>We are trying to decipher a book here and need to know what the 
>definition of a "health visitor" is and what their qualifications 
>are in terms of postpartum visits and support.
>
>Thanks,
>
>Pat Thomas PHN IBCLC
>Winona County Community Health Department
>Winona, MN 55987


Hi, Pat.

"Health visitor (HV)
  Health visitors are registered nurses who have undertaken further 
training to provide health education and preventative care for 
children under five years. Some may also specialise in school health 
and preventative care of the elderly."

In practice, *all* mothers from pregnancy to the time when their last 
child is aged five have a health visitor. She (usually, though there 
are males) is assigned to you by your PCT (Primary Care Trust, 
responsonsible for all healthcare in a defined area). Like all 
healthcare, the service is free to all.

In terms of postpartum visits: typically, the HV will take over care 
from the midwife at about day 10, but sometimes the midwife and the 
HV are involved at the same time. The new mother can usually expect 
at least one home visit from the HV early on, and mothers of multips, 
prems, sick babies, with social probs or postnatal depression etc etc 
will get further visits according to need. Otherwise you would 
normally meet your HV at the clinic, which is a community-based 
service often in a doctor's premises or a health centre but sometimes 
in a community hall or a Sure Start building (Sure Start - govt 
initiative targetting deprived areas). The HV weighs the babies and 
gives feeding advice and so on, up to age 5. They can specialise in 
issues like child protection, and some may be involved in local 
projects like stop smoking or healthy eating and so on.

Their knowledge of breastfeeding and weaning that's supportive to 
breastfeeding varies hugely - some really do know nothing at all, 
some know lots of the wrong stuff, and a few are excellent both in 
terms of knowledge and support. There is a training issue - too many 
even newly-qualified HVs have not had good bf training.

Sheila Company, who subs to Lactnet, is a health vistor, and she is 
one of the excellent ones :)

Heather Welford Neil
NCT bfc, tutor, UK

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