Children and Families Health visiting

Healthy Child Programme

Health Visitors lead the delivery of the Healthy Child Programme. This is a national programme consisting of a series of developmental and health reviews, screening tests, vaccinations, and information to support parents.

Below you will find information regarding the core / universal programme provided within the Healthy Child Programme.

Timeline of Universal Contacts

Antenatal

Once your midwife has told us that you are expecting your baby, you will be offered an appointment to meet your health visitor. This contact will provide you with information about our service and provide you with the opportunity to discuss your pregnancy, your feelings, your health, your baby’s health, development and wellbeing, and preparations for parenthood. This visit will enable us to get to know you and your family, and it is also a chance for you to ask any questions, and discuss any concerns or worries you may have.

New Birth Visit

The New Birth visit takes place between 14-28 days post-delivery normally after your midwife has handed your care over to your local health visiting team. The contact is performed by your named health visitor, and we will discuss your labour and birth, and your and your baby’s health and emotional wellbeing. We can support you with evidence based advice and information about caring for your new baby, infant feeding, safe sleep, crying, and any other health issues relating to your family. We work in partnership with parents and professionals to facilitate a smooth transition to parenthood.

 6-8 week contact

A health visitor will contact you to offer a 6-8 week review. The review will explore you and your baby’s health, development, emotional wellbeing, feeding, sleeping patterns, and any other concerns you may have. We will provide evidence-based information on safe sleep, home safety, and minor illnesses, and we will discuss your baby’s immunisations. Your baby’s growth will be assessed. Working in partnership with the family, the health visitor will agree future contact with the family which may be the universal programme, or universal plus, where extra support is given for issues such as perinatal mental health, feeding and for babies with additional or complex needs.

3-4 month review

When your baby is between 3-4 months of age, a member of our team will contact you to discuss your baby's health, development, feeding, sleep patterns and any other questions you might have. We will also discuss your family's health and wellbeing.

This review will also detail dental hygiene and weaning; the team member will communicate the Department of Health's recommendations for weaning, and when and how to introduce solid food whilst offering any help, guidance or advice required.

Babies are all individuals and grow and develop at their own pace.

7-9 month review

This visit may take place in the home or in a local clinic, and focuses on the assessment of your baby's development. It provides an opportunity to discuss how to respond to your baby's needs and to look at safety and health promotion messages linked to next stages of development. It also provides an opportunity to identify where additional support may be needed, including things such as the child's diet, dental health, sleep patterns and safety issues.

As part of the visit, a member of the health visiting team may weigh and measure your baby and discuss that all immunisations are up to date. 

The next scheduled visit is not until the child is 2½ years old, however parents can always contact their health visiting team or GP, if there are any questions or concerns about the child's development.

2½ year review

When your child is around 2½ years old, a member of our team will contact you. We will ask you to complete the Ages and Stages questionnaires about your child's development. This will enable you to think your childs development and progress. This review is integrated and we would gain consent before sending the results to your child's nursery, play group or child-minder. This is to ensure we work together to help your child grow and develop further. We will continue to monitor your childs growth.

School readiness review

A new school readiness contact service was introduced in January 2020 as part of our healthy child programme. This new service will ensure that children are ready for the school environment, and one of our team will contact you in advance to discuss your child's progress and development in preparation for school.

In this section, you will find information to support the transition to parenthood and the early days of having a baby.

The relationship with your baby starts before birth. Did you know babies can hear from around the 24^th week of pregnancy and may move around to music? During pregnancy, your baby’s brain is growing very quickly and you can help this growth by taking some time out to relax and talk to your baby. By being close to your baby you will start to understand your baby needs and start to recognise their signals to tell you they are hungry or wanting a cuddle. Responding to these signals will make your baby feel safe and secure whilst supporting their brain development.

Becoming a new parent can be wonderful, but it can also be challenging. If you would like some support with any aspect of parenting, please contact your local health visiting team.

Leaflets and Links

• Sepsis leaflet / Sepsis webpage
• Building a happy baby - A guide for parents
• Fatherhood Institute
• Domestic Violence leaflet 
• Caring for your baby at night

The Isle of Man Health Visiting team supports parents to make informed decisions about feeding and caring for their babies.

Our aim is to enable parents to breastfeed by providing support and information both before and after your baby is born.

www.gov.im/breastfeeding

Start4Life - Breastfeeding

Types of formula milk - NHS

Start4Life Guide to Bottle Feeding

First Steps Nutrition

Health and Wellbeing

There are many aspects to keeping your child healthy and promoting their wellbeing such as feeding, immunisations, sleep, dental hygiene, play and exercise to name a few.

Please find below brief descriptions and leaflets to aid keeping your child healthy.

Feeding

www.gov.im/breastfeeding

Vitamins

See the leaflets below. 

Immunisations

Vaccinations

Seasonal flu for children aged 2-3 years (new for 2020 – 2021)

Dental Hygiene

Evidence tells us that tooth brushing with fluoride toothpaste is one of the most effective ways of preventing dental decay. Gum disease can also be prevented by regular, thorough tooth brushing to remove plaque.

Top tips for tooth brushing:

• Start brushing your child’s teeth as soon as the first baby tooth appears

• Parents / carers should brush or help their child in brushing their teeth until the child is able to tie their own shoe laces

• Brush the teeth at least twice a day, last night at night before bed, and at least on one other occasion

• Brushing at bedtime ensures the fluoride continues to work whilst your child is asleep and when saliva flow decreases.

Ensure your child is registered with a dentist.

You can find the list of NHS Dental Practices on gov.im/dentists, where you will also find an indication as to which practices are currently accepting new NHS patients. In the event no practices are showing having NHS availability and you would like for your child to join one, please contact Dental@gov.im with your child’s name, date of birth, address, a contact email and telephone number, and you will be added to the allocation list held by Primary Care Services.

Also see www.gov.im/oralhealth.

Sleep

Sleep is important for children as it can directly impact their physical and mental development.

Top tips for sleep:

• Develop a regular daytime and bedtime schedule which works for your family

• Create a consistent and enjoyable bedtime routine;
  • Avoid watching television at least 1 hour before bedtime
  • The majority of children fall asleep within 45 minutes

• Establish a regular and sleep friendly environment;
  • Keep room calm, comfortable, cool and dark
  • The optimum temperature for safe sleep is between 16-20 degrees (see ‘Safe Sleep’ and Lullaby Trust webpage)

• Encourage children to fall asleep independently.

Toddlers require about 11-14 hours of sleep in a 24-hour period. When children reach about 18 months of age, their naptimes decrease. At the age of 2, children tend to nap once a day lasting 1-2 hours.

Safe Sleep

Safe sleep advice gives simple steps for how to reduce the risk of sudden infant death syndrome (SIDS) for your baby.

Always follow safer sleep for your baby:

• Always place them in their own space (and in parents’ room till 6 months)

• Put them on their BACK for every sleep

• In a CLEAR, FLAT SLEEP SPACE

• Keep them SMOKE FREE day and night.

Leaflets

• Potty and Toilet Training
  Sleep sheet
• Vitamins
• Ditch the Dummy
• IHV vitamins for children
• IHV looking after your children's teeth

Links

• ERIC
• Lullaby Trust
• In car safety
• Child car seats
• Crying and sleeping
• Cleaning children’s teeth
• Oral Health
• Sleep sheet
• Vitamins

Development

Your childs development is a continuous process which is unique to them, your health visiting team will:

• Support and empower you to help your child achieve their potential

• Monitor your child’s development to ensure support can be put in place for your child if they need support meeting their expected milestones.

From the moment your child is born, they are ready to interact with the world. Brain development is most rapid in preschool children, and 90% of brain development has happened by the age of 5.

The Healthy Child Programme is the basis of our service, and focuses on the health, wellbeing and development of your child. During your child’s reviews, your health visitor will ask you how your child is doing, and about any concerns you may have.

Please note: If your baby was born prematurely, their developmental age will be calculated from your original due date, not from the actual date they were born.

We will contact you to review your child’s health, wellbeing and development at the following key stages:

• 6-8 weeks
• 3-4 months
• 7-9 months
• 2.5 years
• School readiness

Developmental Concerns

As your child grows, they are learning new skills and developing socially and emotionally. Sometimes development can be slower than you expect (physically or emotionally), or you notice something different about your child or young person.

If you have any concerns regarding your child’s development, please, contact your local health visiting team to seek support.

Leaflets and Links

• Baby brain facts
• Tummy Time
• How to support development
• Best Beginnings
• Public health birth to 5 years
• Solihull Approach to Parenting

In this section you will find tips and information to promote healthy nutrition and weight in your child’s diet. These include tips on feeding your child, encouraging children to eat vegetables, among others.

Feeding 0-6 months

Please see our Infant Feeding page for information on feeding your baby.

Feeding 6+ months

The Department of Health recommends exclusively breastfeeding or artificially feeding your baby for the first 6 months of life.

Introducing your baby to solid foods, otherwise known as weaning, is recommended at 6 months of age.

By about 6 months of age, your baby is ready for solids if:

• they are able to sit up in a chair and hold their head up

• grab and hold food and put it in their mouth

and

• swallow food they have in their mouth rather than just spit it out.

Breastmilk (or infant formula) will still provide important energy and nutrients for your baby between 6 and 12 months, and the food you offer will be ‘complementary’ to this, and a great way to explore new flavours and textures.

The volume of food will increase, and it will be no time at all when your baby has moved onto three family meals a day.

By the age of 1 year, your toddler should be offered 3 meals and 2-3 healthy snacks, each day. Your toddler should also be commenced on full fat cow’s milk.

Here are our top tips for healthy, happier mealtimes:

• Children learn from you! – Let your children see you eat the food (including snacks) and drinks that you would like them to eat and drink.

• Eat family meals together, offering smaller amounts of the same food that you’re having, as long as this is not highly processed. Do not add salt or sugar.

• Don’t make your child eat everything on the plate. Let them decide how much food they want to eat.

• Don’t reward, treat or comfort your child with food. Use alternatives, such as story time or a visit to the park.

• Give a healthy range of colourful foods.

Weaning | Start4Life (www.nhs.uk)

Weaning Chart

Keeping Active

Young children love to be active and explore their surroundings. By the time children can walk, they should be physically active for about 3 hours a day. This should include a mixture of different activities.

Play is an important part of being active, both for your child and yourself. Play requires a lot of your babies’ brain and muscle power encouraging social, intellectual and language development in addition to problem-solving skills.

As parents and carers, playing with our children is great fun; it encourages bonding and attachment, and you can build healthy habits which can last a lifetime.

Keeping older children active can be challenging. Older children require at least 60 minutes of activity a day. This doesn’t have to happen all in one go, it can be broken up into chunks to fit in with life and routines.

It is important that three times a week, children and young people are taking part in activities that gets their heart beating faster, which is vital for a healthy heart and lungs, and to build fitness levels.

Leaflets

• Introducing Solid Foods
• British Dietetic Association Food Fact Sheet
• Portion Size Guidance

Links

• First Steps Nutrition
• Eat well booklet
• The Eatwell Guide
• Baby 1st solid foods
• Physical activity
  
• Infant & Toddler Forum

In this section you will find tips on a wide range of minor illness topics, as well as tips for reducing accidents and promoting safety.

Minor Illness

Every parent or carer wants to know what to do when a child is ill.

Most minor illnesses your child will have are part of growing up, and are often helped by talking to your midwife, health visitor or local pharmacist. Almost all babies, toddlers and children will get common childhood illnesses like chickenpox, colds, sore throats and earache. Some of these are easily treated at home with advice from your GP, pharmacist, or your health visitor rather than going to your surgery or A&E.

The Lullaby Trust has developed a free app called 'The baby check' which can help you decide if your baby needs to see a doctor.

It can be difficult to tell when a baby, toddler or child is seriously ill, but the main thing is to trust your instincts. You know better than anyone else what your child is usually like, so you’ll know when something is seriously wrong. If your child requires urgent attention, call 999.

What to do when your child is ill.

Leaflets

• Understanding Umbilical Granuloma

Accident Prevention

Annually in the UK, 40,000 under-fives are admitted to hospital following accidents, and lots of these accidents are preventable.

Annually in the Isle of Man, 3,500 children attend Emergency Department (ED) and Minor Injury and Illness Unit (MIU) with unintentional injuries.

The majority of accidents are preventable, therefore home safety and accident prevention will be discussed at each of your child’s universal contacts.

Leaflets

Little steps to accident prevent

Links

• Lullaby Trust
• In car safety
• Car seats

In this section, you will find tips to help and support the promotion of mental health and emotional wellbeing as new parents.

Pregnancy, birth, and parenthood is a life-changing experience, whether this is your first child or not. It can be overwhelming and cause a number of emotions. Our Health Visiting Service is here to support you through this journey.

By providing antenatal contact, this enables us to explore these feelings and assess how you are. We will regularly explore your emotional health and wellbeing, and within the 6-8 week review, a more in-depth assessment will be completed by your health visitor.

Having a baby is a huge life event and a time of change. It is normal to feel many different emotions during the transition to parenthood, for example, over half of all new mothers will experience what is known as the “baby blues”. The “baby blues” are due to the sudden hormonal and chemical changes that take place in your body after childbirth. This can affect many women, and should only last for a few days. However, for some women, these symptoms can be more severe and last longer, and could be postnatal depression.

Depression and anxiety are thought to affect 15-20% of women in the first year after childbirth.

Signs of postnatal depression may include:

• Feelings of being unable to cope, hopelessness and excessive anxiety

• Not being able to stop crying

• Panic attacks

• Concerns about bonding with your baby.

Fathers are important, and good mental health is important for fathers, their partners and their children. Close involvement of fathers from birth supports positive family/couple relationships, and fathers have an important role to play in child development. Men go through many complex changes when they become a father, which can make the perinatal period (from conception to one year after the birth of a baby) a particularly vulnerable time in a man’s life. The adjustment to these changes, and the challenge of balancing demands, including your home and work life, economic pressures, the emotional needs of you and your partner, and the unfamiliarity that can come with a new role, can affect your mental health.

Good mental health makes such a difference. It helps us to relax more, achieve more and enjoy our children and family more.

If you are experiencing perinatal mental illness such as prolonged baby blues, depression or anxiety, speak to your health visitor, midwife or GP for support.

Tips to support emotional wellbeing and mental health:

• Get as much rest, relaxation and regular sleep as possible

• Try to stop drinking alcohol altogether (you can ask your health visitor, midwife or GP for advice and support with this)

• Stop smoking – it’s a common belief that smoking helps you relax, but smoking actually increases anxiety and tension (ask your health visitor, midwife or GP about stop smoking services)

• Eat a healthy, balanced diet

• Take regular, gentle exercise

• Do not try to do everything at once. Make a list of things to do and set realistic goals

• Meditation or Mindfulness – either through a class or an app such as the “Headspace” app.

Leaflets

• Maternal Mental Health
• IHV understanding your mental health and emotional wellbeing during pregnancy and after the birth of your baby (Mothers)
• IHV understanding your mental health and emotional wellbeing during pregnancy and after the birth of your baby (Fathers)

Links

• Every Mind Matters
• Mental Health IOM
• Fatherhood Institute
• Ready Steady Mums

Health visitors can see children and families in one of many child health clinics at various locations around the Island. Within the clinic, issues such as general health matters, development, infant feeding, sleep routines etc. can be discussed, and routine developmental checks carried out. Appointments can be booked through the health visiting team by contacting your local clinic.

Safeguarding Children Team for Health Services

The safeguarding children team led by the designated nurse, provides expert advice and support on all aspects of safeguarding children; including children looked after by the Isle of Man Government, to frontline staff and their managers.

Safeguarding Children Team for Health Services

Telephone: +44 1624 656058

Privacy Notice

The Department of Health and Social Care is committed to protecting your privacy and will only process personal confidential data in accordance with Data Protection Act 2018, the Data Protection (Application of GDPR) Order 2018, the Common Law Duty of Confidentiality and the Human Rights Act 2001. For further details visit www.gov.im/dhsc-privacy.

Health Visiting Admin Office

Telephone: +44 1624 642650

Health visitors can be contacted at the following places:

Douglas
Palatine Health Centre: +44 1624 642378

South
Castletown Health Centre: +44 1624 686941

West
Peel Medical Centre: +44 1624 686972 / +44 1624 686973

North 
Ramsey Dalmeny House: +44 1624 811840 / +44 1624 811842