Frequently asked questions
The next time you’ll see your public health nurse (health visitor) will be when your baby is between 10 and 14 days old, when you’ll receive a home visit.
You’ll be able to talk about your birth experience and discuss how you’re coping now your baby is home. The public health nurse (health visitor) will also examine your new baby and update the Red Book (your baby’s personal child health record). The Red Book is full of useful information for you to keep, as well as somewhere for health professionals to record their notes when they see your baby.
Between six and eight weeks after the birth, you’ll need to make an appointment for you and your baby to see your GP, just to check you’re both doing well. You’ll also see your public health nurse around this time too, either in a clinic or at home. They’ll talk to you about your baby’s development and review how you feel feeding is going. They’ll also offer advice about immunisations and discuss with you how you’re feeling both physically and emotionally.
When your baby’s three or four months old, you’ll be contacted by the public health nursing (health visiting) team who will offer advice around baby’s development, starting solid foods, safety and play.
You’ll then be offered an appointment when your baby is between 10-12 months, again in a local clinic. The public health nurse (health visitor) will look at your baby’s development and talk through any issues or concerns you may have.
The next developmental check happens at some point between two years three months and two years six months and will be carried out by a member of the 0 to 19 Torbay team.
Your 0 to 19 Torbay team also offer local advice clinics, which your public health nurse will tell you about.
What if I need more help?
If you and your public health nurse (health visitor) feel that you need more support, you can talk about this together, either at one of the set appointments or by giving them a call. Even if you just need to discuss a concern or worry you have, they’re at the end of the phone so don’t be afraid to give them a call. Parenting doesn’t always go exactly to plan, and they will be happy to help. You’ll find their number at the front of the Red Book. You can email the team if you prefer.
This is not an emergency service, should you require urgent health advice in the meantime, please contact your GP, visit an NHS walk-in centre or call NHS 111. For emergencies, dial 999 or visit A&E.
Jaundice describes a yellow tinge to the skin and to the whites of the eyes.
It can be difficult to detect in some babies’ skin colours, but might be obvious if you look at their gums, the palms of their hands or the soles of their feet. Jaundice is not liver disease!
Babies are born with extra red blood cells, and in the process of getting rid of these, their bodies make a substance called bilirubin, which is then broken down by the liver. In the first few days of life, a baby’s liver isn’t yet working very efficiently, so the amount of bilirubin in the blood can build up, causing the skin to look a bit yellow.
As a baby grows, their liver starts working more effectively, so the jaundice fades away gradually. Frequency of feeding (2-3 hourly) can help speed up this process, but sometimes bilirubin makes babies sleepy, so you may need to wake your baby for feeds.
For some reason, breastfed babies are more likely to have jaundice for longer than formula-fed babies, but don’t let that put you off breastfeeding!
Your midwife or public health nurse (health visitor) might feel your baby needs help breaking down the bilirubin, and may arrange for your baby to go to hospital for phototherapy – a treatment which involves shining light on the baby’s skin. Don’t try and recreate this by exposing your baby to direct sunlight. It won’t work in the same way, and could lead to sunburn or overheating.
What do I need to look out for?
If your baby is less than 24 hours old and you suspect they have jaundice, seek immediate medical attention.
Check the colour of your baby’s wee and poo. Normal urine (wee) is colourless and not persistently darker than you would expect, and a couple of days after birth, your baby’s poo should be a yellow colour. If you think there may be a problem, talk to your midwife or public health nurse (health visitor) straightaway. This applies at any age, and whether there is jaundice present or not.
If your baby still has jaundice at two weeks old (or three weeks old if they were born before 37 weeks), your midwife or public health nurse (health visitor) will arrange for your baby to have a blood and urine (wee) test so more serious medical problems can be ruled out.
If at any time you think that the jaundice is getting more obvious, rather than fading away,then do not wait for your next midwife or public health nurse appointment, seek medical attention.
When your baby is about five days old, the midwife will offer you a screening test called the newborn blood spot screen (sometimes known as a heel prick test).
This is recommended as it screens for nine rare but serious health conditions:
Sickle cell disease (SCD)
A serious inherited blood disease which about 1 in 2,000 babies born in the UK suffer from.
Cystic fibrosis (CF)
1 in 2,500 babies born in the UK suffer from CF, which affects the lungs and digestive system.
Congenital hypothyroidism (CHT)
1 in 3,000 babies born in the UK suffer with (CHT), which means that they don’t have enough of the hormone thyroxine.
The blood spot screen also screens for six inherited metabolic diseases:
- Phenylketonuria (PKU)
- Medium-chain acyl-CoA dehydrogenase deficiency (MCADD)
- Maple syrup urine disease (MSUD)
- Isovaleric academia (IVA)
- Glutaric aciduria type 1 (GA1)
- Homocystinuria (pyridoxine unresponsive) HCU
These inherited conditions need to be identified and treated treated quickly as they can be life threatening or, if left untreated, can lead to severe developmental problems.
These conditions, once identified, can all be treated in a variety of ways. From medication to a carefully managed diet or physiotherapy, the treatment will be different in each case.
As parents, if either of you have a family history of a metabolic condition, it’s important to let a health professional know about this as early as possible.
How is the test done?
The midwife will take a small amount of your baby’s blood and put it onto a card which is sent to the laboratory for testing.
They will use a small device to prick your baby’s heel to get the blood. This is uncomfortable and can make your baby cry for a moment, so they may need a cuddle or a feed afterwards to reassure them.
The test is normally done in the first couple of days after birth, however occasionally this may be completed later than five days.
Sometimes the test may need to be repeated, but the midwife will explain to you if that is the case. A specialist blood spot public health nurse (health visitor) can do this if your baby is over 28 days old.
Babies can be screened for all of these conditions up to 12 months of age (except for cystic fibrosis (CF) which is up to eight weeks).
The newborn hearing screening test helps identify babies who have permanent hearing loss as early as possible.
This means parents can get the support and advice they need right from the start. More information can be found by clicking this link.