session 2 - child health and surveillance

Question 1

formulate a list of important questions to ask a new mother at their postnatal check.

Answer 1

general wellbeing:
- “How have you been feeling overall since the birth?”
- “Are you managing to get enough rest or sleep when possible?”
- “Do you have enough support at home with the baby and your recovery?”

physical health:
- “How has your recovery been from the delivery? Do you have any pain or discomfort?”
(Specific for vaginal/cesarean delivery, e.g., perineal stitches, cesarean scar, etc.)
- “Are you experiencing any issues with passing urine or bowel movements?”
- “Do you have any vaginal bleeding or discharge, and is it what you expected?”
- “Have you noticed any breast issues, such as pain, lumps, or difficulties with breastfeeding?”
- “Are you up to date with your postnatal medications or supplements, such as iron or pain relief?”

emotional and mental health:
- “How are you feeling emotionally?”
- “Do you find yourself feeling low, overwhelmed, or tearful more than you’d expect?”
- “Have you been able to enjoy the things you usually do, or does everything feel like a struggle?”
- “Do you ever feel anxious, worried, or have trouble coping with the baby?”
- “Have you had any thoughts about harming yourself or feeling like you can’t go on?”

bonding and infant care:
- “How are you finding life with your new baby?”
- “Are you managing to feed your baby the way you intended (breastfeeding, formula, combination)?”
- “Do you feel you’re bonding well with the baby, or are you struggling with that?”
- “Do you have any concerns about the baby’s feeding, sleeping, or health?”

social support:
- “Do you have family or friends who are helping you with the baby?”
- “Are you able to take time for yourself or feel like your own needs are being met?”

sensitive enquiries:
Postnatal Depression:

• “Many women feel overwhelmed or sad after childbirth—have you felt this way at all?”
• “Do you feel supported emotionally by those around you?”
  Domestic Abuse:
• “Do you feel safe at home?”
• “Is anyone making you feel unsafe, controlled, or unsupported?”
• “Is there anything happening at home that you would like help with?”

contraception and sexual health:
- “Have you thought about contraception now that you’ve had your baby?”
- “Have you resumed sexual activity, and are you experiencing any discomfort or concerns?”

addressing practical needs:
- “Do you need help accessing any services, such as lactation support, childcare, or social services?”
- “Are there any concerns about finances, housing, or work that you’d like to discuss?”

Question 2

outline the benefits of breastfeeding in contrast to formula.

Answer 2

nutrition:
- contains all the nutrients a baby needs, supporting healthy weight gain
- breast milk changes to provide the correct nutrients over different periods to a developing baby

immune system:
- provides baby with antibodies
- contains bioactive components like growth factors and hormones

mothers health:
- lowers risk of postpartum depression
- lowers risk of breast, ovarian, endometrial and thyroid cancer
- reduces risk of developing osteoporosis
- produces oxytocin - uterine contraction after pregnancy
- burns calories to help lose weight after pregnancy

attachment:
- naturally soothes baby
- significant differences between mother-baby attachment of those breastfeeding compared to formular
- helps parent learn the infant ques

other:
- convenient
- affordable
- able to pump and store so others can feed baby
- produces no waste

Question 3

Outline the newborn and childhood health screening programme in the UK.

Answer 3

antenatal screening - before birth:

newborn screening - heel prick:

newborn hearing screening program:

newborn physical examiniation

childhood:
1. Infant Development and Health Checks (6-8 Weeks)

2. Vision Screening (4–5 Years)
3. Growth Monitoring
   Conducted at school entry (4–5 years) and during primary school years.
4. Immunisation Programme

Question 4

what members of the MDT are involved in infant and child health screening.

Answer 4

Midwives:
Perform NIPE and blood spot test.
Provide early postnatal support and educate parents.

Health Visitors:
Monitor growth, development, and perform routine health checks during home visits or clinics.
Play a key role in childhood immunisation and early intervention.

General Practitioners (GPs):
Perform 6–8-week postnatal check for both the baby and mother.
Assess concerns raised by parents or health visitors.

Paediatricians:
Involved in further evaluation if any anomalies are detected during screening.

Audiologists:
Conduct newborn hearing tests and follow-up diagnostic testing if required.

Specialist Nurses:
Support families with diagnosed conditions, such as metabolic disorders or cystic fibrosis.

School Nurses:
Conduct vision screening and growth monitoring during school years.

Dietitians:
Support nutritional needs if metabolic conditions or growth issues are detected.

Question 5

when plotting a child health on a growth chart, at what point should you become concerned?

Answer 5

• if it’s off the chart - doesn’t have a line correlating with it
• if the growth isn’t continuous and there are peaks