Organization of preventive work with a healthy child
Huge social significance in modern conditions of preventive activity of children's outpatient and polyclinic institutions is to implement a wide range of effective recreational activities aimed at preventing pathology, reducing morbidity and infant mortality, improving the health of the younger generation as the potential of public health.
The organization of preventive measures aimed at protecting the child's health actually begins before his birth. The plans of preventive work of the children's polyclinic include nursing and medical patronages to pregnant women, conducting classes in schools of young mothers( in conjunction with doctors of the women's consultation).It is advisable to involve fathers in such activities, creating schools of young parents in children's polyclinics and women's consultations, which is important for creating the right psychological climate in a young family. It is important to create a program of studies so that it reflects the physiological characteristics of a woman, the course of pregnancy and childbirth, the regime of the day and nutrition, the hygiene of the pregnant woman, the harmful effect on the child's drinking and smoking of a pregnant and nursing mother, and the need for a healthy lifestyle. You should also teach future parents to properly feed the baby, swaddle, bathe;to acquaint them with the peculiarities of the child's behavior in the first weeks after birth;pay attention to the necessary items of hygienic care, which should always be ready and kept in perfect purity.
The district nurse of the children's polyclinic must fulfill at least two antenatal care: the first after the receipt of information about the placement of the pregnant woman on the account in the antenatal clinic, the second usually on the 31-32nd week of pregnancy.
According to the existing situation, the pediatrician and the nurse of the children's polyclinic jointly visit the newborn in the first 3 days after discharge from the maternity hospital. If a child was born in the family, then patronage is recommended for the first day after discharge. In the future, the district nurse visits the child at home 1-2 days during the first week and weekly during the first month of life. The district pediatrician re-visits the child at home in 7-10 days. At the primary patronage of a newborn pediatrician collects a genealogical, obstetric-gynecological and social anamnesis. Particular attention is drawn to the age of the mother and father;hereditary burden;complaints;the state of health of the mother and child;features of the course of pregnancy and childbirth;on what day the baby is attached to the breast, how to suck;for what days the umbilical cord disappeared;when the child is discharged from a maternity hospital;physiological loss of body weight, etc. In objective research, it is necessary to evaluate the overall health of the child, features characteristic of the neonatal period: skin condition, umbilical ring and wound, mucous membranes, musculoskeletal and nervous system, sex and other organs and systems. The anthropometric data of a newborn( length, weight
ca body, chest circumference and head) are compared with the indices of the physical development of this age group of children. The pediatrician receives a large help at the first acquaintance with the child with a detailed and professionally completed extract from the maternity hospital( an exchange card) reflecting the nature and characteristics of the course of ante, intra- and postnatal periods and containing the recommendations of the neonatologist of the maternity hospital to the district doctor of the children's polyclinic. The district pediatrician, on the basis of the analysis of the obtained data, determines the level of physical and neuro-psychological development of the child, gives a comprehensive assessment of the state of health with the definition of the group of health of the newborn.
The district pediatrician justifies the plan for further monitoring of the child individually for each newborn, including a set of recreational, educational and therapeutic activities.
All the above data are recorded in the "History of Child Development".From the careful and qualified observation of a child under 1 month, the prevention of septic diseases, the successful treatment of central nervous system disorders, the timely detection of congenital diseases and, consequently, the state of the child's health in the future largely depend on prevention. At the slightest suspicion of deviations in the state of health of the newborn, the district pediatrician should, as soon as possible, establish a diagnosis and prescribe the appropriate treatment, resorting, if necessary, to the assistance of the head of the pediatric department, medical specialists, laboratory and diagnostic services.
All children are twins;premature babies;born with a large body weight;from mothers with the pathology of pregnancy and childbirth or who have had infectious diseases during pregnancy, and who have received a birth injury;children discharged from the neonatal pathology department and from unfavorable social conditions belong to the risk groups and should be under special supervision of the district doctor and the nurse.
It is advisable that the pediatrician conducts the primary patronage together with the nurse who processes the umbilical wound to the newborn( if necessary), performs the prescription of the doctor, receives instructions for further monitoring the child.
Mothers, depending on the child's health and individual characteristics, give advice on the creation of appropriate hygienic conditions, proper organization of feeding, day regimen, walks.
antenatal care aims to:
• contact the children's polyclinic with a future mother;to find out the state of her health, the social situation of the family, her psychological climate, the conditions of her future child's life, to support in the future mother the confidence in the birth of a healthy baby;
• give necessary recommendations on the labor regime;life, rest, nutrition, to prepare a corner for a newborn, to teach the rules of child care and feeding;
• to warn a woman against smoking, using medicines without prescription of a doctor and spirits;
• check the regularity of a woman's attendance at school for young mothers.
A nurse who teaches the mother how to care for her baby, bathing, toilet, pays attention to the baby's clothes. It is important to establish contact with the child's family, to calm the mother, to try to eliminate possible causes of unrest, since the first weeks of taking care of the newborn are especially difficult for the mother.
In case of repeated active visits, the nurse examines the child, monitors the performance of the physician's appointments by the mother.
A doctor visits a healthy child at home usually on the 20th day of life, assesses his health, development, pays attention to the adaptation of the baby to new conditions for him. Special caution in this case should be manifested in relation to septic diseases, their prevention and timely active detection.
During the patronage visit at the 4th week of the newborn's life, a precinct medical nurse is invited by the mother and her child to the first reception at the polyclinic.