Transcript for A nurse​’s experience in assessing children’s growth​
Megan Cluff (Paediatric nurse): In my practice, I try as much as I can to do that routine growth assessment. When we do recognize that a child is either above a healthy weight or under a healthy weight, we may flag it with parents at that time. Did you realize that your child is sitting here on the chat? Actually physically showing parents on a color-coded piece of paper where their child sits sometimes can be eye-opening to them. That's the time that you can engage with them and say, "Is this something that you would like to address?"
Is this something you would like us to give you some help with? On the back of the routine growth assessment chart, you'll find eight healthy habits and there are eight ideas for families that they can change in their lifestyle.
What I say to parents is, we don't expect you to change all eight at once, but I'll indicate a couple that are really important to change to start off with. I think as clinicians we do worry about the preconceptions that parents would have when we start a conversation about their child's weight. I think good language to use around parents is around healthy growth. It's really important when you're talking to families to be very sensitive to not make the child feel in any way any sort of guilt or any sort of ownership about where they have plotted on that growth assessment.
It's important to do a routine growth assessment for all children, make it a normal part for every child when they visit health professionals. I am lucky to be the registered nurse that joins Hornsby Healthy Kids, because I do get to see down the track the changes in the child, the way they become more positive, the way that they become more active, the relationships they have with their friends and sometimes with their siblings as well.
Health is through the lifespan and we do know that heart disease, osteoporosis, diabetes are ever-increasing illnesses that create capacity on our health system, and you may have that opportunity now to help prevent that family end up in that situation in later life.
Transcript for Assessing children’s growth: a parent experience​
Mikhaila O'Brien (Lachlan's mother): Lachie's always been cuddly, a little bit squishy, ever since he was little, but he was always a tippy-toe walker. So we were then referred to a paediatric physiotherapist at our local community health centre, and while we were there, we had meetings with the local paediatrician who referred us to the Healthy Kids Program and it's gone from there. So we had our first appointment in August last year, and in the 10 months his BMI on the graph has come straight down.
Someone, like myself, who has dealt with my weight all my life, and I think in the area that I grew up, it was a lot more negative attention on that. I decided I didn't want my son to have that journey and we're going to do it in a positive way. It's really important that clinicians have these conversations with parents, it can be worded in a really positive, gentle way, not putting blame on the parents.
It's been really wonderful seeing Lachie grow and develop and build that confidence in himself. Going from a quite a shy child who was very self-conscious, he doesn't feel that he's different anymore. He feels like he fits in and he's keen, he wants to audition for everything, try out for every team. He is just going ahead in leaps and bounds. I've seen other parents here at the clinics and all of us are like, we wish this would have happened sooner. Seeing our children as they become more confident in themselves and as they become more healthy, as their parents, that's all you want. So having clinicians have the courage to raise that with parents, I think, is a really good thing.
Transcript for Assessing children’s growth: an allied health professional experience
Ellen-Marie Confos (Speech pathologist): I work with children with a range of speech, language and fluency issues. In my role as our routine practice, we take the BMI of a child at initial assessment as well as routinely every three months. We plot by their age as well as their height and weight into EMR, our computer systems and from there we can track where a child is and sometimes we are the only person involved in a child's care so from there we're able to have those discussions with families if children are presenting above a healthy weight or below a healthy weight.
Growth assessments are important for a child's overall wellbeing. Weight can affect both physical state but also social wellbeing and mental health for children. So I make sure when I am discussing with families to use appropriate terminology such as within a healthy weight, above and below a healthy weight. So if they're using positive communication tools I believe that the family will be more willing to take advice on board and also say that I am empathetic and wanting to assist the family in making a change I feel like that means we can collaborate together more. Professionals may at times think it's out of their scope of practice. Also it is quite a difficult conversation to have with families that their child is presenting above or below a healthy weight.
It's just really important that health professionals speak to their wider team as well as health services to gain that support to have that conversation and being a part of this initiative has made me realize the importance of seeing a child as a whole and the importance of this routine measure making a positive impact for a child's wellbeing.​
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