Healthy Child Programme: final report
6.1. Work package 1 (page 17 of 3) in 6. Appendix B – Survey Results and Analysis (chapter 8 of 9) within Healthy Child Programme: final report
Please refer to accompanying item information.
6.1.1. Birth Details
Respondents were provided with the draft birth details headings and asked if they felt there were any essential pieces of information missing. A thematic analysis of the qualitative responses identified the following common themes and the project team’s recommended response:
| Additional birth detail information | Recommended Response |
|---|---|
| Baby admitted to neonatal intensive care unit | Add a new heading called ‘problems detected prior to discharge’ this heading may include reasons for admission to a NICU, including respiratory distress, neonatal fits, hypothermia, feeding difficulties etc. |
| Consider including admission to NICU as a new event. | |
| Baby’s blood group | This needs to be considered by PRSB as there is not an obvious place in the record to record this. |
| Place of birth of the child | This would be recorded under the ‘person demographics’ section but may be carried as part of the birth details. |
| Maternal drugs in pregnancy | This should be considered by the NHS Digital maternity events project. |
| Parental mental health | This should be considered by the NHS Digital maternity events project. |
| Oral health of the child | This would be included as part of the health and wellbeing reviews. |
6.1.2. Type of Delivery
Respondents were provided with the following options for type of delivery and asked if there were other types of delivery they would like to see included:
- Spontaneous Vertex
- Spontaneous Other Cephalic
- Low forceps, not breech
- Other Forceps, not breech
- Ventouse, Vacuum extraction
- Breech
- Breech Extraction
- Elective caesarean section
- Emergency caesarean section
- Other
A thematic analysis of the qualitative responses identified the following common themes and the project team’s recommended response:
| Other types of delivery | Recommended Response |
|---|---|
| Include Born Before Arrival (BBA) | Recommend including a new heading to record ‘location of birth’ |
| Include concealed pregnancy | This should be considered by the NHS Digital maternity events project |
| Water birth | This should be considered by the NHS Digital maternity events project |
| Category of caesarean section | This should be considered by the NHS Digital maternity events project |
| Shoulder dystocia | This should be considered by the NHS Digital maternity events project |
| Still birth | This should be considered by the NHS Digital maternity events project |
| Induction | This should be considered by the NHS Digital maternity events project |
| Delayed cord clamping | This should be considered by the NHS Digital maternity events project |
Respondents were also asked if it was appropriate to record more than one option for ‘type of delivery’. The responses were as follows:
| Response | Number | % |
|---|---|---|
| Yes | 267 | 43% |
| No | 134 | 22% |
| Not Sure | 214 | 35% |
In line with the survey findings, the project team recommends that it is appropriate for more than one option to be selected, for example forceps or ventouse proceeding to a caesarean section.
6.1.3. Maternal Problems in Pregnancy
Respondents were provided with the following options for maternal problems in pregnancy and asked if there were other types of delivery they would like to see included:
- Diabetes
- Gestational diabetes
- Systemic Lupus Erythematosus (SLE)
- Mother taking opioids
- Thyrotoxicosis
- Anti - D positive
- Idiopathic Thrombocytopenic Purpura
- Vitamin D deficiency/osteoporosis
- Myotonic dystrophy
- Achondroplasia
- Rubella
- Cytomegalovirus (CMV)
- Hepatitis B antigen/antibody
- Toxoplasmosis
- Group B streptococcus colonization
- HIV
- Anticonvulsant therapy
- Alcohol abuse
- Myasthenia Gravis
A thematic analysis of the qualitative responses identified the following common themes and the project team’s recommended response:
| Other maternal problems in pregnancy | Recommended Response |
|---|---|
| Hypothyroidism | Recommend including this as an additional option |
| Chicken Pox | Recommend including this as an additional option |
| Hepatitis C | Recommend including this as an additional option |
| Maternal mental health problem | This is too general and not appropriate to include a range of specific mental health disorders |
6.1.4. Problems During Delivery
Respondents were provided with the following options for problems during delivery and asked if the list was appropriate:
- Shoulder dystocia
- Foetal heart deceleration
- Cord prolapse
- Acute foetal compromise
- Foetal acidaemia
- Meconium Aspiration Syndrome
- Acute foetal blood loss
A thematic analysis of the qualitative responses identified the following common themes and the project team’s recommended response
| Problems during delivery | Recommended Response |
|---|---|
| Foetal heart deceleration is common and can be a normal part of labour | Remove these options and replace with ‘Foetal distress’ |
| Acute foetal compromise was felt to be vague | |
| Foetal acidaemia is not an isolated finding and is usually because of one of the other problems during delivery | |
| Meconium Aspiration Syndrome is diagnosed after the birth however Meconium Aspiration may be present at birth | Change to ‘Meconium Aspiration’ |
6.1.5. Neonatal Resuscitation
Respondents were asked if ‘neonatal resuscitation’ was an appropriate term. 73% of respondents felt that it was, 7% did not think it was appropriate and 20% were not sure. Due to the high level of consensus the project team recommends that this term is retained.Respondents were also asked if they would like to see 1, 5 and 10 minute APGAR scores in the child health record. The results are provided in the following table:
| APGAR score | Number | % |
|---|---|---|
| 1 minute APGAR | 366 | 65% |
| 5 minute APGAR | 356 | 63% |
| 10 minute APGAR | 320 | 57% |
| None of the above | 13 | 2% |
| Unsure | 147 | 26% |
N: 562
Thematic analysis of the qualitative comments identified a common theme that the 10 minute score should only be recorded if the score is poor at 1 and 5 minutes.
Due to the high level of consensus the project team recommends that all 3 APGAR scores are included however implementation guidance should specify that the 10 minute score should only be recorded where the score is poor at 1 and 5 minutes.
6.1.6. Abnormalities Detected at Birth
Respondents were asked which of the terms were preferable to describe physical problems with the baby identified at, or shortly after, birth: 1. Physical abnormalities detected at birth 2. Physical problems detected at birth| Preferred term | Number | % |
|---|---|---|
| Physical abnormalities detected at birth | 188 | 34% |
| Physical problems detected at birth | 245 | 45% |
| Neither | 59 | 11% |
| Unsure | 57 | 10% |
N: 549
In line with the survey findings, the project team recommends that physical problems detected at birth should be included as a heading.
Respondents were provided with the following options for physical problems detected at birth and asked if the list was appropriate:
- Cephalohaematoma
- Caput succedaneum
- Extensive bruising
- Erythematous skin rash
- Vesicular skin rash
- Talipes equina varus
- Plagiocephaly
- Laceration
- Erb’s Palsy
- Cleft lip
- Cleft palate
- Anal atresia
- Absent finger
- Absent toe
- Fractured clavicle
- Other (SNOMED CT)
A thematic analysis of the qualitative responses identified the following common themes and the project team’s recommended response.
| Physical problems detected at birth | Recommended Response |
|---|---|
| Caput succedaneum is a common result of the labour process and has no ongoing significance | Remove this option from the list |
| Erythematous and vesicular skin rashes are very common and should not be in the same list as physical problems | Remove this option from the list |
| Plagiocephaly often occurs following vaginal delivery but rarely persists. | Remove this option from the list |
| Absent finger/ toe is uncommon | Remove this option from the list |
6.1.7. Multiple Births
Respondents were asked in cases of multiple births is it important to record if the baby is identical to one of the siblings. The results are provided in the following table:
| Record whether babies are identical | Number | % |
|---|---|---|
| Yes | 419 | 76% |
| No | 63 | 11% |
| Unsure | 67 | 12% |
Respondents were also asked who this information was important to. 82% felt it would be important to parents/carers, 95% felt it would be important to health and care professionals and 44% felt it was important to public health professionals.
In line with the survey findings the project team recommends that the ‘multiple births’ heading definition states to record whether the baby is identical to one of the siblings.
6.1.8. Screening Reviews
Respondents were provided with the draft screening review headings and asked if they were appropriate. A thematic analysis of the qualitative responses identified the following common themes and the project team’s recommended response:
| Additional birth detail information | Recommended response |
|---|---|
| Protocol was felt to be confusing and not useful | Remove this heading from the section |
| Screening test status should include a deferred option | Recommend including deferred as an option |
6.1.9. Feeding Status
Respondents were provided with the draft feeding status headings and asked if they were appropriate. The results are provided in the following table:| Feeding status headings appropriate? | Number | % |
|---|---|---|
| Yes | 345 | 65% |
| No | 145 | 28% |
| Unsure | 37 | 7% |
N: 527
Thematic analysis of the qualitative responses identified one common theme; that it is important to know the method by which the baby is fed. The recommendation is that the ‘alternative feeding methods’ heading is amended to ‘feeding method’ to include whether the baby is breast fed, bottle/cup fed in addition to the alternative feeding methods (gastrostomy, nasogastric feeds etc.).
Respondents were provided with the following options for feeding status and asked if the list was appropriate:
- Totally breast milk fed
- Partially breast milk fed
- Not breast fed
Thematic analysis of the qualitative responses identified a theme which was to reference formula milk feeding. The project team recommendation is to change the ‘feeding status of the baby’ to ‘milk feeding status of the baby’. Public health professionals requested the following options were included:
- Totally breast milk fed
- Partially breast milk fed
- Not breast milk fed
6.1.10. Babies Put to Breast
Respondents were asked if it is important to record whether or not the baby is put to the breast following delivery. 62% felt it was appropriate, 16% felt it was not appropriate and 22% were unsure. The project team recommends that this is recorded in the birth details section and considered as part of the maternity project.6.1.11. Introduction to Solids
Respondents were asked if it is important to record when the baby is introduced to solid food. 75% felt it was appropriate, 7% felt it was not appropriate and 18% were unsure. The project team recommends that this should be recorded under the ‘introduction of solids’ heading.
Page last updated: 18 June 2026