I am a Health Visitor

This episode links really well with our previous episodes about combination feeding and giving top ups (linked in resources section below). In this episode Jen shares all her IBCLC wisdom with us on expressing breastmilk. How much do you know about flanges?! We talk about: - when to express - the emotional and physical load of pumping - how to pump - 'hands on' expressing - does the flange fit - how much milk to expect Resources and Further Reading: Our previous episode on Combination Feeding with Lucy Ruddle (IBCLC and author of 'Mixed Up'): https://soundcloud.com/iamahealthvisitor/combination-feeding-with-lucy-ruddle-ibclc?utm_source=clipboard&utm_medium=text&utm_campaign=social_sharing Our previous episode on Top Ups: https://soundcloud.com/iamahealthvisitor/top-ups-when-what-how-and-how-much-to-give?utm_source=clipboard&utm_medium=text&utm_campaign=social_sharing Breastfeeding twins and triplets charity (Kathryn Stagg IBCLC): https://breastfeedingtwinsandtriplets.co.uk Hand Expressing Video: https://globalhealthmedia.org/videos/how-to-express-breastmilk/ Hands Free Pumping Bra Hack: https://www.youtube.com/watch?v=8stY-2fxt4M Flange Sizing: (see our instagram account 'IamaHV' for a visual) Hands On Expressing: http://www.nancymohrbacher.com/articles/2012/6/27/to-pump-more-milk-use-hands-on-pumping.html Some social media pages to follow and recommend for free resources: Olivia - Hospital Lactation Consultant https://www.instagram.com/olivia_lactation_consultant/?hl=en Stacey Zimmel at Feed Eat Speak: https://www.instagram.com/feedeatspeak/ Kathryn Stagg IBCLC https://www.instagram.com/kathrynstaggibclc/

Jen and Amy delve into the murky world of infant poo in the first six months! What to expect, what is a worry and what isn't. How is poo different between formula and breast or chestfed babies? Or mixed fed babies? What does that green poo mean? What about giving a bit of fruit juice or water for constipation? We answer all your questions and as usual it turns out to be more complicated than we imagined! Thanks to a listener for this request! Do get in touch with any questions, comments or suggestions for future episodes on iamahealthvisitor@gmail.com Thanks for listening! Amy and Jen Resources The baby poo gallery: https://www.facebook.com/babypoogallery/ Philippa Pearson-Glaze IBCLC on green poo: https://breastfeeding.support/why-is-my-babys-poop-green/ Drugs in Breastmilk Advice: https://www.breastfeedingnetwork.org.uk/detailed-information/drugs-in-breastmilk/ Child Liver Disease on pale stools: https://www.childliverdisease.org/wp-content/uploads/2018/01/Yellow-Alert-Stool-Chart-Bookmark.pdf Frequency of stool slowing - Carol Smythe IBCLC: https://www.carolsmyth.co.uk/breastfeeding-resources/posts/2016/december/should-my-breastfed-baby-poo-every-day-or-is-breast-milk-all-used-up/ First Steps Nutrition: https://www.firststepsnutrition.org Our previous episode on the Aptamil formula changes: https://soundcloud.com/iamahealthvisitor/those-aptamil-formulation-changes GP Infant Feeding Network on constipation: https://gpifn.org.uk/constipation/

Amy and Jen take a dive into a recent research paper suggesting there may be a newly identified biomarker for infants at high risk of SIDS. We look at the recent paper in detail, review the statistics and the methodology and consider what we are able to say and what we are not, as well as possible harms that might come from misinterpretation of the results. We also discuss the article in the context of the current theoretical approaches to SIDS research and general safe sleep advice which importantly still needs to be followed. We love to hear from you. Contact us with suggestions or ideas for future episodes at iamahealthvisitor@gmail.com. Thanks for listening, Amy and Jen References and Resources for further reading: Harrington, Hafid & Waters 2022 - the full text article: https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(22)00222-5/fulltext Media coverage: 1. https://www.biospace.com/article/researchers-answer-how-and-why-infants-die-from-sids/?utm_content=207502735&utm_medium=social&utm_source=facebook&hss_channel=fbp-10530620221 2. https://www.theverge.com/2022/5/13/23071364/sids-research-hype-science-studies for context - there is so much about SIDS deaths we still do not understand: https://www.nejm.org/doi/full/10.1056/NEJMp2119221 Critical analysis of the media hype: https://www.theatlantic.com/health/archive/2022/05/sudden-infant-death-syndrome-cause-study/629886/ Lullaby trust statement about this article: https://www.lullabytrust.org.uk/our-response-to-new-australian-sids-biomarker-study/

Amy and Jen chat to the inspiring Alison Spiro who has a PhD in anthropology as well as practicing as a health visitor. Listing all her achievements is a podcast summary in itself, but across her career she has worked as a breastfeeding counsellor herself, established an incredibly successful peer support service, taken both a hospital and community trust to BabyFriendly accreditation, worked on the world breastfeeding trends initiative report in 2015, contributes to the APPG on infant feeding on behalf of BestBeginnings, volunteers with the Breastfeeding Alliance, has been the iHV expert advisor on breastfeeding. Most recently, she is the author of 'Breastfeeding for Public Health: A resource for community healthcare professionals'. We discuss with Alison some of the most important issues in breastfeeding support - from culture and anthropology to emotions, wellbeing, mental health and therapeutic communication skills. We talk about the importance of debriefing your own infant feeding experiences and bringing an unbiased listening ear to your interactions with families. Hopefully this will be an interesting and relevant discussion for your health visiting practice. We would love to her your thoughts and comments at iamahealthvisitor@gmail.com Reading & Resources: Alison's new book - 'Breastfeeding for Public Health: A resource for community healthcare professionals': https://www.amazon.co.uk/Breastfeeding-Public-Health-Healthcare-Professionals/dp/0367689561/ref=sr_1_2?crid=3M4VF06U18GP7&keywords=breastfeeding+for+public+health&qid=1652711900&sprefix=breastfeeding+for+p%2Caps%2C71&sr=8-2 World Breastfeeding Trends Report: https://www.worldbreastfeedingtrends.org/resources/publications Becoming Breastfeeding Friendly with Yale University: https://ysph.yale.edu/bfci/ Kathryn Stagg IBCLC: https://kathrynstaggibclc.com Eve Canavan lived experience story: https://www.app-network.org/news-events/news/personal-experiences/story-eves/

This week Jen talks to Maria Renshaw who runs a local sling library in Colchester about her experience of slings and all things baby-wearing from a very practical perspective. She goes through different types of baby wearing from soft wrap slings to buckle carriers with some tips on the differences, fitting, safety tips including the TICKs acronym, common worries about hips and knees, how to find your local services for sharing with parents. Thanks so much Maria for sharing your experience and knowledge with us! As ever we love to hear from you, contact us with your comments or feedback on iamahealthvisitor@gmail.com Amy and Jen References and Resources: Maria's website: https://www.beautiful-bonds.co.uk/meet-the-team The TICKS rules for safe baby wearing: http://babyslingsafety.co.uk Sling Pages (to find a local sling library): http://www.slingpages.co.uk 'Why Babywearing Matters' by Rosie Knowles https://www.amazon.co.uk/Why-Babywearing-Matters-Pinter-Martin/dp/1780665350 Babywearing training and resources: https://www.carryingmatters.co.uk/training/

Amy and Jenny chat to the lovely Alice from the Baby and Infant Sleep Information Source (BASIS) about sleep pods and nests. We cover the evidence base - what can we and can't we say about these products. Are they safe or not? In what circumstances? How do we actually know one way or the other? We talk about what manufacturing standards these products are held to, as well as some of more the hidden risks and implications the use of these items have. We also consider the disproportionate impact on families who live with a low income, who may be tempted to recreate homemade versions and leading to a cluster of co-occurring SIDS risks. Alice tells us about her research from a recent survey with parents about their use of sleep pods and we discuss how to have appropriate conversations with families to help minimise risk while sticking to the evidence base and avoiding scaremongering or judgement. We have quite a few other episodes on sleep now - so do check back through our back catalogue if this is a topic that interests you! Thanks so much for listening everyone - we would love to hear from you with any comments or suggestions to iamahealthvisitor@gmail.com Resources and Further Reading: The BASIS website - check out their resources if you haven't ever used them, they're brilliant: https://www.basisonline.org.uk Professor Helen Ball webinar on "What is Normal Infant Sleep: The View From Anthropology": https://www.youtube.com/watch?v=g5fOogsUpIk Lullaby Trust Resources on Baby Products: https://www.lullabytrust.org.uk/safer-sleep-advice/sleeping-products/ and: https://www.lullabytrust.org.uk/wp-content/uploads/The-Lullaby-Trust-Product-Guide-Web.pdf Specific to sleep positioners: https://www.lullabytrust.org.uk/are-sleep-positioners-safe-for-babies/

Jen and Amy go through the world of contraceptive advice. Although not directly our work, it's definitely connected and very relevant to health visitors. Often a bit of a neglected topic, it can be something we feel uncomfortable or poorly prepared to discuss with families. We hope our discussion solves some of those problems as we go through the contraceptive options for families, talk about contraception and lactation and the more emotional side of the conversation about physical intimacy after the birth of a baby. References and further reading: Faculty for Sexual and Reproductive Health Guideline: https://www.fsrh.org/documents/contraception-after-pregnancy-guideline-january-2017/ NHS Contraception Guide: https://www.nhs.uk/conditions/contraception/ Lactation and Breastfeeding: https://www.breastfeedingnetwork.org.uk/contraception/ iCaSH Sexual Health Service & the C-Card Scheme: https://www.icash.nhs.uk/contraception-sexual-health/c-card-scheme Emotional Factors and broader conversation prompts: https://www.nct.org.uk/life-parent/sex-after-baby/sex-after-baby-10-questions-ask-yourself

Jen and Amy gently guide you through the main headlines of the huge, massive, overwhelming and generally awe inspiring 'CHILD Cohort Study' all about the human microbiome. We will discuss how all the things you might expect, and some very unexpected factors, can all impact the infant microbiome and the important long term impacts this can have on that child's health. If you would like to look more into the myriad of research which has been produced from the CHILD dataset, just do a quick google scholar search and you will find heaps to keep you going. For a more curated starting point, check out our further reading down below! We love to hear from you, contact us on iamahealthvisitor@gmail.com Thanks for listening! Further reading: YouTube Summary of the CHILD study: https://youtu.be/eL9dAGiCNLU Study website with the key discoveries highlighted: https://childstudy.ca/portfolio/key-discoveries/

We discuss postnatal anxiety, specifically the measurement of anxiety after birth. In practice we are often using generic anxiety measures which are simply just not appropriate for use in this specific period of a parent's life. Listen in to learn more about the scale, how it can be used and how you might be able to incorporate it in your clinical practice. As ever, we love to hear from you. Get in touch with comments or suggestions at iamahealthvisitor@gmail.com If you would like to use the PSAS in your practice or you would like to be involved with her stakeholder engagement research then Vicky would love to hear from you! Email her at vfallon@liverpool.ac.uk. Resources and Further Reading: Dr Vicky Fallon - other relevant publications mentioned in the episode: 1. A feasibility trial of a single session Acceptance and Commitment Therapy intervention to reduce fear of childbirth in first time mums. https://www.tandfonline.com/doi/full/10.1080/08870446.2021.2024190 2. Challenges and opportunities for child health services in responses to the COVID-19 pandemic https://www.tandfonline.com/doi/full/10.1080/02646838.2021.1890422 THE POSTPARTUM SPECIFIC ANXIETY SCALE - Research Background: Parent Infant Foundation Briefing Paper: https://www.researchgate.net/profile/Sergio-Silverio-2/publication/351736241_The_Postpartum_Specific_Anxiety_Scale_PSAS_Briefing_Paper/links/60a6c586299bf1031fbe1378/The-Postpartum-Specific-Anxiety-Scale-PSAS-Briefing-Paper.pdf Validation study: https://link.springer.com/article/10.1007/s00737-016-0658-9 Short form validation: Creation and validation of the Postpartum Specific Anxiety Scale Research Short-Form (PSAS-RSF) https://pubmed.ncbi.nlm.nih.gov/33900462/ Childbearing specific validation - predicts infant feeding outcomes: https://link.springer.com/article/10.1007/s00737-017-0775-0

Amy and Jen discuss a government guidance document published in the past year which reviews the Hepatitis B selective immunisation pathway for pregnant people and newborns. We look at this guidance from the perspective of health visitors in practice - what do you need to know? What should be happening, what actually IS happening and what do you need to do when this crops up on your caseload? As ever we love to hear from you with any comments or thoughts by email on iamahealthvisitor@gmail.com. Resources and Further Reading: I am a HV episode on the Hexavalent vaccine: https://soundcloud.com/iamahealthvisitor/changes-to-the-immunisation-schedule-august-2017-episode-2 Guidance Document - Hepatitis B antenatal screening and selective neonatal immunisation pathway. https://www.gov.uk/government/publications/hepatitis-b-antenatal-screening-and-selective-neonatal-immunisation-pathway

Extra bonus episode! In this special extra episode, Jen and Amy talk to the lovely Kitty Lamb of the CPHVA Education Development Trust Macqueen Bursary team. Kitty walks us through the types of projects the Macqueen bursary funds and how to apply. Hopefully it will give you lots of ideas for your own career development projects. Good luck and get applying! The deadline is the 29th January 2022. To reach Jen and Amy, you can email the podcast at iamahealthvisitor@gmail.com Resources: Download the Macqueen form and guidance document from here: https://cphvaeddevtrust.wordpress.com Macqueen bursary social media: Twitter: https://twitter.com/cphvaeddevtrust Facebook: https://www.facebook.com/cphvaeddevtrust/

Happy new year everyone! For our first podcast of 2022 we are lucky to be joined by Hannah Poulton, who is an experienced physiotherapist with a specialism in women's health, scar therapy and c-section recovery. We talk all things pelvic floor! We learned heaps from this episode and could have talked all day, so hopefully this episode will really help you add to your clinical knowledge in this important area. As ever, we love to hear from you with any comments in relation to this episode or any other. Get in touch with us by email at iamahealthvisitor@gmail.com References and further reading: Follow Hannah on social media at HLP Therapy: https://www.instagram.com/hlptherapy/ Hannah's YouTube page: https://www.youtube.com/channel/UCWv85jKP4N2WZSfWxTdreIw Physiotherapy centre Liverpool: https://thephysiotherapycentre.com https://www.instagram.com/thephysiotherapycentre/?hl=en https://www.facebook.com/PHYSIOTHERAPYCENTRE1/

Merry Christmas! Get your IamaHV Bingo card at the ready (downloadable from our twitter and instagram feeds @IamaHV), mince pies and cup of tea lined up and get ready to laugh. A lot. Have your tissues at the ready for the last section, which got unexpectedly emotional! Thank-you everyone for all your amazing funny stories. You are all hilarious! Thank-you to our volunteer voices who have recorded the specially selected few. Thank-you to every single one of you who is continuing to just. keep. going. through everything and still managing to have a smile on your face from time to time. You are awesome. Merry Christmas with so much love, Jen and Amy x iamahealthvisitor@gmail.com

Amy and Jen talk about something we see and manage all the time, but as we always find there is more to it than meets the eye! We discuss definitions and different forms of jaundice in terms of the underlying mechanism, red flags and risk factors, assessment including how to spot jaundice in darker skin tones (and some promising new tech to help with this!), how to judge severity and what your management plan should be. We also talk a lot about feeding issues - as is to be expected with this topic. The episode would pair really well with our top-ups episode where Jen puts her IBCLC hat on to give us loads of detail on how to supplement a baby who is struggling to transfer enough milk at the breast, if you wanted to check that one out too the link is in the resources section below. We also discuss some International differences with the management and response to jaundice and wonder whether there are lessons we can learn from other places in the world. We always love to hear from you - please do get in touch with any comments or suggestions by email iamahealthvisitor@gmail.com. You can also send us your funny anecdotes for our Christmas episode to this address too! **References and Further Reading: ** Our Top-Ups Podcast Episode: https://soundcloud.com/iamahealthvisitor/top-ups-when-what-how-and-how-much-to-give?si=d2195fa54aa04d19aec62fdcb4e5d179 Pilot study of a smartphone app for jaundice recognition in babies with darker skin tones: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0216970 NICE Clinical Knowledge Summary for Jaundice: https://cks.nice.org.uk/topics/jaundice-in-the-newborn/ Massage for neonatal jaundice - an RCT: https://europepmc.org/article/med/33116094 Systematic Review of Massage for neonatal jaundice: https://www.sciencedirect.com/science/article/abs/pii/S1355184119301255 ABM Jaundice Protocol: https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/22-jaundice-protocol-english.pdf NHS Direct page: https://www.nhs.uk/conditions/jaundice-newborn/

Ahead of road safety week, Amy and Jen talk to two experts in car seat safety to get the key messages for you to pass onto parents. I know I often talk with parents at the antenatal contact about what kit they have bought for baby, often they are keen to share with me their ideas or thoughts and often quite receptive to suggestions regarding safety. When it comes to car seats, I am often out of my depth and struggle with what to tell them! There's huge variety in safety and mistakes with fitting to the car and fitting the child in the seat are common. We are sure you will learn heaps from this discussion, just as we did. Thankyou to Margaret and Ron for all your time and passion - it really came across so strongly. For more information see the resources on Margaret's website and Facebook page, listed below. If you would like to contribute to our conversation or for thoughts or feedback please do contact us on iamahealthvisitor@gmail.com **Resources and Further Reading: ** Margaret's Website: www.rearfacingtoddlers.com YouTube Channel: www.youtube.com/rearfacingtoddlers Facebook Page (Car Seat Advice UK): https://www.facebook.com/groups/CSAUK Check It Fits Ireland service (where Ron is based): https://www.rsa.ie/road-safety/road-users/passengers/children/check-it-fits

Have you ever considered a career in academia? Or perhaps a blended career with a mixture of clinical and research across your week? If so then listen in as Amy chats about the process of finding and applying for a PhD. You might be more well qualified than you realise! Health visitors make excellent candidates because of our passion for evidence based healthcare and our ability to read and think critically about the literature; applying it to real life. For comments, suggestions or questions get in touch at iamahealthvisitor@gmail.com Further reading and Resources: National Institute of Healthcare Research Fellowship Programmes: https://www.nihr.ac.uk/explore-nihr/academy-programmes/fellowship-programme.htm Find a PhD: https://www.findaphd.com

Jen is leading the way this week sharing her IBCLC knowledge with us on the topic of mastitis. We discuss a new school of thought on the treatment of blocked ducts as inflammation - moving away from vigorous massage and towards cold compresses and Ibuprofen. What's the deal with cabbage leaves - an old wives tale or does it work? What about antibiotics? How might disposable nappies be helpful here? All these questions and more. As ever, there is more to know than we realised! As ever we welcome your thoughts and contact about all our episodes, email us at iamahealthvisitor@gmail.com Resources and Further Reading: Nancy Morbacher's Website: http://www.nancymohrbacher.com NHS Choices: https://www.nhs.uk/conditions/mastitis/ La Leche League: https://www.laleche.org.uk/mastitis/ KellyMom (American IBCLC run evidence based page): https://kellymom.com/bf/concerns/mother/mastitis/ Breastfeeding Network: https://www.breastfeedingnetwork.org.uk/wp-content/dibm/BFN%20Mastitis%20feb%2016.pdf The Flipple Technique for a deep latch: https://www.llli.org/breastfeeding-info/positioning/ https://www.lactationmotivation.com/post/using-the-flipple-technique Positioning including Laid Back/Biological Nurturing Breastfeeding Positions: https://www.llli.org/breastfeeding-info/positioning/ The TABBY Tool for Tongue Tie assessment: https://pubmed.ncbi.nlm.nih.gov/31346346/ NICE clinical knowledge summary on Mastitis: https://pubmed.ncbi.nlm.nih.gov/31346346/ Bergmann, H; Rodriguez, J.M; Salminen, S; et al (2014) Probiotics in human milk and probiotic supplementation in infant nutrition: A workshop report. British Journal of Nutrition 112(7) 547-549 cited in Mohrbacher, N (2021) Breastfeeding Answers (2nd Edition). Available from: https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/probiotics-in-human-milk-and-probiotic-supplementation-in-infant-nutrition-a-workshop-report/EBA29A2197CEBDFB90950B2628552309#

Our 'bread and butter' (no pun intended!) but as with everything our perspective and advice changes over time so time for an update! What are the current important messages we should be conveying to parents as they begin to introduce solids to their babies. Why should we not be calling it 'weaning' and what about giving milk alongside solids? What signs of readiness should we look for? What is responsive feeding in terms of solid foods and what key messages about this should we be passing on to parents? What is the current guidance on introducing allergens, including where there is a known allergy in the family? We put the emphasis on discussing the important messages about food - feeding responsively to the child's cues, building healthy habits for life, satiety and hunger signals, the social aspects of a mealtime and enjoyment of food; rather than on arbitrary rules or lists of requirements. We would love to hear from you with any thoughts or suggestions, email us at iamahealthvisitor@gmail.com **Resources and Further Reading: ** Our previous podcast - Does early weaning REALLY make babies sleep better?: https://soundcloud.com/iamahealthvisitor/does-early-weaning-really-help-babies-sleep-better Dewey 2001 - Nutrition, growth, and complementary feeding of the breastfed infant: https://pubmed.ncbi.nlm.nih.gov/11236735/ First Steps Nutrition 'Eating well recipe book Simple, cost-effective ideas for the whole family': https://www.firststepsnutrition.org/eating-well-infants-new-mums Introducing allergens to baby - Allergy UK: https://www.allergyuk.org/assets/000/002/342/Weaning_–_Introducing_your_baby_to_solids_original.pdf?1547805087 St John's Ambulance: https://www.youtube.com/watch?v=oswDpwzbAV8 Introducing solids to the breastfed baby: https://kellymom.com/nutrition/starting-solids/solids-how/ Rewards and Punishments for food - Why not?: https://www.health.qld.gov.au/news-events/news/ask-an-expert-reward-punish-children-with-food HENRY - Health Exercise and Nutrition for the Really Young: https://www.henry.org.uk NHS Choices info on food storage and preparation: https://www.nhs.uk/start4life/weaning/safe-weaning/preparing-food-safely/#anchor-tabs Feed Eat Speak: https://www.feedeatspeak.co.uk

Amy and Jen discuss the importance of using the right language and being kind and respectful when working with parents. We go through the use of pronouns, preferred names and discuss LGBTQIA+ communities and how they relate to our role. We go back to basics with definitions for those people who don't yet understand the difference between sex and gender, what to do if you make mistakes and how to get it right; as well as talking briefly about the potential complexities of lactation and birth for transgender parents. You might think of these issues as niche but it they truly aren't - this is an issue for every single health professional. If you think it doesn't apply in your area, or you have not come across it yet, even more reason for you to listen to this and gain more knowledge and understanding. As a society we are on a journey to become kinder, more inclusive, more compassionate and more empathetic to other human beings. This is all part of that journey. We won't get it right every time - but we urgently need to start trying. We would love to hear your thoughts. If you feel we have missed something or you would like to contribute to this conversation please do drop us an email at iamahealthvisitor@gmail.com Resources and Reading: Mentioned in the podcast - The queer birth club - https://queerbirthclub.co.uk 'Animal: The Autobiography of a Female Body' by Sara Pascoe Academy of Breastfeeding Medicine Clinical Protocol: https://abm.memberclicks.net/assets/33%20Lactation%20Care%20for%20LGBTQ%20Plus%20Patients.pdf Brighton Midwives Gender Inclusion: https://www.bsuh.nhs.uk/maternity/our-services/specialist-support/gender-inclusion/ Statistics on Outcomes for Transgender People: https://www.stonewall.org.uk/sites/default/files/trans_stats.pdf Additional Resources: If you are looking to understand more about gender issues there are some excellent resources to help you learn. Gender Spectrum - a range of excellent summary articles covering the essentials: https://www.genderspectrum.org/articles/understanding-gender An Ally's Guide to Terminology: https://www.glaad.org/sites/default/files/allys-guide-to-terminology_1.pdf Birth for Every Body: Group of midwives aiming to make birth feel safe and inclusive for everyone: http://www.birthforeverybody.org

In the last of our summer #Replay series, we look back at a simple intervention health visitors can recommend in practice to resolve a common clinical issue. Health Visitors are well placed to identify these granulomas and advice parents on how to treat these, preventing unnecessary and potentially harmful treatment with silver nitrate. Jenny and Amy discuss what Health Visitors need to know to advise parents confidently on this, including the practicalities of how to apply the salt and common parent concerns with this. We would love to hear your thoughts or suggestions for future episodes. Email us at iamahealthvisitor@gmail.com Thanks for listening! iHV Top Tips for Parents: ihv.org.uk/wp-content/uploads/…a_26_9_2017_b-1.pdf iHV Good Practice Points: file:///Users/richard/Downloads/iHV_GPP_Treatment_of_Umbilical-Granuloma_19_9_2017_b-1.pdf

Third in our summer #Replay series, we have selected this review of the BATHE study of eczema. After a recent conversation with researchers at the University of Southampton, where this study was conducted; it appears that their research has not yet filtered down to the primary care settings. We hope this #Replay helps some of you to manage eczema more confidently and perhaps leads to a change in practice in terms of bath emollient usage. This new research represents strong evidence for a significant change in health visitor practice - share it far and wide! We really recommend reading the paper and looking at the infogram abstract and the accompanying video explaining the results - it's a very well presented and accessible piece of research (and, as a bonus, Professor Howard Williams has a very nice friendly voice!) To get in touch contact us at iamahealthvisitor@gmail.com Thanks for listening! Reading: Study website at Southampton University: https://www.southampton.ac.uk/bathe/index.page Full article at the BMJ: https://www.bmj.com/content/361/bmj.k1332

As part of our summer #Replay series we are curating for you some of our best episodes from several years ago which you may not have come across yet in our archives. This one was recorded in the December of 2017 and discusses what is normally a Christmas theme - bronchiolitis. Thanks to the strange circumstances this year, we are seeing an emergence of RSV and surges in cases causing hospitalisation outside of the normal 'bronchiolitis season'. So we thought this one might be a particularly apt episode to #Replay for you today. We hope it's useful! Jenny and Amy discuss how to assess the babies on your caseload who have caught the dreaded RSV, when to signpost them to the GP and how to know when it's urgent enough to be sending them to A&E. We also discuss the progression of the illness and some encouraging words you can share with parents on your caseload who are exhausted with bronchiolitis at the moment. Have you ever heard of the bronchiolitis vaccine? Amy and Jenny tell you who is eligible and what the vaccine is all about. Further Reading: NHS Choices: https://www.nhs.uk/conditions/bronchiolitis/ Bronchiolitis Vaccine - The Green Book: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/458469/Green_Book_Chapter_27a_v2_0W.PDF Example of Work of Breathing in an infant: https://www.youtube.com/watch?v=bYso_Oz-35k *PLEASE NOTE: we chose this clip because it is quite a good, natural example of what you are looking for on a child's chest, however the terminology is American. If you are a SCPHN in the UK then we usually refer to 'subcostal recession' and 'tracheal tug'. Jingle Bells from: https://freesound.org/people/juskiddink/sounds/110158/

#Replay! This summer we are taking the opportunity to put a spotlight on some of our favourite older episodes which we feel are still incredibly useful for HVs today. If you are a relatively new listener, we hope you will enjoy this curated list of some of our best ones! To kick it off, this #Replay was first released in January 2018 and was our very first ever guest! Bridget discusses her experiences with health visitors and how we can help women share how they are truly feeling. We talk about what we should (and shouldn't!) say and do when someone tells us they're having a really bad time, how to use scales like the Edinburgh Scale, the PHQ-9 and the Wholly Questions, how feeding issues and reflux or colic can impact on mood and interventions such as listening visits. We talk about our own experiences in practice, the Nice Guidance on Perinatal Mental Health and Bridget talks from her own lived experience and those of the other women shared in her book. As ever, give us a shout if you have any thoughts or comments to iamahealthvisitor@gmail.com on Twitter @IamaHV or on FaceBook at I am a Health Visitor. Bridget's book is excellent and is available at Amazon on the following link: www.amazon.co.uk/Fine-Not-Perspec…on/dp/1853432202 NICE guidance on Antenatal and Postnatal Mental Health: www.nice.org.uk/guidance/cg192/re…df-35109869806789

Following our previous episode with Harry's Hat, Amy and Jen review the guidance on measuring head circumference. We discuss when (and how frequently) as well as how to measure. Many of us may be doing it incorrectly - using lasso/plastic tapes (which can stretch and lead to inaccurate measurements), instead of paper. We also discuss the potential consequences of not detecting problems with head circumference with reference to a recent court case and consider what lessons we can learn from this case. Further Reading and Resources: Court Case https://www.bailii.org/ew/cases/EWHC/QB/2020/3102.html NICE Guidance on abnormal head shape or size: https://www.nice.org.uk/guidance/ng127/chapter/Recommendations-for-children-aged-under-16#head-shape-or-size-abnormalities https://www.nice.org.uk/guidance/qs198/chapter/Quality-statement-2-Head-size-and-shape-in-children NHS Choices page on Plagiocephaly and Brachycephaly: https://www.nhs.uk/conditions/plagiocephaly-brachycephaly/ Great Ormond Street pages on positional plagiocephaly: https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/positional-plagiocephaly/ Craniostenosis CDC pages: https://www.cdc.gov/ncbddd/birthdefects/craniosynostosis.html#:~:text=Lambdoid%20synostosis%20%E2%80%93%20The%20lambdoid%20suture,the%20rarest%20types%20of%20craniosynostosis Image of Cranial Suture Lines: https://www.stanfordchildrens.org/en/topic/default?id=anatomy-of-the-newborn-skull-90-P01840 BMJ article evidencing that plastic lasso Measuring tapes stretch: https://adc.bmj.com/content/90/8/820

Jen and Amy chat to the wonderful Lucy Ruddle IBCLC about her new book 'Mixed Up: Combination Feeding By Choice or Necessity', which is an absolute must read for any health visitor wanting to give evidence based information to families about combining formula and breastmilk. Combination feeding is massively under-rated and misunderstood; despite being central to almost every UK parents feeding journey. In this episode we cover the toxicity of the 'formula versus breastmilk' debate and how to honestly and sensitively negotiate conversations with families who have introduced formula, the WHO code and how to safely and confidently practice within it as well as different types of combined feeding and their value. If you have something to add to our discussion or would like to give us some feedback we would love to hear from you at iamahealthvisitor@gmail.com Resources and Further Reading: Lucy Ruddle IBCLC https://www.facebook.com/LucyruddleIBCLC/ The WHO code: https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/international-code-marketing-breastmilk-substitutes-resources/the-code/

Following our last episode talking about combi-feeding with Lucy Ruddle, we discuss top-ups; how they're used, how they should be used, and alternative strategies that can be used to limit or reduce their use. The NICE faltering growth guideline is the starting point, while it does detail everything that needs to be done, it remains open to interpretation over the level of breastfeeding assessment needed, and quickly moves on to talk of setting goals/review dates without specifying which actions can help establish and continue breastfeeding. To try and fill this gap, Jenny uses her IBCLC knowledge to talk through strategies used in practice which can be adopted by HV's/HCP's and how there are many more ways to do top ups than just using a bottle. To help avoid all babies of any age or size being told to have 40mls top-ups (the figure that most often seems to be plucked from the air without an evidence base), we explain how to calculate a top up using weight and weight loss. The NICE Faltering growth guideline https://www.nice.org.uk/guidance/qs197 Finger feeding: https://breastfeeding.support/what-is-finger-feeding/ Breast compressions: https://breastfeeding.support/what-is-breast-compression/ Paced bottle feeding: https://breastfeeding.support/tips-to-bottle-feed-a-breastfed-baby/ Book recommendation: Making more milk by Lisa Marasco & Diana West https://www.amazon.co.uk/Making-More-Milk-Breastfeeding-Increasing-ebook/dp/B07SQS22LC/ref=sr_1_1?dchild=1&keywords=making+more+milk&qid=1625065400&sr=8-1

Jen and Amy chat to the wonderful Terri and Caroline from the charity Harry's HAT (Hydrocephalus Awareness Trust). We talk about the pitfalls and common things to look out for as a health visitor, as well as some lesser known warning signs that should be ringing alarm bells for us all. Do you know what the most accurate tape measure is we should be using? The most important factor in getting accuracy for head circumference measurement? Why you shouldn't be measuring head circumference for hydrocephalus monitoring in a baby clinic? We certainly learnt a lot in the process of this episode and we hope you will too! Thank-you to Caroline for sharing her very personal story of her son Harry's journey navigating this complex condition and her own experience of health visitor support... and thank-you to her HV Becks - it sounds like you are doing a FANTASTIC job! This episode may be usefully listened to alongside our additional episode on head circumference measurement more broadly, which includes other conditions as well as when and how to measure. Please do contact us at iamahealthvisitor@gmail.com with any comments or suggestions. Resources and Further Reading: Harry's HAT: https://harrys-hat.org Shine: http://shinecharity.org.uk

Small seizures with big consequences. Infantile spasms or 'west syndrome' is a devastating diagnosis for any family and can so easily be missed. Listen to Jen and Amy discuss the health visitors role in supporting the family with identification of this tricky and subtle disorder as well as being alongside them through diagnosis, treatment and supporting the development of the child as they grow. For comments and suggestions please do email us at iamahealthvisitor@gmail.com Resources and Further Reading: UK Infantile Spasms Trust: https://ukinfantilespasmstrust.org/about-infantile-spasms/ https://ukinfantilespasmstrust.org/ukistwp/wp-content/uploads/2018/11/UKIST-Information-Guide.pdf Epilepsy Action: https://www.epilepsy.org.uk/info/syndromes/west-syndrome-infantile-spasms Infantile Spasms Trust YouTube channel for example videos: https://www.youtube.com/channel/UCIZdN9LjQrYF7EwT16cuhmw Pavone et al 2020 academic review article: https://link.springer.com/article/10.1007/s10072-020-04600-5 Sheilds 2006 "little seizures, big consequences". Clinical summary article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1464162/

Jen and Amy go through the new Public Health England Tool 'Early Language Identification Measure'. We discuss what the tool is aiming for, the pilot research results, how it differs from the ASQ and some reservations that we have about the application of this tool to health visiting practice. We would absolutely LOVE to hear from you especially if you have been involved with the pilot of this project or are involved in the roll out of it right now in your area. Drop us an email to iamahealthvisitor@gmail.com. References and Further Reading: ELIM Handbook https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/939872/ELIM_Handbook_December-2020.pdf PHE Report of the ELIM Pilot Research: https://myimpact.ncl.ac.uk/UploadFiles/270761/7d1567da-dbc1-460b-94ac-53f2e62f42f7.pdf Tiny Happy People Materials: https://www.bbc.co.uk/tiny-happy-people Hungry Little Minds: https://hungrylittleminds.campaign.gov.uk/

Jen and Amy chat to the lovely Rosy Whitwell who is a health visitor and nurse, who now specialises in infant and child sleep and has a private practice to support families with this important area. We talk about her journey to specialism as well as the controversies in the field of infant sleep and how health visitors are stuck in the middle often in a difficult position to support parental expectations and face a damaging amount of societal pressures on families. Sleep is one of the most common challenges for new parents, the cause of lots of HV contacts with families and is interwoven into almost everything we cover - from reducing risk of accidents or injuries, safeguarding to mental health and feeding issues. Despite all this there is so little high quality training for health visitors on what is normal in infant sleep. We hope this podcast will give you a starting point to update your knowledge on infant sleep and act as an inspiration for more learning on this important topic. Thank-you to Rosy for sharing her thoughts with us on this and please do get in touch if you have specific questions or would like us to look into more detail on a specific sleep issue. Email us at iamahealthvisitor@gmail.com Resources and Further Reading: Lullaby Trust Resources for Safe Sleep: https://www.lullabytrust.org.uk BASIS Babies and Sleep Information Source: https://www.basisonline.org.uk Australian Centre for Perinatal Psychology: https://www.centreforperinatalpsychology.com.au The Children's Sleep Charity: https://thesleepcharity.org.uk Normal Infant Sleep: A View from Anthropology, a webinar by Helen Ball of BASIS: https://www.youtube.com/watch?v=g5fOogsUpIk https://festivalofsocialscience.com/events/what-is-normal-infant-sleep-the-view-from-anthropology/

Amy and Jen discuss the recent guardian headlines stating that 'bottle fed babies swallow millions of micro plastics every day'. We discuss what micro plastics are, where they can be found and whether or not they are in babies' milk as this headline reports. We give answers to the questions that might be springing to your mind according to the most recent evidence available - do we ingest them, do we absorb them into organs, can they cross into the placenta and most importantly - should we be worried about them? We talk about some possible alternatives to reduce the risk for parents who are concerned about potential health risks, as well as pitfalls to watch out in terms of formula milk preparation and advice health visitors can give with confidence. As ever we love to hear your comments, suggestions or ideas for this or future episodes, drop us an email to iamahealthvisitor@gmail.com Resources and References: Guardian Article https://www.theguardian.com/environment/2020/oct/19/bottle-fed-babies-swallow-millions-microplastics-day-study Microplastics in food (adults and children) Cox et al 2019 https://pubs.acs.org/doi/abs/10.1021/acs.est.9b01517 Microplastic contamination of drinking water: A systematic review Danopoulos, Twiddy & Rotchelle 2020 https://pubmed.ncbi.nlm.nih.gov/32735575/ Plastic teabags have recently been shown to release microplastics and nano plastics into our cups of tea. https://pubs.acs.org/doi/10.1021/acs.est.9b02540 We can also estimate that we all ingest around 80g of micro plastics per day from fruits and vegetables, because the soil is polluted with them. Ebere, Wirnkor & Ngozi 2019 http://www.worldscientificnews.com/wp-content/uploads/2019/06/WSN-131-2019-256-267.pdf Smith et al 2018 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6132564/ Campanale et al 2020 https://www.mdpi.com/1660-4601/17/4/1212/pdf First Steps Nutrition Guidance on preparation of milk: https://www.firststepsnutrition.org/making-infant-milk-safely

We talk to School Nurse and EU national Dina Mendez about the coming deadline for application for Settled Status on the 31st June 2021. Is this deadline a hidden crisis? "Windrush number 2?" A buried scandal that we have somehow not been aware of up until now? Do you know what challenges your colleagues and families are facing in their application for settled status? What should you do if you haven't yet managed to get confirmation of your own settled status? What do you need to know to protect the children and families you are working with? Have you let your EU colleagues know that you care? That they are not alone and that you stand beside them? We discuss all the things you didn't know, and NEED TO KNOW about Brexit and the impact it is still having right now. Resources and further reading: Statistics on EU NHS staff: https://commonslibrary.parliament.uk/research-briefings/cbp-7783/ Video featuring Dina: https://twitter.com/mayoroflondon/status/1356252347379425288?s=21 Mayor of London EU settled status pages: https://www.london.gov.uk/what-we-do/european-londoners-hub?utm_source=twitter&utm_medium=post&utm_campaign=x&utm_content=x Grassroots organisations supporting EU citizens in the UK: The 3 Million https://www.the3million.org.uk Settled https://settled.org.uk/en/ Drop the Letter Campaign - write to your MP https://twitter.com/the3million/status/1362047956594155524?s=24

Jenny and Amy chat to the lovely Stella Parkin from the Lullaby Trust. In a really broad and interesting interview Stella shares with us lots of information and guidance for health visitors on having informed, non judgemental and helpful conversations with parents and caregivers about SIDs and safe sleep and how to support a family in reducing the risk to their baby on any given sleep occasion. We also chat about the upcoming Safe Sleep Week starting next week on the 15th March and the theme of that week this year which is dads and coparents. Finally, we end with a brief overview of the wonderful CONI scheme - what it involves, how it operates and the rationale behind it. Feel free to email us with questions or comments at iamahealthvisitor@gmail.com, we love to hear from you Resources and Further Reading: Lullaby Trust Webpages: https://www.lullabytrust.org.uk Training joint with Basis: https://www.lullabytrust.org.uk/professionals/sids-training/ CONI scheme: https://www.lullabytrust.org.uk/professionals/care-of-next-infant/ Baby Check App by the Lullaby Trust: https://www.lullabytrust.org.uk/safer-sleep-advice/baby-check-app/

Amy and Jen take a deep, deep dive into the muddy murky world of "Cry It Out" or "Extinction" sleep techniques. Put on your wellies and join us! We talk about the research groups and individual studies which have looked at these techniques with our usual critical eye. Attempting to keep our personal feelings out of the objective assessment of the research; nevertheless we still concluded that there is a substantial body of evidence which suggests CIO sleep techniques should not be recommended by health visitors. In the episode we take a closer look at the studies suggesting it is harmless and discuss why these are flawed and why we have come to a different conclusion. We will also talk about possible alternatives for health visitors who are reaching for some sort of intervention to support parents who feel they are at their 'wits end' in terms of sleep and those suffering with mental illness which may be exacerbated by a lack of sleep. Hopefully, we leave you with some possible avenues to explore with families as well as getting into the sleep debate in a meaningful way. As always, we love to hear from you so drop us an email on iamahealthvisitor@gmail.com to chat with us. Thanks Amy and Jen Resources and Further Reading: Honakar et al 2018 https://scholarworks.iupui.edu/bitstream/handle/1805/18975/Honaker_2018_real.pdf?sequence=1&isAllowed=n Accessed 30.11.2020 The news furore recently caused by Bilgin & Wolke 2020 https://www.theguardian.com/lifeandstyle/2020/mar/11/leaving-babies-to-cry-does-no-harm-study-finds?CMP=Share_iOSApp_Other Accessed 30.11.2020 Bilgin & Wolke 2020 https://sovendeboern.dk/wp-content/uploads/2020/06/Bilgin-og-Wolke-2020.pdf Accessed 30.11.2020Accessed 30.11.2020 Lindsey Hookway 2020 statement - an IBCLC critique and response to the Bilgin & Wolke study. https://feedsleepbond.com/response-to-bilgin-and-wolke-cry-it-out-study/ Accessed 30.11.2020 Tronnick Still Face Phenomenon Video example: https://www.youtube.com/watch?v=apzXGEbZht0&list=PLpCQJ8MCxYM7yJXB2vcib0ai-4PZ4TlBL&index=12 Accessed 30.11.2020 Middlemiss et al 2012 - Cortisol and Asynchrony http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.671.2134&rep=rep1&type=pdf Accessed 30.11.2020 Hiscock et al 2007 - Cluster Randomised Trial of CIO intervention https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2083609/ Price et al 2012 - five year follow up https://www.researchgate.net/profile/Anna_Price5/publication/230830539_Five-Year_Follow-up_of_Harms_and_Benefits_of_Behavioral_Infant_Sleep_Intervention_Randomized_Trial/links/54d9d57c0cf24647581f8c21/Five-Year-Follow-up-of-Harms-and-Benefits-of-Behavioral-Infant-Sleep-Intervention-Randomized-Trial.pdf Middlemiss and colleagues - commentaries on Hiscock et al 2007 follow up Price at al 2012 https://pediatrics.aappublications.org/content/130/4/643/tab-e-letters#unethical-and-unscientific-conclusions-ignore-how-infants-are-harmed Rudzik, Smith & Ball 2018 - Parent's reported infant sleep against actigraphy data: https://pubmed.ncbi.nlm.nih.gov/30097331/ Douglas & Hill 2013 Review CIO (0-6m) found no improved sleep outcomes. https://www.pameladouglas.com.au/sites/default/files/pdfs/Douglas_Hill%20JDBP%20%2023_9_13.pdf Ball et al 2020 - "Sleep, Baby and you" https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0237240 A proposed possible alternative to CIO - new, awaiting full validation. Proposes balance between meeting parents sleep needs and infant needs. Durham Infant Sleep Lab: https://www.dur.ac.uk/disc/projects/current/slb/ Middlemiss et al 2017 Second proposed alternative - increased total sleep time but no crying. Teaching responsive soothing and cues based methods. https://static1.squarespace.com/static/5666b428dc5cb462d9f1e05a/t/5905be69725e256add1604d2/1493548654959/Early+Human+development+2017.pdf

Jen and Amy do a 'small but mighty' overview of Infantile Sebhorric Dermatitis, otherwise known as Cradle Cap! Something we all see in clinic and at 6-8week checks, but do we actually know what the evidence base is for the advice we give? What actually causes the sebaceous glands to excrete excessive oils causing the scaley rash which can be so distressing to parents? What (if anything) can we or should we do about it? What advice or reassurance can we give to parents on this? As ever, we love to hear from you with any comments on this episode or requests for other episodes on iamahealthvisitor@gmail.com References and Further Reading: Cochrane Review: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011380.pub2/full iHV parents information sheet: https://ihv.org.uk/wp-content/uploads/2015/10/22-PT_Cradle-Cap_V4.pdf NHS Choices page https://www.nhs.uk/conditions/cradle-cap/ - however be aware this page still advises olive oil so is outdated advice.

Jen and Amy respond to your questions following the first vaccines episode and cover the myth around infertility, conception and the vaccine, allergies and anaphylaxis as well as natural and vaccine-induced immunity - do you still need the vaccine if you've had COVID before? THIS EPISODE DOES NOT STAND ALONE - Please also listen to our COVID-19 Vaccines Episode For any questions, comments or if you have a related issue you would like us to cover, please email us at iamahealthvisitor@gmail.com Resources and Further Reading: Royal College of Midwives and Royal College of Gynacologists Statement on Infertility Myth: https://www.rcog.org.uk/en/news/RCOG-and-RCM-respond-to-misinformation-around-Covid-19-vaccine-and-fertility/ CDC data on anaphylaxis: https://www.cdc.gov/mmwr/volumes/70/wr/mm7002e1.htm Summary article on the infertility myth: https://www.webmd.com/vaccines/covid-19-vaccine/news/20210112/why-covid-vaccines-are-falsely-linked-to-infertility Tommy's Charity -FAQs: https://www.tommys.org/pregnancyhub/blogs-stories/covid-19-vaccine-pregnancy-and-breastfeeding PEG allergy published case series: https://pubmed.ncbi.nlm.nih.gov/33011299/ Allergy detailed info: https://www.allergyuk.org https://www.anaphylaxis.org.uk SIREN study update from PHE: https://www.gov.uk/government/news/past-covid-19-infection-provides-some-immunity-but-people-may-still-carry-and-transmit-virus

We chat to Rachael about her wonderful book "Handle with Care: Confessions of an NHS Health Visitor". It was so easy and wonderful to talk about her journey to writing the book, as well as all the daily challenges of health visiting in the current climate, chronic underfunding, poor understanding and valuing of the health visiting role and increased pressure on health visitors. We hope you feel heard and understood listening to this - you are doing such a wonderful job.

Amy and Jen discuss the efficacy (and what that percentage ACTUALLY means, in terms of the stats), safety and mechanisms of the three vaccines currently approved for use in the UK at the time of recording - The Oxford-AstraZenaca, Moderna-NIAID and the BioNtech-Pfizer. We also talk about some worries that either you might be having about these vaccines or that you might come across from families in your practice over the next few weeks and months. As ever, fear is born of a lack of understanding. Some of this science is new, but despite that there is much we do know and much that we can say with confidence. If you have a worry we have not covered - we want to hear from you. Please don't be shy - if you have thought it there will certainly be plenty of others worrying the same things. Questioning and thinking about these things demonstrates that we are scientifically minded and keen to interrogate the data. So speak up and we can work it out together as a community. Email us at iamahealthvisitor@gmail.com. Thankyou for all your incredible work, both inside and outside of a pandemic. Health visitors are superheroes. Amy and Jen xxx Resources and Further Reading: COVID19 chapter in the Green Book: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/948757/Greenbook_chapter_14a_v4.pdf Clear explanation on different types of vaccines and how they work: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/how-they-work.html The Oxford-AstraZenaca Trial Data: https://www.thelancet.com/action/showPdf?pii=S0140-6736%2820%2932661-1 The Pfeizer-BioNTech Trial Data: https://www.nejm.org/doi/pdf/10.1056/NEJMoa2034577?articleTools=true The Moderna-NIAID Trial Data: https://www.nejm.org/doi/full/10.1056/NEJMoa2035389 Drugs in Breastmilk Service (Breastfeeding Network) Info on the COVID vaccines: https://www.breastfeedingnetwork.org.uk/coronavirus/ WHO guidance on pregnancy and COVID: https://www.who.int/news/item/01-09-2020-new-research-helps-to-increase-understanding-of-the-impact-of-covid-19-for-pregnant-women-and-their-babies November 2020 BMJ study of COVID in pregnancy: https://www.bmj.com/content/370/bmj.m3320 Panorama BBC episode ‘the race for a vaccine’. https://www.bbc.co.uk/iplayer/episode/m000qdzd/panorama-the-race-for-a-vaccine E-Learning for Healthcare: https://www.e-lfh.org.uk/programmes/covid-19-vaccination/ Oxford Vaccine Group FAQs: https://www.research.ox.ac.uk/Article/2020-12-30-oxford-vaccine-regulatory-faq WHO description of how vaccines work: https://www.who.int/news-room/feature-stories/detail/how-do-vaccines-work?utm_source=facebook&utm_medium=landingpageviews&utm_campaign=vaccinebls&fbclid=IwAR1H5aAE-KZTfzLrEqzkxKQAH4BDd-UsFo_BcH4dP3C67CifXkQJwBy3LB0 Interesting discussion on vaccine hesitancy: https://www.ox.ac.uk/news/science-blog/covid-19-vaccine-hesitancy-uk

We're BACK! We are so excited to be back in your ears! Thank-you so much to all you wonderful health visitors who have been so kind and so complimentary about our podcasts. We absolutely love hearing from you and we have been so touched by people telling us they were missing the episodes and wanted more! Between a new small human on the block (for Amy), new IBCLC credentials (for Jen) and a new global pandemic (neither of us are taking any responsibility for that one) we have been extremely busy and have had our hands full up till now. But we are now so happy to announce our relaunch! We're back and will be here fortnightly - dropping onto your phone every two weeks with the usual mix of clinical topics, evidence digests, policy reviews and professional issues for health visitors. As ever, give us a shout with any topic suggestions or ideas on iamahealthvisitor@gmail.com Thanks for listening! Amy and Jen

Jen and Amy interview the wonderful Kathryn Stagg IBCLC of the charity Breastfeeding Twins and Triplets (@BFTwinsUK). Kathryn talks us through the common myths and concerns with breastfeeding multiples with some really useful tips and hints for health visitors who come across parents planning to breastfeed multiples, things to watch out for and how to help them access support. Kathryn has lots of wonderful articles and resources available on her website (below) and is running a webinar for healthcare professionals on the 6th November and 4th December, specifically targeting health visitors. If you would like to attend this seminar see the resources section below. As ever we love to hear from you, send any ideas or suggestions to iamahealthvisitor@gmail.com Thanks Amy & Jen Resources and further reading: Kathryn Stagg's website: https://kathrynstaggibclc.com/ Website for Kathryn's charity: www.breastfeedingtwinsandtriplets.co.uk Kathryn's webinar: https://www.eventbrite.co.uk/e/supporting-breastfeeding-multiples-tickets-116285690631 Discount code (£5 off for health visitors, takes the cost of the seminar down to £20, student HVs it is just £5 for you): BfTwinsUKHV Breast Compressions teaching video: https://www.youtube.com/watch?v=60R7pd-HCtE Dropping top-ups gradually: https://breastfeedingtwinsandtriplets.co.uk/2017/06/07/dropping-top-ups-gradually/

This week's episode was recorded last summer when Jen interviewed her colleague Debbie who is a Specialist Homelessness HV. Debbie has a real passion for her role both as a health visitor and as an advocate for the families she works with. She explains in the interview how she has built relationships with local MP's, councillor's and the CCG highlighting the levels of need in the community and what she is able to do. Debbie says that attending http://homelesshealthnetwork.net/ meetings helped her meet like-minded professionals and led to her putting herself forward for QNI membership: https://www.qni.org.uk/nursing-in-the-community/queens-nurses/ The London Network of Nurses and Midwives (LNNM); which Debbie mentions in this episode; is a voluntary network of health care professionals, health support workers and peer advocates working directly or indirectly with people experiencing homelessness. It has been in existence since 1999. It has recently evolved from being a purely nurse, midwife and health visitor focused network to include allied health professionals and peer advocates. It is London based, but many members are from outside London. The group exists to provide informal supervision and mutual support to members, and a shared voice within the sector. The network also provides CPD opportunities, a chance to share best practice, and a chance to benefit from the experience of others.​ Debbie is on twitter https://twitter.com/debbief108 and as mentioned in the podcast is worth following for her informative comments and carefully curated feed. As ever, you can get in touch with us via email: iamaheathvisitor@gmail.com via FB https://www.facebook.com/IamaHealthVisitor/ or via twitter/instagram @iamahv

E-Cigarettes in Pregnancy: What is the evidence base? Some surprises for Jen and Amy today when we look into the safety of vaping or using e-cigarettes in pregnancy. We look at the main guidance document for health professionals in the UK produced by the Smoking in Pregnancy Action Group and endorsed by Ash (Action on Smoking and Health), Best Beginnings, Bliss, the Lullaby Trust, Royal College of Midwives, Royal College of Obstetricians and Gynaecologists, Royal College of Paediatrics and Child Health, Royal Society for Public Health, Royal College of Nursing, SANDS, and Tommy’s; among others… So it’s a well supported document! As ever please contact us on iamahealthvisitor@gmail.com, thanks for listening. Resources and Further Reading: Smoking in Pregnancy Challenge Group: https://smokefreeaction.org.uk/smokefree-nhs/smoking-in-pregnancy-challenge-group/smoking-in-pregnancy-challenge-group-resources/e-cigarettes-in-pregnancy/ Clearing Up Myths (Public Health England): https://publichealthmatters.blog.gov.uk/2018/02/20/clearing-up-some-myths-around-e-cigarettes/ Accident prevention around E-Cigarettes: https://www.rospa.com/Home-Safety/Advice/Product/Vaping Tommy’s video on smoking in pregnancy: https://www.tommys.org/pregnancy-information/im-pregnant/smoking-and-pregnancy Tommy’s ‘cost of smoking’ calculator: https://www.tommys.org/pregnancy-information/im-pregnant/smoking-and-pregnancy/check-cost-smoking Evidence Review 2018: McNeill, A; Brose, L S; Calder, R; Bauld, L; Robson, D. Evidence review of e-cigarettes and heated tobacco products 2018: A report commissioned by Public Health England. PHE. 2018 Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/684963/Evidence_review_of_e-cigarettes_and_heated_tobacco_products_2018.pdf

NSPCC new tool for practitioners: Look, Say, Sing, Play NSPCC has launched a new campaign called Look, Say, Sing, Play which aims to help prevent abuse early by supporting parents to build strong attachments and relationships with their children. This is an excellent resource to use with families, and to organise a local campaign in your community is totally free and is something the NSPCC could do in partnership with your local health visiting team - get in touch at help@nspcc.org.uk and ask for ‘Look, Say, Sing Play’. Resources and Further Reading: NSPCC campaigns: https://www.nspcc.org.uk/what-we-do/campaigns/ NSPCC Look, Say, Sing, Play: https://www.nspcc.org.uk/keeping-children-safe/support-for-parents/look-say-sing-play/

Amy attended the fabulous CPHVA conference last year in Harrogate, without her podcast wife! In this episode Amy tells Jen everything she missed. If you don’t follow us on twitter, now is the time to check it out and go back to our twitter feed from the 15th and 16th October 2019 - we were tweeting lots from every session and this will also give you lots of insight alongside this episode to the learning and resources you can get from conference. We also cover in this episode how to get involved with your local branch or apply for a grant to get funding to attend this year’s conference in 2020 - hopefully we will see you there! As ever we love hearing from you - email us at iamahealthvisitor@gmail.com Resources and Further Reading: CPHVA education and development trust: https://cphvaeddevtrust.wordpress.com Baby Milk Action https://www.babymilkaction.org First Steps Nutrition https://www.firststepsnutrition.org UNITE CPHVA - find your local branch https://unitetheunion.org/contact-us/ NSPCC new tool https://www.nspcc.org.uk/keeping-children-safe/support-for-parents/look-say-sing-play/

Jen and Amy are back in the first of a series of five brand new episodes! In this first episode we are looking at a proposed new 8-stage model of domestic abuse published earlier this year by Dr Jane Monckton-Smith of Gloucester University. Dr Monckton-Smith has produced an excellent summary video explaining the 8 stages if you would like to see her talking through the model - link is below. We talk about the utility of this model in practice, compare it with other tools we are currently seeing, including the DASH, and also discuss the portrayal of intimate partner violence in UK media and how this may impact on perpetrator and victims as well as us professionals. As ever we would love to hear from you, email us at iamahealthvisitor@gmail.com Thank-you and we hope you enjoy this new series! Amy and Jen References and further reading: BBC News article summarising 8-stage model: https://www.bbc.co.uk/news/uk-49481998 Original article (Monckton-Smith 2019) Intimate Partner Femicide: Using Foucauldian Analysis to Track an Eight Stage Progression to Homicide https://journals.sagepub.com/doi/pdf/10.1177/1077801219863876 Video explaining the model by Probation Service and Dr Jane Monckton Smith http://eprints.glos.ac.uk/7010/1/7010%20Monckton-Smith%20National%20Probation%20Service%20film.mp4 DASH risk assessment checklist: https://www.dashriskchecklist.co.uk/ Almond, McManus, Brian & Merrington 2017 Demonstrates that individual questions on DASH not independently predictive of reoffending. https://www.emerald.com/insight/content/doi/10.1108/JACPR-01-2016-0211/full/html Turner, Medina & Brown 2019 DASH little better than random at predicting high risk cases https://academic.oup.com/bjc/article/59/5/1013/5518314 Challenging the dominant discourse around domestic abuse in the media: Luke and Ryan Hart https://www.cocoawareness.co.uk/ “he just snapped” media representations https://www.tandfonline.com/doi/abs/10.1080/1461670X.2017.1350117 Smoke and Mirrors: U.K. Newspaper Representations of Intimate Partner Domestic Violence https://journals.sagepub.com/doi/full/10.1177/1077801216634468

We're back! Launching back into podcasting after a few months gap while Amy looks after a tiny human. Thank-you for your patience! To celebrate being back in the HV world, Amy will be travelling to Harrogate next week for the CPHVA conference and bringing you all the news and learning from the two days. To whet your appetite for next week, here is last years' conference episode. If you don't have your ticket yet they are available here: https://www.cphvaconference.co.uk As ever, contact us on iamahealthvisitor@gmail.com Looking forward to meeting you there!

The lovely Alina joins us from ERIC - the children's wee and poo charity to talk all things bladder and bowel. In this episode we focus on toilet training, constipation and nighttime dryness. Alina gives us loads of really fabulous information based on her extensive experience as well as the latest research. For me to be honest, chatting with Alina was a bit like being on an episode of QI - everything you think you know is wrong! Although lots of health visitors are now likely spending less time talking to parents about toilet training and our nursery nurse colleagues may be taking on more of this role, recording this chat reminded me just how complex and important these issues can be for families and I certainly learnt loads from Alina. We talk about lots of myth busting around common questions - when should parents start thinking about toilet training and how do you know the child is 'ready'? What is the first line treatment for constipation according to the NICE guidelines? Is dietary change the best solution? You might be surprised by some of the answers, I certainly was! We would love to hear from you with any suggestions or comments to iamahealthvisitor@gmail.com Resources and further reading: ERIC website and helpline: https://www.eric.org.uk/poo-and-wee ERICs guide for children with additional needs: https://www.eric.org.uk/Handlers/Download.ashx?IDMF=9b1c4466-ef97-436f-ad8a-9d53ffddb6a9 ERIC resources and guides: https://www.eric.org.uk/guides-to-childrens-bowel-and-bladder-problems Intake and Output chart to help parents know if their child is 'ready': https://www.eric.org.uk/pdf-intake-output-chart ERICs 'Children who will only poo in a nappy and other toilet avoiders': https://www.eric.org.uk/pdf-children-who-will-only-poo-in-a-nappy ERICs guide to children's bowel problems: https://www.eric.org.uk/Handlers/Download.ashx?IDMF=d34eca57-7f98-48ec-a538-0ea08abe8c4c NICE guidelines for childhood constipation: https://www.nice.org.uk/guidance/cg99

Just in time for cleft lip and palate awareness week 2019 Jenny interviews mum Jenny (of @mamaboost) and her lovely little one Will. Both Jen and Will were born with bilateral cleft lip and palate and Jen was kind enough to explore with us their journey from diagnosis antenatally to his recent surgery. We talk about feeding challenges and different options, Jen's experience of discovering Will would have a cleft, her birth and early days with Will as well as speaking to her again after Will had his surgery. She shares with us some suggestions of where to signpost families for additional support. Thanks very much to Jen for sharing their story... and apologies for the sound quality and little additions to the podcast from the newest member of the team! As ever we would love to hear from you with comments or suggestions to iamahealthvisitor@gmail.com Further reading/resources available at the Cleft Lip and Palate Association - https://www.clapa.com/

Health visitors often get thrown into running groups - whether they are antenatal groups, weaning, minor illness or first aid; even team meetings or group supervision sessions. Sometimes we can go out for home visits and end up running an impromptu health promotion group! For anyone who has felt overwhelmed by the prospect of running a group with little to no experience or specific training in this, know that this is totally normal! Also tune in and we will try to share some tips and ideas from our own experience; loosely based around the ’forming, storming, norming and performing’ model. Thank-you for listening. Do send your suggestions or ideas as well as examples of groups you are running to iamahealthvisitor@gmail.com Resources and Further Reading: Who, Me Lead a Group? by Jean Ilsley Clarke for a basic introduction to running groups from a transactional analysis background https://www.amazon.co.uk/Lead-Group-Jean-Illsley-Clarke/dp/1884734413 Example of good practice - First Steps Group https://www.communitypractitioner.co.uk/resources/2017/09/first-steps-postnatal-group-addressing-high-impact-areas Ready Steady Mums (IHV) https://ihv.org.uk/families/ready-steady-mums/

This week it’s all “Apples and Pears”.... nope we’re not going cockney, we’re reviewing the recent reports from First Steps Nutrition regarding dried fruit snacks and vegetable/fruit pouches. Resources: Paper on free sugars: Swan GE, Powell NA, Knowles BL, Bush MT (2018). A definition of free sugars for the UK. Public Health Nutrition; 21: 1636-38. Here’s the link to the reports (& gateway to the wider First Steps website: https://www.firststepsnutrition.org/babyfood-composition/ Also, if you haven’t heard it already, here’s a link to our podcast discussing weaning: https://itunes.apple.com/gb/podcast/i-am-a-health-visitor/id1296676475?mt=2&i=1000417749887 As always we love to hear from you email us at iamahealthvisitor@gmail.com Thanks for listening!

Amy and Jen discuss the recent change my the medicines regulatory authority to remove teething gels and powders from UK supermarkets and to sell them only in pharmacies. While we're on the topic we also refresh on the basics of normal teething patterns, some top tips to offer to parents and talk about the care of infant teeth including the importance and purpose of the dental check by 1yr. As ever we would love to hear from you! Email us on iamahealthvisitor@gmail.com Resources & Reading: NICE Clinical Knowledge Summary: https://cks.nice.org.uk/teething#!scenario NHS Choices: https://www.nhs.uk/conditions/pregnancy-and-baby/teething-and-tooth-care/ https://www.nhs.uk/conditions/pregnancy-and-baby/teething-tips/ British Society of Paediatric Dentistry: www.bspd.co.uk/Patients/Dental-Check-by-One https://www.bspd.co.uk/Resources