When Claire Lee found out her eight-week-old son may have had his last appointment with a maternal and child health (MCH) nurse, she was "shocked".
"I said no, that can't be right," she told ABC Radio Melbourne Mornings.
"But what I found is, actually the current service being provided by [the city of] Casey is only until your eight-week visit, so that's just four out of the total 10 key ages and stages visits."
The Victorian MCH service provides free development support for all families with children from birth to school age.
This includes 10 appointments at key stages from the age of zero to three-and-a-half years old.
Mrs Lee said the MCH nurse was invaluable when she had her first child seven years ago, helping with everything from her mental wellbeing to her baby's health, feeding and sleeping problems.
"There's just something about having a rapport and a relationship with someone [over] three and a half years," she said.
"They're watching growth over time, so they're noticing things that you might not notice."
Earlier this week Mrs Lee spoke to a local father who said an MCH nurse picked up a misalignment in his daughter's hip that no one else had noticed.
"Who knows what the outcome for his daughter would have been [if she didn't have the four month visit]," Mrs Lee said.
"She went into a brace, so she did need a quite significant health intervention."
Under the arrangement in Casey, a baby with a similar problem might be missed.
Recruitment underway
City of Casey community life director Callum Pattie said workforce pressures across Victoria's healthcare sector were having a "significant impact" on MCH service staffing.
"While managing these staffing challenges and proactively working to recruit additional MCH staff, it was necessary for council's MCH service to prioritise appointments for newborns aged zero to eight weeks and families with additional needs," he said.
Mr Pattie said additional staff had been recruited, including 12 final-year MCH students.
"This will allow us to expand our service to offer regular MCH appointments for babies up to four months old," he said.
"Council is continuing to work closely with the Victorian Department of Health, Municipal Association of Victoria, Australian Nursing and Midwifery Federation and Safer Care Victoria to resolve the workforce issue as early as possible to bring us back up to full service levels as quickly as possible."
If parents in the area are concerned about their child's development and do not have an appointment, they can call Casey's MCH central booking number on 9705 5590 and request to speak to a team leader about their concerns.
Mrs Lee said some concerned parents have struggled to get additional MCH appointments with the City of Casey.
Many are seeking appointments with an MCH service in a neighbouring council and others are going to GPs or paediatricians.
The City of Kingston and Glen Eira City Council confirmed their MCH services provide care for people outside the area.
Widespread pressure
The Municipal Association of Victoria (MAV) said the City of Casey was not the only council struggling to provide a full MCH service.
"The workforce issue is particularly sharp in those growth corridors including Casey, Wyndham and Melton because of the number of new children in those areas," MAV president David Clark said.
"Funding is an ongoing issue too, but the workforce issue is our biggest immediate concern."
The Victorian government and councils have a 50/50 funding agreement to pay for MCH services.
But Cr Clark said the state government's contribution had not kept pace with costs and councils were making up the shortfall.
The costing model is being reviewed.
Cr Clark is calling for all levels of government to work together to get more health staff into the system.
"We need to look for something that is going to get us through the next 12-18 months as well as in the long-term," he said.
More councils struggling
Last year two councils in Melbourne's west were forced to slash MCH visits and babies older than eight weeks were not guaranteed further appointments.
Melton City Council told the ABC its MCH service remained "under pressure, mainly due to our high local birth rate, along with a shortage of fully qualified MCH nurses across the state".
"We're currently operating at 60 per cent capacity in maternal and child health and we are actively recruiting up to 11 more nurses, which would enable us to deliver a full service to our community," Melton City Council's director of city life Troy Scoble said.
"We are prioritising support for zero- to eight-week-old babies and those families experiencing vulnerability, as well as providing breastfeeding support, immunisation services, sleep and settling services as well as a number of toddler developmental education programs."
Wyndham City Council said it has been able to increase capacity and offer some catch-up appointments, but was still struggling to recruit enough staff.
In the past six months Wyndham has hired 10 MCH nurses, but there are still four full-time positions vacant.
"Based on our current workforce availability, our services are targeted to our youngest infants and children, all aboriginal infants and children, and all children and families with additional needs or concerns," Wyndham director of city life Liana Thompson said.
"All vulnerable children and families are able to be seen and families with concerns are encouraged to contact our service."
The Victorian government said it was working closely with affected services to expand the workforce so full care could be restored for families as soon as possible.
"We recently invested $10.1 million into maternal and child health services to address increased demand for the services in growth corridors like Casey, Wyndham and Melton to attract more staff to the profession and these communities, and better utilise existing staff across metropolitan Melbourne," a spokesperson said.
"The vast majority of our MCH services are operating as usual to service their community."
Long wait for private service
Wyndham paediatrician Raj Khillan said many parents struggling to get a MCH check-up were paying to come to his clinic.
But he said availability was an issue even if parents could afford an appointment.
"I have a waiting time of six months," he said.
"If they are waiting for appointments it could lead to late diagnosis and late intervention — this could definitely impact the child's development."
Parents who want advice about the care and health of their baby or toddler can call the 24-hour Maternal and Child Health Line on 13 22 29.
