FAMILY HEALTH DIARY 1 FAMILY INFORMATION Mother Father Name Native/Ethnic Name Blood Type Religion Educational Attainment Occupation Nationality/Tribe Age at Marriage Place of Marriage Number of Live Children Address: _________________________________________________________ (House No. Street Purok Barangay ________________________ Municipality/City/Province) Contact Number(s): Source of household water: Type of toilet used: NOTE: Keep this book and always bring it with you when you visit the health center or hospital or clinic for any maternal or child health services or con- sultation.
Transcript
FAMILY HEALTH DIARY
1
FAMILY INFORMATION
Mother Father
Name
Native/Ethnic Name
Blood Type
Religion
Educational Attainment
Occupation
Nationality/Tribe
Age at Marriage
Place of Marriage
Number of Live Children
Address: _________________________________________________________ (House No. Street Purok Barangay
NOTE: Keep this book and always bring it with you when you visit the healthcenter or hospital or clinic for any maternal or child health services or con-sultation.
INSTRUCTION: This is to be accomplished by the mother/pregnantwoman with the assistance of the health worker. Please put a check(√√√√√) on the appropriate column.
Tooth decay/gum diseaseOthers: Anemia, Edema, etc (specify)Medications taken (Specify)
Previous operations/surgery (Specify)
Smoking
Health Problem/Illness/Unhealthy Lifestyle Past Present
FAMILY HEALTH DIARY
3
Previous Pregnancies
INSTRUCTION: This is to be accomplished by the pregnant womanwith the assistance of the health worker. Write (Y) for Yes if applicableand (N) for No if not.
Type of Delivery:- Normal
- Forceps Delivery- Cesarean Section (CS)
Multiple Births (Y/N)(If yes, specify if twins, triplets, etc.)
Miscarriage/Abortion (Y/N)Stillbirth (Y/N)Bleeding during pregnancy (Y/N)Profuse* Bleeding after delivery (Y/N)
No. of Pregnancies
1 2 3 4 5 67&
above
Past and Present Illness/Health Problems
*Profuse bleeding – more than 500cc of blood or pads soaked andchanged more than once in an hour
Health Problem/Illness/Unhealthy Lifestyle Past PresentAlcohol IntakeSubstance abuse (i.e. shabu, marijuana, etc.)No exercise/lack of physical activityPoor NutritionExposure to chemicals like pesticides,lead,mercury, cyanide, merthiolate, etc. (Specify)
(Continuation)
FAMILY HEALTH DIARY
4
Age: (in years) : ________________________________
Height of mother (in cm.): ________________________________
Last Menstrual Period: ________________________________
Duration of last Menstruation: ________________________________
Expected Date of Delivery: ________________________________
Order of Present Pregnancy: ________________________________ (1st, 2nd,3rd, etc)
OB Score: G ____ P ____ ( ____ ____ ____ ____ ) (1) (2) (3) (4)
G = # of pregnancies
P = # of deliveries including still births, pre-term deliveries
(1) = # of term deliveries
(2) = # of pre-term births
(3) = # of abortions
(4) = # of live children
Present Pregnancy
INSTRUCTION: This is to be accomplished by the pregnant womanwith the assistance of the health worker during the first visit/ prenatalcheck-up.
FAMILY HEALTH DIARY
5
INST
RU
CTI
ON
: Th
is i
s to
be
acco
mpl
ishe
d by
the
hea
lth w
orke
r du
ring
ever
y vi
sit
of t
hepr
egna
nt w
oman
.
Findings Dur
ing
Prenatal
Exa
mination
s
Dat
e of
Pre
nata
l vis
it
Wei
ght (
kg.)
Blo
od p
ress
ure
Tem
pera
ture
(o C
)
Hei
ght o
f fun
dus
(in c
ms)
Feta
l Hea
rtbea
t per
min
ute
Feta
l Mov
emen
t (Y/
N)
1st
2nd
3rd
4
th
5
th
6
th
7
th
8th
9th
mo.
m
o.
mo.
m
o.
mo.
m
o.
mo.
m
o.
mo.
1
st T
rimes
ter
2
nd T
rimes
ter
3rd
Trim
este
r
Mon
ths
of P
regn
ancy
FAMILY HEALTH DIARY
6
Findings Dur
ing
Prenatal
Exa
mination
s
1st
2nd
3rd
4
th
5
th
6
th
7
th
8th
9th
mo.
m
o.
mo.
m
o.
mo.
m
o.
mo.
m
o.
mo.
1
st T
rimes
ter
2
nd T
rimes
ter
3rd
Trim
este
r
Mon
ths
of P
regn
ancy
Pre
sent
atio
n of
the
baby
:
-Sh
ould
er
-B
utto
cks/
Bre
ech
-Fo
otlin
g/H
and
-H
ead
Labo
rato
ry te
st re
sults
:
-he
mog
lobi
n
-ur
inal
ysis
-ot
hers
:HIV
, Hep
B,Sy
philis
scre
enin
g,et
c. (S
peci
fy)
(con
tinua
tion)
peci
FAMILY HEALTH DIARY
7
Findings Dur
ing
Prenatal
Exa
mination
s
1st
2nd
3rd
4
th
5
th
6
th
7
th
8th
9th
mo.
m
o.
mo.
m
o.
mo.
m
o.
mo.
m
o.
mo.
1
st T
rimes
ter
2
nd T
rimes
ter
3rd
Trim
este
r
Mon
ths
of P
regn
ancy
Pal
lor o
r ane
mia
(Y/N
)
Sw
ellin
g of
face
and
hand
s (Y
/N)
Diff
icul
t or f
ast b
reat
hing
(Y/N
)
Blu
rrin
g of
vis
ion
(Y/N
)
Sev
ere
dizz
ines
s (Y
/N)
Sev
ere
head
ache
(Y/N
)
Sev
ere
vom
iting
(Y/N
)
Sev
ere
abdo
min
al p
ain
(Y/N
)
(con
tinua
tion)
peci
FAMILY HEALTH DIARY
8
Vagi
nal b
leed
ing
orsp
ottin
g (Y
/N)
Vagi
nal in
fect
ion/
prob
lem
s(Y
/N):
-itc
hing
-di
scha
rge
-ot
hers
(sp
ecify
)
Pain
ful u
rinat
ion
(Y/N
)
Con
vuls
ions
or l
oss
ofco
nsci
ousn
ess
(Y/N
)
Findings Dur
ing
Prenatal
Exa
mination
s
1st
2nd
3rd
4
th
5
th
6
th
7
th
8th
9th
mo.
m
o.
mo.
m
o.
mo.
m
o.
mo.
m
o.
mo.
1
st T
rimes
ter
2
nd T
rimes
ter
3rd
Trim
este
r
Mon
ths
of P
regn
ancy(c
ontin
uatio
n)
FAMILY HEALTH DIARY
9
Mate
rnal
Immun
ization
Record
Teta
nus
Toxo
idIm
mun
izat
ion
D
ate
Giv
en
R
emar
ksW
hen
toR
etur
n
1st d
ose
– as
ear
ly a
spo
ssib
le d
urin
g pr
egna
ncy
2nd d
ose
– af
ter 4
wee
ks
3rd d
ose
– af
ter 6
mon
ths
4th d
ose
– af
ter 1
yea
r
5th d
ose
– af
ter 1
yea
r
INST
RU
CTI
ON
: Thi
s is
to b
e ac
com
plis
hed
by th
e he
alth
wor
ker.
NO
TE: C
ompl
ete
the
five
dose
s to
ens
ure
lifet
ime
prot
ectio
n ag
ains
t tet
anus
for
the
mot
her.
This
will
als
o pr
otec
t the
bab
y in
the
wom
b (a
nd fu
ture
bab
ies)
aga
inst
neo
nata
l tet
anus
.
FAMILY HEALTH DIARY
10
Oth
er
Prob
lems
Identified
& Actions
Take
n
INST
RU
CTI
ON
: Thi
s is
to b
e ac
com
plis
hed
by th
e he
alth
wor
ker.
Firs
t Trim
este
r1st
Mon
th
2nd M
onth
3rd M
onth
Sec
ond
Trim
este
r4th
Mon
th
5th M
onth
6th M
onth
Third
Trim
este
r
7th M
onth
8th M
onth
9th M
onthM
onth
s of
Preg
nanc
yD
ate
of V
isit
H
ealth
Pro
blem
s
Act
ions
Tak
en
FAMILY HEALTH DIARY
11
Other Prenatal Health Services
INSTRUCTION: Put a check (√√√√√) if done.
Date
Vitamin A, 10,000I.U. capsule (1 cap 2x a wkstarting on the 4th month until deliveryto consume 45 capsules)
Iron folate 60mg/400mcg tablets (givenonce a day as soon as pregnancy isdetected, to consume 48 tabs)
D e w o r m i n g -Mebendazole 500mgtablet/ Albendazorole400mg tablet (given at 6th
month onwards)
Oral Health Check-up(at least twice during the whole
duration of pregnancy)
Breast examination(first and third trimester)
Sputum examination(if with signs & symptoms of TB)
Attendant during delivery:____________________________________ Name of doctor/nurse/midwife
Place of delivery:___________________________________________ Name of hospital/health center/clinic
Estimated cost of the maternity package in the mentioned facility:P__________________ (inclusive of newborn care)
Mode of payment (Pls. check what applies):
____ Cash ____ PhilHealth/PHIC
____ Other financing scheme, specify _________________________
Amount to be saved daily/weekly/monthly (in case of emergency and/orin the absence of insurance coverage for the cost of delivery & newborncare) :______________________________
Available transport to be used:________________________________
Person(s) who will bring/accompany pregnant woman to the hospital/health center/clinic:_________________________________________
Person(s) to care for/look after the other children while mother is in thehealth facility:
____________________________, ___________________________ Name Name
INSTRUCTION: This is to be accomplished by the mother and thehusband/partner with the assistance of the health worker and/orcommunity health teams.
FAMILY HEALTH DIARY
14
Possible donors to be contacted in case of blood transfusion:
1. __________________________________ ___________________ Name Tel.no/CP no. ______________________________________________________ Adress2. __________________________________ ___________________ Name Tel.no/CP no. ______________________________________________________ Adress3. __________________________________ ___________________ Name Tel.no/CP no. ______________________________________________________ Adress
In case of complications, referral will be made right away to:
All pregnancies are at risk.Complications are unpredictable and can develop anytimeduring delivery.All pregnant women must deliver in a hospital/health center/birthing clinic and attended to by a skilled birth attendant (doctor,nurse, midwife).
Birth and Emergency Plan
FAMILY HEALTH DIARY
15
Labor and Delivery
Start of labor pains: time: _____________ date: _________________Pregnancy outcome (pls check): alive: __________ stillbirth: _________Age of gestation at delivery: __________________________________
(Indicate estimated age in weeks)
Date of delivery: ___________________ Time of delivery: __________Type of delivery: _______________ Place of delivery: ______________Attended by:_________________________________________________________
Name of physician/nurse/midwife
Observation of the Baby after Delivery
INSTRUCTION: Write (Y) for yes if observed and (N) if notobserved. if N, please indicate actions done.
Preterm ________ Full term ________ Post term ________
Spontaneously cried outDid not cry at onceBody, hands and feet are pinkBody, hands and feet are blueStrong body movementsWeak/no movementNormal breathingAbnormal breathing/not breathingAPGAR score at I and 5 minutes(Indicate score)Other observations: cord loop, cordprolapse, birthmarks, etc. (specify)
Observation Action Taken
FAMILY HEALTH DIARY
16
Essential
Postpa
rtum
Ca
re, Serv
ices, and
Coun
seling
INST
RU
CTI
ON
: Ple
ase
indi
cate
dat
e w
hen
give
n or
don
e.
Vita
min
A 2
00,0
00 IU
cap
sule
(with
in1
mon
th a
fter
deliv
ery,
pre
fera
bly
durin
g th
e 1s
t wk.
afte
r del
iver
y)
Iron/
Fol
ate
tabl
et,(
60m
g/40
0mcg
,on
e ta
blet
dai
ly fo
r 3 m
onth
s)
Dew
orm
ing:
Meb
enda
zole
500
mg/
Albe
ndaz
ole
400m
g ta
blet
(if n
ot g
iven
w/in
the
last
6 m
os)
Per
inea
l car
e
Info
rmat
ion
and
Act
ion
on:
-E
xces
sive
vag
inal
ble
edin
g (m
ore
than
500
cc
of b
lood
)
-Fo
ul s
mel
ling
vagi
nal d
isch
arge
-Fe
ver (
39 d
egre
es a
nd a
bove
)
-Pa
llor
24ho
urs/
48 h
ours
1 w
eek
2 - 4
wee
ks4
- 8w
eeks
Beyo
nd8
wee
ksR
emar
ks
FAMILY HEALTH DIARY
17
Info
rmat
ion
and
Act
ion
on:
-C
are
of b
reas
t
-Br
east
pro
blem
s (i.
e. e
ngor
gem
ent,
sore
/ cra
cked
nip
ples
)
-E
xclu
sive
bre
astfe
edin
g
-G
ood
posi
tioni
ng
&
pr
oper
atta
chm
ent i
n br
east
feed
ing
-P
rope
r die
t
- P
erso
nal
hygi
ene
(bat
hing
dai
ly,
douc
he, c
hang
ing
sani
tary
nap
kins
,et
c)
-P
rope
r cor
d ca
re
-R
outin
e ba
by c
are
-P
ostp
artu
m d
epre
ssio
n
-Im
mun
izat
ion
for b
aby
-Fa
mily
pla
nnin
g
Essential
Postpa
rtum
Ca
re, Serv
ices, and
Coun
seling
24ho
urs/
48 h
ours
1 w
eek
2 - 4
wee
ks4
- 8w
eeks
Beyo
nd8
wee
ksR
emar
ks
(Con
tinu
atio
n)
FAMILY HEALTH DIARY
18
INSTRUCTION This is to be accomplished by the woman/motherand husband/partner with the assistance of the health worker.
Date ofscheduledfollow-up
Dateof Actual
Visit
Preferred FP Method
Natural ArtificialQuantity
GivenRemarks
Family Planning Record
FAMILY HEALTH DIARY
19
INSTRUCTION: This is to be filled up by both mother and father.Write down thoughts and feelings/emotions on the experiencethroughout pregnancy, labor, and delivery and the postpartumperiod. Information herein will be useful for health workers andcommunity health teams in responding to concerns expressedduring the various obstetric events.
MOTHER’S REFLECTIONS
A. Pregnancy:
Parents’ Reflections
D. Post Partum/After Delivery:
C. Delivery:
B. Labor:
FAMILY HEALTH DIARY
20
INSTRUCTION: This is to be filled up by both mother and father.Write down thoughts and feelings/emotions on the experiencethroughout pregnancy, labor, and delivery and the postpartumperiod. Information herein will be useful for health workers andcommunity health teams in responding to concerns expressedduring the various obstetric events.
__________________________ _______________________________ Date of birth registration Place of registration__________________________ _______________________________ Date of Newborn Screening Name of Hospital/Clinic
________ __________ ___________________ __________________ Sex Blood Type Birth Weight (kg) Length (cm)
INSTRUCTION: This is to be accomplished by the health worker.Write (Y) for Yes if done and (N) for No.
Cleaning of airways (mouth, nose)ResuscitationThorough Physical ExaminationCord dressingBaby wiped, dried and wrappedAnal Temperature (write temp.reading)Crede’s eye prophylaxis (i.e.Tetracycline)Vit. K injectionFoot printingBreastfeeding initiated within 30 min. (If notinitiated with in 30 minutes, put exact timein”Remarks” column)
Done Remarks
Details of Birth
Immediate Newborn Care
FAMILY HEALTH DIARY
22
INSTRUCTION: Please put the date when immunization is given.
NOTE: A Fully Immunized Child is a child who has received 1doseof BCG, 3 doses of Oral Polio Vaccine, DPT and Hep B & 1 doseof measles before reaching the age of 1 year.
INSTRUCTION: To be filled up by mother or father or health worker.
Other Problems Identified and Actions TakenOther Problems Identified and Actions TakenOther Problems Identified and Actions TakenOther Problems Identified and Actions TakenOther Problems Identified and Actions Taken
FAMILY HEALTH DIARY
26
Note: This page will be for the
Growth Monitoring Chart for Boys
FAMILY HEALTH DIARY
27
Note: This page will be for the
Growth Monitoring Chart for Girls
FAMILY HEALTH DIARY
28
KEY HEALTH MESSAGES AND HELPFUL TIPS
FOR THE FAMILY
Things that the Pregnant Woman & Family Should RememberDuring Pregnancy:
Have at least 4 prenatal check up with a health worker(1 during thefirst three months,1 within the 4th to 6th months , one during the 8th
and one on the 9th month). Whenever possible, the pregnant womanshould be accompanied by husband/partner during these visits to thehealth worker.
Eat foods that are rich in protein, ironand calcium such as dark green leafyyellow vegetables, milk and fish
Use iodized salt daily.
Practice oral and personal hygiene. Visit the dentist every 6 months.
Start breast care in preparation for breastfeeding.
Do not resort to self medication because this can harmthe mother and the baby.
Make sure to receive tetanus toxoid immunization to protect the motherand the baby.
Prepare for possible emergency (money, blood donor,transportation).
Avoid exposure to chemicals( pesticides/insecticides),cigarette smoke and avoid alcohol.
If living in a malaria-endemic area, sleep inside an insecticide-treated mosquito net every night.
FAMILY HEALTH DIARY
29
Keep surroundings clean and do the 4S against dengue (Searchand destroy mosquito breeding sites; seek early consultation; self-protection; and say “no” to indiscriminate fogging)
Dispose of wastes properly.
Seek immediate consultation at the health facility if any of the followingwarning signs and symptoms of pregnancy is experienced:
o Swelling of legs, hand, &/or faceo Severe headache, dizziness, vomitingo Blurring of vision
o Convulsionso Fast or difficult breathingo Severe abdominal paino Palloro Vaginal bleedingo Watery vaginal dischargeo Painful urinationo Fever and chillso Absence of/or reduced fetal movements (less than 10 kicks in 12
hours in the second half of the pregnancy
Things that the Pregnant Woman & Family Should RememberDuring Pregnancy: (Continuation)
FAMILY HEALTH DIARY
30
Development of the Baby in the Mother’s Womband Reminders to the Expectant Woman
0-4 weeksThe baby has the beginnings of a brain, asimple spinal cord and marks where the facewill be.The baby measures about 2mm in length. Look at beautiful scenes and pictures. Avoid any medications or drugs that canaffect the developing baby.
4-8 weeksThe heart begins to beat around six weeks,and all the other organs start to develop.Facial bones form, eyes and eye colordevelop, and fingers and toes appear.Listen to sweet and soothing music.Eat foods rich in protein, calcium, iron,zinc and folate. What you will eat alsoprovide nutrients for the baby. However,do not eat more than you should or youmay gain excess weight.
8-12 weeksMajor organs are now formed. The head is large compared to therest of the body to accommodate the growing brain.Chin, nose and eyelids have become defined.Baby floats in the amniotic fluid.Baby will be kicking gently.Don’t forget to take your iron with folicacid supplements daily.Take time to relax and have some freshair.
FAMILY HEALTH DIARY
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Avoid salty foods as this will cause swelling around your feet,ankles and fingers.
12-16 weeksBaby’s legs are longer than the arms.Lungs are developing and heartbeat can beheard by ultra sound.Baby has facial expressions, and eyebrowsand eyelashes grow.Can turn head and open mouth.The hair coarsens and develops its color.Consult a health worker right away if youhave any health problem.Eat a well-balanced diet.
16-20 weeksMovements more coordinated now, althoughgrowth has slowed a little.Baby can suck thumb and responds to thesound of its mother’s voice.Taste buds develop and can differentiatebetween sweet and bitter flavorsFingerprints develop and body is covered withfine hair called lanugo.Talk to the baby. Resolve to breastfeed the baby.Listen to/play beautiful music.Take regular light exercises.
20-24 weeksBaby’s body is still thin, but now in proportionwith the headBone centers are hardening.Genitals are developed, nostrils open, andbaby makes breathing motions.Sleep pattern is developed.Take a rest, as the baby would like to resttoo.
FAMILY HEALTH DIARY
32
Talk to the baby at least 15 minutes daily. Let it feel yourlove for it.Listen to sweet and soothing music everyday.
24-28 weeksFat builds up under baby’s skin, head hairgrows, eyelids open and brain is more active.Can hear a lot now, including internal andexternal noises. Baby can recognize mother’svoice and heartbeat will quicken when motherspeaks.Take care so baby will reach term.Reduce work load and start eating calorie-rich food.
28-32 weeksBaby now perfectly formed.Can see light through the mother’s abdominalwall and blinks.Moves around less as it put s on weight. Lungs are not fully mature yet but baby hasa good chance of survival if born at this time.Let the father touch your abdomen andto talk to the baby.
36 weeksBaby is readying for birth by practicingbreathing, sucking and swallowing.The fine downy hair on the body has gone.Intestines are filled with meconium (firstbowel movement) which will be passed outin the first two days after birth.Baby’s head has now dropped into mother’spelvis ready for birth.Be sure that you are prepared for the baby’s coming.
FAMILY HEALTH DIARY
33
THINGS TO PREPARE FOR BIRTH OF THE BABY
One or two sets of comfortableor loose dress with frontopeningPanties/braTowelCombMaternity sanitary napkinsCloth/cotton girdle (bakget)Shampoo/soapToilet paperToothbrush/toothpasteSlippersFamily Health DiaryPhilHealth Card/ money
For the Mother For the BabyBaby blanketsBaby clothesDiapersBonnetMittens or glovesSocksMild baby soapSoft baby towelMosquito netWash clothsSafety pinsEban or Oban (Blanketbaby carrier)
APGAR Scoring for Newborns
A score is given for each sign and added at 1 minute and 5 min-utes. If there are problems with the baby, an additional score isgiven at 10 minutes.
Sign 0 Point 1 Point 2 PointsActivity (muscletone)PulseGrimace (reflex irri-tability)Appearance (skincolor)Respiration
absent arms and legsflexed
active movement
absentno response tostimulationblue-gray, pale alloverabsent
below 100 beats/mingrimace/feeble crywhen stimulatedblue at extremities,body pinkslow/weak or irregular
above 100sneeze, cough,pulls awaypink all over
strong, good cryingInterpretation:Scores 3 and below : critically low; requires immediate resuscitation
4-6 : fairly low; might require some resuscitative measures7-10 : normal
FAMILY HEALTH DIARY
34
ROUTINE BABY CARE
Keep baby warm always through skin to skincontact with the infant held close to the mother’schest with a blanket or eban/uban covering thebaby and tied around the neck of the mother(kangaroo carry).
Exclusive breastfeeding (no other food or water/fluids) up to six months of age. Breastfeed babyfrequently and for longer periods.
Sponge bath baby daily until the cord falls off, thengive full bath
Keep the baby away from smoke or otherhazardous substances.
Proper cord care:o Wash hands before and after cord care.o Wash cord only when soiled. If soiled, wash it
with clean water, pat dry with clean cloth or allowit to air dry.
o Do not apply talc, powder, medicine, merthiolate,iodine, betadine or anything to the cord stump.
o Keep stump loosely covered with clean clothes.Do not put bandage on stump or abdomen.
o Do not pull the stump. The cord will come off byitself after 6-7 days.
Seek immediate consultation at the health facility if:o Baby refuses to feedo Baby has a foul smelling discharge from the cord or bleeding from
the stump or umbilical redness extending to skino Baby feels hot when touchedo Baby has convulsionso Baby is floppy or stiff
FAMILY HEALTH DIARY
35
Newborn screening is an essential service to find out if a baby has ahereditary metabolic disorder that, if left untreated, may lead to mentalretardation or even death.It is done by pricking the heel of a newborn and obtaining a few dropsof blood to be tested at designated laboratories.It is ideally done 48 to 72 hours after the baby is born.It is available in any participating hospital, Rural Health Units and lying-in clinicThe cost is between P550.00 to P600.00.The following are the metabolic disorders detected with newbornscreening:
Clinical Description Effects on the BabyMetabolicDisorder
Congenitalhypothyroidism
Lack or absence of thyroid hor-mone which is needed forgrowth of the brain and body
Stunted growth and severemental retardation if not de-tected and treated before 4weeks old
CongenitalAdrenalHyperplasia(CAH)
Inborn defect in the productionof the hormone, cortisol, thatcauses salt-losing dehydrationand abnormally high levels ofmale sex hormones in bothboys and girls
Baby may die within 7-14days if not detected early
Galactosemia Baby unable to processgalactose(sugar present inmilk)
Causes cataracts, liver andbrain damage
Phenylketonuria(PKU)
A disorder in which the babycannot properly use phenyla-lanine, an amino acid which isa building block of protein
Brain damage
Glucose-6-phosphatedehydrogenase(G6PD) deficiency
Lack of the enzyme, G6PD Episodic hemolytic anemia(destruction of red bloodcells) induced by infectionsand certain drugs/sub-stances
NEWBORN SCREENING
FAMILY HEALTH DIARY
36
Common Problems When Breastfeeding
Characteristics What to DoBreastfeeding
ProblemsNipple Cracks/Fissures
Express breast milk andfeed the baby using adropper/ cupWash with clean waterand mild soap and applyanalgesic creamResume breastfeedingafter 1-2 days of healing
PainSometimes bleeding
Engorgement ofthe breast
Breastfeed immediatelyafter birthHot or cold compressDon’t stop breastfeeding
The first milk (colustrum)in the first 3-4 days afterdelivery is enoughbecause the baby hasenough stored energyuntil the milk flows Mother to relax a fewminutes before feedingthe babyInitiate breastfeedingwithin 30 minutes ofdeliveryBreastfeed frequently dayand night for as long asthe child wantsDon’t introduce bottlefeeding. Baby should beintroduced to the breast
No milk flowespecially in the firstfew daysMother may be tootired and anxiouswhich prevent the milkto flowIntroduction of bottlefeeding interferes inthe establishment ofbreastfeeding due toless sucking, lessstimulation andtherefore lessproduction of milk
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Characteristics What to DoBreastfeeding
ProblemsTemporary sepa-ration of motherand child
Express breast milk tobe given to the babythrough cup feeding
Mother goes to work/field
Flat or invertednipple
Using the thumb andforefinger, gently pinch thenipple and roll it on bothsidesLet husband/older childsuck out the nippleExercise the nipple orbreast pump can be used
Nipple is buried oralmost at level with theareola
Sore nipples Nipple and areola are inside the baby’s mouthwhen suckingGood positioning andproper attachment duringbreastfeeding*
Temporary pain felt bysucking with improperpositioning
Blocked duct Gently massage withstrokes directed towardsthe nippleBreastfeed the baby.Offer the affected breastfirst to ensure emptying
Lump, hard, tenderand redness in thebreast
Mastitis Breastfeed the baby withthe unaffected breastGive antibiotics to combatinfection and pain relieverApply hot or coldcompress to relieve thepain
Breasts are painful,red, swollen and hotMother may havechills and fever (flulike)
Common Problems When Breastfeeding (Continuation)
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Characteristics What to DoBreastfeedingProblems
Apply hot or coldcompress to relieve thepainGive antibiotics and painreliever
Ducts are affectedPresence of pus dueto infection
Common Problems When Breastfeeding
Breast abscess Continue breastfeedingon the unaffected breastIncision drainage of theaffected breastResume breastfeedingon affected breast whenpus is minimal or hasdisappeared
Hard breast andlumpy to soft andfluctuant
*Signs of proper positioningwhile breastfeeding
1. Baby’s head and body straight2. Child facing mother’s breast3. Baby’s body close to her
around the mother’s nipple)seen above than below themouth
Mastitis
(Continuation)
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Feeding Recommendations
Birth to 6 mos Exclusive breastfeeding as often as the child wants,at least 8 times in 24 hrsDo not give any other foods or fluids
6 mos to12 mos
Breastfeed as often as child wantsAdd any of the following 2-3x a day: Lugaw with addedoil, mashed vegetables (like camote, squash,potatoes), steamed tokwa, flaked fish, finely-groundmeat, egg yolk, fruits like mango, banana, avocado,chicoNutritious snacks such as taho
12 mos to24 mos
Breastfeed as often as the child wantsGive adequate amount of family foods with oil ormargarine (5x per day): rice,camote, potato, fish,chicken meat, monggo, dark green leafy & yellowvegetables, milk and eggs, fruits, steamed tokwa
24 mos andolder
Give adequate amount of family table foods , 3x aday at mealtimesGive nutritious snacks between meals, 2x a day,such as: boiled camote, boiled corn, boiled saba,peanuts, taho, fruits and fruit juices
Sample Menu of Complementary Foods for a Day’s Meal
10-12months
What to GiveHow much to Give
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Feeding Recommendations
for a Child who has PERSISTENT DIARRHEA
If still breastfeeding, give more frequent, longer breastfeeding, day
and night
If taking other milk, such as milk supplements, replace with
increased breastfeeding and replace half the milk with nutrient-
rich semi-solid food
Do not use condensed or evaporated filled milk.
For other foods, follow feeding recommendations for the child’s
age.
Vitamin A Supplementation and Deworming
Vitamin A supplementation is given when the baby is 6 months
old and every 6 months thereafter.
Deworming should start when the baby is 1 year old and every 6
months thereafter.
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TB in Children
Children with the following symptoms should be brought to a health workerfor further evaluation:
Cough or wheezing for two weeks or moreUnexplained fever of two weeks or more after common causes suchas malaria or pneumonia have been excludedLoss of weight/failure to gain weight/weight faltering/ loss of appetiteFailure to respond to 2 weeks of appropriate antibiotic therapy forlower respiratory tract infectionFailure to gain previous state of health 2 weeks after a viral infectionor exanthema like measlesFatigue/reduced playfulness/lethargy
At 4 mos.
AgeMilestonesin Child’s
Development
PlayRecommendations
& Suitable Toys*
Ways ofDeveloping EarlyCommunication
SkillsAble to appreciatebright colors,follows movingobjects with eyes,smiles and laughsRecognizes voicesand facesMakes gurgling andvocal sounds
Have large colorfulobjects for child toreach for and holdProvide area forchild to move, playand develop hissenses of sight,touch and hearingToys: rattles,brightly coloredballs, washablestuffed toys
Look into baby’seyes and smile athim/herGet a conversationgoing with soundsor gestures whilebreastfeeding
Developmental Milestones
At 8 mos. Can turn over, holdhead erect and situpright.Can reach forobjects and put inmouth
Give clean, safecolorful objects indifferent sizes andshapes to hold,play with, bangand drop.
Respond to yourchild’s sounds andinterests.Respond to child’sattempts to talk
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At 8 mos.
AgeMilestonesin Child’s
Development
PlayRecommendations
& Suitable Toys*
Ways ofDeveloping EarlyCommunication
Skills
Developmental Milestones
Can differentiatebetween familymembers andstrangersRecognizes andsearches out peopleCan sit alone andstand up without helpCan say meaningfulwords
Give child things tostack up, put intocontainers andtake outAllow child to walkand run activelyaround but underan adult’s watchfuleyesToys: large smoothblocks, push-pulltoys
Ask child simplequestionsTell names ofthings and people
Counting andnaming gamesComparing things
May stumble at firstbut can run andsteadily climb up thestairsEnjoys stories andexperiments withthingsFollows simpledirections
Encourage child totalk and answerthe child’squestionsTell stories, teachsongs, rhymes
At 12 mos.
At 24 mos.
Can walk up anddown the stairs,pedal three-wheeledbicycles, gain controlof hands and fingersWants to doeverything by self
Read/tell stories,recite rhymes, singsongsEnroll at a day carecenter to socializewith friends
At 2-4 yrs.
Can draw picturesusing ownimaginationCan button shirtand tie own shoelacesDresses alone
Around 5- 6 yrs.
Listen to child andtalk with slow andc o r r e c tpronunciation ofwordsRead and write
Allow child to play withfriends on good terms,keeping rules andpromisesGive moreopportunities for playand explorationToys: puppets, pushtoys, building blocks,magnetic board,puzzle, pictures andcolor matching games
* Characteristics of a Good Safe Toyeducationalstimulatingattractive and beautiful in colors and formdurable and economicalsafeo cleano non toxico non flammableo large enough not to be swallowedo free from sharp points or cutting edgeo does not make a loud noise that can damage hearingo not electric or battery – operated
(Continuation)
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An Early Childhood Screening Tool(Adopted from Coordinator’s Notebook,
an International Resource for ECD)
The following is a simple screening tool which parents or any caregiver/health worker who is part of a child’s daily life can use. Immediatelyconsult a health worker if the child presents some of these behaviors:
HEARING – If the child:Does not turn towards the source of new sounds or voices
Has frequent ear infections (discharge from ear, earache)
Does not respond when called unless he/she can see you
Watches ones lips when he/she speaks
Talks in a very loud or soft voice
Does not talk or talks strangely
SEEING – If the child:Often is unable to find small objects which he or she dropped
Has red eyes or chronic discharge from eyes, a cloudy appearanceto eyes, or frequently rubs eyes and says that they hurt
Often bumps into things while moving around
Holds head in an awkward position when trying to look at something
Sometimes or always crosses one or both eyes (after 6 months ofage)
TALKING – If the child:
Does not say mama/mommy/nanay by 18 months of age
Cannot name a few familiar objects or people by age 2
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Cannot answer simple questions by age 4
Cannot follow simple stories by age 3
Seems to have difficulty in understanding things one is saying, whencompared to other children of the same age
PLAYING – If the child:
Does not enjoy playing waving games by age 1
Does not play with common objects(e.g. spoon and pot) by age 3
Does not join games with other children by age 4 (e.g. catch, hideand seek)
Does not play like other children of the same age
MOVING – If the child:
Is unable to sit unsupported by 10 months
Cannot walk without help by age 2
Cannot balance on one (1) foot for a short time by age 4
Moves very differently from other children of the same age
Cannot repeat simple songs or rhythms by age 3
Is not talking in short sentences by age 4
Is not understood by people outside the family by age 5
Is talking differently from other children of the same age
UNDERSTANDING - If the child:
Does not react to own name by age 1
Cannot identify parts of face by age 3
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Oral Health Care
The baby’s teeth are important because:
These act as guide for the growth of permanent teeth
These help the baby to eat well
These stimulate the jaw to grow
They play a major role in proper speech development especially theFRONT TEETH
Tooth Eruption Schedule
Central incisor
Lateral Incisor
Cuspid
First molar
Second molar
6 months – 7 months
10 months
18 months
14 months
24 months
TEETH AGE
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Teeth Development and Care
AgeDental
DevelopmentalMilestone
Proper Oral/Dental Care
Birth to4 mos
Clean gums and tongue with cleancloth, gauze or cotton soaked incooled boiled water at least once aday
5 mosto6 mos
Bring child to the dentist as soonas first tooth appearsStart brushing teeth with a soft-bristled toothbrush and mildtoothpaste
Teething starts
6 mosto24 mos
Avoid use of teethers or pacifiersfor these can cause mal-alignmentof teethStart teaching child to brush teethproperly after every mealDiscourage thumb-sucking, lipbiting, teeth grinding, nail biting andtongue thrashing as these lead toimproper growth of teeth anddevelop into undesirable habit
Eruption and completionof primary/milk teeth
2 yrsto6 yrs
Continue proper brushing afterevery mealBring child to the dentist 2 times ayear for check-up and treatmentlike sealant application, flouridationAvoid junk foods and sweets
Eruption and completionof primary/milk teeth
6 yrsto12 yrs
Visit the dentist twice a yearBrush teeth properly after everymealEat nutritious foods and avoid junkfood
Milk teeth start toloosen and fall outEruption of permanentteeth start and iscompleted by age 12
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Brush outer part of the upper teeth from the gumsdownward.
Brush outer part of the lower teeth from the gumsupward.
Brush inner part of the upper teeth from the gumsdownward.
Brush inner part of the lower teeth from the gumsupward.
Using the short back-and-forth stroking “scrubbing”motion, brush the upper chewing surfaces of the teeth.
Brush the lower chewing surface of the teeth.
Brush the tongue.
After brushing, use dental floss to clean in-betweenthe teeth.
PROPER TOOTHBRUSHING
It is important to teach the child proper tooth brushing techniques to preventtooth decay. The following techniques may be taught:
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PRACTICAL TIPS TO ENSURE CHILD’S SAFETY
Minimize the occurrence of accidents that may lead to trauma or evendeath with the following guidelines:
Never leave child alone without an adult supervision
Put baby to sleep on a crib/indayon/cloth hammock.
Let child sleep in a prone position or on side.
Never leave child to bathe alone until 6 years of age
Never toss baby around.
Keep matches, lighted candles, and hot liquids out of reach of thechild
Keep kerosene, medicines, caustics and insecticides away from child
Never smoke or allow someone to smoke nearby
Keep small and sharp objects away from child
Keep plastic bags away to avoid suffocation.
Keep away from electrical outlets and cords.
Never leave water on a bucket or tub.
Install safety locks on cabinets, drawers and wooden cribs.
Install side guards on beds.
Always use a seatbelt when in a car.
Never allow child to play on the street.
Never leave a child alone inside a vehicle.
Never allow child near swimming pools, ponds, rivers without adultsupervision.
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To be born, to have a name and nationality
To have a loving and caring family
To live in a peaceful community and a wholesomeenvironment
To have adequate food and a healthy and active body
To obtain a good education and develop potential
To be given opportunities for play and leisure
To be protected against abuse, exploitation, neglect,violence and danger
To be defended and given assistance by thegovernment
To be able to express own views.
RIGHTS OF A CHILD
“Promote the Convention on the Rights of the Child.“Promote the Convention on the Rights of the Child.“Promote the Convention on the Rights of the Child.“Promote the Convention on the Rights of the Child.“Promote the Convention on the Rights of the Child.Build Child-Friendly Communities!”Build Child-Friendly Communities!”Build Child-Friendly Communities!”Build Child-Friendly Communities!”Build Child-Friendly Communities!”
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ACKNOWLEDGEMENT
The collective efforts and valuable support and contributionsof many individuals have made completion of this handbook possible.
Special thanks to the staff of the Health Operations Divisionof CHD – CAR headed by Dr. Amelita M. Pangilinan for theirinvolvement in the peer reviews and critiquing of the original Maternal& Child Book and subsequent revision of the first handbook and earlydrafts. Many thanks to the following individuals for their work asreviewers: Dr. Juanita Basilio of the NCDPC, Dr. Virginia L. Narciso,Dr. Jovita G. Austria, Dr. Flora B. Pelingen, Zenaida Patal-e, CaridadB. Binwag, Aida T. Gonzales, Imelda T. Aboy, and Ursula P. Segundo;to Edna T. Pamo and Christine K. Dirige who painstakingly encodedthe outputs from the writeshops and reviews; and to Estrella C.Mendoza for her generous administrative support.
The expert guidance, critical assistance, substantive inputsand gentle encouragements of Dr. Myrna C. Cabotaje and Dr. JudithN. Allaga, Director IV and Director III, respectively, of the CHD – CARand Ms. Izumi Murakami, Chief Advisor of the JICA – MCH Projectwere integral to the process.
The handbook has also benefited greatly from the contributionsof others. Particular acknowledgement is made to Ms. Michiru Suda,JICA – MCH Project Coordinator and to Ms. Marcelyn Dulnuan,Assistant Project Manager, for their tireless efforts in coordinatingmeetings and reviews; to Dr. Janice Z. Bugtong, Chief of the LHAD,who stirred into action the pre-testing of this material with hersuggestion of a qualitative design for gathering opinions andexperiences from different perspectives; to the Philippine HealthSocial Science Association led by Dr. Erlinda Castro-Palaganas forconducting the pilot study in Ifugao, Mt. Province and Baguio City; toMa. Visitacion P. Molintas, Atty. Modesto Onia, Jr., Alenna A.
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Galdayen, and Sharmagne D. Aban for going through the rigors offield work as facilitator of the FGDs and KIIs; to the women and menFGD participants and key informants for the interviews whose practicalappraisal and recommendations have greatly enhanced the form,content and relevance of the handbook; and to Dr. Elvira D. Belingon,Jose V. Costales, Jr. and Joseph Joshua C. Sibaen for spendinglong hours of editing, re-rwiting and designing the materials for thehandbook.
The support, inspiration and understanding of and the servicesmade available by significant others and new friends met along theway are deeply appreciated.
Grateful acknowledgement, likewise, goes to the writers of theoriginal Mother and Child Book from which this was patterned.
The development and publication of this handbook have beenmade possible by the generous financial support of the governmentof Japan through the JICA – MCH Project.
