With the advent of the baby, not only great happiness, love, caring, but also the inalienable feelings of anxiety and fear come to the family. No matter how prospective parents are prepared for the birth and education of their little miracle, they can not do without outside help, especially medical care.
In the maternity hospital, where there are 24-hour medical staff, supervision and counseling, my mother and relatives feel confident, but only they should leave the walls of this institution and stay alone with the baby, panic, uncertainty and certain fears may arise. Therefore, there is a patronage of the newborn.
After discharge from the hospital, the polyclinic service receives data on the newborn. If the family changes residence or residence, they must without fail inform on their move and register with the children's polyclinic at the place of actual residence. This is necessary for the ability of health workers to patronize the newborn. A sample of the necessary documents is always in the treatment-and-prophylactic institution. Small children are served regardless of the place of residence or the city of birth.
Terms of the patronage of newborns
The medical examination and the initial visit of medical personnel must be made in the first three days after discharge from the maternity ward and are regular during the first month. It should be noted that the doctor comes together with the nurse for acquaintance and examination of the newborn child, and then, if there is no reason to do so, the nurse makes visits on her own. She keeps the district pediatrician in the state of the baby's state, also filling out all the necessary medical documentation.
How is the patronage?
The first patronage of a newborn, if the baby is assigned to a group of risk, should be performed on the first day after discharge. The first week of visits are applied daily, then their multiplicity decreases, and in the absence of abnormalities in child development and physiological changes, follow-up visits are conducted at the third and fourth weeks of the baby's life.
The primary patronage of the newborn has the following objectives:
- acquaintance with the newborn and his family;
- check the health of the baby and mom;
- assessment of housing conditions and social status of the family;
- teaching the mother the basic rules of child care;
- psychological and advisory assistance to young parents.
Of course, patronage primarily consists in assessing the state of health and development of the baby. To do this, the doctor collects a detailed anamnesis of the course of pregnancy and childbirth, possible complications and pathological conditions, risk groups and chronic diseases in parents and blood relatives, conducts a general examination of the child.
Then the doctor starts a direct examination of the baby. Particular attention is paid to the condition of the skin (their color, purity and the presence of any rashes, diaper rash, or wounds, especially in wrinkles) and mucous membranes. The pediatrician evaluates reflexes, weight gain, feeding characteristics, the nature of breathing and palpitations, the severity of the swelling and the nature of the bowel movement. Additionally, auscultation of the lungs and heart, palpation of the abdomen, examination of the fontanel and umbilical wound.
The present patronage of the newborn is complemented by the examination of the mother. Particular attention is paid to the breast, and if the baby is breastfed, - the correct application and activity of sucking the baby. At the same time, recommendations are given for feeding the mother.
Additionally, medical personnel may inquire about the availability of a home medicine kit and its components and, if necessary, recommend supplementing it with the necessary emergency medicines and childcare facilities.
Patronage of the nurse is not only to help the doctor and filling in the routine documentation, but also in direct work and communication with the newborn and his family.
The nurse will tell you and in practice will show how to properly handle the umbilical cord, clean the spout, ears and eyes, how to bathe the baby and trim the nails.
Preparing parents for patronage
The patronage of a newborn child requires the training of not only medical personnel, but also the parents themselves. No special actions, of course, are required, but it is worth buying shoe covers and a paper towel. Also, stock up on disposable gloves and disinfectants and ask them to look at your baby in them and do not let the doctor forget to treat your phonendoscope with alcohol, which you kindly offer him.
Prepare a place for a convenient examination of the child. It is best if it is a changing table with free access to it. No less important is good lighting in the room.
Collect all the medical documentation and prepare a list of issues that you are interested in, because when it comes to them, you can forget with excitement what you wanted to ask.
Filling in medical records
After the inspection and consultation, all the necessary documentation is filled. On this can be considered completed the patronage of the newborn. The sample is presented below.
At the age of _______, on the ____ the day of discharge from the maternity hospital ____, the boy (girl) from ____ pregnancy, ________ was born (full) / prematurely (-s). Weight at birth ______, weight at discharge ______, height _______, head circumference ________. The condition of the child after childbirth ______. Diagnosis __________, treatment (if conducted) _____________. The baby is breast-feeding _______________. umbilical cord injury ______. Jaundice appeared on ______ day, was not. Blood type and Rh factor ___________ child. Chronic diseases of the mother ________________________________, father ____________________________. Contact on tuberculosis __________. The condition of the mother's mammary glands _________________________________________________________________.
General examination of the child: state __________, body temperature ________. Skin covers _________________________, turgor of tissues ________________, muscle tone. Scrapers _________, head shape ___________________, a large fontanel _______________________, small ______________. Reflexes of a newborn _________________________________________________________. Musculoskeletal system __________________________________________________, lungs _________________________, respiratory rate ______________, auscultation __________________________, heart ____________________________, heart tones _______________, Heart rate ________, abdomen ____________________________, liver _______________, spleen ___________, genitals _________________.
Musculoskeletal system _______________________________________________ Conclusion ______________________________________________________________
Vaccination ______________________________________________________________ Infant feeding consultation ___________________________________________________________ Signature of nurse _____________________________ Signature of doctor ___________________________
After the lapse of the first month, an active examination at home stops, and parents have the opportunity to visit the clinic together with their baby. Monthly monitoring is necessary during the first year of life. During the examination, the doctor evaluates the development of the child (physical, neuropsychological), advises parents about the regime of the baby's day, its age requirements and stages of development, conducts anthropological measurements (determines weight and height, the circumference of the head and thorax), carries out preventive measures, aimed at preventing the development of anemic conditions, rickets and other vitamin deficiencies.
The patronage of the newborn implies another important function - the compliance with the schedule of vaccinations.
The Cabinet of a healthy child
An integral part of the successful prophylactic medical examination of infants is the presence of the so-called healthy child's cabinet. Thanks to his work, a young mother can get the necessary counseling and knowledge about the development of her baby, the principles of rational nutrition and the timing of the introduction of lures, the basic rules of hardening and techniques of massage and preventive exercises. In this room, there is always enough literature and visual aids that will facilitate understanding of the development processes of infants, the principles of rational nutrition and the organization of the correct regime of the day.
The patronage of a newborn is not only necessary but also a useful technique for monitoring a small member of society, providing timely diagnostics of pathological conditions and preventing their development, giving knowledge and skills in caring for the baby, inspiring confidence in oneself and their actions, contributing to the controlled care of the child and saving young parents from many mistakes.