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The challenges in child health


Health visitors are proving vital after lockdown


Picture of author Rachael Hearson.


Health visitors have been among the first to see the damage done behind closed doors during lockdown, Rachael Hearson writes

Post-lockdown is proving just as tricky as before it. What is a safe ‘bubble’? A support bubble? And what kind of ‘bubble’ encased the beach-goers jammed onto Bournemouth and Durdle Door over summer, chucking litter and worse around?

But social exchanges – whether it is fraternising with the postman, the fishmonger or the delivery bloke bearing Amazon parcels – are life-affirming and pivotal to our wellbeing and existence, whoever with and however fleeting. We all need to be reassured that ‘someone’ is out there with whom to chatter about the state of the nation or the obligatory ‘staycation’.

This is where we health visitors come in. How many of us were met with open arms, tears even, when we crossed the threshold in our weird masks or visors, gloves and aprons? ‘Come in, soooooo good to see you, take a seat, I’ve been wondering how much little Johnny weighed. Let’s do it, before Matt Hancock rushes out a daily policy shift, banishing you back to your offices, video-link and phones again.’

Our highly attuned antennae, informing us who to visit. A certain inflection or uncertainty in the voice at the other end of the phone, an inconsolable tot in the background, an email from a GP requesting a home visit as ‘there are possibly weight issues here’. Lordy, he wasn’t joking. Baby was, shockingly, underweight with ribs and hip bones jutting out.

But I have also discovered the polar opposite in terms of two pre-schoolers in as many weeks, who have both gained an inordinate amount of weight. Both are ‘off the charts’ in terms of centiles and by no small margin. No swimming or dancing or gymnastics or ball-pit. A surfeit of calories will do it (and I speak as one prone to the siren call of stress-busting chocolate, myself). Maybe quite a few of us were partial to a bit of extraneous’ ‘noshing’ as a result of the joyless tedium and isolation from friends and family during this period?

It’s hard to convey a consistent message even during ‘normal’ times as a health visitor. Raisins and dried apricots, anyone? Of course, we realise that they are also packed to the gunnels with sugar and will happily push the insulin around the cells with ruthless efficiency. We mention carrot sticks and hummus, avocados, maybe, brekky could be a full fat Greek yoghurt with fresh berries, supper might be protein packed, we earnestly suggest, say, a chicken breast, a salmon fillet, pile it high with veg. But then I hear myself add several £ to the weekly grocery bill and, inwardly, I groaned. Perhaps, I was being insensitive, especially if finances are tight? Mums are always well intentioned and motivated but money worries, accompanied by the paucity of group activities for their little ones, and having to work with no easy childcare options, make it all such a blooming battle.

Nursing in Practice also conducted a Q&A with Ms Hearson, who has written a memoir on health visiting and told us about being a health visitor during Covid-19.