Roles, responsibilities and referrals
This module consists of the following sections:
- Supporting children with unhealthy weight
- Roles in promoting healthy weight at pre-school age
- Tipping points
- Onward referrals
This module aims to equip professionals with key knowledge of their own and other professional’s roles in the prevention and management of pre-school weight, and when and where to refer a child of unhealthy weight.
By the end of this module, you will be able to:
- understand your professional role in the prevention and treatment of unhealthy weight;
- understand the roles of other professionals involved in pre-school weight management and where you fit with this; and
- identify factors to consider when determining where and who to refer to (including signs and symptoms of genetic conditions).
Who is involved in promoting healthy weight in pre-school children?
“As health visitors, it is our role to discuss healthy eating in the post-natal period during our visits (up to 9 months). If families bring their child to the health drop in at children’s centres for their baby/child to be weighed this allows us a further opportunity to promote healthy lifestyles. We will discuss appropriate family foods, milk intake and physical activity. I may refer children to leisure services for example, buggy buddies. We also have contact with ‘targeted’ families until the child is 5 years old. Although weight is not the main focus it provides potential further opportunity for health promotion. We refer to a GP when indicated in our guidelines” (Health Visitor)
“Following a referral into secondary care (i.e. children over 98th centile, where: the family is seeking help; the child has extreme obesity (BMI 3.5 SD above the mean); or the child has risk factors for underlying pathology e.g. short stature for the degree of obesity; comorbidities). If a child is referred to me for obesity, I would take a history/examine the child with the view of diagnosing any comorbidities of obesity (for example, high blood pressure, type II diabetes, etc.) and/or look for any underlying pathologies pre-disposing the child to obesity. Pharmacological treatments would only be employed if multi-component interventions aiming at diet, exercise and other life style changes had been unsuccessful. I would work with other health professionals including GPs, dieticians, community weight reduction services to help support the family with education around obesity and lifestyle changes. Extremely obese children and/or children with certain co-morbidities may be referred to tertiary care.” (Paediatrician)
The children’s centres aim to promote health and healthy weight from pre-birth onwards, we support families in a number of ways; we provide HENRY parenting courses and universal daily activities, in addition to nursery provision which are all underpinned by EYFS child development. All the activities we offer have underlying themes of healthy eating and increasing physical activity, and healthy snacks are provided. The café’s in children’s centres offer healthy foods for all the family.
The relationships children’s centres have with families means we are in a position to notice and raise any issues or provide the opportunities for parent to raise any issues they have. We regularly work with health visitors in order to support families and recently the two year development checks have been moved to take place in children’s centres, as the Health Visiting teams are now based within Children’s Centres.
The Geographical Team have also been trained to deliver the family Health Drop In’s and are able to offer universal support and advice in relation to weighing and measuring children, If there are any concerns parents are able to discuss these there and then with a health visitor. These sessions run in parallel to the Midwifery Clinics, Breastfeeding Groups and Baby Play Group.
In addition to the services provided by children’s centres, as Geographical Senior Early Years worker we are able to go out and make home assessments of any targeted families or families who may need some additional support. From here, we will often work alongside a range of other professionals to support families in a coordinated way. This also provides and extra opportunity to inform parents about what children’s centres offer.
Children’s centres in Blackburn with Darwen provide a wide range of universal groups and services that any professional can refer/signpost families to. Are you aware of the children’s centres in your area?
Find your nearest children’s centre.
Below is a list of the types of services and activities your local children’s centre may offer:
Health visitor drop-in: health visitors hold regular drop-ins at children’s centres where families can come in to talk to health visitors and have their child weighed. Children’s centre staff are now running weigh-in clinics which overlap with the health visitor drop ins. If any concerns around the child’s weight arises during these weigh-ins parents are able to discuss any concerns with a health visitor.
HENRY (health exercise and nutrition for the really young) parenting courses: Children’s centres run universal 8 week HENRY courses for parents of carers of children aged 0-5 years old. There are free for parents to attend. Parents are able to self-refer onto these courses or can be referred by a health professional. HENRY courses aim to support parents and equip them with the skills to give their child a healthy start in life.
Other children’s centre services include:
- Active play
- Routine family meet and greets
- Classes on healthy eating and portion sizes
Are you aware of the leisure centre services in Blackburn and what they offer? (e.g. parent and toddler swimming)
To find out more take a look at the website.
“If I was in a consultation with a family with a pre-school child and for example they had come in about a child’s asthma and the child visually looked overweight (which is something that may contribute to their health problems), I would plot the child on the centile chart and use this to help explain to the family about the weight status of their child. I would then spend a few minutes talking to the family about their child’s eating and activity, and offer advice on this. I would give the parents the opportunity to go away with this information and come back to see me or the practice nurse about how things are going. If the parents felt they needed extra support I would signpost them to the children’s centre.” (GP)
Community nursery nurse
As a nursery nurse I regularly see children from birth to 5 years, either at weekly clinics or routine health development reviews. Development reviews are completed at a number of stages. For pre-school age children these take place between 2, and 2 and a half years of age. During these contacts I have the opportunity to discuss and promote healthy lifestyles. I talk about the types of food the family eat, the child’s milk intake, physical activity and the child and families meal time routines. If I have any concerns, I may refer the family to a ‘HENRY’ course, or for targeted support with mealtime management and eating routines at home. The child’s measurements are taken during these health reviews and plotted on the centile charts to review the measurements. Where concerns are identified with obesity or underweight, referrals are completed as appropriate to other professionals.