Health visiting (0 to 5 years)

Domestic Abuse Support

If you are experiencing domestic abuse during this period there are places that can support you through this.

Domestic abuse can be defined as physical, emotional and sexual abuse in couple relationships or between family members. Domestic violence can happen against anyone, and anybody can be an abuser.

During the COVID-19 pandemic, domestic abuse charities and other organisations are reporting an increase in cases. 
If you need some guidance on domestic abuse the NHS has some good advice online you can access.

The 24-hour National Domestic Abuse Helpline number is 0808 2000 247 and associated online support available at nationaldahelpline.org.uk.

In addition, Respect is an anonymous and confidential helpline for men and women who are harming their partners and families. The helpline also takes calls from partners or ex-partners, friends and relatives who are concerned about perpetrators. 

Other online resources include Men's Advice Line and the Government support for Domestic Abuse.

Your six-week postnatal check during COVID-19 

At the six to eight-week check, babies have a thorough physical examination - this is usually done by a GP. Babies’ eyes, heart, hips and, for boys, testicles are checked – and they also have their weight, length and head circumference measured to ensure that the baby is developing as they should.

Due to some babies not receiving this check for various reasons, parents are being asked to consider the following in their baby:

Eyes

• Do you think your baby can’t ever fully open both eyes?
• Do you think your baby doesn’t make good eye contact and hold his/her gaze at you?
• Do you think that your baby doesn’t follow your face if you move your head from side to side when standing near him/her (less than one metre)?
• Do you think that your baby’s eyes shake/flicker/ wobble? Do you think there is something unusual about, or in, your baby’s eyes, for example, the dark central area (pupil) looks cloudy or the eyeball is an unusual shape or size?
• Are the whites of your baby’s eyes yellow?

Hips

• When you change your baby’s nappy, do you find that one leg cannot be moved out sideways as far as the other?
• Does one leg seem to be longer than the other?
• Do you have any other concerns about your baby’s hips?

Heart
If the answer to either of the following questions is “yes”, you should speak to someone the same day

• Does your baby seem breathless or sweaty, at any time, especially when feeding?
• Does your baby have blue, pale, blotchy, or ashen (grey) skin at any time?

If there are any concerns please contact your GP or Health Visitor for further assessment and guidance.

 
This guidance is published as an iHV Parent Tip on its website.
 

Derby City Council’s Family Information Service has produced an information leaflet explaining how childcare providers are keeping children safe during the COVID-19 pandemic.

The full government guidance about childcare and schools can be found on the gov.uk website.

You can also view the latest news on childcare in Derby on the Derby City Council website.

Breastfeeding

To contact the Infant Feeding Team Monday-Friday please call 0300 1234586 option 3.

The following national helplines are also available:

National Childbirth Trust (helpline: 0300 330 0700)

La Leche League – monthly meetings in Derby (24-hour helpline: 07980 262358)

Breastfeeding Network (helpline: 0300 100 0210)

National Breastfeeding Helpline (helpline: 0300 100 0212)

NHS Start4life - NHS Breastfeeding Guide

NHS Start4life - Going back to work guide

Supporter Line in Bengali & Sylheti – 0300 456 2421

View our breastfeeding support page

Infant Feeding

UNICEF guide - Guide to Bottle Feeding

NHS Start4life - Baby Vitamins

First Steps Nutrition Trust - Infant Milks

Safe Sleep

NSPCC website – handling your baby

Lullaby Trust website - Advice on safe sleeping for your baby

Handlng baby with care - NSPCC Need to Know Guide

Don't shake your baby - Advice leaflet

Caring for baby at night - a guide for parents

Immunisations

Gov.UK - Guide to immunisation

NHS Website - Guide to Vaccination

NHS Start4Life - Vaccination Schedule

NHS - Protecting your baby against Meningitis and Septicaemia

Useful Apps

Handi Paediatric -  An app to provide advice on common childhood illnesses.

Baby Check Up - 19 simple checks that parents can do if their baby is showing signs of illness.

Other Information

NHS Website - Information on collic

NHS Website - Information on oral thrush in babies

Unicef - Building a happy baby

First Steps Nutrition  - Healthy Start

Your Information Your Rights - Data Security

As a minimum, we offer:
 

• Antenatal contact - completed by a health visitor from 28 weeks of pregnancy. This will be a home visit where we discuss the role of the Health Visitor and discuss your pregnancy.
• Primary birth visit (10 to 14 days) - completed by health visitor or a staff nurse if it’s your second baby. At this contact we will assess baby's feeding, gather some information, give you some information and talk about your emotional wellbeing after the delivery of your baby.
• Six to eight-week review - completed by health visitor or staff nurse. We will assess the feeding and development of your baby at this contact. We will also assess how you are feeling emotionally.
• Six to 12-month review - completed by family health practitioner, staff nurse or HV. Development assessment and full growth review on your baby.
• Two to 2.5-year health review - completed by family health practitioner, staff nurse or HV. A full development and growth review will be completed at this contact.

Learn more about the two-year health review by downloading our leaflet.

We also:

• Host a number of children's health clinics and breastfeeding clinics in Derby each month
• Provide confidential advice to families with babies and young children up to five years old - supporting parents to feel confident in their parenting skills, and to provide the best opportunities for their baby
• Work closely with children’s centres to promote family activities which help build a strong bond with your child
• See families in their own homes, local health centres, clinics, and children’s centres.

Newborn blood spot test

Every baby born in the United Kingdom is offered newborn blood spot screening, also known as the heel prick test, when they are five days old. Newborn blood spot screening involves taking a blood sample to find out if your baby has one of nine rare but serious health conditions.

If you have moved into Derby from outside the UK and have not had the test done previously, our newborn blood spot screening team will contact you to offer to carry out the test. The test is available up to your child’s first birthday. For information on the newborn blood spot test, view the NHS website. The Derby screening team can be called on 0300 3690574 extension 31859.

We can advise on…

• Child development – vision and hearing, speech and development, growth, toilet training, meeting milestones, emotional health and wellbeing, school readiness, additional needs and more
• Infant feeding – breastfeeding support, healthy diet, weaning, feeding problems and more – we run infant feeding clinics 
• Health promotion - dental care, physical activity, immunisations, home safety, accident prevention and more
• Support for parents – on post-natal depression, relationship support, sexual health, stopping smoking, substance misuse, domestic abuse and more
• Community support – building links with children’s centres, parent and toddler groups, midwives, GPs, peer support workers, family workers, social care and more. 

Safe sleep practices with a baby are really important.

Health professionals may refer to something called Sudden Infant Death Syndrome, or SIDS for short. This is where a baby has died suddenly and in an unexplained circumstance. Other families may refer to this as 'cot death'. 

We don't know why babies die from SIDS, but we can identify risk factors that can contribute to increasing the chances of SIDS.

You can find out more information about SIDs and how to prevent it on the NHS website.

There are some key principles you can follow to make your baby's sleep time safer.

Position of your baby

• The safest place for your baby to sleep is on their back in their own moses basket or cot.
• It is not safe to place your baby on their side or front to sleep.
• If your baby turns onto their tummy, you should place them back on to their backs, especially if they cannot roll back on their own.
• If your baby can roll from front to back, and then from back to front again, it is OK to leave them in the position they put themselves into. But always put them to sleep on their backs to begin with.

Where your baby sleeps

• If possible try and keep the baby in the same room as you for sleep times for the first six months of their lives.
• Use a firm, flat, waterproof mattress that is clean and in a good condition.
• You should avoid using soft or bulky bedding (quilts, pillows and duvets).
• Never sleep on a sofa or in an armchair with your baby.
• Don’t cover your baby's face or head whilst they are sleeping.
• Avoid the use of loose bedding.
• Use blankets which are firmly tucked in, no higher than the baby's shoulder, or a sleeping bag.
• Babies do not need to wear hats indoors. Keep their head area clear from toys etc.
• Try to avoid using sleeping aids and cot bumpers for sleep times (if you have a sleeping aid, only use this under adult supervision).

Breastfeeding 

• Breastfed babies have a lower risk of SIDS.

• You should try to breastfeed your baby, even if only for some of the time, as this can help reduce the risk of SIDS.

• Breastfeeding some of the time may reduce the chance of SIDS compared to a baby who is fully formula fed.

Co-sleeping

• Some parents choose to share a bed with their baby at night for sleep (not just for comforting or feeding, but for the whole night).
• Babies should sleep in a clear sleep space, which is easy to create in a cot or moses basket.
• We know however that families also bed share, and so recommend making your bed a safer place for baby whether you doze off accidentally, or choose to bed share. Our advice on co-sleeping with your baby will tell you how.

For safer co-sleeping:

• Keep pillows, sheets and blankets away from your baby, as well as any other items that could obstruct your baby’s breathing or cause them to overheat. A high proportion of infants who die as a result of SIDS are found with their head covered by loose bedding.
• Follow all of our other safer sleep advice to reduce the risk of SIDS, such as putting your baby to sleep on their back.
• Avoid letting pets or other children get in the bed.
• Make sure the baby won’t fall out of bed or get trapped between the mattress and the wall.

Avoid bed-sharing if:

• Your baby was born before 37 weeks gestation, or had a low birth weight of less than 2.5kg (5.5lbs). The best place for babies to sleep is in their own Moses basket or cot, on a flat surface.
• You smoke or your partner smokes. Even if you do not smoke in the house, it is still on your breath, clothes, hair and hands.
• Either you or your partner has drunk alcohol or taken drugs (including medication that may make you drowsy).

Smoking 

• You and your partner should try to avoid smoking around the baby.
• Smoking during pregnancy and around the baby greatly increases the risk of SIDS.
• Don’t let other people smoke near the baby, as the baby can breathe in their secondhand smoke.
• If you or your partner smoke, it is very unsafe ever to share a bed with the baby.

If you would like help with quitting smoking see your GP, or you can call the NHS smoke-free team on 0800 022 433.

Dummy use

• Some research suggests that it is possible that using a dummy when putting a baby down to sleep can reduce the risk of SIDS.
• You should stop giving baby a dummy when they reach 6-12 months of age.
• Don’t worry if the baby doesn’t want to take a dummy; you do not need to force them to have one.
• Avoid using dummy cords at sleep times.
• An orthodontic dummy is the best shape for baby's mouth.
• If you start using a dummy, ensure you use the dummy at every sleep time.

Always remember to follow these principles:

• Place your baby in the 'feet to foot' position - this is where the baby's feet are placed at the foot of the cot, so they cannot wriggle down under the blankets.
• Use blankets which are firmly tucked in, no higher than the baby's shoulders, or a baby sleeping bag.
• Babies do not need to wear hats indoors.

Information sourced from Lullaby Trust.

Never shake a baby

Public Health Wales have produced a video explaining why shaking a baby is very dangerous. Watch the Shaken Baby video on YouTube.

This Video is also available to watch in the following languages:

• Spanish
• Hindi
• Arabic
• Turkish
• Cantonese
• Mandarin
• Dari
• Dinka
• Farsi
• Vietnamese

One of the best ways to protect your baby against diseases like measles, rubella, tetanus and meningitis is through immunisation. Your baby needs their first injections at eight weeks, then 12 weeks, 16 weeks and one year.

Vaccinations are offered free of charge in the UK – just book your appointments with your GP. Remember, as well as protecting your own baby, you're also protecting other babies and children by preventing the spread of disease.

These are the vaccinations your baby will need:

Quick guide to your baby's vaccinations

6-in-1 protects against:

• Diphtheria – a highly contagious bacterial infection, spread by coughs and sneezes, or close contact with someone with diphtheria.
• Hepatitis B – an infection of the liver caused by a virus spread through blood and bodily fluids.
• Hib (haemophilus influenzae type b) – bacteria that can cause several serious conditions including meningitis, sepsis (a kind of blood poisoning) and cellulitis.
• Polio – a viral infection that can cause paralysis.
• Tetanus – bacteria that can enter the body through a wound like a cut or scrape.
• Whooping cough (pertussis) – highly contagious bacterial infection of the lungs and airways.

Other immunisation information

• PCV or pneumo jab protects against pneumococcal infections that can lead to pneumonia, sepsis and meningitis.
• RV protects against rotavirus infection that can cause diarrhoea and vomiting.
• MenB protects against meningitis and sepsis.
• Hib/MenC protects against haemophilus influenzae (a bacterium that can cause different serious illnesses) and meningitis C.
• MMR protects against measles, mumps and rubella (German measles).

MenB vaccine and fever

Babies given the MenB vaccine alongside their other routine vaccinations at eight and 16 weeks are likely to develop a high temperature (fever) within 24 hours of vaccination. This fever is an indication that your baby is responding well to the vaccine.

It's important to give your baby liquid paracetamol following vaccination to reduce the risk of fever. You will need to give a total of three doses of paracetamol over a 24-hour period (2.5mls of infant paracetamol 120mg/5ml suspension). This will be needed after the eight and 16-week vaccination visits.

Other common side effects include irritability, and redness and tenderness at the injection site. The liquid paracetamol will also help with these symptoms.

Information sourced from NHS Childhood Immunisations.

Please note: if your baby starts to get excessive bruising following the vaccinations please seek urgent medical attention.

Jaundice is a common and usually harmless condition in newborn babies that causes yellowing of the skin and the whites of the eyes. The medical term for jaundice in babies is neonatal jaundice.

Your Midwife and Health Visitor will be assessing for this within the first 14 days of your baby's life initially.

Symptoms of newborn jaundice include:

• yellowing of the palms of the hands or soles of the feet
• dark, yellow urine (a newborn baby's urine should be colourless)
• pale-coloured poo (it should be yellow or orange)

The symptoms of newborn jaundice usually develop two to three days after the birth and tend to get better without treatment by the time the baby is about two weeks old.

When to get medical advice

Your baby will be examined for signs of jaundice within 72 hours of being born as part of the newborn physical examination.

If your baby develops signs of jaundice after this time, speak to your midwife, health visitor or a GP as soon as possible for advice.

While jaundice is not usually a cause for concern, it's important to determine whether your baby needs treatment.

If you're monitoring your baby's jaundice at home, it's also important to contact your midwife straight away if your baby's symptoms quickly get worse or they become very reluctant to feed.

Find out more about diagnosing jaundice in babies

Why does my baby have jaundice?

Jaundice is caused by the build-up of bilirubin in the blood. Bilirubin is a yellow substance produced when red blood cells, which carry oxygen around the body, are broken down.

Jaundice is common in newborn babies because babies have a high number of red blood cells in their blood, which are broken down and replaced frequently.

Also, a newborn baby's liver is not fully developed, so it's less effective at removing the bilirubin from the blood.

By the time a baby is about two weeks old, their liver is more effective at processing bilirubin, so jaundice often corrects itself by this age without causing any harm.

In a small number of cases, jaundice can be the sign of an underlying health condition. This is often the case if jaundice develops shortly after birth (within the first 24 hours).

How common is newborn jaundice?

Jaundice is one of the most common conditions that can affect newborn babies.

It's estimated six out of every 10 babies develop jaundice, including eight out of 10 babies born prematurely before the 37th week of pregnancy.

But only around one in 20 babies has a blood bilirubin level high enough to need treatment.

For reasons that are unclear, breastfeeding increases a baby's risk of developing jaundice, which can often persist for a month or longer.

But in most cases, the benefits of breastfeeding far outweigh any risks associated with jaundice.

Treating newborn jaundice

Treatment for newborn jaundice is not usually needed because the symptoms normally pass within 10 to 14 days, although they can occasionally last longer.

If your baby has jaundice for longer than 14 days your Midwife or Health Visitor will request a blood test at your local hospital. Treatment will then commence if tests show very high levels of bilirubin in a baby's blood.

This is because there's a small risk the bilirubin could pass into the brain and cause brain damage.

There are two main treatments that can be carried out in hospital to quickly reduce your baby's bilirubin levels.

• phototherapy – a special type of light shines on the skin, which alters the bilirubin into a form that can be more easily broken down by the liver
• an exchange transfusion – where your baby's blood is removed using a thin tube (catheter) placed in their blood vessels and replaced with blood from a matching donor; most babies respond well to treatment and can leave hospital after a few days

You can also read the National Institute for Health and Care Excellence (NICE) guidance about jaundice in newborn babies under 28 days.

Information sourced from the newborn jaudnice page on the NHS website.

A guide to your baby's development up to one year

This outline is just a guide and all babies develop at different rates.

Please speak to your health team if you are concerned that your baby isn't meeting their developmental milestones as the health team members are trained to assess your child’s development. They will do this by looking at the facts and at detailed research. They will refer you and your child to other services if they think it is needed.

Toilet training

• Stages for toilet training
• Toileting supplementary information
• Boys' toileting sequence
• Girls' toileting sequence
• Constipation and soiling booklet
• Bowel and bladder diary

Sleep support

• Sleep support leaflet

After you have had your baby you may experience some feelings of low mood for a couple of days. These are usually referred to as the 'Baby Blues'.
This is totally normal and many new mums go through this period. The feelings should only last for a couple of days.

Symptoms

• feeling emotional and bursting into tears for no apparent reason
• feeling irritable or touchy
• low mood
• anxiety and restlessness

Sometimes 'Baby Blues' can occur again around the time your baby is a few weeks old, so dont worry.

Is it postnatal depression?

Depression after a baby is born can be extremely distressing. Postnatal depression is thought to affect around 1 in 10 women.

Many women suffer in silence. Their friends, relatives and health professionals don't know how they're feeling.

Postnatal depression usually occurs two to eight weeks after the birth, though sometimes it can happen up to a year after the baby is born.

Some of the symptoms, such as tiredness, irritability or poor appetite, are normal if you've just had a baby. But these are usually mild and don't stop you leading a normal life. The time to get help is when these feelings have an impact on your day-to-day life.

When you have postnatal depression, you may feel increasingly depressed and withdrawn. Looking after yourself or your baby may become too much.

Emotional signs of postnatal depression

• loss of interest in the baby
• feelings of hopelessness
• not being able to stop crying
• feelings of not being able to cope 
• not being able to enjoy anything
• memory loss or being unable to concentrate
• excessive anxiety about the baby

Other signs of postnatal depression may also include:

• panic attacks
• sleeplessness
• extreme tiredness
• aches and pains
• feeling generally unwell
• anxiety
• loss of appetite 

Getting help for postnatal depression

If you think you have postnatal depression, don't struggle alone. Your Health Visitor will assess your emotional wellbeing at your six-eight-week check. She will ask you to fill in an assessment called a HADS. This will assess your feeling and identify any anxiety or depression you may be experiencing.

It's not a sign that you're a bad mother or are unable to cope. Postnatal depression is an illness and you need to get help, just as you would if you had an illness like flu.

Talk to someone you trust, such as your partner or a friend. You can ask your health visitor to call in and visit you. Many health visitors have been trained to recognise postnatal depression and have techniques that can help. If they can't help, they'll know someone in your area who can.

It's also important to see your GP. If you don't feel up to making an appointment, ask someone to do it for you. 

Treatment for postnatal depression

Milder cases of postnatal depression can be treated with counselling. This can be given by the health visitor; we can offer six listening visits in your home and then if further support is needed we can refer to a counsellor. More severe cases often require antidepressants and you may need to see a specialist.

It's important to let your GP know if you're breastfeeding. If you need to take antidepressants, they'll prescribe a type of medication that's suitable while you're breastfeeding.

Within Derby there is a service called 'Talking Mental Health' that service users can self-refer into for support with mental health illness.
They also offer relationship support through their service 'Relate'.

You may also find it helpful to contact the Association for Post-Natal Illness or the National Childbirth Trust.

The mental health charity Mind provides useful resources for people affected by postnatal depression

Your local Children's Centre can put you in touch with your nearest postnatal group. These groups provide contact with other new mothers and encourage mums to support each other. They offer social activities and help with parenting skills.

Weaning is the term used when you start to introduce solid foods to your baby's diet.  There are a few ways you can start this process and this section will guide you through this.

When to Start

Weaning should commence when your baby turns six months of age. You should continue to give your baby breast milk or first stage formula milk alongside this food.

At six months of age the baby's body is equipped to digest the food, and they are more developed to assist them in chewing, swallowing and holding the food.

How to know baby is ready

Your baby will start to show signs they are ready to wean. Some of these include:

• They can sit in a seated position with a steady head. They may need to be supported by a high chair in the seated position so don't worry if your baby isn't sitting independently.
• They may start watching everything you eat and some babies may grab for the food.
• They are able to coordinate their hands and mouth so they can try to guide food to their mouths.
• They are able to swallow the food given to them rather than spitting it straight out.

What to offer

• Start off with a small amount of food once a day
• Pick a time that is convenient for you
• Single vegetables or fruits are good to start with
• You can mash the food with a fork, you don't need to fully blend the food down from six months
• Foods to try: Mash, soft cooked carrot sticks, soft cooked parsnip sticks, broccoli, sweet potatoes, cooked apple, cooked pear and baby porridge
• You can mix food with breast milk, first stage formula milk or full fat milk (from six months)

Baby-Led Weaning

Baby-led weaning is a way of introducing solid foods to your baby where they can feed themselves the food. There is no need for spoon feeding or the use of jar foods with this method. If you want to do a mix of spoon feeding and baby-led weaning this is also ok.

Baby-led weaning enables your baby to explore lots of different textures, tastes, colours and smells. (They may get messy but that's all part of the fun.)

It will help the baby to develop hand-eye co-ordination and encourages chewing skills.

Here are some examples to get started if you choose this method:

• Sit your baby in an upright position. They can be in a highchair and face the dinner table with the family.
• Offer your baby foods such as boiled carrots, boiled broccoli or other boiled vegetables on their tray. Sticks and long strips of things are easy for babies to pick up. Let them pick what they want from the tray.
• Carry on offering breast or formula milk (following the meal time if they are over six months of age and before the food if they are before six months).

Good foods to offer also include: Fruit, cooked vegetables, meat, fish, cheese, well-cooked eggs, bread or toast, rice and pasta.

Introducing foods that may trigger allergic reactions once at a time in small amounts. Examples of these foods are:

• Cow's milk
• Eggs (eggs without the red lion stamp should not be eaten raw or lightly cooked)
• Nuts and peanuts (serve them finely crushed or smooth peanut butter)
• Seeds
• Soya
• Shellfish (dont serve raw or lightly cooked)
• Fish

If baby tolerates these you can keep offering them

Foods to Avoid

• Avoid adding salt or sugar to cooking. Also avoid putting these onto the baby's foods
• Avoid honey for the first year of life. Honey contains Clostridium Botulinum and can cause botulism in babies under one year
• Avoid giving shark and marlin
• Avoid giving undercooked eggs if the egg doesn't have the red lion stamp

Worried about Choking?

There's no more risk of choking when a baby feeds themselves than when they're fed with a spoon.

If you remain concerned St Johns Ambulance have produced a very good video for you to watch.

When to start

This differs for all children and totally depends on the individual child. Most children will be showing signs of wanting to toilet train from 18 months to three years of age.

Try to avoid starting this if you have big changes coming up such as moving house, or having a new baby.

How to know when they are ready

• Your child needs to be physically ready
• They need to be able to sit on a potty and stand up when they have finished
• They need to be able to tell you what they want or need
• They need to be able to stay dry for an hour or two at a time
• They will start to be telling you when they are having a wee or a poo. This is a good sign that they are getting the feelings and the control needed to start toilet training.

How to get your child ready

• When changing their nappies get them to stand up and get them to lift their clothing to help you
• Talk about wee and poo. If they have a wet or dirty nappy talk to them about it
• Change your child's nappy in the bathroom so they associate the toilet with this time
• Start a reward system, maybe a sticker chart or lucky bag, and reward them when they use the potty or tell you they need the toilet
• Read a picture book to about toilet training with them.

If you need more support with toilet training contact your Health Visiting Team.

These are two really good videos you can show your toddler: 

• Pirate Pete's Potty Video
• Princess Polly's Potty

Buying your baby or child a car seat can be confusing. It is recommended to buy a baby car seat before your baby is born. Please make sure the seat fits in your car and it is suitable for the age of your baby or child. 

Tips on buying a car seat:

• If possible go to a retailer where they have trained staff that can fit a car seat into your car. Ask them if you can try the car seat in your car before you buy it. 
• Does your car have Isofix connectors? If so, you can get a car seat with the Isofix sign and this will make fitting the car seat into your car an easier process. 
• Always pick a car seat that is right for your child’s weight and height. Click here for further guidance on this from RoSPA. 

Putting your baby/child into their car seat

• By law you must ensure your child is using a car seat, if one is available, for every single car journey. 
• Make sure the car seat is fitted in the car correctly. Please click here for further guidance on this from RoSPA. 
• When you are adjusting the harness on your child’s car seat make sure the harness is quite tight. You should only be able to get one to two fingers between the harness and your child’s chest. Watch this video by Which? on YouTube called 'how to put a newborn baby in a car seat'.
• When using a booster seat, make sure the seat belt goes around both your child and the booster seat. The seat belt should be worn as tight as possible. 
• Never tuck the seat belt under the child’s arm as this does not offer any protection in the event of a car crash. 
• Please make sure you take off your child’s coat or bulky clothing before placing them into their car seat. Coats can be very padded and this stops the car seat straps from working properly in protecting your baby in the event of a car crash. Learn more by reading this information leaflet on the besafe.com website.

For further information on car seat choices and safety please see guidance from RoSPA by clicking here.

Come and meet your health visitor at one of the child health clinics, which are held Monday to Friday across the city. These clinics are all appointment based.

If you would like a private session or separate meeting, please discuss this with your health visitor. 

To find your local health visiting team call 0300 1234586 option 3.

To contact the Derby blood spot screening team, call 0300 3690574, Extension 31859

Your baby's Personal Child Health Record is also known as the red book or PCHR. It's used to record your child's weight and height, vaccinations they've been given and other important health information. You can also add information yourself – it's a great way of keeping track of your child's progress. Remember to take it with you when your baby has appointments at the clinic, GP or hospital.

An online version – the eRedbook – is being trialled in some areas in the UK. Sign up via the link if you're interested in participating in the trial or being kept up–to–date with the developments.

Starting school is a big transition for your child.  There are a few things you can do to help with this transition period.

You may hear your Health Visitor talk about 'school readiness'. The information below will outline what this means.

Here are some handy tips that can help your child learn valuable skills before school starts and they will help them when they start school.

• Does your child know what their coat looks like? Can they put it on and do their zip/buttons on it?
• Let them practise peeling a banana or a satsuma. This will give them great skills for break times
• Can they put on items of clothing by themselves? Make a racing game of it. Can they identify their clothes and put them on first?
• Model putting on and taking off pumps, shoes and socks
• Can your child remove a turning lid?
• Encourage them to use a knife and a fork at meal times
• Talk to them about dinners and packed lunches. What do they want to do? Let them practise carrying their lunch box or a tray if you have one
• Can your child follow simple instructions?
• Show them how to sit with their legs crossed. Get them to practise this with you
• Start reading with your child if you haven't done so already. Encourage them to turn the pages from right to left. Let them tell you a story from the pictures
• They will develop listening skills from you reading to them
• Get some crayons/ colours for them and sheets of paper. Let them colour you some pictures
• Is your child toilet trained? Can they turn a tap on to wash their hands?
• Can your child communicate their needs, such as needing the toilet?

Top tips for when they start school

• A school day can feel like a really long time for a 4/5 year old. To try and help with this, it's really important they get a good night's sleep
• Always provide your child with breakfast in the morning. This will help them to concentrate throughout the school day
• Start to talk about things like assembly, break time, dinner hall, lining up and PE
• If you have any concerns with your child's development, talk to the teacher about it and let them know of any worries nursery may have had

If you require any support with school readiness please call your Health Visiting team and they can support with this.

General Information

• Attend Anywhere - we are now offering video consultations
• NHS website – pregnancy and baby section
• Derby City Council - birth registration
• Mother Hub - Derbyshire's online resource with information for parents before and after birth
• TALK Derby Facebook page - Speech and language support service

Maternal Mental Health

• World Health Organisation (WHO) - Information on maternal mental health
• Mind - What is postnatal depression?
   

Childcare

• Derby City Council - Childcare information for parents/guardians
• Derby City Council – funded childcare
   

Breastfeeding

• National Childbirth Trust (helpline 0300 33 00 771)
• La Leche League – monthly meetings in Derby (24-hour helpline 0845 120 2918)
• Breastfeeding Network (helpline 0300 100 0210)
• Association of Breastfeeding Mothers (helpline 0300 330 5453)
• NHS Start4life - NHS Breastfeeding Guide
• NHS Start4life - Going back to work guide
• Supporter Line in Bengali & Sylheti – 0300 456 2421
• Read our breastfeeding guide 
• View our breastfeeding support page
   

Weaning

• NHS Start4life - Guide to bottle feeding
• NHS Start4life - Guides to weaning
• First Steps Nutrition - Eating well
• First Steps Nutrition  - Healthy start
• NHS website – Weaning
   

Infant Feeding

• NHS Start4life - Baby vitamins
• First Steps Nutrition - Information on infant milks
   

Eating Well

• Healthy Start – applying for vouchers for vitamins and food
   

Keeping Your Child Safe

• NSPCC website – handling your baby
• RoSPA website – safety in the home
• RoSPA website – avoiding children’s accidents
• RoSPA website – product safety information
• RoSPA website – car seats
• Read our leaflet on domestic abuse
   

Safer Sleeping

• Lullaby Trust website - Advice on safe sleeping for your baby
• Handlng baby with care - NSPCC Need to Know Guide
• Don't shake your baby - Advice leaflet
• Caring for baby at night - a guide for parents
   

Immunisations

• Gov.UK - Guide to immunisation
• NHS Website - Guide to Vaccination
• NHS Start4Life - Vaccination Schedule
   

Toilet Training

• Read our guides
   

Useful Apps

• Handi Paediatric -  An app to provide advice on common childhood illnesses
• Baby Check Up - 19 simple checks that parents can do if their baby is showing signs of illness
   

Other Information

• NHS Website - Information on collic
• NHS Website - Information on oral thrush in babies
• Your Information Your Rights - Data Security
• Up Beat Communities - A What's On Guide for Refugees and Asylum Seekers in Derby