Health Education and Promotion

Young families are growing up more isolated, without the support of extended families. In the UK health promotion is delivered by health visiting teams through the Healthy Child Programme. The programme involves a package of care that includes guidance, immunization, screening and identification of children with a variety of needs. It is underpinned by a principle of progressive universalism where all children receive a basic service with increased input according to a child’s or family’s needs, so ensuring that the most vulnerable families are supported. Routine contact takes place in the first two weeks, at 6–8 weeks, 6–12 months and at 2–2½ years, and parents can attend drop in clinics when they choose. Sure Start Children’s Centres, a UK government initiative, provide skilled staff and facilities where child health promotion is core to their work.

Parental Mental Health

Parents’ ability to provide a quality home life for their families can be profoundly affected by mental health. An important aspect of child health promotion is to recognize when this is an issue and to guide parents towards receiving appropriate help. Postnatal depression is common and health visitors are alert to identifying it and ensuring support is in place.

Parenting Support

Many young parents have had little experience of young children before having a baby, and lack the support of an extended family. An important component of health promotion is supporting parents and helping them develop the skills to cope with the challenges of bringing up children. One way is to offer parents the opportunity to participate in a parenting programme where they are helped to enhance their parenting skills and have the benefit of sharing their concerns with others.

Baby Care

Guidance is routinely offered to parents about all aspects of baby care, including clothing, bathing, handling and positioning the baby. Information is also given about normal development, what to expect from the child, how to promote learning and how to recognize developmental difficulties. Advice is given about common medical problems, and how to manage them.

Nutrition

Addressing nutritional issues forms a major part of a health visitor’s work. It includes promotion of breast-feeding, advice about weaning, dealing with eating difficulties commonly encountered in toddlers, and education about healthy diets for the entire family. Now that obesity is epidemic in children, an important aspect of child health promotion relates to ensuring that children have a healthy balanced diet and to increasing their physical activity (see Chapter 10).

Child Development

Early intervention is important if a child has developmental delay or a developmental disorder. A key aspect of child health promotion involves the early detection of developmental concerns and directing the family to appropriate evaluation and input (see Chapter 3).

Behavioural Problems

Behavioural concerns around crying, sleep and temper tantrums are universal. Advice and support in the early stages can avoid them developing into major problems.

Immunization and Screening

These important aspects of the child health promotion programme are covered in Chapters 8 and 14.

Passive Smoking

Children exposed to passive smoking are at greatly increased risk for respiratory disorders. Avoidance of exposing children to smoke at home is an important health promotion issue.

Injury Prevention

Most injuries occur in the home, so education of parents can have an important impact on their prevention. Issues of importance include car seats and belts, road safety and use of cycle helmets, gates on stairs, safety in the kitchen, protection against fire hazards, covering electric sockets, and keeping medicines/poisons out of reach.

Identifying Risks and Safeguarding Children

Raising children is a challenging task and it is made more so when families live in poverty, when parents lack education, where there are mental health problems or there is domestic violence. Where there are concerns that a child might be the victim of neglect, non-accidental injury or emotional or sexual abuse, social care needs to be informed (see Chapter 65). Health visiting teams have a key role in monitoring children who require safeguarding and are particularly well placed for this.

Health Promotion in School

School provides an invaluable opportunity to educate the young about healthy living, and, hopefully, the school years are a time when adjustments in lifestyle can be made more easily than later on in life. Issues of particular importance that are addressed are:

• Nutrition
  
• Physical activity
  
• Reducing risk factors for obesity
  
• Drugs and alcohol abuse
  
• Contraception and safe sex
  
• Sexually transmitted diseases
  
• Smoking
  
• Healthy relationships
  
• Parenting skills.