Well Child Tamariki Ora (WCTO) Provider Update
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Well Child Tamariki Ora Provider Update_August 2021
Well Child Tamariki Ora (WCTO)
Provider Update
August 2021
Ngā mihi ō te rā ki a koutou mā mai i a mātou ngā kaimahi ō Immunisation Advisory Centre.
Greetings from the WCTO Promotion Team at the Immunisation Advisory Centre.
In this newsletter:
• The Power to Protect programme
• Research: Study to prevent paracetamol poisoning in children (safe administration)
• World Breastfeeding Week events
• New Ministry of Health oral health initiative
• Immunisation coverage and update (in brief)
• Celebration Corner: Rica Larkin, Tamariki Ora nurse, Te Puawaitanga ki Ōtautahi Trust,
Christchurch
• Upcoming events
Plus information on how to register for the WCTO Collective
Hui and the SUDI Prevention Leads across Aotearoa Hui.
In the whakatuaki at right, feathers can refer to teamwork
and the support we provide each other in our work, without
which we are unable to fly.
Similarly, our mahi provides support to whānau, empowering
them to soar.
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Well Child Tamariki Ora Provider Update_August 2021
The Power to Protect Programme
Content provided by Sheila Fowlie, National Co-ordinator, P2P
The Power to Protect (P2P) Programme is a Ministry of Health initiative designed to prevent paediatric
abusive head trauma or shaken baby syndrome. The programme aims to support healthcare providers
support parents/caregivers of young children about the dangers of shaking a baby and to provide
parents/caregivers with tools to cope with a crying baby. Sheila Fowlie is the new National Co-ordinator
for P2P—her role is to provide leadership, co-ordination and support for the implementation and
evaluation of the P2P programme at a national level. The P2P Programme was developed by the team in
Te Puaruruhau (Child Protection) at Starship Child Health and is led by Dr Patrick Kelly, Clinical Service
Director and Honorary Associate Professor, Department of Paediatrics at in the University of Auckland.
What is Abusive Head Trauma (also known Shaken
Baby Syndrome)?
Abusive Head Trauma (AHT) or Shaken Baby Syndrome (SBS)
is defined “as an injury to the skill or intracranial contents of
an infant or young child younger than 5 years of age due to
inflicted blunt impact and/or violent shaking.” 1
AHT is the leading cause of head injury in children under 2
years of age. Around 20 to 30 infants and children with an
average age of 5 months are admitted in New Zealand
hospitals each year. One in five of these children will die and
most survivors will have permanent brain damage. There is
evidence that there are many more children who are shaken
or injured than those admitted with a recognised head injury.
AHT or SBS is a public health issue, that costs New Zealand
approximately 11.7 million dollars per child. This type of
injury can occur in any type of family or ethnicity.2
P2P--6 key messages for keeping baby safe
1. It is normal for babies to cry- and it is normal for caregivers to get frustrated. Crying is
baby’s form of communication.
2. It’s ok to walk away- and take a short break from crying. Put the baby in a safe place,
close to the door and take a break. Do not pick up the baby until you have calmed down.
Talk to someone or call a whanau, a friend or a trusted neighbour.
3. Never, ever shake a baby.
4. Never leave a baby alone with anyone who you think might lose control.
5. If you think the baby has been injured, seek medical help at once.
6. Share this message with everyone.
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Well Child Tamariki Ora Provider Update_August 2021
Prevention is always better than cure.
True prevention is not waiting for something bad to happen before we act on it. It is preventing bad
things happening in the first place.
To keep baby safe, we want new parents and caregivers of young children to know it is ok to recognise
when they have reached their limit. Parenting is hard--but it is ok to ask for help. Encourage them to
have a plan for when baby cries continually. Let them know that crying is worse in the first few months
of life but will get better as baby grows. Talk them through the crying checklist (below). This checklist
may help them identify a reason for their baby’s distress. It may also help parents/caregivers feel less
helpless.1
Crying checklist
• Cuddle baby.
• Try offering baby a feed.
• Change baby’s nappy if it is wet or dirty.
• Make sure baby’s clothing is not too tight.
• Make sure baby isn’t too hot or cold.
• Burp baby (wind pain can be very uncomfortable).
• Wrap and hold baby safely in a lightweight blanket.
• Is baby tired? Put baby down somewhere safe to sleep.
I’ve done all this and baby’s still crying…now what?
• Hold baby close, massage their back, sing, hum or talk to them.
• Give baby a warm soothing bath or take one together. Never leave baby unattended in the
bath.
• Put baby in a stroller and go for a walk or in a car seat for a short drive.
• If you are worried baby is unwell, contact your midwife, GP or Well Child provider.
Resources
• Educators Guide “Power to Protect - coping with a crying baby”, September 2016. Available by
emailing the National Co-Ordinator at SheilaF@adhb.govt.nz
• Posters, Leaflets, DVD’s can be found at https://www.healthed.govt.nz/resource/power-protect-
coping-crying-baby
• E-learning: www.learnonline.health.nz
• Power to Protect video: https://www.youtube.com/watch?v=bM2yc3oRu8g
• Kidshealth- https://www.kidshealth.org.nz/what-can-you-do-when-your-baby-cries
• Plunket- www.plunket.org.nz or call plunketline: 0800-933-922
References
1. National Center for Injury Prevention and Control, Division of Violence Prevention, 2021. Centers for
Disease Control and Prevention. [Online]
Available at: https://www.cdc.gov/violenceprevention/childabuseandneglect/Abusive-Head-
Trauma.html#:~:text=Understanding%20the%20dangers%20of%20shaking,all%20ways%20to%20pr
event%20AHT [Accessed 07 July 2021].
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Well Child Tamariki Ora Provider Update_August 2021
2. Kelly P. Paediatric Abusive Head Trauma in New Zealand. MD thesis.
https://researchspace.auckland.ac.nz/handle/2292/53050
Research: Study to prevent paracetamol poisoning in children
A new Māori-led study will design and evaluate strategies to help caregivers safely administer
paracetamol to children to avoid dosing errors that can potentially cause paediatric acute liver failure
and even death.
Lead researcher Dr Rawiri McKree Jansen (Ngāti Raukawa-Waikato), a practicing GP and clinical
director of the National Hauora Coalition, has received funding from a partnership between the Health
Research Council (HRC), Ministry of Health (via Medsafe) and ACC, to address the challenges caregivers
can face in accurately dosing paracetamol and other medicines for children based on weight.
While the incidence of paediatric acute liver failure caused by paracetamol poisoning is low, Dr McKree
Jansen says it disproportionately affects tamariki Māori, with half of paediatric acute liver failure
patients in New Zealand over the past decade being tamariki Māori.
“The national Poisons Information Centre in Aotearoa New Zealand receives an average of 804 calls per
year relating to paracetamol ingestion in children, nearly a third of which are due to a medication
administration error. This suggests to me that many more whānau struggle with accurate paracetamol
dosing than the small number who end up in emergency departments,” says Dr McKree Jansen.
He says the high rate of potentially dangerous medication errors involving children is due in large part
to the complexity of weight-based dosing. In New Zealand and Australia, common errors in medication
administration that lead to paediatric acute liver failure include exceeding the recommended dosages,
increased dosing frequency and prolonged duration of dosing.
“This kaupapa Māori research will help us understand the needs of Māori caregivers and put their
voices and ideas at the centre of the design and testing of effective strategies to improve the safe use
of paracetamol for tamariki. Our research team also have the knowledge and practical experience to
apply the findings to the safe use of other medicines,” says Dr McKree Jansen.
[…] Medsafe Group Manager Chris James says this research will be a valuable contribution to
Medsafe’s strategy for improving the safe use of medicines, particularly paracetamol use in children.
https://www.hrc.govt.nz/news-and-events/study-prevent-paracetamol-poisoning-children
World Breastfeeding Week: 1—7 August 2021
Organisation for World Breastfeeding Week are well underway. Browse here Virtual Big Latch On events
being held across the country.
Women's Health Action is hosting two events - one in the evening on Friday 6 August, and one in the
morning on Saturday 7 August. They will be running a latch count at both events.
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Well Child Tamariki Ora Provider Update_August 2021
Oral health initiative
The Ministry of Health has launched a new Oral Health Promotion Initiative. A key component of the initiative is the provision of free toothbrushes and fluoride toothpaste
(planned launch later this year) to preschool children and their whānau, with a particular focus on Māori and Pacific children, and those living in low income families.
It is proposed that this be undertaken as a complementary activity to the oral health messaging provided through the Well Child Tamariki Ora (WCTO) programme, as well as via
health providers and community organisations, so that we can opportunistically reach pre-schoolers who may need additional support and/or are not enrolled with a WCTO
provider. The Ministry of Health will circulate further information about this initiative in September. If you have any questions, or wish to provide input into the initiative,
please contact Rebekah Henderson on rebekah.henderson@health.govt.nz.
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Well Child Tamariki Ora Provider Update_August 2021
Immunisation coverage and update
As always, WCTO providers play a significant role in promoting routine childhood immunisation and catch ups.
You can draw upon immunisation existing resources from HealthEd and the 2019 Immunisation Week Toolkit
and if you or your families/whānau have questions about COVID or the COVID vaccines, these may be
answered here.
The most effective way to prevent diseases such as pertussis, rotavirus and measles, is to
promote on-time vaccination as this provides individual and community protection.
Inequities still exist with coverage for Māori and Pasifika children being lower than for non-Māori and non-
Pasifika children. However, as shown in the graph (see next page), coverage for Māori infants appears to have
stopped its downward decline.
Timely vaccination at all ages is important. The importance for older children (ie, at 18 months of age) is to
avoid another measles-susceptible cohort for when the borders open and at 5 years of age before they go off
to school.
6Well Child Tamariki Ora Provider Update_August 2021
Celebration Corner: Rica Larkin, Tamariki Ora nurse, Te Puawaitanga ki Ōtautahi
Trust, Christchurch
Ko Tarakeha te maunga
Ko Opepe te awa
Ko Mataatua to waka
Ko Te Whakatōhea me Ngāti Awa ōku iwi
Ko Ngai Tamahaua tōku hapū
Ko Opape tōku marae
Ko Muriwai tōku whare tipuna
No Otautahi tōku kāinga noho
Ko Te Puawaitanga Ki Ōtautahi Trust te wāhi mahi
Ko Rica Larkin ahau
Tēnā koutou, Tēnā koutou, Tēnā koutou katoa
I have been working as a Well Child Tamariki Ora Nurse since
completing my post-graduate certificate in Primary Health care in Rica, pictured with hubby Mike and
youngest of three, Jade (aged 7 years)
2008. I previously worked for Plunket and am currently working at
Te Puawaitanga ki Ōtautahi Trust and have been since 2011.
Following the birth of my third child in 2014, I had some time off to
be with my whānau and returned to Te Puawaitanga ki Ōtautahi in 2016.
I love the diversity and being able to support and advocate for Māori. In 2019, I completed a post-graduate
diploma in Care and Protection through Child Matters and am currently studying towards becoming a
Lactation Consultant. Timely support is important for whānau.
As well as Tamariki Ora/ Well Child Te Puawaitanga ki Ōtautahi Trust offers a range of services including:
Breastfeeding Advocacy
Wahakura Wānanga
Whānau Mai- antenatal education for Māori
Whānau Ora Navigators
7Well Child Tamariki Ora Provider Update_August 2021
Social Work
Ūkaipō - breastfeeding support
SUDI Prevention
Stop Smoking Practitioner
Family Start
Support to access early childhood education centres
Incredible Years Parenting Programme
Child Car Seat Installation
Healthy Day at the Pa
Māori mobile nursing service
Rapuora- older persons health
Support for mothers who are in Christchurch Women’s Prison with their pēpē
Whānau Whakapuawai- Maternal Mental Health, first 1000 days
Support to navigate the legal processes of the Family Court and Oranga Tamariki
Our newest initiative is the opening of a COVID-19 vaccination clinic with Tangata Atumotu Trust and the Life
Pharmacy at the Hub Hornby. It is called the Māui Clinic@ The Hub Hornby.
As a frontline health worker, I have had both COVID-19 vaccine doses, so I am able to continue to care for and
support whānau accessing our Well Child Tamariki Ora service.
If you or someone you work with would like to feature in the next edition, please contact Andrea
(andrea.teahan@auckland.ac.nz ) adding the subject line “WCTO newsletter: Celebration corner”.
August → events
• World Breastfeeding Week: 1—7 August 2021
• The virtual BIG latch on 2021: 6 & 7 August 2021
• Breathe Better September: 1—30 September 2021, from the Asthma and Respiratory Foundation
• Mental health awareness week: 27 September--3 October 2021
• Midwives Conference: 5 & 6 November
Note that WCTO Symposiums for the remainder of 2021 are currently paused at the request of the Ministry of
Health, who have activities planned for providers as a result of the WCTO programme review.
Website address: www.wellchild.org.nz
Remaining newsletter mail-out dates for 2021: 15 November
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