Contact with health professionals
All parents caring for babies and young child at times need advice and support and even help with caring for their children. This can come from a variety of sources and will depend the way care is organised locally and on the particular problem or issue.
During pregnancy and soon after the baby is born the main contacts with health professionals outside hospital will be with the community midwife and family doctor or general practitioner (GP) with whom you are registered. You may see the same community midwife or one of a team and home visits will go on for approximately ten days after the birth, and sometimes up to four weeks, depending on your needs and those of your baby. Their care is mostly focused on women's physical health and wellbeing and recovery after childbirth and on the health, feeding and early growth of the baby. During that time you may be seen at home by your GP and at some point in the first six weeks after giving birth attend the surgery or practice for a post-natal examination.
At this time mothers and fathers, especially first time parents, often have lots of questions or minor worries about their baby. Many concern feeding, sleeping and crying, while others relate to spots and rashes and other minor conditions:Why does he cry so much?
The period around the time that a baby is born is an important one when parents and their GP can establish a good relationship. As healthy adults parents may have had little to do with the health care system, but with a small baby, feeling that you have got to know the family doctor is essential if you are to feel confident about any care that may be needed. What is important is to be able to share the kind of concerns just listed with health professionals who can provide the reassurance and clinical and practical advice you need.
Similar questions may arise as your baby grows, however, at the end of the first month another professional, the health visitor, usually linked with the GP practice, takes on responsibility for some aspects of care, especially those relating to your child's health and development. Health visitors see mothers and babies, and often whole families at home, but usually also run clinics based in practices or health centres which parents can attend with their babies. These are likely to be run at regular intervals, often on a weekly basis and are a good place to talk over your baby's growth and development. Typically there are regular checks on weight gain and discussion about introducing solid food, problems such as colic and teething, sleeping and the timing of immunisations.
While they have a particular responsibility for carrying out health checks on your baby, health visitors can also be sources of support and advice more broadly. For example, they can provide information about local mother and baby groups, play groups for pre-school children and child care, both in the form of nurseries and registered child-minders.
At this time parents usually make contact with GPs if their child is ill or if they have serious or persistent worries about their baby's health or development:
My child seems a little behind compared with other babies, is he child developing normally?
I am not sure she can hear properly, can this be checked accurately?
Why does she have repeated colds and ear infections?
I think my child has an allergy, what should I do?
Immunisations may be carried out by your GP or by another member of the practice staff such as a nurse practitioner at a regularly held clinic or sometimes by individual appointment. If you are uncertain about a prescription you may have been given for your baby, you can discuss this with the dispensing pharmacist who can also give advice about proprietary medicines.
More specialist help is available if needed and your GP may refer you and your child to a consultant community paediatrician, physiotherapist, speech therapist, ophthalmologist (vision specialist) or audiologist (hearing specialist), depending on the type of problem or concern. Babies who have been born preterm or who were sick in the newborn period will probably have hospital follow-up appointments for some time, often with more than one specialist, and they may be part of a long term follow-up programme.
Signs of serious illness, accidents or emergencies usually involve a visit to your local Hospital's Accident and Emergency Department, where children's nurses and other staff will be involved in your baby's care.
Babies and toddlers need to be examined in a variety of circumstances. Examining a newborn usually involves unwrapping, undressing and waking them up if they have been asleep. With early checks often the nappy is taken off too. Your baby might respond with startles, fussing and even crying, and, once fully undressed, is also likely to be make big and often uncontrolled movements with his arms and legs.
It is hard to feel organised, in control and comfortable lying on your back, naked, on a firm surface and with a stranger checking you out! So it is important to appreciate your baby's responses if you are to be able to make him feel better during and after such procedures.
Being placed on your back, with little or no clothes tends, as parents can empathise, to make a baby feel insecure. However, talking quietly, leaving your hand on their tummy or helping them to suck on their fingers can help calm them, though this may not always be possible. Putting your baby's clothes on again and having a cuddle or a feed is probably the most comforting response from a parent.
Examining an older baby or toddler is also likely to involve undressing. Typically a doctor or nurse will want to listen to your baby's chest with a stethoscope, check their ears with what seems like a cold instrument (an auroscope) and give immunisations. All these procedures involve strange and unfamiliar activities or painful surprises and can result in tears. This may be helped by distracting with toys or by the doctor or nurse demonstrating the procedure on 'Teddy' first. Cuddles, together with distraction are usually the best remedy with older babies. However, if you are a person who doesn't like doctors and is frightened, for example, of injections, it is important to try not to pass this on to your baby. Perhaps letting your partner or a grandparent help out could be a solution.