When Sarah Wendelborn took her five-day-old baby Matilda home from the hospital after giving birth, she was struggling to breastfeed, and concerned her baby had jaundice.
However, she said, it was three weeks before a maternal and child health nurse from her local council in outer-west Melbourne could schedule a visit.
"It was a nightmare. I was crying and sleep-deprived," she said.
"I would stand on the scales and weigh myself and then weigh myself with her thinking, 'Is she gaining weight?' because she had jaundice, and they were saying, 'She needs to gain weight to pass the jaundice'.
"It was so scary."
With no face-to-face support available, Sarah taught herself to breastfeed online.
"I was going to pay for a lactation consultant, but they're over $200 a session and my husband had lost his job, so we couldn't do that at that time," she said.
Sarah and Matilda are thriving now: Matilda is learning to roll over and Sarah says she has lots of family support around.
But a council decision to slash maternal and child health check-ups means she does not know when her next visit will be.
Services cut in outer-west Melbourne
Sarah lives in the local government area of Wyndham, in Melbourne's booming outer-south-west, where up to 117 babies are born every week.
Most Victorian parents get free regular check-ups with a council nurse for the first three-and-a-half years of their child's life.
During the state's recent code brown, only newborns were guaranteed a visit.
Most councils have since gone back to normal service.
However, in the growth areas of Wyndham and Melton, in Melbourne's outer-west, the local councils cannot say when babies older than eight weeks will get a visit.
In his western suburbs clinic, paediatrician Dr Raj Khillan is already seeing health issues that were missed because of the pandemic, and he worries this move will make it worse.
"The issues missed are the developmental delay, the autism spectrum disorder, the child is 18 months not walking and the mother thinks: 'OK, that's still fine'," he said.
He said that cuts to maternal and child health nurse visits in the west were very concerning, because those visits often led to early intervention.
Dr Khillan said his waiting time for new patients had already grown from about one month to four months during the pandemic.
Why cut services?
Wyndham City Council said the issue was funding.
In 2016, the Victorian government agreed to fund 50 per cent of the cost of maternal child health nurses, and councils would fund the other half.
But Wyndham council data, seen by the ABC, shows the Department of Health provided 40.2 per cent of funding in 2016-17, and the council paid 59.8 per cent.
By 2025-26, it is projected that the Department of Health will pay just 29 per cent, and the council will pay 71 per cent.
Councillor Josh Gilligan said that was not sustainable.
"We know there's a $10 million gap over the next five years to adequately resource the amount of nurses and staff we need to deliver a universal service to families here in Wyndham," Cr Gilligan said.
"We're happy to pay our fair share and we're asking the state government to front up the $10 million gap."
Cr Gilligan said the council could not tell families when the full service would resume.
"We're under enormous pressure in terms of asking them to wait as we prioritise the more-critical age group," Cr Gilligan said.
The council is currently advertising for seven maternal and child health nurses.
Last year, the ABC revealed the Werribee Mercy hospital was turning expecting families away because it could not fit them all in, and some families were giving birth by the side of the road as they travelled out of Wyndham to other hospitals.
A 'known shortage' of specialist nurses
The chief executive of the Melton City Council, Roslyn Wai, said the issue has been a lack of staff.
"Melton Council is driving an ongoing recruitment campaign to attract more qualified maternal and child health nurses. However, there is a known shortage of qualified nurses," she said.
She said the council wanted to see training made more affordable and accessible to locals.
"We're calling on the Victorian government to create incentives for existing nurses to move to maternal and child health and to create a pipeline of new nurses through additional training and education," she said.
A 2017 Auditor-General report found increasing demand meant it was likely there would be a shortage of maternal and child health nurses.
"Overall, there is no sound understanding of the demand for, and supply of, [maternal and child health] nurses at the local level," the report stated.
The report found Wyndham had experienced the biggest increase in demand on its services between 2011 and 2015, with an increase of more than 1,000 home consultations.
The Department of Health acknowledged COVID-19 was continuing to impact health services in Victoria, including maternal and child health services.
"Due to COVID-19-related workforce shortages, some MCH [maternal and child health] services may need to temporarily prioritise their support to children, mothers/caregivers and families, or provide MCH support in different ways," a spokesperson said in a statement.
