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Presentation on theme: "Well baby clinic Dr. Khalid D. Al-Harby MBBS,ABFM,SBFM CONSULTANT FAMILY PHYSICIAN."— Presentation transcript:


2 DR/KHALID ALHARBY2 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 )

3 DR/KHALID ALHARBY3 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 : 1) Name of parents 2) Date of birth

4 DR/KHALID ALHARBY4 Cont … 3) Place of delivery 4) Attendance at labor 5) Type of delivery (NSVD, forceps, C.S, … ) 6) Health condition at birth (weight, length, and any congenital anomalies) 7) Social data of the family 8) PMH, PSH 9) Immunizations 10) Measurements of wt., length, ? H.C and comparison with the normal

5 DR/KHALID ALHARBY5 لما رأيت القوم أقبل جمعهم يتناصرون كررت غير مذمم يدعون مارادونا والدفاع كأنه جدران سد في طريق مهاجم

6 DR/KHALID ALHARBY6 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

7 DR/KHALID ALHARBY7 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

8 DR/KHALID ALHARBY8 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

9 DR/KHALID ALHARBY9 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

10 DR/KHALID ALHARBY10 اتق شر كل من اقترب من الارض

11 DR/KHALID ALHARBY11 Growth indices - weight At birth: 3-3.5 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

12 DR/KHALID ALHARBY12 Abnormal weight Above 90 th percentile Below 5 th percentile No increase over 3 subsequent months Curve down in 2 subsequent visits

13 DR/KHALID ALHARBY13 Growth indices - HC Between 97 th and 3 rd 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

14 DR/KHALID ALHARBY14 Growth indices- height At birth: 50 cm At the end of 1st year: 75 cm Thereafter: 5 cm per year Between 90 th and 5 th percentile

15 DR/KHALID ALHARBY15 Home visits Should be done by the nurse of the WBC for the following children: A. Delayed mile stones or delayed growth B. Diarrhea : chronic OR recurrent acute C. Social or psychiatric problems D. Defaulters

16 DR/KHALID ALHARBY16 At risk children I. Group A : 1) Babies of working mothers 2) Babies of poor family (low income) 3) Loss of a parents, or divorce 4) History of mental or psychiatric disturbance of a parent 5) More than 7 children in the family

17 DR/KHALID ALHARBY17 Cont … 6) Non – breast feeders 7) Early weaning 8) Twins

18 DR/KHALID ALHARBY18 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

19 DR/KHALID ALHARBY19 Cont. at risk children II. 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

20 DR/KHALID ALHARBY20 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

21 DR/KHALID ALHARBY21 Cont … at risk children III. Group C : 13) Congenital abnormalities 14) Bronchial asthma 15) Diabetes mellitus 16) Handicapped ( mental or physical)

22 DR/KHALID ALHARBY22 Management Shared care

23 DR/KHALID ALHARBY23 Child health card o Two copies (one with the family and one in the WBC) o It should contain the following : 1. Family file number 2. Child number in WBC 3. Delivery information 4. Growth and developmental measures in the first 5 years of life 5. Immunization status 6. Schedule of follow-up visits in WBC

24 DR/KHALID ALHARBY24 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

25 DR/KHALID ALHARBY25 Health education methods A. Individual counseling B. Group discussions C. Lectures D. Demonstration (using pictures, leaflets, posters etc … ) of the following : 1) Feeding position 2) Bathing 3) Preparation of semi-solid foods in hygienic methods 4) Preparation of ORS

26 DR/KHALID ALHARBY26 المهارة واسطة المبدعين الى القمة

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