Open letter backed by neurosurgeons calls for more routine health checks on babies brains
Harry's Hydrocephalus Awareness Trust is urging the Health Secretary to review the current guidelines around head circumference measurements for babies.
Last updated 13th Mar 2024
18 paediatric neurosurgeons from across England and Wales have signed an open letter to the Health Secretary calling for more routine monitoring of babies, to help identify serious brain conditions.
Harry's Hydrocephalus Awareness Trust (Harry’s HAT) has written the letter after the charity's own research revealed England is lagging far behind other countries when it comes to routine checks on head circumference in a child's first year.
The measurement can help to diagnose various brain conditions, including hydrocephalus, where affected children often present with an unusually large or rapidly growing head.
Jay Jayamohan is one of the top paediatric neurosurgeons to sign his name on the letter, he works at Oxford Children's Hospital: "The frequency of head circumference measurements has changed since I became a consultant 20 years ago. Babies used to routinely have their head circumference measured by health visitors whenever they were around, along with weight and length. There has been a reduction in the number of measurements - now there's the birth measurement and the measurement at the 6-8 week check, but it's not uncommon for that measurement to be missed."
Currently in England, it's recommended that two routine head circumference measurements are recorded in infancy, which take place around birth and at the 6-8-week check. That’s compared with Finland or Germany, which perform multiple measurements throughout the first year of a child's life.
Mr Jayamohan continued: "The whole point of this is that it's part of preventative medicine. Weighing a baby to make sure they're not going behind on their feeds makes sense. In the same way - if you think a baby's head circumference is growing abnormally large and you think there may be an underlying condition; you can refer on for investigations before that baby becomes unwell or shows symptoms of disfunction of the brain. You can try to treat that child sooner rather than later.
"If you get down to the brutal nitty gritty of being a politician - it's got to be better to spend a small amount of money to prevent illness than have to spend a large amount of money, possibly for the rest of that child's life, managing a major illness. It's got to be the best thing to do for a patient.
"Knowing about this earlier and maybe being able to treat it without such an impact on the child, has got to be better than waiting for the balloon to go up at the last minute. Yes, it makes sense to keep up with other countries - but actually it makes logical sense that we're not just following a fad and we're doing what makes logical sense. But we also need money, investment and education. "
Along with the signatures from neurosurgeons, the open letter has also been signed by a dozen nurses working within the neurosurgical field across the NHS in England.
Caroline Coates is chief executive of Harry's HAT, which runs the GET-A-HEAD campaign to raise awareness of the importance of head circumference measurements in infancy. She's one of the authors of the open letter: "We did a comparison between lots of other high-income countries and found that England was falling far short of the measurements taking place in other countries, such as Norway and Canada. These countries are more routinely measuring infant head size in the first year of life. In England we only take two routine measurements but places like Finland, for example, are taking 11 measurements on average in the first year.
"One of the key signs of hydrocephalus is a rapidly increasing head circumference and for many of the families we support, their child's condition was picked up through head circumference measurement. It's a really basic way of seeing if there's an issue with a baby. If you're seeing a jump in head circumference when it's plotted in the Red Book - it triggers further investigation.
"We want the Health Secretary Victoria Atkins to look at this issue. Most new parents and parents-to-be don't know the correlation between head circumference measurement and infant health, so we feel that if she was able to approve a review of the guidelines - it could lead to better practise and lead to wider conversations about why head circumference measurement is so important."