Keeping tabs on our young children

By Dr Nikki Turner

New Zealand kids are not doing well and in under-5 mortality rates we are falling behind other developed countries.

We have gone from sixth out of 21 OECD countries in 1960 to 15th in the 1990s. Under-5 mortality is a well-accepted indicator of the overall health status of a country. Local figures are equally depressing - our children have lousy teeth, poor nutrition, low immunisation rates, poor hearing from glue ear ... the list goes on.

So why are we doing so badly? The answer appears to lie in a pile of socio-economic and sociopolitical issues.
Unemployment, poor housing conditions, cultural disadvantages, and broken families are endlessly recurring themes. We cannot easily produce jobs, make happy families or prevent inherent racism. But there are some basic things that we can do as parents, that many of us are not.

How many parents are aware that they are entitled to have eight free Well Child checks for children between the ages of 6 weeks and 5 years? These are obtainable from Plunket, doctors, nurses and, in some areas, local community health workers. In a Well Child check an experienced health professional looks at the whole child.

The aim is to pick up early any problems such as hearing, vision, nutrition, dental, and behavioural, and whether they are getting the necessary immunisations.

A problem that is recognised and addressed early can stop a lifetime of disability. For example untreated iron deficiency causes permanent brain damage, an unimmunised baby can have severe permanent complications from whooping cough, and an uncorrected infant behavioural problem can lead to a school dropout.

To keep children well requires active intervention. We cannot just wait until they are ill to consider their health. Many of these problems are not obvious to a parent and hence the need for a check by a health professional.

It is somewhat like maintenance on a car. When I was a child my mother had this fantastic Plunket Book that recorded a whole range of issues about my growing up. I still use this book frequently to compare with my own children's development. There is a child's record book available, the WellChild Tamariki Ora Health Book. This is where all children's health status should be recorded and followed.

How many parents are given this book and encouraged to use it? Let us start asking for it, taking it everywhere with our children, and insisting all health professionals use it.

The safest record for children is in the hands of their parents.

I believe we can improve on our child health status, but it requires a more active approach, thinking ahead, spotting problems early and recording progress. Well Child NZ is an initiative by all health professionals involved in child health, to refocus on preventive health.

Well Child NZ is a cry for parents to demand children's rights and for the health professionals to deliver easy access to free Well Child visits.

Let us look for the health problems and address them before they overwhelm the children.

* Dr Nikki Turner is the medical director of the Immunisation Advisory Centre and senior lecturer on immunisation and well-child health at the University of Auckland Goodfellow Unit.