brain? I wasn't very well when my children were young I've not heard before this can cause damage to their brains?

Oh just seen next post some parental stress etc can cause brain damage? Same as if they are being neglected or abused, where the pathways develop incorrectly?

Loads of parents are stressed though, loads are not very well, this is common. Do you have a link? I feel a bit sick

There is loads of evidence about it. Tons. Obviously all parents will experience stress and anxiety from time to time but who knows the OP may have been having a particularly shitty time of it and a conversation with the GP would inform her they are aware and she is getting the right help. Luckily it appeared to be an isolated event and OP is doing fine.

There is a big report called 1001 critical days by the wave trust. Also a report by Frank Field.
This is why health visitors do the EPDS and ask questions about maternal well being at the baby checks. Anyway of detecting and trying to intervene to reduce this impact is always useful and it doesn't end when they are small babies.

hag My HV was trying to give me leaflets for "Young Parent" support. I had to say in the end that I was v flattered that she thought I looked so youthful but it had been my 30th birthday the day before. (she was quite affronted and tried to accuse me of falsifying my DOB... nope, she just didn't read properly)

Anyway of detecting and trying to intervene to reduce this impact is always useful and it doesn't end when they are small babies.

Except, clearly, when it does. It's not a consistent service despite what some claim.

(As far as my HV is aware, I could have buried my son in the back garden ages ago. The neighbours can attest that I didn't; he's curently loudly chasing frogs. But we didn't opt out of the service; the HV opted out of us. The last time I saw any HV DS was still having feeding problems and I was overwrought about it.)

Brain damage? Loads of mothers have pnd and other mhps after birth, many are just generally stressed as are fathers. Loads of evidence this is linked to brain damage in the child? Same as where there is neglect or abuse I assume you mean the pathways in the brain develop incorrectly?

I don't know that parents are told this, are women with ante natal or pnd told this? I don't understand if the child is being cared for well and everything is being done as it should but still the presence of the illness in the parent damages the child?

Should women who have ante-natal problems with mh be given options in the light of this?

I can see both sides. I have been on the end of incompetence with the health service that made me look bad. Dd has regular paed check ups and I didn't receive the letter stating the time for the next one so phoned to check. it was on the system that 'the patient' had cancelled the appointment and so they were looking in to what to do next. As the patient was currently 16mo the implication was that I had cancelled the appointment, which doesn't look good for me. Luckily I phoned to check And the mistake was found.

On the other hand, hv's have been quite involved in mine and dd's lives because of my mental health history. I understand the need to keep an eye, and have cooperated with them even when it has felt intrusive. They have a duty to dd and every child in their area to make sure nothing is missed. They would not be doing their job otherwise.

I have found my hv to be A wonderful source of information and support, and feel they get an unnecessary amount of criticism on this site. It's. not an easy job, getting the balance right must be incredibly difficult sometimes.

Op I think if you feel aggrieved, there is no harm in a polite letter to say you did not find their actions to be particularly helpful, but I don't think it deserves the amount of stress it is causing you.

Similar happened to me when I moved (5 minutes away!) I had no contact from the hv it's only because he was due his check and I wanted the book start pack that I bought him to their attention.

We get a home visit after the birth and that's it. After that you can go to the clinic if you want (I wish I'd known that was optional). You get a 6 week check (I think?) at the doc. That's it really.

Sharon, we didn't even move! I got our books at the library....

to whoever regarded my earlier statement as stupid - I absolutely stand by it, sorry. where it's genuinely required absolutely 100% these services are brilliant. Where it is not required it's a waste of resources, unhelpful and removes attention from those who do require it. No brainer. I'm not saying that those who need the services would recognise that fact, but the departments themselves should stop wasting time chasing after those who are fine when so many who do need them are still not helped and supported adequately. I think it's quite grotesque. I also think this country's family courts are shocking and disturbing, I think many children are damaged by it, families are devastated and I don't have the patience to sit around pretending otherwise to appease someone for fear of the consequences.

Sharon, I sincerely hope that you are not EVER telling parents that parental stress and anxiety hinder brain development in that way.

This is absolutely untrue when stated as a reductive one liner like this.

What is true is that chronic, maladaptive parental stress and anxiety (where stress and anxiety either "don't fit the facts", are excessive, longstanding and/or related to mental illness) can impact upon children's learning experiences negatively, particularly where the parent experience increases coercive and or avoidant/ambivalent parenting practice.

Learning to ride a bike affects your brain development. It opens up neural pathways that wouldn't be open if you never learned to ride a bike. All experience affects brain development.

It is only significant for us as HCPs when there are indicators it is chronic or maladaptive.

I don't have an issue with you saying the HV, if concerned, needed to take action but for the love of God don't be telling women that if they're stressed or anxious that will negatively impact upon their baby's brains! Stress and anxiety are absolutely normal experiences in everyday life, and are heightened for many at this sensitive period of time.

Teaching parents to be afraid of their internal experiences, thoughts and feelings is a recipe for disaster: disengagement, shame and stress are likely to increase as a result of such an approach. What matters is what parents DO, not the basics of what they think are feel. There's also quite a lot of evidence on this!

By all means, those of you who are demonising the HV service, don't use it. It's not compulsory and frankly, the fewer people using it, the less it costs to provide.

I've had issues with a health visitor in the past. I spoke to another HV about it and I now get visits from her specifically and they take place in my home. Some HVs are more tactful than others, because they're only human.

The HV in this case agreed OP's DD was developing well but expressed concerns about her stress levels to the GP. This is her job. The GP called the OP and though his wording certainly left a lot to be desired, he did his job. The stress I'm picking up on in the OP and subsequent comments make me think that they had reason to be concerned about your stress levels...you do seem very stressed.

Whirlpool- the standard now should be to do antenatal visits. Mothers with a history of mental health are treated just like all other mothers but additional support may be offered as required such as perinatal mental health team infant massage sessions home start etc. We try to encourage responsive parenting and explain how this helps the brain development of the child even in utero. Talking to your baby, singing to them, responding to their kicks etc.
After birth health visitors are looking at bonding and attachment, how is mum responding to baby etc. Then if it's felt there is a problem it may be something that needs discussing with appropriate support agencies.

Whirlpool, can I reassure you absolutely that for the vast majority of children whose mothers have been women with AND and PND, there are no long-standing ill effects with attachment, development or long-term outcomes for the children. The risks are higher if the woman has untreated AND or PND, which means HV's do need to be aware of and sensitive to signs and symptoms of stress and anxiety in mothers but 1 in 7 women will have some sort of mood disturbance around the perinatal period and I promise you, their babies brains are not broken by the fact their mothers are human, and have experienced illness they never chose for themselves.

Duplo did I not say it CAN affect brain development and the hv has no idea if this stress is an ongoing thing so speaking to the gp to get the bigger picture was the right thing to do? Ffs talk about twisting my words and taking one line out of context !

If you have ante natal mh issues though surely it needs to be flagged doubly that this could have adverse implications re brain damage and the woman offered appropriate options.

I had antenatal depression and no-one told me this could cause my child brain damage and obviously if it continued after they were born, I think that should have been given as info with the option to women whether they want to proceed.

I don't think my children have brain damage but how would you know? I don't know what they would have been like had I not been ill.

cupid women are not told that it is optional and in some areas they are chased up and it is flagged if they dont' want the service etc. Round here no-one notices but the prevailing wisdom is that you have to go, so people struggle along even when they really don't feel up to it etc.

Sharon, it's a HUGE one liner. It's a one liner that is insanely triggering for women with current or past mental health histories, and I think you need to be very careful about how you use language in this regard.

You say I am twisting your words, but surely as a HV you know and understand the terror women with perinatal mh issues feel that their illness is impacting upon their baby, and have some sense of how damaging throwaway one liners about how it can affect brain development can be on their wellbeing and recovery?

And how about you check the way you speak to people with your 'I sincerely hope you're not telling parents..' guff!! Pompous much?

But it's this "Of course you being stressed and agitated is related to your DDs development- stress and anxiety has been known to hinder the developing brain " this has freaked me out.

Surely it's a lot of stress over a period of time, which impacts on the parent's relationship with the child and ability to care for it and stuff? Not just as an isolated thing? I mean, if you feel stressed but behave completely normally how does the mechanism work to damage the child?