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Well Child Tamariki Ora (WTCO)

Provider Update

August 2016

Happy World Breastfeeding Week

(August 1st-7th)!

From the WCTO Promotion Team at the Immunisation Advisory Centre

World breastfeeding week acknowledges the value of breastfeeding for mums and babies.

Breastfeeding is the biological norm and is universally accepted as giving infants the best start in life.1 Breast

milk not only provides optimum nutrition for infants but also includes other functional components that

contribute significantly to the prevention of

illness and disease in the infant, toddler,

child and adult.

Scientific evidence indicates that

breastfeeding has a wide range of health,

nutritional, developmental, immunologic,

psychological, social, economic and

environmental benefits. For the infant/child,

breastfeeding is an important protective

factor against, for example, respiratory

infection, gastroenteritis, glue ear, urinary

tract infection, meningitis, SUDI and diabetes, enhances cognitive function in later childhood and can help

reduce the risk of metabolic syndrome in adulthood.

Breastfeeding contributes to maternal health as it reduces postpartum bleeding, and reduces the risk of pre-

and postmenopausal breast cancer, ovarian cancer and heart disease. In addition, the hormones induced by

breastfeeding provide an emotional support for the postpartum mother. Breastfeeding also aids maternal

bonding.

Figures show that just under 80% of infants are exclusively or fully breastfed at 2 weeks. Latest data show a

drop of 8% between March and September (to 66%) in infants exclusively or fully breastfed at discharge

from LMC. The rate at 3 months of age is 55%.2

1 Unless otherwise stated, this section on breastfeeding is taken from the Well Child / Tamariki Ora Practitioner Handbook, available at www.health.govt.nz/publication/well-child-tamariki-ora-programme-practitioner-handbook-2013 2 Ministry of Health. 2016. Indicators for the Well Child / Tamariki Ora Quality Improvement Framework: September 2015. Wellington: Ministry of Health.

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Breast-milk substitutes

For babies who are not breastfed or do not receive breast milk, an infant formula is the only appropriate

breast-milk substitute in the first year of life.3

The composition of infant formula is modelled on breast milk, although it cannot replicate breast milk

completely because of the large numbers and complexity of the non-nutritional components in breast milk.

While stressing the superior benefits of breastfeeding for both infants and mothers, where mothers and

families decide to feed infant formula to their infant, health practitioners must give objective, consistent and

accurate advice on its safe and proper use.

Health practitioners also need to be aware that some baby bottles sold in New Zealand have inaccurate

volume markings. These bottles tend to be cheaper bottles sold in discount shops. Inaccurate markings on

some of these bottles overestimate the volume of water added to make up the formula, which can have

both short- and longer-term health consequences for babies.

The Ministry of Health recommends that consumers, where possible, buy baby bottles marked with the

EN14350 standard as these are accurate to within 5 mL of 100 mL fluid volume. If parents are not sure

whether their baby bottles meet this standard and/or cannot buy new bottles with the EN14350 stamp, they

should be advised to take their bottles to the pharmacy where pharmacy staff can check the bottle and mark

the correct volume level on them if necessary. There may be a fee for this service. For more information on

this, see the Ministry of Health website (www.health.govt.nz).

There are loads of MoH breastfeeding-related resources available, online or for order, in multiple languages,

and for health practitioners or as health education tools. We’ve picked a few of those available at

www.healthed.govt.nz:

Breastfeeding your baby (HE2098) – a health education resource for mothers

Breastfeeding naturally (HE2255) – a DVD developed for pregnant women as a guide to breastfeeding

Feeding your baby infant formula (HE1306) – for use by health practitioners in advising parents who have

decided to partially or completely formula feed

For a comprehensive list, see pgs 139-141 of the Well Child/Tamariki Ora Programme Practitioner Handbook

As the name suggests, the Well Child / Tamariki Ora Practitioner

Handbook is a resource designed specifically for YOU. Make

sure you download the latest version for intact hyperlinks and

lots of useful information.

The Well Child website has information for providers and

parents alike, and includes a useful “Find a provider” map.

You can complete an online form to add your organisation to this map.

3 Ministry of Health. Implementing and Monitoring the International Code of Marketing of Breast-milk Substitutes in New Zealand: The Code in New Zealand. Wellington: Ministry of Health.

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Well Child Week 2017 and the low-down on next year’s resources

To assist with your planning, we have designated the 27th February—4th March 2017, as Well Child Week.

These dates have been chosen to fit around Children’s Day on the 5th March.

We encourage you to think about planning an event to take place that week

to promote the WCTO programme…

In response to feedback about resources provided for this year’s Well Child Week, next year we will trial a

new approach. Rather than allocating resources in one hit, we will distribute them over the course of the

year.

1. November, 2016: Due to popular demand, we are reproducing our 2015 calendar, in a requested

smaller size. This will be distributed to a resource centre near you in November of this year.

2. February, 2017: We will reproduce our Journey card for next year’s Well Child Week.

3. September, 2017: Finally, we will develop a new resource for distribution at this time.

Upcoming events & notable dates

New Zealand College of Midwives 14th Biennial National Conference: 26th-28th August

https://www.midwife.org.nz/

Final newsletter mail-out date for 2016: 4th November

Updating your contact information

You’ve received this newsletter because you’re on our MailChimp list. You can click on the ‘update’ link on

the bottom of the email to change any details.

If you know other providers who do not receive our newsletter or updates, you can forward this link

(http://eepurl.com/Kp0RP) to them to register.

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Key messages for promotion of the Well Child Tamariki Ora Programme:

1. Enrol your baby at birth to get all their free Well Child Tamariki Ora checks

Your midwife or family doctor can help you choose a Well Child service provider that’s right for you

and your family. Early enrolment gives your child the best follow up care after your midwife’s visits

finish. Making sure your child gets every Well Child check gives them the best start in life.

2. The Well Child Tamariki Ora programme is free for all children, from birth to age 5.

Every child in New Zealand is entitled to a free series of visits with a Well Child heatlh provider,

which cover everything from health and development assessments to whānau care and support, and

health education.

3. The Well Child Tamariki Ora programme is a free, universal package of care to support you to

protect and improve your child’s health.

“Universal” means it is for all children, from birth to age 5. The programme is based on a set of

scheduled visits within certain age bands. Your Well Child Tamariki Ora Health Book shows you when

the health visits are and what they cover. It also has tips for keeping your child healthy and safe.

Well Child providers can make referrals to other services and specialists if your child needs them.

4. There’s a free Well Child Tamariki Ora service to suit you and your whānau.

There are different service providers you can choose from, including Plunket and local Māori or

Pacific providers. Your midwife or family doctor can help you choose. Well Child health visits are

carried out by health professionals including midwives, nurses, health workers (such as Kaiāwhina)

and some GPs. Other people such as vision and hearing technicians and oral health providers can

also undertake some parts of the Well Child service.

5. Is your child getting all their free Well Child Tamariki Ora health visits?

Every child gets a set of free health checks from birth to age 5. These help your kids get the best start

in life. Each visit builds a more complete picture of your child’s health and development. This gives

you the opportunity to know your child is developing well as they grow. Skipping any visits could

mean something important is missed.