Uptake of postnatal services for mothers of newborn babies up to eight weeks of age

Aim, Significant changes have occurred in the way postnatal care is funded in New Zealand since July 1996. This study investigated three aspects of po stnatal care: the uptake of the six-week check, the six-week immunisation a nd breast feeding rates. Method. A prospective prevalence survey of 504 mothers of newborn babies re cruited from birthing centres in urban Auckland over the period November 19 97 to February 1998. A postal questionnaire was sent at ten weeks postnatal , covering issues concerning the six-week: check, six-week immunisation and breast feeding. Results. Four hundred and four completed questionnaires were obtained (82%) ; 98% of respondents had obtained a six-week check and 90% a six-week immun isation for their infant. Infants who received their six-week check from a general practitioner were more likely to be immunised. Younger mothers (15- 19 years) and older mothers (35 years plus) were less likely to have immuni sed children. Of reasons given for not immunising, 43% were concerns over i mmaturity of the baby and 27% because the child was not well. At birth, 88% of mothers were fully breast feeding and 62% at six-weeks postnatal. Of th e reasons given for stopping feeding, 41% stated insufficient milk or poor weight gain and 15% stated failure to establish feeding. Conclusions. Removing the six-week check from a general practitioner check and splitting it from the immunisation, has a deleterious effect on immunis ation uptake. Mothers, particularly under 20 years, but also 35 years plus, are less likely to have immunised infants. A significant number of unimmun ised babies arose from concerns that the baby may be too immature. The rate of breast feeding in New Zealand is continuing to drop. Actual rates fall well below mothers' desires to breast feed. Reasons given for stopping brea st feeding point to a general need for greater postnatal support. The high rate of failure to establish feeding raises concerns over lack of early pos tnatal support.