AP meets HV
Health Visitors get a lot of stick. They are seen as judgemental, interfering busy bodies. And let's face it, some of them are. From the stories that circulate you'd be forgiven for thinking that they are all vile creatures who spend their days sucking lemons and watching out for excuses to get their cronies in social services (another group who only ever get bad press) to come and destroy families. But there are also plenty who are supportive, helpful and encouraging. Positive stories aren't such good gossip-fodder, though. I'd like to redress the balance a little by sharing my experience at my ten month old daughter's development check.
I am not a mainstream mum. I don't think we're an especially radical family, but there are some things we do that traditional healthcare professionals have been known to frown at - breastfeeding despite difficulties and beyond six months, babywearing, co-sleeping and so on. Mostly we do these things because they feel right, but I also have evidence to back up the benefits of some of the bigger decisions - evidence that HCPs often seem to be unaware of.
Last week I took Susan for her first development check. These happen between 8 and 12 months old and Susan was right in the middle at 10 months and 1 day. The health visitor on the day was someone I'd never met before so I didn't know if she'd think me an ordinary mum or a whacky "Earth Mother" type. I decided to give her the benefit of the doubt and hoped she'd return the favour.
After brief introductions and pleasantries about the weather, she started going through the big list of questions they have to ask. Among the first was about milk feeds. She noted that the "breastfeeding" box had been ticked previously and asked if that had still been the case at 26 weeks - a standard thing to record for statistics. I replied that yes, I still breastfed Susan at that stage. I decided to test the waters. I told her I was still breastfeeding and waited for the raised eyebrow or thinly-veiled shock. There was none. Instead there was an instant and enthusiastic expression of approval.
Next she asked about weaning. How old was Susan when we started weaning her? Half expecting a lecture about waiting for six months (this is the official NHS guidance) I said that she'd been about five months when she started taking food from my plate. A simple nod of approval. She checked what kind of foods Susan ate, whether she seemed to have any issues with dairy (a common intolerance among young children) and whether the breastfeeding between meals was on demand. At no point did she ask about when or even if I was planning on weaning Susan off breastfeeding. The WHO guidelines say at least two years, but the ingrained culture of the NHS is to discourage feeding that long.
The question of sleep is a tricky one. If looked at in the wrong light, Susan's sleep pattern is very poor - she feeds at least three times most nights. I decided to be honest again, almost daring the health visitor to disapprove. Susan generally goes into her cot between 7 and 9pm, and then between 11pm and 1am she comes in with us for the rest of the night, feeding on and off until morning. She took all this in, nodded, and scribbled some notes. In Susan's Red Book, she has summarised the situation as "good sleep routine."
Part of the development check is a long list of questions about what you have seen your baby do. It's impossible to do an overall assessment of a child's abilities based on half an hour in their company, so this fills in some gaps and gives an overview of what they can and can't do. Susan scored well in all areas bar one. That one she lost points on handing us toys when we asked, simply because I couldn't recall asking. This meant she had to be recorded as a "no" on those questions, putting her score low enough to raise a minor concern. The standard procedure when a child falls into that category is to recall them in a few months to see if they can do it then. After a brief chat the health visitor was quite happy to sign Susan off as fine and with no worries. In other words, common sense won over protocol.
On every point she was supportive and positive. The whole conversation was peppered with compliments for Susan. I left the check feeling happy and reaffirmed in my parenting decisions. Not exactly a dragon, was she?
I am not a mainstream mum. I don't think we're an especially radical family, but there are some things we do that traditional healthcare professionals have been known to frown at - breastfeeding despite difficulties and beyond six months, babywearing, co-sleeping and so on. Mostly we do these things because they feel right, but I also have evidence to back up the benefits of some of the bigger decisions - evidence that HCPs often seem to be unaware of.
Last week I took Susan for her first development check. These happen between 8 and 12 months old and Susan was right in the middle at 10 months and 1 day. The health visitor on the day was someone I'd never met before so I didn't know if she'd think me an ordinary mum or a whacky "Earth Mother" type. I decided to give her the benefit of the doubt and hoped she'd return the favour.
After brief introductions and pleasantries about the weather, she started going through the big list of questions they have to ask. Among the first was about milk feeds. She noted that the "breastfeeding" box had been ticked previously and asked if that had still been the case at 26 weeks - a standard thing to record for statistics. I replied that yes, I still breastfed Susan at that stage. I decided to test the waters. I told her I was still breastfeeding and waited for the raised eyebrow or thinly-veiled shock. There was none. Instead there was an instant and enthusiastic expression of approval.
Next she asked about weaning. How old was Susan when we started weaning her? Half expecting a lecture about waiting for six months (this is the official NHS guidance) I said that she'd been about five months when she started taking food from my plate. A simple nod of approval. She checked what kind of foods Susan ate, whether she seemed to have any issues with dairy (a common intolerance among young children) and whether the breastfeeding between meals was on demand. At no point did she ask about when or even if I was planning on weaning Susan off breastfeeding. The WHO guidelines say at least two years, but the ingrained culture of the NHS is to discourage feeding that long.
The question of sleep is a tricky one. If looked at in the wrong light, Susan's sleep pattern is very poor - she feeds at least three times most nights. I decided to be honest again, almost daring the health visitor to disapprove. Susan generally goes into her cot between 7 and 9pm, and then between 11pm and 1am she comes in with us for the rest of the night, feeding on and off until morning. She took all this in, nodded, and scribbled some notes. In Susan's Red Book, she has summarised the situation as "good sleep routine."
Part of the development check is a long list of questions about what you have seen your baby do. It's impossible to do an overall assessment of a child's abilities based on half an hour in their company, so this fills in some gaps and gives an overview of what they can and can't do. Susan scored well in all areas bar one. That one she lost points on handing us toys when we asked, simply because I couldn't recall asking. This meant she had to be recorded as a "no" on those questions, putting her score low enough to raise a minor concern. The standard procedure when a child falls into that category is to recall them in a few months to see if they can do it then. After a brief chat the health visitor was quite happy to sign Susan off as fine and with no worries. In other words, common sense won over protocol.
On every point she was supportive and positive. The whole conversation was peppered with compliments for Susan. I left the check feeling happy and reaffirmed in my parenting decisions. Not exactly a dragon, was she?