"As a first time mother I wasn't expecting to get a letter that said, "you’re on your own", download information off the internet and "take it from there".

Carlotta Fagan, from Shackleton Grove, Lucan, Co Dublin explains her shock on getting a letter ten days ago from her local HSE Community Healthcare Organisation (CHO7), telling her that her baby son Riccardo will no longer get his standard development checks by a public health nurse in his early years.

Instead the public health nurse system in the area is moving to one of "prioritisation", meaning that only young children with proven medical risk or need will be seen.

At eleven months, Riccardo, was overdue a key milestone developmental check up at 9-11 months. Such checks are to ensure that young children like Riccardo are gaining weight correctly and progressing with early speech and mobility as normal.

But Riccardo is just one of thousands of infants who have failed to get key milestone checks in their first year of life since the pandemic began.

According to the latest HSE figures in April this year, 80.5% of one year olds received their standard development checks, meaning that 3,475 failed to get them. In Dublin, as many as one in three babies did not getting their vital checks within the first year.

In the first year of the pandemic the situation was far worse. In 2020 when public health nurses were redeployed into vaccination programmes and elsewhere across the health service, development screening within the first 10 months, fell to as low as 52% of all eligible children.

This contrasts starkly with pre-Covid rates. For example, in 2019, the vast majority of children, 92%, were getting them.

Vicci Roche’s, who also lives on the Shackleton estate, told Prime Time that both her young children have missed development checks.

Her two-year-old daughter, Madison, missed vital checks in 2020 and 2021 and now her three-month-old daughter Riley, due a check will get nothing.

"Riley was born on the first of April, we had the PHN (Public Health Nurse) call in at the end of that week. It as then that she told us that she was leaving and there was no replacement."

The HSE letter referred Vicci to a booklet provided on early childhood development as a guide to what she should look out for. But she laughs at the idea that she is up to the task. "I don’t know what the circumference of my child’s head should be. I don’t know what a correct hip alignment is. How can I?"

Prime Time spoke to one mother in Lucan, who did not wish to be identified, whose baby failed to get development checks this year and last. At 13 months, her daughter cannot crawl due to a hip issue.

Paediatric experts say that there are huge risks in failing to monitor a baby’s weight progress, motor skills, speech and language & emotional development. Typically, a home visit by a public health nurse helps to identify problems which if not caught early can become more serious.

Francis Chance, chairman of the Prevention and Early Intervention Network, says removing development screening is storing up longer term problems. "If you miss the window for prevention and early intervention, then you're talking about much more deep set problems arising. Early interventions are typically quite short, quite focused and very effective. If problems become deep set, then you're talking about long term and much more intensive interventions."

The HSE told Prime Time that due to staffing shortages, a similar curtailment of PNH services applies across the wider Community Healthcare Organisation, CHO 7 (Kildare, West Wicklow and Dublin West) and in many parts of Dublin and surrounding areas - CHO 6 (Wicklow, Dun Laoghaire and Dublin South), and CHO 9 (Dublin North city and County). In the Galway area, three areas have also removed standard public health nurse checks for a prioritisation system.

According to the latest HSE data, 240 public health nurse posts are vacant nationally – 62% of these empty posts are in the Dublin area.

The HSE letter advised new mums in Lucan to "contact your GP if you have any specific concerns about your baby’s health."

"The other challenge about this area – locally called Nappy Valley as it has so many young families – is that we cannot get a GP or dentist in our local area. I have to travel into the city centre to visit mine," said Vicci Roche.

When Prime Time contacted over-stretched local GP surgeries they said they don’t carry out developmental checks. One surgery told us they hadn’t been told about the cut in screening, until they had distressed mums calling them.

The public health nurse home visits are more than just screening for the baby, they are also a vital support service for new mothers.

"Public health nurses are looking at parental bonding, infant mental health. They're looking at the parents' needs themselves: are they stressed? Are they getting enough sleep themselves? Are they getting enough support? All of those things are crucial."

Rosalyn Shanahan, also living in Lucan, is expecting her second baby in September. She had postpartum depression with her first daughter four years ago, and relied heavily on her local public health nurse (PHN) for support.

"So I had postpartum anxiety pretty much by day three and the PHN that I had was indispensable. She was always checking with me. She had a lot of advice around post-natal anxiety and post-natal depression and she was just a big crutch. So it's hard to think that it’s not there this time."

"I find it frightening. What if I don't recognise a symptom [of post-natal depression] or what if I don't realise that it's happened this time?"

Early years expert, Francis Chance, is sceptical that a public health nurse service of "priorisation" can in anyway fulfil the function of routine standard checks.

"The notion that, that can be replaced with a targeted service will mean that a significant number of children and a significant number of parents who need support would be missed. That's absolutely inevitable. You cannot predict with certainty the families that are going to need support and the families that aren't going to need support. Families who cope very well otherwise can, during a pregnancy have postnatal depression, mental health issues, other problems, the child can have additional needs."

The HSE says four new public health nurses and some student nurses will be deployed in the area later this month. This still leaves with a short 42 public health nurses in the wider healthcare area.

In a context where babies born in the pandemic era already missed so much, it's cold comfort to new parents.