It turns out that plenty of new mothers aren’t exactly forthcoming with Plunket nurses.

Pressured new mums not always honest

For people from outside New Zealand, Plunket is an in-home baby and new parent support service. When you have a new baby, and after you have left your midwife’s care, or hospital care, you sign on with a child and baby health support service. Someone from that service will visit you at home while your baby is tiny, to give you advice and assistance with everything from bathing the baby, to feeding it, to managing older siblings. Once your baby is a little older, you will visit the support provider’s rooms. The support provider will carry out a series of “well child” checks (height, weight, developmental milestones, general health). Plunket is the oldest of these services in New Zealand, and for a long time, it was the only provider of such services. It is much lauded, with good reason.

But… it’s very judgey, even when it’s not meant to be. You will breastfeed your child for six months. You will worry if your child is not lifting her head at 3 months. You will never let the baby sleep with you. All the rules for looking after small babies and children, laid down in black and white.

Here’s the problem. Even when Plunket nurses try not to be judgey, they are. You can be made to feel very small for having strayed from the guidelines in any way. And those guidelines turn out to be not very flexible at all. When my younger daughters were about 18 months old, I took them in for a regular checkup. They were doing well, but then I was asked how much milk they drank each day. About 400 to 500mls, I said. Neither of them were fond of milk.

I got the look. “You really should get them to drink more milk. They should be drinking about 600mls a day.”

My older daughter was with us, so the Plunket nurse took the opportunity to check up on her too. She was about four at the time. “And how much milk is Miss Four drinking each day.”

About 800 to 1000mls. She really liked milk. “Too much. She should only be drinking 600mls a day.”

So it turned out that the “guideline” was in fact a rigid rule, and any straying from that was not to be discussed in the context of the whole child, and what else she was eating and drinking.

I am a highly educated, middle class, white woman, and I felt intimidated, and judged. And really, even if I was doing all the “right” things, it would be hard not to feel judged. Health service visitors come into your home and assess what you are doing with your children. It’s very intrusive, even when it’s very helpful. My Plunket nurse was also a source of some great advice, especially with respect to managing twins. Even so, at times I found the advice, well, judgemental.

But for all that, take a look at the story about new mums not necessarily being honest with Plunket. It’s all framed as being a problem with the mothers.

Lying to Plunket nurses has become commonplace among first-time mums as they shy away from confrontation and questions about their baby’s milestones.

Let’s turn it around, and think about the source of the problems. How about…

Pressure from Plunket nurses is so great that young mothers feel they have to conceal things.

Then this becomes a story about how the support structures around new parents aren’t working, and a story about the need for better training of Plunket nurses and other health care workers. Simple stuff, like how to frame a conversation. For example, here’s a bad conversation.

Mum: I’ve started my five month old on solids.
Nurse: Really, she shouldn’t have solids until she’s six months old.

And here’s a simple way to talk about exactly the same issue.

Mum: I’ve started my five month old on solids.
Nurse: Okay. What was your thinking around that?
Mum: She seemed to be very hungry, and she’s a big baby for her age. It’s only a little amount of rice cereal, in the evenings.
Nurse: Yes, I understand that. Just take it gently, and try to keep it down to just a little bit for the next month or so.

Framing. It makes a difference.