Well baby clinic

1. 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 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: 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

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 educationcontents • 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 educationmethods • Individual counseling • Group discussions • Lectures • Demonstration (using pictures, leaflets, postersetc…) of thefollowing : • 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