New weight management service for pre-school children in Somerset

You may have seen in the media this week that we've launched a new service in Somerset to give children under the age of four-years-old, who are living with severe obesity, and their families, access to specialist compassionate support.

The Somerset Pre-school Lifestyle Activity Skills for Self-Help – also known as SPLASH – is a weight management service where doctors, dietitians, and psychologists support children aged 0-4 years – one of very few services of its kind in the country.

The service first started as a trial in April 2022, but proved so successful that it has now been given permanent funding.

It’s made up of five colleagues in total – dietitian Isobel Feakins, clinical psychologist Dr Megan Rowley, and paediatricians Drs Chris Knight and Alan Rice for Musgrove Park Hospital, and Dr Camelia Vaina for Yeovil District Hospital.

Dietitian Isobel explains how there was very limited support for children living with severe obesity before this service was set up in Somerset, except for a small service provided at YDH.

“We decided to set up this service as there was a real gap in specialist weight management support for children under four, and their families,” she explains.

“The reason we’ve developed the service specifically for pre-school children is because we know from research that if we can help address the complexities of obesity at a very early age, then the outcomes in later life for those children tend to be a lot more positive.

“Our approach is to build up a partnership with parents, and other adults who support the child, to offer a strengths-based approach.

“We offer a really compassionate and non-blaming approach to weight, ever mindful that this topic can be a highly emotive and stigmatised area, and not always an easy thing for families to talk about.

“We know they may have had conversations in the past that have been stigmatising, and it’s part of our role to validate their previous experiences and understand their experience of parenting a child living with obesity.

“One of the key things of our service is that we’re not based on weight loss, as this shouldn’t be the goal for children of this age as they’re growing, but we’re here to help them to have a healthier relationship with food and their bodies.

“We’re currently supporting around 30 families at one time, with four in five of those referred to us choosing to engage with the programme, which is really impressive for this type of service.

“We’ve helped over 50 families since our service was set up, with two in five of those also benefiting from the support of our team’s psychologist.”

The team’s clinical psychologist, Megan (pictured being interviewed by the BBC), explains how children can be referred into the service. “We accept referrals from any healthcare professional,” she says. “Parents can self-refer into us too, and that’s something that we really want to raise awareness of.

“If a family meets our referral criteria, our dietitian Isobel will arrange a home visit to meet them and understand their needs, background, and what support they’d like from the team – this can be done either face-to-face in their home or virtually, however they’d prefer.

“We offer monthly appointments, that are again face-to-face or virtual, with the family making their own personal goals of what they want to achieve from the support.

“Isobel may be involved in helping a family with issues related to food, including variety, quantity, or cooking, and if parents would like psychological support then I’ll meet with them to explore this with them.

“As part of the service we offer, the child will have one medical appointment at either MPH or YDH with one of our paediatricians. This is to check that there are no underlying reasons for the child’s weight, as well as offering reassurance and blood tests – very much a general health MOT.

“We’ve noticed that the value in SPLASH is very much in the relationships that we’ve developed with families, getting to understand them, what they’re finding difficult, and where they would like the focus of the support to be.

“We also work closely with the Somerset Activity and Sports Partnership (SASP) and can refer our families for extra support where needed.

“The child stays on the caseload for our service for a year, before we check in with them again, and then discharge them into a new service in the community, called ‘FOREST’, which will take some of our SPLASH patients for follow-up support.

“The FOREST care pathway is an enhanced parent programme that’s being trialled in the Bridgwater and Yeovil area, providing families with additional support alongside the Healthy Child Programme.

“It’s made up of experienced assistant practitioners who’ve had specialist training and have been involved in developing methods of working with families, and identifying the level of need.

“While building upon a therapeutic relationship and meeting the needs of the family, the FOREST team has also created a 10 week programme called Fun through Food and Movement, as part of the Healthier Lives aspect of the pilot in Bridgwater, Taunton, and Yeovil.

“Our SPLASH team has had some very positive feedback from families so far with some really interesting patient experiences.

“For some of the families we support, it doesn’t just have an impact on the child, but also on the parents as well – who learn about their own relationship with food,” says Isobel.

“Our service is expanding all the time and we’re constantly learning new things as we go along, with lots of other health and social care services showing an interest in what we do and how the families they support might benefit.”

One of the families the team has successfully been able to support was a single mum who had financial difficulties, and her own difficult relationship with her weight.

“We provided online support sessions followed by monthly reviews with the dietitian and psychologist to support reducing the child’s milk intake, understanding behaviour around food, and building parental confidence,” says Megan.

“We were also able to signpost her to additional money for food, and she took part in an online cook-along session to increase confidence in cooking.

“This family is now coming to the end of their journey with us, and we’re pleased that there have been so many improvements for both the child and mum in many areas.

“The mum’s feedback is that this is the best one-to-one service she’s ever had, as she felt listened to by our team and found the support very helpful.”

More information about SPLASH, and how to self-refer into the service can be found here.