Declining the health visiting service

[Sleeplessem]

I’m 29 weeks pregnant with my second and I’m thinking about opting out or declining the HV service past the 6 week weight check. I’m happy to have the 1 year and 2 year development reviews, it’s just the weight clinics. Does anyone know if you can actually do this? My reason for not wanting to go, isn’t bashing health visitors as a whole (I know there are good and bad in every profession, although I do think in health care you can’t have ‘bad eggs’) but it is based on the abysmal advice and service I had with my first.
I think of my local area there are just one or 2 HVs that provide advice in line with NHS guidelines, the rest of what we’ve been told is utter nonsense and ultimately caused a lot of stress unnecessarily so I’d rather avoid if possible.

Reasons below:
My actually HV is ok, but incredibly lazy. Refused to help support breastfeeding and said I was only allowed 3 chances to get it right and then I had to move to formula (made no sense at the time either). She’s also given advice that directly contradicts the nhs, ie around water to babies under 6 months and snacks under 12 months.

My daughter was a low birth weight but classed as constitutionally small, birth notes explain this, but at every weight check we we berated about her size, until 6 months she tracked consistently between 2nd and 9th centile and then after 6 months between 9/25th. She’s stayed in this place til 2, it’s clearly where she is meant to be. We’ve been told she’s too small still but they refused to write referrals to a paediatrician for further investigation rather insisted she needed to be force fed. I was told social services would be called if I carried on breast feeding (under a year she was having solids too), that she’s too pale and that’s a sign her diet is lacking, (it’s not her blood work is fine which they had a recent print out for, they are also saying this as she mixed race as she doesn’t have a sickly complexion but she is fair). There are more comments such as these but these are the ones off the top of my head. Basically weight clinics were nightmare, always saw a different HV and this sort of issue was constantly brought up with an undertone of accusations of neglect and each of the issues they raised they refused to refer. We paid private so get her seen by a paediatrician who we now see 6 monthly on the nhs as hes aware of the issues the HVs raised , was disgusted and wanted his notes on her medical records, he also monitors her growth. We paid for a paediatric dietitian who evaluated her eating and said she’s fine and developmentally normal, both of these consultants were aghast at the comments made and how there was no clinical basis. It was attributed to not understanding child growth and poor breastfeeding training. We bought a proper calibrated baby scale during lockdown when weigh in clinics stopped so I will monitor dc2s weight gain. I’ve a great relationship with the infant feeding team and know they’ll support in the case of breastfeeding issues and likewise my daughters paed is fantastic so would pay private to go to him and he’d refer back to nhs.
In summary my reasons for not wanting the HV weight checks is just to avoid the headache. But equally I don’t want them calling social services as that would be a headache too.

Anyone else opted half out like I’m considering? Again I’m happy for the checks up to 6 weeks and then the 1 year and 2 year development check, but in the interim it’s been a complete 0 value add. Tbh even the development checks we do with the paed but I’m happy to do them with the Hv too xxx

Actually I 'd hVe liked an antenatal check - it would have given me the opportunity to weigh them up before I had a 10 day old baby and establish an idea of their potential competence.

@ChequerBoard my daughter was born way before the pandemic and we never had the ante natal appointment for her 🤷‍♀️

@CandyFIosss I think they are horrible to everyone. I felt very targeted for being white, middle, class and married. I am convinced they just like little digs and micro aggressions.

At the end of the day the hv service is, ime, a job creation scheme for nurses who don't want to get their hands dirty actually nursing or to work shifts.

I didn't go at all with my DS. I saw the HV for their general checks. Told her I wouldn't be going to weigh clinics unless I wanted to and had concerns. Having had 2 kids in a year I felt i was more than equipped to know my own children and was happy that if there was input and output then I was good with that!

I never got chased up but maybe I have that assertive tone that means people don't bother harassing me once I've said no thanks!

It's voluntary. You don't need to see one at all and they don't follow up if you decline.

Doctor once suggested a go to a weigh clinic but I thought it was unnecessary and didn't go. Didn't think they were mandatory.

@Realyorkshiretea

I’m not saying I don’t believe you OP, it just seems odd that so many health professionals in one go seems to be obsessing over a seeming non-issue (the odd one wouldn’t be surprising). The fact your daughter had a little jump after starting solids does sound like she wasn’t quite getting what she needed from bfing, but not super worrying either. Why did you feel bfing wasn’t going well & need advice?

Funny thing is @Realyorkshiretea my actual assigned HV was really nonchalant about her size. My belief (based on my experience and more educated professionals) is that all of these comments come from a fundamental misunderstanding about infant growth and especially in the case of SGA babies. It’s actually very dangerous for them to gain weight too quickly as they have a high likelihood for things like diabetes. My daughter had a horrible tongue tie that reattached so she was ‘catching up’ but when my milk production stabilised her weight stagnated. As I mentioned in my original post HV refused to help or refer, thankfully I had the means to pay for a private IBLBC and tongue tie practitioner to sort it. Hv had never heard of tongue tie, despite apparently being a midwife or a nurse. When we sorted this her weight gradually started to move up the centiles, but it wasn’t happening quickly enough for them.

@CornishGem1975 I understand it's voluntary. What I don't understand is why they withhold that information. I had to go all the way to the Trust CEO to establish that.

For the HV appointments that you do have, make sure they put any of their advice or threats in writing in your child's record book. It will focus their minds on what they are saying!!

[quote RosesAndHellebores]@ChequerBoard why were my expectations too high regarding the HV being 15 minutes late. The apt was at 9am and was not mutually agreed. It was also the first appointment of the day so absolutely no excuse of being delayed earlier. She was late for work and presumably her next appointments were all late too. It's a shocking culture.

I couldn't have got away with being late fir work and certainly never fir a client meeting.[/quote]

With health services there are usually lots more going on behind the scenes that just a list of appointments for the day. That HV would have been to the office before going to see you for your appointment, she could well have had a urgent call from another healthcare professional about a safeguarding issue or concerned parent to deal with before setting off to your appointment or whilst en route.

It's just not as simple as thinking the HV is late for work if she's not bang on time for your appointment.

@CandyFIosss

Yes some areas are funny, my area they call ss if you won’t see them at the 10 day check

Postcode seems important as ever.

While living in a very deprived neighbourhood I made the mistake of asking the MW if I needed to have the HV as it was my 3rd baby and my first 2 only saw the HV 2/3 times overall.
This was at my first meeting with the midwife, she told me I could opt out but I would get referred to SS as "there is no good reason for not putting your childs welfare and development first and SS would be right to be concerned that you may be hiding something, wouldn't you agree?"

Me and my neighbour had referrals too SS made for not answering the door (did not respond?) when the hv turned up unnannounced. We were at the park 5b mins up the road together!

I would say it really depends on where you live.

Yes that makes sense. At the time I was a single mother living in a very rough part of SE London. I was out then the HV called unannounced it’s not even like I knew she was coming!

That’s what worries me @lilmishap, the comments that have already been made to me about neglect and the fact I started to argue back a bit with them when they’re talking bollocks wonder if I’m on their ‘naughty list’ or so to speak lol

@CandyFIosss

Yes that makes sense. At the time I was a single mother living in a very rough part of SE London. I was out then the HV called unannounced it’s not even like I knew she was coming!

If you're living in a postcode area that's had a recent major safeguarding failure (remember poor Baby P and Victoria Climbie) they will be much hotter in ensuring mandatory checks are carried out.

Whilst I agree that some HV are annoying and can be condescending and outdated, the universal checks are there so that all babies and children are assessed and seen at set points by trained healthcare professionals. If that helps even 1 serious safeguarding issue to be identified then it's hard to argue against it.

@BertieBotts

Don't worry. Due to covid all health visitors seem to have vanished from the face of the planet

Yes! In my area the HV is meant to come to the house for visits however she calls to make the appointments and never actually turns up...

I tried to cancel our recent health visitor appointment (2 year review) as DD already had a paediatrician, speech and language, portage support worker and other things needed for her, so the appointment is redundant for us as the health visitor can't actually help us and dd doesn't like people she doesn't recognise in our home. I was threatened with social service involvement. So I told them they could show up, but I wouldn't be available as I had nothing to worry about with social services showing up at my home. I've heard nothing since, so assuming it was an idle threat but it's a joke honestly.
Also can't blame it on postcode, as we live in one of the nicest areas in our town.

That does seem odd OP, but I wouldn’t disengage from them completely as you might need them for something at some point, and you won’t want to dread making contact. Can you try and build a relationship with one you like? Maybe ask if they can visit you before the birth, form a bit of a rapport.

My Health Visitor was great for my first, but I really didn't need that level of support for my second. I just went along every few weeks for an occasional weigh in.

I found the Health Visiting team helpful and reassuring for all 3 of mine. Used them as much/little as I needed depending on issues with each child, aside from mandatory checkpoints. Maybe it is a postcode lottery.

I interact with Health Visitors at my work within joined up specialist children's services. Their main function within the community is to screen for and support children where safeguarding is an issue, and where any additional support/medical needs are indicated that may otherwise not be picked up by doctors or childcare staff. They hold massive caseloads, and in my experience do an amazing job in supporting families to access the right medical, educational, financial and housing support, including first point of contact for many refugee families. They have huge involvement with Child Protection services too.
I don't dispute any experiences of poor breastfeeding advice etc but I don't think that is where their main value lies. I have a lot of respect for them, it's not a job I would choose.

@peboh

I tried to cancel our recent health visitor appointment (2 year review) as DD already had a paediatrician, speech and language, portage support worker and other things needed for her, so the appointment is redundant for us as the health visitor can't actually help us and dd doesn't like people she doesn't recognise in our home. I was threatened with social service involvement. So I told them they could show up, but I wouldn't be available as I had nothing to worry about with social services showing up at my home. I've heard nothing since, so assuming it was an idle threat but it's a joke honestly. Also can't blame it on postcode, as we live in one of the nicest areas in our town.

So you had a child who was getting extra support/healthcare needs but you refused a hv home visit?

Yeeeaah where I lived with my Third, a refused home visit when your baby had support/health needs and other agencies involved would have DEFINITELY got you referred to and visited by SS.
But you weren't referred on.

But your experience does show how freely they throw that threat around to intimidate people with.

I mean where did they get this authority from? It's supposed to be a voluntary fucking service, but for a lot of us, it definitely is not.

I don't blame you, one of the most sensible things any parent can do is avoid health visitors. If you don't see one, you will not be receiving misinformation, anecdotes or having the wind put up you. Life will go on more smoothly.

Good luck to you.

@Realyorkshiretea

That does seem odd OP, but I wouldn’t disengage from them completely as you might need them for something at some point, and you won’t want to dread making contact. Can you try and build a relationship with one you like? Maybe ask if they can visit you before the birth, form a bit of a rapport.

Thing is there is literally nothing I will need from them. They’ve been useless with health queries so from now on I bypass them and go to the GP, developmental queries we know a fantastic paediatrician, feeding great relationships with feeding team and no referral needed and foodwise we know a wonderful paediatric dietitian. I’m aware of all developmental milestones and I’m happy to have the checks up to 6 weeks and even the 1 and 2 year but I’m not happy with the service as a whole, their attitudes and training were severely outdated and it was a bit of a bully boy service. So seeing as there is 0 value add, what’s the point, it’s a waste of time and anxiety provoking.

Well, you sound like your mind is made up, so I’m not sure if this thread is really needed. Health professionals really don’t have the time or energy to be needlessly pursuing concerns like this, so they must’ve been worried about something. Either way if you’re very confident you don’t need them, that’s a decision for you.

@MotherOfMonkeys0

I found the Health Visiting team helpful and reassuring for all 3 of mine. Used them as much/little as I needed depending on issues with each child, aside from mandatory checkpoints. Maybe it is a postcode lottery.

I interact with Health Visitors at my work within joined up specialist children's services. Their main function within the community is to screen for and support children where safeguarding is an issue, and where any additional support/medical needs are indicated that may otherwise not be picked up by doctors or childcare staff. They hold massive caseloads, and in my experience do an amazing job in supporting families to access the right medical, educational, financial and housing support, including first point of contact for many refugee families. They have huge involvement with Child Protection services too.
I don't dispute any experiences of poor breastfeeding advice etc but I don't think that is where their main value lies. I have a lot of respect for them, it's not a job I would choose.

Disagree on where their ‘main value lies’ the vast majority of mothers and babies won’t be circumstances with SS involvement, so thus the majority of their encounters will be to provide infant feeding guidance and introducing solids guidance and blimey if they can’t get that right when it’s the cornerstone of what they do. As I said in my area none of them turn up to infant feeding workshops despite having the bandwidth, one or two will of course be missed but at a certain point it’s a choice to stay under skilled.

Purely anecdotal but even in the case of child neglect and abuse they have failed in my area, specifically my names HV. I had a ‘friend’ (not anymore a friend) but she was letting her partner, the child’s father abuse the child who was under 3 potentially even sexually, I called the police after her beat them both up, they landed up staying with me. My HV was meant to be assigned to check on the child’s welfare, the mother got one phone call and the HV never turned up. Disgusting

The thread @Realyorkshiretea was about if it would actually be a massive headache to ‘opt out’ / decline / not go to weight checks as I have experienced first hand the social services threats.

They can’t have been concerned bottom line or they’d have written a referral to a paediatrician or paediatric dietitian rather than recommend force feeding. They also had no clinical basis to be concerned, their only issue was the fact I was breastfeeding so they couldn’t work out how much milk she was getting on a daily basis and the fact that she was small. It’s weird though how people who were more qualified and specialised in the areas they were so ‘concerned’ about had no concerns about my child just the advice being given by this HV team. So sorry but you’re wrong here.