Child and family health nursing in Hunter New England

Our service offers a home or a clinic visit after the birth of your baby. Our nurses will:

• conduct your baby's 1-to-4-week check (see My Personal Health Record (the Blue Book)
• provide health related information 
• suggest other resources and referrals, if needed
• discuss any concerns you may have about baby's health (sleeping, feeding, and how you're going as a parent).

At the 1-to-4-week check, your nurse will check your baby's:

• weight
• length
• eyes
• skin
• umbilicus
• genitalia
• anal region
• circumference
• reflexes 
• femoral pulses
• fontanelles (soft spots on your baby's head)
• hip test for dislocation
• testes (full descended).

After the home visit, you can book a follow-up appointment at one of our clinics.

Immunisation is a simple, safe and effective way of protecting your child against harmful diseases before they encounter them. 

Vaccinating your child helps protect them as well as the broader community. 

The more people who are vaccinated (adults included), provides a greater ability to control serious vaccine preventable diseases.

Child and Family Health Nurses provide free immunisation clinics to children from 6 weeks to less than 5 years.

You will need to call and book prior to attending a clinic.

More information about immunising your child

• NSW Immunisation schedule
• How are vaccines shown to be safe?
• What is in vaccines?
• Following vaccination - what to expect and what to do
• Vaccination and autism - how we know vaccination does not cause autism

From birth to 5 years, every child reaches certain milestones in how they play, learn, speak, act and move.

In NSW, the My Personal Health Record (the Blue Book) is given to all parents after the birth of a child. 

Child and family health nurses conduct health checks based on the development stages in the Blue Book.

When your child reaches pre-school, they will be offered a StEPS vision screening for 4–5-year-olds.

More information about children’s development and screening in NSW

• First five years
• Learn the Signs. Act Early
• Raising Children Network
• Child health and development
• Brighter beginnings (early childhood development)

Audiometry clinics (hearing checks) are conducted by an Audiometric Nurse for children aged from 3 and a half years to 18 years (still at school).

Our hearing clinics are in: 

• Waratah
• Tomaree
• Raymond Terrace. 

To access this service, you will need an audiometry referral form. We can accept referrals from:

• medical professionals
• speech therapists (within the Local Government Area)
• child and family health nurses
• schools and pre-schools
• other health professionals
• a GP (general practitioner) referral is needed for out-of-area clients.

A full hearing check includes:

• hearing history
• otoscopy (ear canal and ear drum check)
• tympanometry (middle ear check)
• pure tone audiometry in a sound booth, which includes air and bone conduction, and air and bone masking (if needed). 

More information about children's ear health

• Boom! Healthy ears = Deadly kids (video)
• Care for Kids' Ears resources
• Care for Kids' Ears - for parents and carers
• NSW Aboriginal Ear Health Program
• Hearing services for children in NSW
• Audiometry Nurses Association of Australia - factsheets
• healthdirect - hearing tests explained
• healthdirect - Ear diseases and disorders explained
• healthdirect - types of hearing loss explained

Infants and children experiencing problems with soiling (encopresis) and wetting (enuresis). This can be a common issue and occur alone or in combination. 

With the right support plan, children experiencing issues with continence (bladder or bowel control) can be more active, social, happy and independent.

About soiling and wetting

Children who experience issues with soiling (pooing their pants), bedwetting (during nighttime) and wetting (during daytime) have usually built this issue up over some time. 

Most children have no control over soiling. It can be associated with constipation or diarrhoea. 

Constipation and soiling

Constipation can occur around the time of toilet training. When your child's stool is hard, painful or difficult to pass, it can make them scared and reluctant to use the toilet.

Soiling (encopresis) can happen without your child knowing. It is when smears of their stool appear in their underwear. It can mean that the bowel is overloaded, and overflow is taking place.

Your child may not feel the urge to go to the toilet because their rectum always feels stretched.

Management of soiling issues include:

• dietary advice
• a good water intake
• a stool diary
• laxative regime
• a toileting program.

Our Paediatric Continence Service

Our Paediatric Continence Service (PCS) can help children with long standing continence issues. We conduct specialist assessments and reviews.

To access this service, your child must:

• be aged 3-16 years
• live within the Greater Newcastle area
• have initially been treated by their GP (General Practitioner), which has been unsuccessful after 3-6 months.

You will need a medical referral from your GP to access our service. Please use our Paediatric Continence Service referral form. 

Please make sure the referral includes:

• detailed information regarding treatment provided so far
• any pre-existing conditions that could affect the treatment plan (example: ASD/ADHD)
• tests completed relating to the continence issue
• outline of the GP's treatment plan to date.

For more information email HNELHD-PaedContSrv@health.nsw.gov.au  

Wetting and bedwetting

Wetting (enuresis) and bedwetting (nocturnal enuresis or 'urinating in the night') is common in school age children from 5 to 17 years.

Bedwetting conditions can be:

• mono-symptomatic - bedwetting only at nighttime.
• non-mono-symptomatic - nighttime and daytime bladder control symptoms:
  • wetting while they're awake
  • needing to wee more often than usual
  • needing to wee as soon as they feel the urge (urgency).

Our Paediatric Urology Team

Our paediatric urology team can assess your child to see which of the two conditions they may have and discuss the right treatment options with you. 

You will need a referral from your GP to access our service. 

Learn more about our child urology services. 

More information about children's continence

• Soiling and constipation
• Bedwetting and Daytime wetting
• Toilet training resources
• Incontinence in children
• Incontinence in teenagers and young children
• How to keep your bladder and bowel healthy
• Five healthy habits for your bladder and bowel - Easy English

Resources

• Bladder diary record
• Bowel diary record
• Drink chart - record of daily fluid intake (PDF 287.57KB)
• Beating sneaky poo - helping children with faecal soiling (PDF 363KB)

After the birth of their child, all parents receive a copy of the My Personal Health Record (commonly known as the Blue Book). 

The Blue Book helps parents and health professionals to track the child's health and development checks and pick up any concerns early. 

The Blue Book is used for record keeping, and as a guide for your child's:

• health checks
• development
• growth
• illnesses
• injuries
• immunisations.

The Blue book is available in English and 18 other languages.

Over the first 6 weeks of your child's life, you will meet our Child and Family Health Nurse a few times. 

Watch little Harry and his mum Jenny's visits to our Child and Family Health Nursing service.

videocam 7:46

Close(Press escape to close)

Video transcript

Look who's talking about their first 6 weeks of life

[Female narrator]
Meet two year old Harry and his mom Jenny
[Male voice over for baby Harry]
Hey how are you?
[Female narrator] 
...and his dad Lachy. 
The first six weeks can be a whirlwind for parents and babies. 
So let me take you back in time and show you all the checks Harry went through to make sure he was growing and developing, protected against diseases, and his mum and dad felt supported.
[Sound of someone knocking on the door]
[Jenny] 
Who's that?
[Male voice over for baby Harry]
Oh come on mum not another visitor, I'm tired! 
[Sound of door opening] 
[Nurse Margaret] 
Hi, I'm Nurse Margaret. 
[Jenny]
Hi Margaret, I'm Jenny and this is Harry. 
[Nurse Margaret]
Hi Harry, how are you? 
[Male voice over for baby Harry]
Good, a bit tired, ready for sleep really.
[Female narrator]
Little did Harry know Margaret is a child and family health nurse who visits families two weeks after birth. 
It's called a universal home health visit, she's there to check all the growth and development of a baby as well as assisting parents with any family health concerns and routine baby questions parents may have.
[Male voice for baby Harry] 
What's going on? What are you doing, measuring me? What for? 
I can't believe this, I don't even know you and the first thing you do is measure my head! 
All right lady, clothes back on now it's not fair! I'm still bumping up, weigh me again in six weeks you'll see!
[Music]
[Nurse Margaret] What about a crawl? Can you crawl for me?
[Male voice for baby Harry]
Come on, honestly, I'm two weeks old! I can't walk, I can't crawl! Next, you'll be asking me to dance!
[Female narrator]
Once the nurse has completed all her checks of the baby, answered any questions mum and dad may have as well as check they're doing okay. All the information is entered in the baby's personal health record it's also called the blue book. 
The blue book records your child's health illnesses, injuries, immunizations growth and development along with valuable health information that you and your child will need throughout their life.
[Male voice for baby Harry] I am so tired! I can't keep my eyes open; I'll see you guys at 1 am. 
[Female narrator]
With Harry asleep it's time to sneak back and see the child and family health nurse. 
For this appointment the nurse will provide practical advice on breastfeeding and can also assist mothers to gain confidence in feeding their baby. 
If a mother is having some struggles, there are also specialist lactation nurses who can offer extra support. 
[Family nurse] 
So, we try and sit with our baby with our feet on the ground and in a lovely position...
[Male voice for baby Harry]
Really? I was having such a nice sleep. Now I wake up to this!
[Nurse speaks to Jenny about breast feeding in the background]
[Male voice for baby Harry]
Mum? Mum, what are we doing here? Well, I'm kind of hungry. Well go on, get on with it! 
[Nurse]
...and your nicely comfortable and relaxed...and baby is comfortable. Try not to be all scrunched up...
[Male voice for baby Harry]
No, no way I prefer how mum does it. Let's not change things now.
[Nurse]
Okay, let's put Harry on the breast, I think he's ready. 
[Male voice for baby Harry]
Hey man, you might want to get out of here. Nothing for you to see. Yeah, just back out of the room, there you go, off you go. Such a pain that guy!
[Male voice snoring sound for baby Harry]
[Female narrator]
Child and family health nurses run early parent groups providing spaces for parents to meet each other, get advice and information from professionals and introduce their babies to each other.
[Male voice for Harry]
Whoa! What's going on here? Where are we? Where all these babies come from? I'm still pretty tired, put me back in the pram mum!
[Nurse in the background]
There are a few new faces today. 
What we might do first of all is get a few introductions. 
If you wouldn't mind just introducing yourself and your baby and tell us how old they are. So do you want to start?
[Jenny]
I'm Jenny and this is Harry and he's 4 weeks old.
[Sarah]
I'm Sarah and this is Fred and Freddy's 10 weeks old. 
[Male voice for baby Harry]
What's up Fred?
[Bianca]
I'm Bianca and this is Lucy and she's 4 weeks old. 
[Male voice for baby Harry makes snoring sound]
[Male voice for baby Harry]
Her cameraman, I'm over you. Get out of here with the camera, okay?
[Female narrator]
Some groups are structured sessions where you can learn about a particular topic. 
Others are more informal where you can share your experiences with other parents, get out of the house, get breastfeeding support, build your confidence or just have a chat with another adult.
It's time for Harry's six-week vaccinations.
Immunisation is a safe simple and efficient way of protecting all our children from diseases. 
All childhood immunization on the New South Wales immunization schedule are free. 
[Male voice for baby Harry]
Oh no! You again, this can't be good. What's this? Hmm, it's not too bad. Maybe this isn't going to be so bad after all. 
More food! Hey, hey...eww, what is that? Can't believe you just did that! Again! 
Why would you do that twice? Mum, I really need a hug! Thanks, mum, really starting to feel a bit better now.
[Female narrator]
Timely vaccination is the best way to keep your child protected from serious vaccine preventable diseases. 
Developmental checks take place in a child and family health clinic from six to eight weeks of age to monitor the health and development of your child.
The child and family health nurse will be looking at how your child is moving and doing for example, holding their head, smiling, making sounds,
looking at you and later on crawling, walking, fingers and hand movement 
[Male voice for baby Harry]
Oh you know one of your friends came to my house a few weeks ago, and I did this. 
Little heads-up, I've had a lot to drink this morning. I'd watch out if I were you. 
I've been doing curls since the last visit you probably can tell. Dad always says I look like a deer in the headlights. 
I think I know what he means right now. Come on you and I both know that's not gonna happen. 
Flip me back over. You just wait in a few months I'm coming back I'll be planking doing one-armed push-ups you name it. I'm doing it.
[Female narrator]
Development checks are our opportunity to discuss concerns and for health practitioners to offer advice and support if your child is
not meeting the milestones for their age. 
If any problems are identified the child and family health nurse can refer your child to the appropriate agency early for help.
[Male voice for baby Harry]
Hey thanks for following me through my first six weeks of life.
Look I know I was a bit of a grump at first but I'm pretty old now, more mature, just turned six months and I know it was to make sure that I stayed healthy.
Mum and dad said I'll be visiting the child and family health nurses until I'm five which is cool.
I want to make sure I don't get sick from something that can be prevented plus I promised the nurse one-armed push-ups before my third birthday.
Hey thanks for watching.
Ta ta

Breast- and bottle-feeding resources

• Pregnancy, birth and baby in Hunter New England | NSW Government
• Breastfeeding and bottle feeding - NSW Government
• Breastfeeding your baby - First five years
• Bottle feeding your baby - Pregnancy Birth and Baby
• Resources - Australian Breastfeeding Association
• Increasing your milk supply - Australian Breastfeeding Association
• Bottle-feeding babies: giving the bottle - Raising Children Network
• Breastfeeding translated resources - Multicultural Health Communication Service

Learning and development

• Love Talk Sing Read Play app: has tips for every family to help their child (from 0 to 5 years) learn and develop. The app is also available in other languages. Download from the Apple App Store or Google Play.
• Deadly Tots app: information for every Aboriginal family with a child/children aged 0 to 5 years, to help their bub learn and grow.

Other resources

• HB4HNEKids Resources: Good for Kids, Good for Life
• Introducing solids: why, when, what & how - Raising Children Network
• Increasing iron in infant nutrition - Raising Children Network
• Common childhood illnesses: stopping the spread - NSW Health
• Serious childhood illnesses: 0-3 years and what to do - Raising Children Network

For new parents, it is normal to feel overwhelmed at tired, the good news is there is information available online to assist you in the parenting journey.

Our Child and Family Health Nurses can offer parents information or advice on:

• feeding and nutrition
• normal infant behaviour
• sleep and settling
• toddler behaviour
• child safety
• immunisation
• play and development.

If you need additional support, other services are available. You can discuss the options with your Child and Family Health Nurse. 

Learn more about parenting education services in Hunter New England LHD.

Resources to look after yourself (parents)

• 1300 1300 52 - Parent Line NSW
• Parenting SA - Parent Easy Guides
• Karitane - parent guidance and support
• Tresillian - parent guidance and support
• Dad's guide to fatherhood - Pregnancy Birth and Baby
• Parents and carers: looking after yourself - Raising Children Network
• Post-birth recovery and healthy lifestyles for mum and dad - Raising Children Network

Parenting groups

Parent groups are a positive way to connect with other families, gain knowledge and support, chat and exchange ideas. A Child and Family Health Nurse runs the groups and discussions, including information on:

• breastfeeding support and advice
• sleep and settling 
• immunisation
• adjusting to parenting.

Many parents continue to support one another and catch-up after the group program ends.

• Our 3-week parent support groups are delivered from multiple sites. This program is for first-time mothers and supports them through their baby's first 12 weeks.

Call (02) 4923 6920 to register for a parent group or for more information.

Every baby sleep and settle in their own way. You can establish a sleep routine for your baby and find where to get help if your baby isn't sleeping.

Your Child and Family Health Nurse can refer you for support to:

• First Steps Parenting Centre
• Tresillian family support service
• Karitane family support service

To access our services, you will need a referral and to make an appointment. 

Referrals can be made by a: 

• Child and Family Health Nurse
• doctor or GP (General Practitioner)
• other health professional 
• family worker.

If accepted, we will contact you to discuss your referral.

What to bring

• Blue Book
• nappies
• wipes
• snacks
• things that help your baby go to sleep.

Phone:(02) 4939 2530

Email:HNELHD-MaitlandFamilyCare@health.nsw.gov.au 

Fax: (02) 4932 0097

Street address:Melbee House, 550-560 High Street Maitland NSW 2320

Postal address: PO Box 2320, Maitland NSW 2320

Hours: 8.30am to 4.30pm, Monday to Friday

This service has wheelchair access.