Childrens Health

Hertfordshire Family Centre Service

Your Baby's Health And Development Reviews

You will be offered regular health and development reviews (health visitor checks) for your baby until they are 2. These are to support you and your baby, and make sure their development is on track.

The reviews are usually done by a health visitor or a member of their team. They may be done in your home or at a GP surgery, baby clinic or children’s centre.

It’s helpful, where possible, for both parents to attend. This gives you both a chance to ask questions and talk about any concerns you have.

 

The personal child health record (red book)

Shortly before or after your baby is born, you’ll be given a personal child health record (PCHR). This usually has a red cover and is known as the “red book”.

It’s a good idea to take your baby’s red book with you every time you visit the baby clinic or GP.

They will use it to record your child’s weight and height, vaccinations and other important information.

You can also add information to the red book yourself. You may want to record any illnesses or accidents your baby has, or any medicines they take.

You’ll find it helpful to keep the developmental milestones section of the red book up to date too.

 

What happens at your baby’s reviews

During your baby’s reviews your health visitor will discuss your baby’s health and development, and ask if you have any concerns.

If your baby is gaining weight and you and your health visitor have no concerns, they should be weighed no more than:

  • once a month up to 6 months of age
  • once every 2 months from 6 to 12 months of age
  • once every 3 months over the age of 12 months

This gives a clear idea of your baby’s weight gain over a period of time.

If your baby was born prematurely, their developmental age will be calculated from your original due date, not from the actual date they were born, until they are 2 years old.

 

The Ages and Stages Questionnaire (ASQ-3)

Your health visiting team will send you a questionnaire, known as the “Ages and Stages Questionnaire” or ASQ-3, to fill in before your child’s 9 to 12-month and 2-year development reviews.

This allows you to try out some of the activities covered by the questionnaire with your baby at home, where they are comfortable and in familiar surroundings.

 

When your baby will have their reviews

Your baby will usually have reviews at the ages we talk about on this page. If you have any concerns at other times, you can contact a health visitor or GP, or go to your local baby clinic.

 

Shortly after birth

Your baby will be weighed at birth and again during their first week. They will also have a thorough physical examination within 72 hours of being born. A health professional will usually check your baby’s eyes, heart, hips and – for baby boys – testicles.

At 5 and 8 days old your baby will have a blood spot (heel prick) test that screens for several rare diseases, including cystic fibrosis and sickle cell disease. This is usually done by the midwife.

Find out more about the newborn blood spot (heel prick) test.

Your baby will also have a hearing test soon after birth. If you have your baby in hospital, this may happen before you leave. Otherwise, it will be done some time in the first few weeks in your home, at an outpatient clinic, or at your local health centre.

Find out more about the newborn hearing test.

A midwife and health visitor will also support you with breastfeeding, caring for your new baby, adjusting to life as a new parent.

 

1 to 2 weeks

A health visitor will do a new baby review within 10 to 14 days of the birth. 

They can give you advice on:

  • safe sleeping
  • vaccinations
  • feeding your baby (breastfeeding and bottle feeding)
  • adjusting to life as a new parent
  • your baby’s development

 

6 to 8 weeks

Your baby will be invited for a thorough physical examination. This is usually done by a GP.

Your baby’s eyes, heart, hips and – for boys – testicles will be checked. They’ll also have their weight, length and head circumference measured.

A GP or health visitor will discuss your baby’s vaccinations with you. These are offered at 8 weeks, 12 weeks, 16 weeks and 12 months old, and before your child starts school.

They’ll also ask you how you’ve been feeling emotionally and physically since the birth of your baby.

 

9 to 12 months

During this time, your baby should be offered another review looking at, among other things, language and learning, safety, diet and behaviour.

This is usually done by a member of your health visiting team. It’s an opportunity for you to discuss any concerns you may have.

Your health visiting team will send you an ASQ-3 questionnaire to fill in before the review. This helps you and your health visitor understand how your baby is developing.

Do not worry if you cannot fill in the whole questionnaire – a health visitor will help you complete it.

 

2 to 2-and-a-half years

At 2 to 2-and-a-half years your child will have another health and development review. It’s best if you and your partner can both be there.

This is usually done by a nursery nurse or health visitor, and may happen at your home, baby clinic or the children’s centre.

If your child has started going to nursery, playgroup or a childminder, the review may be done there. You, a health visitor, keyworker or childminder will all do the review together.

You’ll be sent an ASQ-3 questionnaire about your baby’s development to fill in before the review. A health visitor, keyworker or childminder can help you with this.

This review will cover:

Height, weight and reviews

Learn about your baby's reviews and what happens during them.

 

Teething

How to help your baby with teething and how to look after their teeth.

 

Potty training and bedwetting

Get tips on how to potty train your child and help with bedwetting.

 

Behaviour

Learn how to deal with behaviour issues and temper tantrums.

 

Vitamins for children

Vitamin supplements

The government recommends all children aged 6 months to 5 years are given vitamin supplements containing vitamins A, C and D every day.

Babies who are having more than 500ml (about a pint) of infant formula a day should not be given vitamin supplements. This is because formula is fortified with vitamins A, C and D and other nutrients.

Babies who are being breastfed should be given a daily vitamin D supplement from birth, whether or not you're taking a supplement containing vitamin D yourself.

 

Where you can get baby vitamin drops

Your health visitor can give you advice on vitamin drops and tell you where to get them.

You're entitled to free vitamin drops if you qualify for Healthy Start.

The Department of Health and Social Care only recommends vitamin supplements containing vitamins A, C and D.

But some supplements you can buy contain other vitamins or ingredients. Talk to a pharmacist about which supplement would be most suitable for your child.

Having too much of some vitamins can be harmful. Keep to the dose recommended on the label, and be careful not to give your child 2 supplements at the same time.

For example, do not give them cod liver oil and vitamin drops because cod liver oil also contains vitamins A and D. One supplement on its own is enough, as long as it contains the recommended dose of vitamin D.

 

Vitamin D

Vitamin D is only found in a few foods, such as oily fish and eggs. It's also added to some foods, such as fat spreads and breakfast cereals. But it’s difficult to get enough vitamin D from food alone.

The main source of vitamin D is summer sunlight on our skin. But it's important to keep your child's skin safe in the sun.

Children should not be out in the sun too long in hot weather. Remember to cover up or protect their skin before it turns red or burns.

Young children should still have vitamin drops, even if they get out in the sun.

The Department of Health and Social Care recommends:

Babies from birth to 1 year of age who are being breastfed should be given a daily supplement containing 8.5 to 10 micrograms of vitamin D to make sure they get enough. This is whether or not you're taking a supplement containing vitamin D yourself.Babies fed infant formula should not be given a vitamin D supplement if they're having more than 500ml (about a pint) of infant formula a day, because infant formula is fortified with vitamin D and other nutrients.Children aged 1 to 4 years old should be given a daily supplement containing 10 micrograms of vitamin D.

 

Vitamin A

Vitamin A is important for babies and young children, and some may not be getting enough.

It's needed for a healthy immune system, can help their vision in dim light, and keeps skin healthy.

Good sources of vitamin A include:

dairy productsfortified fat spreadscarrots, sweet potatoes, swede and mangoesdark green vegetables, such as spinach, cabbage and broccoli

 

Vitamin C

Vitamin C is important for your child's general health and immune system. It can also help their body absorb iron.

Good sources of vitamin C include:

orangeskiwi fruitstrawberriesbroccolitomatoespeppers

 

A balanced diet for babies and young children

It's important for children to eat a wide variety of foods to make sure they're getting all the energy and nutrients they need to grow and develop properly.

Children and young people's services

If you're worried about your child's development or wellbeing and you think they need extra support, speak to their GP, health visitor, teacher or nursery worker first.

Ask for advice about what to do next to help your child. If you or your child needs more significant support, contact the children's services team at your local council for a needs assessment.

 

Needs assessments

A needs assessment is carried out by the children's services team at your local council and determines if your child needs more specialised support.

Children's services must work with you when making decisions about your child, so discuss with them the type of help that would best meet the needs of your family.

 

Family support

Family support can include help looking after your child, such as:

day care for children under 5help with parenting – such as parenting classescourses or family support workerspractical home helpaccess to a Children's Centre

Support services may also be provided by education or health authorities, or by voluntary organisations.

Many of these services are available to all families. Check your local council's website to see what's available in your area.

You may also find support from these charities:

Family Lives – provides information, advice, guidance and support on any aspect of parenting and family life. Their helpline number is 0808 800 2222Gingerbread – provides single parents with advice and practical support. You can call the Gingerbread Single Parent Helpline on 0808 802 0925Relate – provides relationship support, including help for children and young people and help with family life and parentingSingle Parents – provides single parents with help, advice and supportYoungMinds for Parents – provides advice about mental health and behaviour problems in children and young people. You can call the parents' helpline on 0808 802 5544Family Rights Group – provides parents or other relatives with advice about their rights and options when social workers or courts make decisions about their children's welfare. Their advice line number is 0808 801 0366

 

Children with special educational needs and disabilities

Additional help is available for parents and children with special educational needs and disabilities.

get an overview of the help available if you have a disabled childfind out about the support available for children with special educational needsGOV.UK has information about the help and support available from local authorities, schools and collegesCaring for a child with complex needs explains the support available for parents whose child has been diagnosed with a long-term conditionTips for caring for a disabled child includes practical advice about everyday hands-on caring, such as feeding, going to the toilet, and moving around

 

Looked-after children

Local authority children's services have responsibilities for the children they look after who live with foster carers or in residential care on either a short- or long-term basis.

These organisations also offer information and advice:

Coram Children's Legal Centre – offers free legal information, advice and representation to children, young people, their families, carers and professionalsThe Fostering Network – offers information and advice to foster carersCoramBAAF Adoption & Fostering Academy – promotes standards of practice in adoption, fostering and childcare services

The Family Rights Group offers independent specialist information and advice for families about children who are looked after in care.

For more information, read the Family Rights Group's advice sheets about looked-after children.

Read more about help available after adoption and fostering

 

Child protection

Child protection is available to children and young people who are at risk of significant harm and need protecting. This includes harm from physical, emotional or sexual abuse, and neglect.

If children's services suspect that a child may be at risk of harm, they must look into the child's situation and take any action necessary to keep them safe and promote their welfare.

If child protection enquiries have been made about your child, it does not necessarily mean your child will be taken away from you. But your child will be interviewed or medically examined without you being present.

The Family Rights Group offers independent specialist information and advice for families about child protection procedures.

For more information, read the Family Rights Group's advice sheets about child protection.