Domiciliary midwives described how they refer on to the MCH nurses in a woman’s residential locality and alert them by e-mail if there was an urgent need. However they perceived that this referral must join a list of other
women who were waiting for a home visit. Midwives identified that women were first visited by MCH nurses towards the end of the second week – when the infant was about 14 days old. Thus many women had no contact with a nurse for a week or even longer with a consequence that hospital midwives reported they were re-contacted after discharge by women having not yet received assistance from others. The first MCH nurse home visit on referral was scheduled according to order of birth date, when a better system might be to triage women having feeding difficulties based on need: