Health visiting

You will meet your health visitor when your baby is around two weeks old. Often this is when you are discharged from your midwife’s care. The health visiting service will continue to work with you until your child is five years old.

Everyone in the health visiting team is highly trained and has specialist skills to help you and your family. Health visitors are registered nurses with a degree in public health nursing. In your team there may also be community staff nurses and nursery nurses who have specialist knowledge in child health and development.  The work of the health visiting team is based on evidence of what works for individuals, families and groups, and the community as a whole.

East London NHS Foundation Trust provides health visiting services for families in Newham and North East London NHS Foundation Trust (NELFT) provides services for families in Waltham Forest. More information can be found on their websites.

Read our health visiting information leaflet here. [pdf] 358KB

For patients

Your health visiting team will give you up-to-date information about many aspects of looking after babies and children like:

  • Breastfeeding, bottle feeding, weaning
  • Sleep
  • Behaviour
  • Meeting developmental milestones
  • Playing and communications
  • Getting out and about
  • Being active
  • Looking after teeth
  • Healthy eating for the family
  • Potty training
  • Preventing accidents
  • Stopping smoking
  • Being a parent

If you are worried about your child’s crying, weight, eating, walking, talking, sleep, behaviour, speech, development or anything else, your health visitor has the specialist knowledge to answer your questions. 

Tower Hamlets health visiting teams can help you whatever language you speak.

Information about where and when you can see your health visiting team and how to contact them by phone is in your child’s personal health record – the red book - along with details of local clinics. If you don’t know how to contact your health visitor, ask at your local GP surgery.

The information in this section has been broken down into five key areas. These can be found in the left navigation:

  • Play and communications
  • Feeding and growing 
  • Fit and active
  • Sleep 
  • Being a parent

Over the coming months we will provide you with more information through these web pages. You will find information about many of the common questions parents have about their children’s development and health with links to recommended evidence-based resources.

Feeding and growing

What babies and children eat, how much they eat and how fast they put on weight are among the issues that parents discuss most often with their health visiting team.

The health visiting team can provide up-to-date information and answer your questions relating to breastfeeding, bottle feeding, mixed feeding, introducing solid foods, moving on to healthy family meals and coping with fussy eaters.

The health visiting service in Tower Hamlets is accredited by the UNICEF Baby Friendly Initiative. This is an internationally-recognised award which recognises the quality of information and support given to parents about feeding and responding to their babies. The Tower Hamlets breastfeeding support team works alongside the health visiting service to support mothers and help them overcome any challenges with breastfeeding. A breastfeeding support worker may see you at home, at a breastfeeding drop-in session or in a child health clinic. You can call the team on 079 6160 9626.

If you are bottle feeding your baby, including if you are mixed feeding, the health visiting team will give you all the information you need to do so as safely as possible.

If you need more information about the Healthy Start scheme your health visitor can help. Your health visitor will also recommend vitamin supplements for your child to take from six weeks until four years old for you to take and will let you know how you can get these.

The team will provide great ideas when it comes to introducing solid foods to your baby at around six months. They will encourage you to give your baby healthy family foods rather than commercial baby foods and will answer any questions you might have about the process. In Tower Hamlets, there are groups and sessions where you can go to improve your cooking skills and learn more about preparing healthy meals for your family. Your health visiting team or local Children’s Centre will tell you what’s on offer in your area. Toyhouse offers an excellent Active Play and Healthy Eating course for families. For more information email Toyhouse at info@toyhouse.org.uk or call 020 7729 7399.

At developmental reviews and child health clinics  you will have an opportunity to have your baby or child weighed and to discuss their pattern of growth. The health visitor can suggest ways to help if their rate of weight gain is unhealthy.

In Tower Hamlets, a quarter of all children are overweight or obese by the time they start school around the age of five years. This figure rises to a third of all children by the time they leave primary school aged 10-11 years old. Being obese can cause all sorts of health problems; this is a reason why the health visiting team is there to help you keep your family healthy through eating well and keeping fit and healthy. If your child is overweight, your health visitor can refer him or her to local weight management services specially set up for young children.

Fit and active

Physical activity is important for children’s development. It helps children’s muscles to develop, aids their coordination and keeps them flexible, fit and healthy.

You can help your baby to be physically active from birth. Before your babies start to crawl, they can reach for things and grab them, kick their legs and move their heads, bodies, arms and legs. You can  help your baby  to be active if you spend some time together every day playing on the floor and allowing your baby to spend some of this time on their tummy.  Letting your baby crawl around the floor is important, once he or she has developed this skill. Allowing your baby to play with toys or household items that they can safely  pick up and move around will help improve their co-ordination and develop the muscles in their hands and arms. The NHS has put together a list of tips for making your home safe for children.

Children who can walk need to be physically active every day for at least 3 hours spread throughout the day. They can be active indoors as well as outside. On days when you find it difficult to get out of your home, how about playing on the floor, building a camp out of sheets or dancing? It’s important that children don’t spend a long time each day watching tv or playing computer games. Try to limit this time and  encourage your child to move around frequently. Your child doesn’t need fancy toys to enjoy physical play. Children have just as much fun with  a saucepans and a wooden spoons or big cardboard boxes as with expensive toys. Whenever you can, let your toddler walk, scoot or cycle instead of pushing him or her in a buggy. This might mean you need to set off a bit earlier for some journeys.

Tower Hamlets is full of lovely parks and open spaces. Children love to walk, run, jump and climb outdoors. Find out where you can take your children by visiting the Tower Hamlets Council website

Cold or wet weather shouldn’t stop you from going outside. In a coat, hat and outdoor shoes or wellington boots your child will be warm enough even when it’s raining or snowing. Babies are never too young to benefit from being outside. Just make sure they have warm clothes and blankets in a pram. If you carry your baby in a sling, they will be warm and cosy next to your body, wrapped inside your coat. Getting outside to walk or play usually helps babies and children to feel happier and to sleep better. It does adults good too.

Tower Hamlets Children’s Centres provide a great range of free indoor and outdoor play activities for children aged under five and their parents every week. Visit their website for timetables of weekly activities.

There are leisure centres all across Tower Hamlets [http://www.better.org.uk/leisure] which run all kinds of sports activities for children and families. You can take your baby swimming from a very young age. There’s no need to wait until they’ve been immunised. Look up details of swimming pools in your local area here.

If you would like more ideas about how to keep your baby or child active, talk to your health visitor.

Being a parent

Parenthood can be full of joy, but it isn’t always easy. Your health visiting team can support you when you are facing challenges – fathers, mothers and carers.

Sometimes the responsibility of looking after children can be overwhelming. If you are worrying about your child you might like to talk through your concerns with someone in your health visiting team as they have in-depth knowledge of child development. Attending Raising Happy Babies, a Tower Hamlets course, might help you if you have recently given birth to your first child. Ask your health visitor or children’s centre for details.

The health visiting team has the knowledge to answer many of the parenting questions you may have – about sleep, fussy eating and managing your child’s behaviour. Tower Hamlets Children’s Centres and other organisations run a huge range of groups and free courses for local families.  

Many parents in Tower Hamlets feel very isolated. Local parents may be living far away from their own families which can be frightening when they are learning to care for a new baby. Some local parents are surrounded by family, but have little contact with other new parents. This might be because they lack confidence in speaking English, or because they have caring responsibilities towards elderly relatives as well as their children and struggle to get out. Getting out and meeting other people can seem scary, but talking to other people who are  in a similar situation really does make everything a bit easier to cope with. Your health visiting team can help you by letting you know about local parents groups which you might like, and supporting you to find ways of getting to them.  See the links at the bottom of this page for ideas of things to do.

Your health visitor is also there to support you and your emotional wellbeing.  Many parents feel overwhelmed, down or stressed after or before the birth of a new baby, or when  caring for small children. If you are struggling with any of these issues you can talk to  your health visitor who can provide you with support and talk to you about what other free help is available.

We know that many parents experience emotional or physical abuse from a family member. If this is happening to you or you are worried about your own safety or your child’s safety for any reason, please speak to your health visitor or GP and they will help you get the help you need.

Sleep

If one thing is certain about life with babies and young children, it’s that their parents’ sleep will be disrupted at times. Sleep is one of the issues that parents discuss most often with their health visiting team. Everybody would like to get more sleep.

It’s common and normal for babies to wake frequently. Young babies need to feed at night as well as during the day, and night feeds are very important for mothers’ breast milk production. There are still things you can do to encourage good sleep. Some parents find that introducing a bedtime routine early helps their baby to settle for sleep and leads to good sleep habits later on. It can be useful to think about where your baby sleeps and how you can keep night feeds quiet and peaceful.  Your health visitor will discuss safe sleeping with you.

As babies and toddlers get older they often start to go for longer periods at night without asking to feed or calling out to a parent. This doesn’t always happen smoothly and some parents choose to try some form of sleep training to encourage their child to settle at bedtime and have a restful night. If you are struggling with your child’s sleep, it could be really helpful to discuss this with your health visiting team. Health visiting staff in Tower Hamlets are trained in a wide range of sleep training methods and will not encourage you to let your child “cry it out.”  You could complete a sleep diary for a week first so that you will have a clear picture of what is happening and the problems that you wish to address.

If you are worried about your own sleep, this is also something that your health visiting team can help you with.

Play and communications

Play is important for helping children to develop their communications skills. Even new babies need someone to look at them, smile at them, talk to them, sing and laugh with them and respond to the sounds they make. These are the building blocks for speech and communication.

For ideas about playing and talking with your baby or child, what language to use, making the most of television and sharing songs, rhymes and books, visit the National Literacy Trust website where you will find quick tips for parents.

Tower Hamlets Children’s Centres provide many play sessions which are great fun for parents and children and which help children’s development and learning. Baby massage and stay and play sessions help to build children’s communication skills as well as allowing you to meet up with other parents and children. Every weekday at every Idea Store and library in Tower Hamlets there is Story Time - rhymes, stories and fun for children under five, plus time to choose your favourite books. These are held Monday to Friday 10.30 - 11.15am.

Toyhouse run a number of interactive group sessions including fun with stories, baby massage and sensory play and rhyme time. For details contact info@toyhouse.org.uk or call 020 7729 7399.

There are many other activities for parents and children all around Tower Hamlets.  It can be hard to find the time to play with your child, especially when there are many other things you need to do. Children learn from everything that’s going on around them, so try to involve your child in whatever you’re doing, even the housework. 

Your health visiting team can help you to work out whether your child is developing the communications skills appropriate for their age and can recommend what to do to help if there is any delay.

Useful websites

The Communication Trust has produced four excellent films to help parents encourage their children's communication development. Narrated by comedian Kathy Burke, the films are full of useful advice on how parents can encourage their child to talk and interact with them. There are four films, divided into age group, for parents who have children up to the age of three. 

Talk To Your Baby has produced a series of quick tips for parents and practitioners to help children develop good talking and listening skills. Each sheet is available bilingually in thirteen languages.

For more information about speech and language therapy at the Trust contact Clare Round at clare.round@bartshealth.nhs.uk