1. Dr. Khalid D. Al-Harby MBBS,ABFM,SBFM CONSULTANT FAMILY PHYSICIAN
Well baby clinic
Dr. Khalid D. Al-Harby
MBBS,ABFM,SBFM
CONSULTANT FAMILY PHYSICIAN

2. INFANT CARE
The health services given to a baby during the first year of life.
It is a function of the MCH centers ( in PHCC, and in some hospitals)
It is done through the “well baby clinics” = the clinics that are concerned with health care for all children under the age of 5 y.(started 1404 )
DR/KHALID ALHARBY

3. Well baby clinic Frequency of visits: (15)
seven visits in first year (including visits at time of vaccination)
Two visits each year from 2-5 years
Wt.,and Ht. For each p.r.n visit
Every infant has a health card kept in the PHCC containing the following information :
Name of parents
Date of birth
DR/KHALID ALHARBY

4. Cont… 3) Place of delivery Attendance at labor
Type of delivery (NSVD, forceps, C.S,…)
Health condition at birth (weight, length, and any congenital anomalies)
Social data of the family
PMH, PSH
Immunizations
Measurements of wt., length, ? H.C and comparison with the normal
DR/KHALID ALHARBY

5. لما رأيت القوم أقبل جمعهم يتناصرون كررت غير مذمم
لما رأيت القوم أقبل جمعهم يتناصرون كررت غير مذمم
يدعون مارادونا والدفاع كأنه جدران سد في طريق مهاجم
DR/KHALID ALHARBY

6. Equipments of WBC Newborn baby weighing scales
Weighing scales for older children
Height scale fixed on the wall
Measuring tape
Infantometer
Stethoscope and sphygmomanometer with small cuff (pediatric)
Torch
DR/KHALID ALHARBY

7. Equipments Examination table (couch) ENT and eye diagnostic sets
Some attractive toys for babies
Well baby register records and growth charts
Posters denoting child growth and development at different ages should be provided
Health education materials and facilities should be readily available
DR/KHALID ALHARBY

8. Process General examination : appearance, clothing
Examine vision: ask the parents and observe the child ( measure visual acuity at school entry and colour testing at 9-13 years)
Examine hearing:
examine hearing abilities for those under 5y.
Test child’s attention to noise\voice at 8-12 months of age
Take parent’s notes on hearing
Arrange for audiometry for children before school age
DR/KHALID ALHARBY

9. Process Growth measurements plotted on the charts.
Children outside the averages are reexamined, investigated, and treated or referred
Developmental milestones are checked
Detection and treatment of malnourished
Health education to the mothers
For ill children : vital signs, preparation and teaching of ORS, nurse-doctor referral, and giving injections when needed
DR/KHALID ALHARBY

10. اتق شر كل من اقترب من الارض
DR/KHALID ALHARBY

11. Growth indices - weight
At birth: kg
1st 4 months: 3\4 kg per month
2nd 4 months :1\2 kg per month
3rd 4 months: 1\4 kg per month
At the end of 4th month: 6 kg
At the end of 1st year: 9 kg
After 1st year: 2 kg per year
DR/KHALID ALHARBY

12. Abnormal weight Above 90th percentile Below 5th percentile
No increase over 3 subsequent months
Curve down in 2 subsequent visits
DR/KHALID ALHARBY

13. Growth indices - HC Between 97th and 3rd percentile At birth: 35 cm
At 6 months: 43.8 cm
At 1 year: 46.8 cm
At 2 year: 49.1 year
At 3 years: 50.2 cm
At 4 years: 50.8 cm
At 5 years: 51.3 cm
DR/KHALID ALHARBY

14. Growth indices- height
At birth: 50 cm
At the end of 1st year: 75 cm
Thereafter: 5 cm per year
Between 90th and 5th percentile
DR/KHALID ALHARBY

15. Home visits
Should be done by the nurse of the WBC for the following children:
Delayed mile stones or delayed growth
Diarrhea : chronic OR recurrent acute
Social or psychiatric problems
Defaulters
DR/KHALID ALHARBY

16. At risk children Group A : Babies of working mothers
Babies of poor family (low income)
Loss of a parents, or divorce
History of mental or psychiatric disturbance of a parent
More than 7 children in the family
DR/KHALID ALHARBY

17. Cont…
Non – breast feeders
Early weaning
Twins
DR/KHALID ALHARBY

18. Management Registration in risk records Regular follow up
Call for defaulters
Comprehensive health education
Take out of registry if no problems by 6 months of follow-up
DR/KHALID ALHARBY

19. Cont. at risk children Group B : 9) Birth weight < 2500 gm.
10 ) Failure to gain weight in 3 successive visits.
11) Loss of weight in 2 successive visits
12) Weight below 80% of expected weight for his age
DR/KHALID ALHARBY

20. Management Registration in risk records
Regular follow up ( at least 1 \ month)
Call for defaulters
Comprehensive health education
Take out of registry if no problems by 6 months of risk removal
DR/KHALID ALHARBY

21. Cont…at risk children Group C : 13) Congenital abnormalities
14) Bronchial asthma
15) Diabetes mellitus
16) Handicapped ( mental or physical)
DR/KHALID ALHARBY

22. Management
Shared care
DR/KHALID ALHARBY

23. Child health card Two copies (one with the family and one in the WBC)
It should contain the following :
Family file number
Child number in WBC
Delivery information
Growth and developmental measures in the first 5 years of life
Immunization status
Schedule of follow-up visits in WBC
DR/KHALID ALHARBY

24. Health education contents
Care of newborn
Dealing with infantile common problems
Nutritional education (especially breast feeding, weaning, and hygienic preparation of bottle feeding )
Family planning
Growth curve and its importance
DR/KHALID ALHARBY

25. Health education methods
Individual counseling
Group discussions
Lectures
Demonstration (using pictures, leaflets, posters etc…) of the following :
Feeding position
Bathing
Preparation of semi-solid foods in hygienic methods
Preparation of ORS
DR/KHALID ALHARBY

26. المهارة واسطة المبدعين الى القمة
DR/KHALID ALHARBY