WEANING

Objective: To evaluate the awareness & practices regarding weaning in lactating mothers of infants. Design: A crosssectional descriptive study. Setting: At pediatrics OPD in Ghurki Trust Teaching hospital, Lahore. Period: From Octoberto December 2007.Methodology: A non probability convenience sampling was done to collect data from 50 mothers who were attending out patient departmentalong with their infants on a pre-formed questionnaire. After gathering, data was analyzed & presented in the form of tables & graphs.Results: In the present study, 66% mothers were in the age group of 20-29 years, all were house wives, 34 % were matriculate and 72%lived in joint family system, Mean age of weaning was 4-6 months in more than 64 % of the sample. Among the women interviewed, 44%used home-made weaning diets, 30% used mixture of homemade and commercially prepared diets, while 16% used only commerciallyprepared diets. Breast feeding was continued during and after weaning, by 64% of respondents along with weaning diets. Conclusion:Mothers need to be educated about the importance of weaning, the recommended age of weaning and about the types of weaning food.This can be achieved by using lady health workers and lady health visitors and the mass media. Importance of continued breast feedingwith weaning diet should be emphasized upon.

The importance of self-compassion for health visitors' wellbeing

This article presents an extended literature review, undertaken to understand the significance of self-compassion for health professionals' wellbeing and its relevance for the health visiting workforce. The review showed that self-compassion reduces compassion fatigue, burnout, anxiety, stress and depression. Further, self-compassionate employees are more compassionate towards colleagues and patients, and compassionate practice enhances staff wellbeing. Organisational support for wellbeing increases staff members' sense of worth, resulting in improved ownership of their own wellbeing, and group interventions in particular foster self-compassionate work cultures. The review concludes that self-compassion enhances staff wellbeing and recommends that all NHS staff should be provided with the tools to prevent compassion fatigue and burnout.

The feasibility of an objective measure of the parent-child relationship in health visiting practice: assessment of the Maternal Postnatal Attachment Scale.

Positive parent infant relationships are key to achieving long term child outcomes. Identifying parents who may need support is difficult because of a lack of robust assessment tools. Working in partnership with health services we piloted the Maternal Postnatal Attachment Scale (MPAS) in a deprived, multi-ethnic urban community in Bradford, UK. The pilot aimed to assess the clinical utility of MPAS to identify need for support: Was it administered to a representative group of women? Is MPAS valid for this population? Data were linked to a cohort study in the pilot area (Born in Bradfords Better Start - BiBBS). Chi Square tests assessed sample representativeness (age, ethnicity, parity, English language, education, deprivation). Exploratory factor analysis explored MPAS validity. 563 women in BiBBS were eligible, 210 (37%) completed MPAS. No differences were found between completers and non-completers, suggestive of a representative sample. In total, 336 women completed MPAS in the pilot. MPAS had ceiling effects and a satisfactory factor structure could not be identified, indicating poor psychometric properties Health visitors were successful in administering MPAS to a representative sample, but poor psychometric robustness indicates that MPAS is unsuitable for routine use in this setting. A gap for such a measure remains.

Research roundup: December 2021

In this section, a range of brief synopses of recently published articles that may be of interest to health visitors is presented. The aim of this roundup is to provide an overview, rather than a detailed summary, of the research papers selected. Should you wish to look at any of the papers in more detail, a full reference is provided.

Implementing the Maternal Postnatal Attachment Scale (MPAS) in universal services: Qualitative interviews with health visitors

A secure parent-infant relationship lays the foundations for childrens development, however there are currently no measurement tools recommended for clinical practice. We evaluate the clinical utility of a structured assessment of the parent-infant relationship (the Maternal Postnatal Attachment Scale, MPAS) in a deprived, multi-ethnic urban community in England. This paper answers the question: what are health visitors views on the parent-infant relationship, and experiences of piloting the MPAS? It explores the barriers and facilitators to implementation, and complements the paper on psychometric properties and representativeness reported in Dunn et al (submitted). Semi-structured interviews were conducted with 11 health visitors and data were analysed using thematic analysis. Health visitors stressed the importance of the parent-infant relationship and reported benefits of the MPAS, including opening conversation, and identifying and reporting concerns. Challenges included timing, workload, the appropriateness and understanding of the questions and the length of the tool. Suggestions for improvements to the tool were identified. Our findings help to explain results in Dunn et al, and challenges identified would hinder routine assessment of the parent-infant relationship. Further work with health professionals and parents has been undertaken to co-produce an acceptable, feasible and reliable tool for clinical practice.

Transferring Knowledge on Motor Development to Socially Vulnerable Parents of Infants: The Practice of Health Visitors

Parents are a determinant factor in a child’s development of motor skills. Studies show that programmes in which health visitors supervise parents may improve infants’ motor skills. This study examines which factors health visitors have found to enhance and hamper the implementation of a motor development programme among socially vulnerable parents of infants. The data consist of three group interviews with 4 health visitors in each (12 health visitors in total) and a subsequent member check with 27 health visitors. All were audio-recorded and transcribed verbatim, and a thematic analysis was conducted. The results show that according to the health visitors, the programme increases the ability and willingness of parents to engage in co-producing its implementation. In particular, the materials that they hand out to the parents enhance the implementation. On the other hand, they perceive the limited time provided for the implementation, together with the many pressing needs of the families, as hampering the implementation. Consequently, the study can inform future policies and programmes for frontline workers and socially vulnerable parents of infants.

The influence of the health visitor

Crystal Oldman discusses why health visitors need to be able to tell their stories in a way that demonstrates their knowledge and skills, and the real impact they have on the communities they serve

Exploring the lived experiences of mothers who identify with ‘gender disappointment’

In a western context, little is known about the term ‘gender disappointment’, which describes feelings of despair around not having a child of the desired sex. This study aimed to explore the lived experiences of British women who identify with the concept. Six mothers with only sons, who also desired a daughter, participated in a semi-structured interview via an online platform. An interpretative phenomenological analysis identified themes related to pity, societal expectations of unfulfillment, and concerns relating to the future mother-son relationship, feelings of guilt and shame, barriers to seeking help and the benefits of talking. The study concludes that there is a need for greater awareness of gender disappointment and the negative impact it has on maternal wellbeing. In addition, mothers who identify with gender disappointment would benefit from support from health visitors to enable them to access the help they need.