‘Development checks by public health nurses should be continued for all babies’

Dr Anne-Marie Casey

(Psychologist at Children’s Hospital Ireland at Crumlin and member of the Special Interest Group in Perinatal and Infant Mental Health group of the Psychological Society of Ireland)

We know early relationships lay the foundation for later social and emotional development. British psychologist and psychiatrist John Bowlby, who was renowned for his work in child development and attachment, said that if a community values its children, it must cherish their parents.

The public health nurse community service is one way to support parents in supporting their children and I would like to see these home visits by public health nurses continued for all babies and not just for babies with proven medical risk or needs as has become the case in some parts of Ireland.

Public health nurses usually meet families during the first three days at home with their new baby to assess and provide advice for a range of issues including feeding, safe sleep, child safety and bonding. They provide support in “well baby clinics” linking new parents with local activities and parenting and toddler groups. They do developmental checks during the preschool years and identify any potential underlying condition, child protection concerns or developmental needs. They also support parents to be confident in their own parenting role and help any mother or father suffering from postnatal blues, anxiety or depression. Without these visits, new parents might not have adequate support in those early days and weeks to support their new relationship with their infant.

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Intervention

Developmental checks provided by public health nurses are a population-based service, designed to cast the net wide to identify the developmental needs of as many children as possible at the earliest point in time. The specific risks identified can include hearing, eyesight, medical, physical, communication, learning, social and emotional wellbeing concerns. This early identification paves the way for intervention to address and support the child and, if necessary, further detailed assessment to better understand the child’s developmental profile.

Across Ireland, public health nurse services have been a vital face of community health services. Covid interrupted this service with over half the infants born in Ireland missing a developmental health check during the pandemic when staff were redeployed to the vaccination programmes.

The proposed removal of routine developmental checks in certain areas of the country and the move towards a short-sighted decision of prioritisation system are hugely concerning. This retrograde step would inevitably lead to later identification of developmental delay, parental distress, undetected child protection concerns and consequent delayed access to further assessment, support and intervention.

It must not happen.

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