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

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

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

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

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

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

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

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

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

اتق شر كل من اقترب من الارض DR/KHALID ALHARBY

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 DR/KHALID ALHARBY

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

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

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

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

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

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

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

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

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

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

Management Shared care DR/KHALID ALHARBY

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

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

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

المهارة واسطة المبدعين الى القمة DR/KHALID ALHARBY