Public health nurse (PHN) visits and baby checks in Ireland: what happens at each one?

The Public Health Nurse, your PHN, is one of the most useful people you'll meet in the first year. They're free, they come to your home for the first visit, and they'll answer questions a Google search will never satisfy. Here's a plain guide to what to expect.

When does the PHN visit a new baby in Ireland?

Your PHN will:

• Visit at home, usually during your first 3 days at home with your baby
• See you and the baby again at 3 months, at the health centre
• See you again at 9 to 11 months
• Provide weight checks and developmental reviews in between if needed

You'll also see her, or him (male PHNs exist, just rarely encountered), at developmental checks at the local clinic.

What happens at the first PHN visit?

This is the longest one, usually 60 to 90 minutes. They'll:

• Weigh the baby
• Check the umbilical stump
• Talk through feeding, especially if you're breastfeeding
• Check on you (how you're sleeping, how you're feeling, any tears that aren't healing)
• Hand you the vitamin D drops if hospital hasn't already
• Talk through the vaccine schedule
• Leave you a folder, a number, and the words "ring me if you're worried"

It's worth saying: they're checking on you too, not just the baby. If you're struggling, this is the time to say it. Postnatal mental health is part of the visit, and you'll never get a better-trained sympathetic ear in your kitchen.

Around the same time your baby is offered the heel prick test, which the midwife or PHN does at 3 to 5 days old.

What happens at the 3-month PHN check?

This check takes place at the health centre rather than at home. They'll:

• Weigh the baby
• Look at general development (smiling, head control, response to sound)
• Check immunisation status
• Ask about feeding patterns and sleep
• Give weaning advice as you approach 4 to 6 months

What happens at the 9 to 11 month PHN check?

• Weighing and measuring
• Developmental check (sitting, babbling, finger food handling)
• Hearing check
• Talking about toddler feeding, sleep changes, the transition to family food

What should I have ready for a PHN visit?

You don't need to prepare a presentation. A few things help:

• A nappy bag and a clean change, in case
• Bottle or breast access for if baby gets hungry
• A list of any questions or concerns, because most parents forget half of them otherwise
• Your baby's red folder if it's an at-clinic visit
• Sleeping baby? Don't wake them. They can usually weigh during a sleep.

What questions should I ask the PHN?

A short list. None of these are silly. PHNs have heard all of them.

• Is what I'm seeing normal?
• How do I know if reflux is bad enough to do something?
• When should I start weaning?
• Why is my baby waking up more than they were three weeks ago?
• What's the actual difference between cradle cap and eczema?

When are the public health nurse checks and developmental checks in Ireland?

Put together, the routine checks in the first year look like this: the first PHN home visit within 72 hours of coming home from hospital, the 2-week and 6-week checks with your GP under the Maternity and Infant Care Scheme, the 3-month PHN developmental check, and the 9 to 11 month PHN developmental check with the hearing test. Further developmental checks follow as a toddler. Weight checks and extra visits happen in between whenever you or the PHN want them. If you are not sure what to bring or what they will ask, our short list of the questions the PHN asks at every visit covers it.

How do I remember what to tell the PHN?

Write it down when it happens, not the night before the visit. You're at home at 2am wondering if a certain sleep pattern is worth mentioning, and by the next appointment you've completely forgotten. If sleep is the worry, our guide to how much sleep a newborn needs covers the normal ranges.

Lullagram lets you flag concerns as they happen, and they sit in your healthcare report ready for the next visit. The full report (feeds, sleeps, nappies, weights, anything you've flagged) is one tap to print or email. It is free to try on Android, iPhone and web.

A lot of PHNs love seeing it. You stop sounding vague ("she's been waking more, I think") and start sounding specific ("she's woken 4 times average for the last 8 nights, up from 2"). The advice you get back is better as a result.

For the full HSE timetable of what your PHN will check at each visit, see the HSE 0 to 6 months health checks page and the 6 to 12 months page.

What developmental checks does my baby have in Ireland?

Your public health nurse (PHN) does your baby's developmental checks at 3 months, 9 to 11 months, 21 to 24 months and 46 to 48 months. Before that, the PHN visits you at home in your first 3 days at home with your baby, and your GP practice checks your baby at 2 weeks and 6 weeks. The 9 to 11 month and 21 to 24 month checks include a hearing assessment.

• First 3 days at home: a PHN home visit to weigh and examine your baby
• 2 weeks: your GP or GP practice nurse weighs your baby and checks how they are developing
• 6 weeks: your GP examines your baby and checks their hips, heart and eyes
• 3 months: a PHN developmental assessment at the health centre, including weighing, measuring and a check of how your baby moves
• 9 to 11 months: a PHN developmental check, including an in-depth hearing assessment, speech and movement
• 21 to 24 months: a PHN developmental check, including hearing and speech
• 46 to 48 months: a PHN check at the local health centre, including weight, height, eyesight and speech