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Nutritional Healthy Start

The following pathway should not be read as stand-alone and MUST be read in conjunction with Section 3: Pathways.

  • This pathway focuses on infant feeding choices, promotion of breast feeding and growth concerns and its management.

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Birth - 6 weeks

3 - 8 weeks

Additional Visit following New Birth Visit and any Follow-up Visiting schedule where there are concerns regarding:

  • Poor weight gain
  • Poor feeding
  • Jaundice

Health Visiting

In-depth assessment and management of growth where concerns exist using WHO guidelines.

  • Provide assessment of baby’s weight. Less than 10% below birth weight repeat visit and inform GP, if more than 10% or there are concerns regarding the babies condition discuss with acute paediatrician.
  • Where appropriate provide breast/formula feeding support - refer to local breastfeeding services where appropriate and peer support groups.
  • Observe feeding and management of faltering growth according to faltering growth guidance.
  • Facilitated access to health education focusing on baby feeding, weaning and wider nutritional issues.
  • Healthy growth management support and referral.
  • Identification and management of digestive concerns and colic.
  • Facilitate attendance at infant massage sessions provided in Universal Pathway.
  • Assessment and management of health condition that could negatively affect growth or nutritional status i.e. tongue tie, cleft lip/palate and provision of any on-going support post operation.
  • Referral as needed for poor growth to GP, Dietician or Paediatrician

Birth - 1 year

Targeted Support

Facilitate Joint working and support integrated care planning.

Primary Care & GP

Working with other key partners provide support for families with issues that are affecting poor baby weight gain/growth.

Consider support and referral to specialist intervention services if required. Monitor results and ongoing care plan in partnership with midwife and HV team.

Birth - 1 year

Core Purpose 1

Outreach home visiting family support.

Childrens Centres & EYFS

Focusing on feeding issues and support - breast and bottle feeding, weaning and the wider nutritional needs of the family.

Birth - 1 year

Core Purpose 1

Group Sessions.

Childrens Centres & EYFS

Run to address the collective needs of a group of families focusing on feeding issues and support breast and bottle feeding, weaning and wider nutritional needs of the family. This may include a series of cookery classes.

8 weeks - 6 months

8 weeks - 6 months

Additional Home Visits

Health Visiting

Assessment and management of growth where concerns exist using WHO guidelines.

  • Provide assessment and management of baby’s weight.
  • Where appropriate provide breast/formula feeding support - refer to local breastfeeding services where appropriate.
  • Observe feeding and management of faltering growth according to faltering growth guidance. Refer to either GP or Paediatrician with sustained drop through 2 or more weight centiles; should include length measurements.
  • Facilitated access to health education focusing on baby feeding, weaning and wider nutritional issues.
  • Healthy growth management support and referral.
  • Identification and management of digestive concerns and colic.
  • Facilitate attendance at infant massage sessions provided in Universal Pathway.
  • Referral to recognised commissioned specialist nutritional programme e.g. HENRY
  • Assessment and management of health condition that could negatively affect growth or nutritional status i.e. tongue tie, cleft lip/palate and provision of any on-going support post operation.

8 weeks - 6 months

Core Purpose 1

Targeted Support

Facilitate Joint working and support integrated care planning.

Childrens Centres & EYFS

Working with the HV team provide specialist nutritional programmes to support the family to deal with a wide spectrum of nutritional issues.

6 months - 1 year

6 - 12 months

Additional Visits

Health Visiting

Where nutritional and/or growth concerns have been identified by any health professional or parent.

The Health Visitor team will:

  • Assess the nutritional intake and growth of the child against pre-established growth patterns
  • Discuss parental concerns and provide appropriate advice and support
  • Liaise with appropriate services and refer onwards to specialist services/GP as required.

6 - 12 months

Targeted Visits – using Solihull Approach

Health Visiting

Individual health education and support regarding infant weaning.

Where possible advice to both parents on weaning/ feeding, appropriate amounts and types of food.

1 - 5 years

1 - 5 years

Targeted Visits – using Solihull Approach.

Health Visiting

Use of Solihull Approach to support parents with a feeding concern.

Where appropriate and with the parents’ consent refer family to local Children’s Centre Groups to increase knowledge around healthy diet, cooking skills, and portion size.

1 - 5 years

Additional Visits.

Delivery of HENRY Programme.

Health Visiting

Where nutritional and/or growth concerns have been identified by any health professional or parent.

The Health Visitor team will:

  • Assess the nutritional intake and growth of the child against pre-established growth patterns
  • Discuss parental concerns and provide appropriate advice and support
  • Give advice and information on healthy eating, portion size and mealtime routines. Refer family to local Children’s Centre Groups to increase this knowledge.
  • Advise on nutritional intake and physical activity for the family.
  • Refer if a child is obese to a recognised commissioned specialist nutritional programme e.g. HENRY, Carnegie or mini-MEND.
  • Liaise with appropriate services and refer onwards to specialist services/GP as required.
  • Assessment and management of health condition that could negatively affect growth or nutritional status.

1 - 5 years

Core Purpose 1

Targeted Support

Facilitate Joint working and support integrated care planning.

Childrens Centres & EYFS

Working with the HV team provide specialist nutritional programmes to support the family to deal with a wide spectrum of nutritional issues.

1 - 5 years

Core Purpose 1

Outreach home visiting family support.

Midwifery

Focusing on feeding issues and support and the wider nutritional needs of the family.

1 - 5 years

Core Purpose 1

Group Sessions.

Childrens Centres & EYFS

Run to address the collective needs of a group of families focusing on feeding issues and support and wider nutritional needs of the family. This may include a series of cookery classes.