Country Experiences

(1)

Please bring this handbook with you every time you come in for services

at the government and private hospitals.

Recommendation for practice

The birth certificate form (T.r. 1/1) in this handbook signed

by health personnel to certify the birth of the child is neither

an official birth certificate nor birth registration. Parents should

contact the district or local registration officer at district/

sub-district office, municipality office, or Bangkok

Metropolitan Administration Office to register the birth of the

child in order to get an official Birth Certificate and to add the

childûs name into the household record within 15 days after

birth. Parents should bring with them this handbook, a copy of

household record, and the identification card of the childûs

mother or father when registering for the official Birth

Certificate. If you register later than 15 days, you as the

parents, will be fined for 1,000 baht by the law.

For your childûs well-being:

1. A copy of household record.

2. Identification card of the childûs mother or father.

3. Marriage license of the parents (if any).

Name-Surname of Child

Please do not lose

this handbook

Documents required for official birth registration :

If the mother is physically and mentally

healthy, then the child will be healthy and happy.

Good physical and mental health of mother has resulted from the

good care of the husband.

This handbook can be used as a reference for obtaining your babyûs Birth Registration Certificate, This handbook can be used as a reference for obtaining your babyûs Birth Registration Certificate,This handbook can be used as a reference for obtaining your babyûs Birth Registration Certificate, This handbook can be used as a reference for obtaining your babyûs Birth Registration Certificate,This handbook can be used as a reference for obtaining your babyûs Birth Registration Certificate,

and adding your childûs name into the household record and adding your childûs name into the household record and adding your childûs name into the household record and adding your childûs name into the household record and adding your childûs name into the household record

(2)

1.

Having children at the ages between 20-35 years

2.

Spacing between each child for at least 2 years.

3.

Together with the husband, having ANC visit soonest before 12 weeks of gesta-tional age, following every appointment of ANC visits, and having the delivery by medical and health personnel.

4.

Receiving complete doses of T.T.vaccine. Having self-practice during the pregnancy

5.

delivery, and postpartum periods as rec-ommended in MCH handbook.

6.

The childûs birth-weight is 2,500 grams or more.

7.

Having the baby suck breastmilk instantly after birth with exclusive breastfeeding for at least 6 months, continuing breastfeeding for at least 24 months along with other food for ages.

8.

Bringing up a healthy child without malnutrition and obesity.

9.

Promoting the childûs age appropriate development as recommended in MCH handbook.

10.

Bringing the child to receive vaccina-tions on appointments.

Chaiman of Advisory group Chaiman of Advisory group Chaiman of Advisory group Chaiman of Advisory group Chaiman of Advisory group

Dr.Vichai Tienthavorn Former Permanent Secretary, Ministry of Health Consultants

Consultants Consultants Consultants Consultants

Dr.Somyos Deerasamee Director-General, Department of Health Dr.Somsak Pattarakulwanich Deputy Director-General, Department of Health Dr.Sompong Sakulisariyaporn Director of Bureau of Health Promotion,

Department of Health Editors

Editors Editors Editors Editors

Dr.Nipunporn Woramongkol Bureau of Technical Advisors Department of Health Dr.Sirikul Issaranurak Professor Emeritus, Mahidol University

Dr.Sarawut Boonsuk Chief of Maternal and Child Health Group

Mrs.Nareeluck Kullurk Public Health Technical Officer, Senior Professional Level Mrs.Chailai Leartvanangkul Public Health Technical Officer, Senior Professional Level Ms.Sukjing Worngdechakul Nutritionist, Senior Professional Level

Mrs.Jintana Pattanapongthorn Public Health Technical Officer, Senior Professional Level Mrs.Nongluk Roongsubsin Dissemination Technical Officer, Senior Professional Level Mrs.Prapaporn Jungpanich Public Health Technical Officer, Professional Level Mrs.Isaree Jedprayuk Public Health Technical Officer, Professional Level Ms.Chaweewan Tonputsa Public Health Technical Officer, Professional Level

Mother and Child Health Handbook

Published Published Published Published

Published bybybybyby Bureau of Health Promotion, Department of Health, Ministry of Pubic Health, Thailand Total

Total Total Total

Total 102 pages 1st

Printing: 1400 copies Printing Office

Printing Office Printing Office Printing Office

(3)

General Identification Number ...

(Pregnant woman)

General Identification Number (Child)...

Firstly Issued at...

Name-surname of pregnant woman...

Identification Number

Occupation... Religion...

Education (Highest educational attainment)...

Telephone number...

Name-surname of the husband...

Identification Number

Occupation... Religion...

Education (Highest educational attainment)...

Telephone number...

Current address No... Moo...Name of village...

Soi...Street...Sub-district...

District... Province...Zip Code

Name-surname of the child... Blood group...

Date of birth...Month... Year 20... time of delivery... hrs.

Identification Number

Child's

Photograph

ID

1

(4)

Introduction to the Use of MCH Handbook

This MCH handbook is a personal health record for the mother

during pregnancy, intra-partum, and post-partum periods, and for the

child since birth up until 6 years of age.

Advantages

™

A source of knowledge and record for the health of mother and

child from pregnancy up until the child is 6 years old.

™

Helping the father and mother to take appropriate care for their

child from birth up until 6 years olds.

™

Providing an evidence for notification of birth and obtaining a

birth certificate using the form T.R.1/1 signed by the birth

at-tendant presented in this handbook.

Instruction

™

Read through and follow all the contents in this handbook.

™

Bring along this book whenever you receive services at any

health facilities.

™

Record the data all by yourself and have your husband record

the data on the pages as identified.

™

When your child attends school, hand over this book to the

teacher for continuous care of the childûs health.

™

If the book is torn or lost, obtain the new one from health

personnel.

(5)

CONTENTS

Page Page Page Page Page

woman to give birth to a newborn > 2,500 g.

■Advantage of nutritional graph 63 ■Nutritional graph for pregnant woman 64

[image:5.420.216.392.58.566.2]

■Nutrition for pregnancy women: 65-66 Table for comparison of percentage

of standard BMI values (BMI 21 = 100) ■Illustration of sets of food exchange 67-68

for pregnant woman

■Fetal development 69

■Thalassemia 70-71

■What is hypothyroidism? 72

■Prevention of mother-to-child 73 transmission of HIV

■Family planning 74

■Self assessment and analysis 75-76 of stress

Part 4 Child related knowledge to bring 77

up a healthy, brilliant, good, happy child

■Breast-milk is the first drop of family 78 love bond

■Food for infant at birth › 12 months 79-80

■Adequate amount of daily food intake 81 for a child 1 › 5 years

■Caring for your child 82

■Caring for your child suffering from 83 respiratory tract infection

■Caring for your childûs teeth 84

■Vaccinations guide 85

■Miracle of reading 86

■Guide to bringing up a brilliant, good, 87 happy child

■Suggestion for parents and guardian in 88 recording the childûs development

■Child development promotion 89-97

■Risks and guide to prevention of 98-100 injuries in early childhood

■Childûs vaccination record 101

■Next appointment date for health exam 102

Page Page Page Page Page

General I.D. number (pregnant woman) 1 Introduction to the use of MCH handbook 2

Part 1 Pregnancy 4

■Health history of pregnant woman 4 and family

■Risk assessment criteria for pregnant 5 woman at the 1st ANC visit

■History of current pregnancy 6

■Pregnancy examination record 7 ■Checklists of care for quality pregnant 9

woman

■Checklists of service inclusion by 10 gestational age

■Uterine heigh graph 11

■Fetal movement count 12 ■Maternal delivery record 15

■Record of the newborn 16

Part 2 Child Care 17

■Risks assessment in mother and 17-18 newborn (prior to hospital discharge)

■Oral health for children aged 6 19 months › 5 years

■Child Development and service 20-39 activities for children aged 1 month›4 years

■Head circumference graph 40-41 (separated for male and female)

■Guide to the use of child nutritional graph42

■Child nutritional graph 43-54

Part 3 Essential Knowledge for Safe 55

and Quality Pregnancy

■Discomforts during pregnancy 56

■Maternal practice during pregnancy 57

■Table of minimum weight for pregnant

58

woman to give birth to a newborn of 2,500 g.

■Self care during pregnancy using 59-60 pregnancy pathway chart

(6)

PART 1: PREGNANCY

Having been married for

...

yrs. Use

...

as a contraceptive method forÇ.years/Ç.months. Most recently stop using contraception before pregnancy forÇÇ.yrs./Ç.months.

Pregnancy History

Pregnancy PregnancyPregnancy PregnancyPregnancy D/M/YD/M/YD/M/YD/M/YD/M/Y

delivery/ delivery/ delivery/ delivery/ delivery/ abortion abortionabortion abortionabortion Gesta-tional tionaltional tionaltional age(wks) age(wks)age(wks) age(wks)age(wks) Delivery/ Delivery/ Delivery/ Delivery/ Delivery/ abortion abortion abortion abortion abortion Method Method Method Method Method of ofof of of delivery/ delivery/ delivery/ delivery/ delivery/ abortion abortionabortion abortion abortion Birth-Birth- Birth-weight weightweight weight weight Sex Sex Sex Sex

Sex PlacePlacePlacePlacePlace of of of of of delivery/ delivery/delivery/ delivery/delivery/ abortion abortion abortion abortion abortion Complica-tions tionstions tions tions Current Current Current Current Current Status of Status ofStatus of Status ofStatus of infant infant infant infant infant

1

2

3

4

5

6

Diabetes Hypertension Heart Disease Thyroid

Anemia Thalassemia Others...

...

History of surgeries

...

in the year

...

at

...

Hospital

...

in the year

...

at

...

Hospital

History of drug allergy Name of the drug

...

Symptom

...

Name of the drug

...

Symptom

...

History of illnesses and pregnancies of family members

Seizure Diabetes Hypertension Congenital anomaly

Multiple pregnancy Mental retardation Others

...

History of menstruation cycle Regular/irregular menstruationÇÇÇand at everyÇ..days

History of Illnesses

(recorded by pregnant woman)

(7)

Past History

1.

Stillbirth or neonatal death (first 1 month)

2.

3 consecutive abortions

3.

Having baby with birth wieight < 2,500 g.

4.

Having baby with birth wieight > 4,000 g.

5.

Hospitalized for hypertension treatment during pregnancy or toxemia of pregnancy

6.

Undergone surgery of reproductive system organ such as myoma, mypmecomy, cervical cerclage, etc.

Current History

7.

Multifetal pregnancy

8.

Age < 17 years (up to EDC)

9.

Age > 35 years (up to EDC)

10.

Rh Negative

11.

Vaginal bleeding

12.

Pelvic myoma

13.

Diastolic pressure

≥

90 mmHg

14.

Diabetes

15.

Kidney disease

16.

Heart disease

17.

Drug addiction, alcohol addiction

18.

Other diseases of internal medicine such as anemia, thyroid, SLE, tc. (please specify)

...

Item ItemItem Item

Item Criteria for AssessmentCriteria for AssessmentCriteria for AssessmentCriteria for AssessmentCriteria for Assessment NoNoNoNoNo YesYesYesYesYes

If any of the responses fall into çYesé, the new approach of pregnancy care is not If any of the responses fall into çYesé, the new approach of pregnancy care is not If any of the responses fall into çYesé, the new approach of pregnancy care is not If any of the responses fall into çYesé, the new approach of pregnancy care is not If any of the responses fall into çYesé, the new approach of pregnancy care is not applicable to the pregnant woman and special care and/or additional assessment applicable to the pregnant woman and special care and/or additional assessmentapplicable to the pregnant woman and special care and/or additional assessment applicable to the pregnant woman and special care and/or additional assessmentapplicable to the pregnant woman and special care and/or additional assessment should be employed.

should be employed.should be employed. should be employed.should be employed.

AssessorÇÇÇÇÇÇÇÇÇÇÇÇÇÇÇÇÇ.ÇÇÇ.DateÇÇÇÇÇÇÇÇÇÇÇÇÇÇ

5

PART 1: PREGNANCY

Risk Assessment Criteria for

Pregnant Woman at the 1

st

ANC Visit

(8)

History of Current Pregnancy

Pregnancy #...Last menstrual period...Expected due date... Weight before pregnancy...kg. Height...cms. BMI before pregnancy... Number of C/S...Number of living children...Age of the last child...yrs...months

Laboratory Test

■ STIs (VDRL)

1

st

time

Date... Result...

2

nd

time

Date... Result...

■ Blood test for HBsAg

1

st

time

Date... Result...

■ Blood test for Hematocrit

1

st

time

Date... Result...

2

nd

time

Date... Result...

■ Screening for Thalassemia (Wife) Date...

Result OF...DCIP...MCV... (Husband) Date...

Result OF...DCIP...MCV...

■ Blood group and (Wife) Blood group...Rh...Hemoglobin type.... Hemoglobin type (Husband) Blood group...Rh...Hemoglobin type....

■ Other examination results...

■ Couple counseling Pre-blood test Date... Pre-blood test Date...

■ Participation in parental school activities 1st

time at gestational age...months 2nd

time at gestational age...months

(recorded by health personnel)

Tetanus Toxoid Vaccination

(Recorded by health personnel)

Received vaccination before pregnancy...times.

Date of most recent vaccination... Vaccination is not given for this pregnancy as the 3rd

dose was given no more than 10 years or with previous tetanus vaccinations for 5 times.

1st

Dose, date... 2nd

Dose, date... Booster Dose, date...

(9)

Diabetes screening

...

Record of Pregnancy Examination

Result of U/S exam, day

...

BPD

...

FL

...

Fetal position

...

Gestational age

...

Corrected EDC...

By

LMP

PV U/S Ut Size

GA...wks Sign...Date...

Date

of

Exam

Weight

Kg.

Blood

Pressure

mm.Hg.

Size of

Uterure

(cm.)

Fetal

position/

presentation

Fetal

heart

sound

Fetal

movement

Gestational

age (wks.)

General physical

exam and risks

assessment

Diagnosis and

Treatment

Appointment

Officer

Place

Urine Exam

Bacteria/

Protein/Sugar

Other special exam

...

8

7

...

(10)

1. Check classifying form, no high risks

2. Check weight, height, blood pressure

3. General physical examination

4. Urine exam (Multiple dipstick) for protein, sugar,

asymptomatic bacteria

5. Transfer to the doctor for lung and heart

sounds exam

6. Pelvic exam (may postpone to the 2nd visit)

7. Test for Hb/Hct/OF/DCIP (every gestational age)

and test for VDRL, Anti HIV, blood gr, Rhtyping,

HbsAgr

8. Give the 1st

dose of tetanus toxoid vaccine

9. Give iron and/or folic, and iodine supplementation

10. Give advice in case of emergency with

abnormal signs, with telephone number for

emergency contact

2 2 2 2 2ndndndndnd

Visit, Date...(20 weeks) Visit, Date...(20 weeks) Visit, Date...(20 weeks) Visit, Date...(20 weeks) Visit, Date...(20 weeks)

1. Check weight, blood pressure

2. Pelvic exam (in case not performed at the 1st

visit)

3. Ultrasound exam (if applicable)

4. Give iron, iodine, calcium supplementation

5. Give the 2nd

dose of tetanus toxoid vaccine

(at least 1 month interval of the 1st dose)

6. Give post-test counseling for the blood result

and abnormal signs, with telephone number for

emergency contact

Checklists of Service Inclusion by Gestational Age

<

12

20

26

32

38

1. Check weight, blood pressure

2. Test urine for protein, sugar

3. General physical examination, check for anemia,

edema

4. Pregnancy exam, estimate gestational age,

measure uterine height, Listen to fetal heart

sound

5. Give iron, iodine, calcium supplementation

through the pregnancy period

6. Advice mother to observe fetal movement

7. Give advice in case of emergency with

abnormal signs, with telephone number for

emergency contact

4 44 44ththththth

1. Test for Hb/Hct, VDRL. Anti HIV

2. Give advice about delivery, breastfeeding plan,

contraception

5 55 55ththththth

1. Check fetal position, if breech presentation,

refer to ECV or CS

2. Record in ANC booklet, remind of bringing it

along when coming for delivery

3. If delivery does not occur at 41 weeks of

gestation, give advice to come to the hospital

Checklists of Service Inclusion by Gestational Age

Weeks WeeksWeeks Weeks Weeks 1 1 1 1 1ststststst

Visit, Date Visit, Date Visit, Date Visit, Date

Visit, DateÇÇÇÇ...(should be before 12 weeks)(should be before 12 weeks)(should be before 12 weeks)(should be before 12 weeks)(should be before 12 weeks)

<

12

20

26

32

38

Weeks Weeks Weeks Weeks Weeks 3 33 3 3ndndndndnd

Visit, Date Visit, Date Visit, Date Visit, Date

Visit, DateÇÇÇÇ...(should be before 26 weeks)(should be before 26 weeks)(should be before 26 weeks)(should be before 26 weeks)(should be before 26 weeks)

(11)

[image:11.420.23.381.92.550.2]

Uterine Height Graph

Figure 4 : Uterine height values by weeks of gestation

Gestational Age

11

PART 1: PREGNANCY

20 21 2223 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 10

12 14 16 18 20 22 24 26 28 30 32 34 36 38 40

10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40

Uterine height (cm.)

Record of oral health exam at ANC visit

Record of oral health service at prenatal

ë

Tooth decay Yes(number....) No.

ë

Ginggivitis Yes No.

ë

Calculus Yes No.

Examiner

...

Date of Exam

.../.../...

Teaching on oral gem control

Number of fillng teeth

...

Number of removing teeth

...

Scaling

Attendant

...

Date of Exam

.../.../...

Oral Health Exam

Talk to the baby in your womb everyday to create your baby.

(12)

Date Morning (time) Daytime (time) Before bedtime (time) Date Morning (time) Daytime (time) Before bedtime (time)

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

1. Counting fetal movement is to prevent fetal death possibly occurs especially in the mothers with complications such as diabetes, hypertension, toxemia of pregnancy, approaching or beyond the due date of delivery.

2. Begin to observe and count the frequencies of fetal movement from 6 months of gestational age up until delivery.

3. Observe fetal movement everyday and record at least 3 times a day. 4. Observe fetal movement when you are free from work such as after a meal,

before bedtime, or getting up in the morning, etc.

5. Fetal movement is when you feel your baby moves in your abdomen, if you only feel abdominal tense or your baby stretches up, it is not considered a fetal movement.

6. If you are doubtful, not understand or unable to do so, consult your doctor or nurse immediately.

7. During 1 hour of observation, you should feel fetal movement at least 3 times, if not or less than 3 times in 1 hour, see your doctor or nurse promptly for additional exam such as to check fetal heart rate with modern device.

MonthÇÇÇÇÇÇÇÇÇÇÇÇÇÇÇÇÇÇÇ

Fetal Movement Count

(13)

13

Date Morning (time) Daytime (time) Before bedtime (time) Date Morning (time) Daytime (time) Before bedtime (time)

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

MonthÇÇÇÇÇÇÇÇÇÇÇÇÇÇÇÇÇÇÇ Date Morning (time) Daytime (time) Before bedtime (time) Date Morning (time) Daytime (time) Before bedtime (time)

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

MonthÇÇÇÇÇÇÇÇÇÇÇÇÇÇÇÇÇÇÇ

When your baby moves 1 time, mark / in the grid

more then 3 /// should be marked in 1 hour of observation

(14)

Record of Fetal Movement Count(continued)

MonthÇÇÇÇÇÇÇÇÇÇÇÇÇÇÇÇÇÇÇ Date Morning (time) Daytime (time) Before bedtime (time) Date Morning (time) Daytime (time) Before bedtime (time)

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

Abnormal signs during pregnancy to be promptly seen

by the doctor or health personnel

■ Headache, blurred vision ■ Vaginal bleeding

■ Stomachache, abdominal pain ■ Fluid from vagina

■ Vaginal discharge ■ Less fetal movement

■ Irritable bowel Syndrome ■ convulsions and coma

(15)

Maternal Delivery Record

(record by health personnel

Abnormal signs during postpartum period to be promptly seen

by the doctor or health personnel

■ Postpartum hemorrhage, blood clot ■ Uretritis, obstructed urine, retention

■ High fever for 2 days of urine

■ Lochia with foul smell, turbid, or ■ Perineum pain, edema, or broken red color for more than 2 weeks wound

■ Sore nipples or mastitis Place of delivery

Place of deliveryPlace of delivery

...

bybybybyby

( )

Doctor

( )

Nurse

( )

Others (specify)

...

Gestational age

Gestational ageGestational age

...

weeksweeksweeksweeksweeks Mode of deliveryMode of deliveryMode of deliveryMode of deliveryMode of delivery

...

Intrapartum complication

Intrapartum complicationIntrapartum complication Intrapartum complicationIntrapartum complication

Yes (specify) No

...

Postpartum complication

Postpartum complicationPostpartum complication Postpartum complicationPostpartum complication

Yes (specify) No

...

Record of Postpartum Check-up

Date of exam

Blood Pressure

Level of Uterus

Lochia Breast and Nipple

Flow of Breast-milk

Hygiene of Umbilical

cord

Name of examiner

Postpartum Check-up: Week 1 › 2, at least 1 time

Week 6, at least 1 time

15

Postpartum check-up, safe motherhood

(16)

Record of the Newborn

Date/month/year of birth

...

Sex

...

Birth-weight

...

grams Length

...

cms.

Head circumference

...

cms. Apgar Score (1 minute)

...

(5 minutes)

...

Congenital anomaly Yes (specify)

...

No

Health condition at birth Healthy Abnormal (specify)

...

Date of hospital discharge

...

Weight at the date of discharge

...

Vitamin K injection Yes No

Newborn screening Date...

...

-

Thyroid deficiency Normal Abnormal

-

PKU Normal Abnormal

■ Jaundice ■ Refuse suckling

■ Raised body temperature, fever, ■ No urination within 24 hrs. drowsiness

■ Rapid breathing over 60 breaths/minute or difficult breasting

■ Swelling, redness, leaking pus at the umbilicus, eyes or skin

■ Diarrhea and/or vomiting

The newborn should be promptly seen by the doctor or

health personnel if displays the following abnormal signs

Yellow stool is normal in a child.

If your child had white or pale yellow stool as in the picture below, bring your child to the doctor promptly as he or she may have liver or

(17)

PART 2: CHILD CARE

Assessment of Risks in Mother and Newborn

(prior to hospital discharge) (recorded by health personnel)

Maternal History Maternal HistoryMaternal History

Maternal HistoryMaternal History YesYesYesYesYes NoNoNoNoNo UncertainUncertainUncertainUncertainUncertain UnknownUnknownUnknownUnknownUnknown 1. Risk group for 6-month exclusive

breastfeeding

2. History of illness effecting child raising

3. Less than 17 years of age 4. Father or mother or relative

raising the child alone. 5. Blood test

- HBsAg+

6. History of a genetic disease about hearing

7. BMI < 18.5 before pregnancy 8. Malnutrition from 20 weeks of

gestation and beyond 9. Other risk conditions

Additional details

Item 1 Item 1Item 1

Item 1Item 1. Risk group for 6 ›month exclusive breastfeeding refers to the mothers with abnormal nipples/working outside the home.

Item 2 Item 2Item 2

Item 2Item 2. History of illness effecting child raising refers to requirement of regular medication or mental illness.

Item 9 Item 9Item 9

Item 9Item 9. Other risk conditions such as undesirable pregnancy, tobacco, alcohol, and substance uses, etc.

17

(18)

Child History Child HistoryChild History

Child HistoryChild History YesYesYesYesYes NoNoNoNoNo UncertainUncertainUncertainUncertainUncertain UnknownUnknownUnknownUnknownUnknown 1. Premature birth (gestational age

< 37 weeks)

2. Birth-weigh < 2,500 grams. 3. Hypoglycemia

4. Hyperbilirubinemia

5. Birth Asphyxia at 5 mins ≤ 4 and with complication

6. Sepsis

7. Convulsion, Meningitis

8. Difficulties in suckling-swallowing, poor suckling

9. Down Syndrome

10. Congenital Anomaly (as determined by the doctor)

11. Anemia Central Hct < 40% (at < 7 days of age)

12. Others (specify)...

Family history

- History of genetic diseases, hearing,

mental retardation in the family

Remarks

If with more than 1 risk, indicating the high risk case, make an appointment to see the doctor at 1 month old.

(19)

19

PART 2: CHILD CARE

Oral Health Record for Children Aged 6 Months-5 Years

Age

D/M/Y of Check up

Having sweeten milk

Using Bottle feeding

Having sweet Time/day

Brushing teeth everyday by parents

Using fluoride toothpaste

Having plaque

Initial stage of tooth aecay

Having tooth cavities(number) Advice tooth Treatment

6

months

9

months

1

year

1

1/2

year

2

year

2

1/2

year

3

year

4

year

5

year

Attendant

(20)

Yes

No

■ Child development Stares at faces

Follows objects with eyes along the body midline

Makes sound (ask)

Lifts head (ask)

■ Food and nutrition Exclusive breast-milk

■ Record of parents about the child and problems that require counseling

...

Consult the doctor or health personnel if Consult the doctor or health personnel ifConsult the doctor or health personnel if

Consult the doctor or health personnel ifConsult the doctor or health personnel if the child tends to exhibit poor development or any of the following signs.

■ At 3 months, no eye contact, no smiling back, no head lifting when lying on stomach

■ Red or inflamed umbilicus

■ Self rolling over before 3 months, may due to tight muscle

Strat having your breastmilk pressed and kept in the fridge, when your child is 1 month old.

Child Development at 1 Month Old (

±

7 Days)

(21)

21

Service Activities for Children at 1 Month Old (

±

7 Days)

Date of examination

...

Weight

...

kg.

Length

...

cm.

Head circumference

...

cm. Nutritional status

...

Check physical appearance, eyes, ears, mouth, heart, abdomen, sexual organ, legs, arms, anterior fontanelle, posterior fontanelle (check

thoroughly), if not possible to complete all, check for the heart sound.

Additional check with the childûs development in case with doubts.

...

Problems with child raising and health (ask from the caregiver) include:

...

Parental school arrangement Yes No

Advices given:

How to use MCH handbook

Exclusive breastfeeding

Food for mothers

Promoting child development in subsequent ages

Accident prevention

...

Refrain the child from wearing gloves, sucking finger, using pacifier,

traditional medicine, throat paint.

Others

...

Referral in case of abnormalities and for care and treatment

No Yes, specify

...

PART 2: CHILD CARE

Do not use bottle milk supplementation with an idea that you have less

breastmilk because our body can produce sufficient milk supply for the baby.

(22)

Child Development at 2 Months Old (

±

7 Days)

(recorded by parents or caregiver)

Yes

No

■ Child development Social smile (ask)

Follows through with eyes along the body midline

Babbles (ask)

Lifts the head 45

...

Consult the doctor or health personnel ifConsult the doctor or health personnel if the child tends to exhibit poor

development or any of the following signs.

■ At 3 months, no eye contact, no smiling back, no head lifting in prone position

■ Red or inflamed umbilicus

(23)

23

Service Activities for Children at 2 Months Old (

±

7 Days)

Date of examination

...

Weight

...

kg.

Length

...

cm.

Head circumference

...

Check physical appearance, eyes, ears, mouth, heart, abdomen, sexual organ, legs, arms, anterior fontanelle, posterior fontanelle (check thor-oughly), if not possible to complete all, check for the heart sound.

...

Advices given:

Exclusive breastfeeding

Food for mothers

Accident prevention suckling as drowning, scald.

Refrain the child from wearing mittens, sucking finger, using pacifier,

traditional medicine, throat paint.

Others

...

No Yes, specify

...

PART 2: CHILD CARE

(24)

±

15 Days)

Yes

No

■ Child development

Looks at his/her own hands (ask)

Follows objects with eyes at 180

Makes cooing sound (ask)

Lifts upper chest when lying on stomach

...

Consult the doctor or health personnel ifConsult the doctor or health personnel if the child tends to exhibits poor

development or any of the following signs.

■ At 4-5 months, does not lit the head, unable to grasp things.

(25)

25

Service Activities for Children at 4 Months Old (

±

15 Days)

Date of examination

...

Weight

...

kg.

Length

...

cm.

Head circumference

...

Physical check-up (If with doubts, check thoroughly)

...

Problems with child raising and health.

...

Advices given:

Breast-milk and food at ≥ 6 months

Reading pictorial books with the child

No use of baby walker

Accident prevention such as drowning and scald.

Refrain the child from wearing gloves, sucking finger,

using pacifier, and baby walker.

No Yes, specify

...

PART 2: CHILD CARE

(26)

±

15 Days)

Yes

No

Gets things to feed him/herself (ask)

Follows falling objects with eyes

Turns toward the calling voice

Holds head steady not flop

■ Food and nutrition Breast-milk

Other food include

...

Consult the doctor or health personnel ifConsult the doctor or health personnel if the child tends to exhibits poor development or the child displays any of the following signs.

■ At 6 months, does not follow objects with eyes, does not turn towardAt 6 months, does not follow objects with eyes, does not turn towardAt 6 months, does not follow objects with eyes, does not turn towardAt 6 months, does not follow objects with eyes, does not turn towardAt 6 months, does not follow objects with eyes, does not turn toward voice, does not pay attention to the one who plays with, does not roll voice, does not pay attention to the one who plays with, does not roll voice, does not pay attention to the one who plays with, does not roll voice, does not pay attention to the one who plays with, does not roll voice, does not pay attention to the one who plays with, does not roll over in either front to back or back to front

over in either front to back or back to front over in either front to back or back to front over in either front to back or back to front over in either front to back or back to front.

(27)

27

Service Activities for Children at 6 Months Old (

±

15 Days)

Date of examination

...

Weight

...

kg.

Length

...

cm.

Head circumference

...

The values of Hematocrit or Hemoglobin

...

(Test performed when the child wasÇÇ.Çmonths)

Check physical appearance, eyes, ears, mouth, heart, lung, abdomen, sexual organ, legs, arms, skin.

If time is not allowed, check for cross-eyes, tight muscles, and hearing.

...

Giving iron supplementation Yes No

Advices given:

Breast-milk and age appropriate food

Reading pictorial books with the child, playing with the child

Accident prevention such as drowning, electric shock, scald, aspiration No use of baby-walker

Oral health care

Try to avoid feeding the baby after bedtime during 8.00 pm.-6.00 am and never put the baby to bed with breastfeeding

Referral in case of abnormalities and for care and treatment No Yes, specify

...

PART 2: CHILD CARE

(28)

±

15 Days)

Yes

No

Waives hands to bye bye (ask)

Holds a cube in each hand

Copies talking voices (ask)

Sits up (ask)

Other food include

...

Number of meals per day

...

meals

...

Do not use baby walker as it frequently cause accidents

and the child may walk on tiptoe.

Consult the doctor or health personnel ifConsult the doctor or health personnel if the child tends to exhibit poor development or the child displays any of the following signs.

■ Stretched and tense legs when creeping and crawling or sitting in

W

position.

(29)

Service Activities for Children at 9 Months Old (

±

15 Days)

Date of examination

...

Weight

...

kg.

Length

...

cm.

Head circumference

...

Physical check-up (If with doubts, check thoroughly)

...

Dental check-up

...

Advices given:

Breast-milk and 2 meals of food for ages

Reading pictorial books with the child, and plying with the child Accident prevention such as drowning, electric shock, scald, aspiration Dental health care

No milk feeding after bedtime

No use of baby-walker

No watching T.V., CD, DVD until 2 years old

No Yes, specify

...

29

Never let the child play with small toy less then 2 cm. as the child may put

it into the month and be choked by it.

(30)

Child Development at 12 Month Old (

±

15 Days)

Yes

No

■ Child development Expresses the need (ask)

Puts a cube in a container

Says meaningful words Pa-Ma (ask)

Says 1 meaningful word (ask)

Other food include

...

Eat snack food Yes No

...

Consult the doctor or health personnel ifConsult the doctor or health personnel if the child tends to exhibit poor

developmentany or the child displays any of the following signs.

■ At 1 year, unable to walk holding on to something, unable to feed him/ herself with fingers, unable to imitate posture or voice, unable to say a single word.

(31)

Service Activities for Children at 12 Month Old (

±

15 Days)

Date of examination

...

Weight

...

kg.

Length

...

cm.

Head circumference

...

Check physical appearance, eyes, ears, mouth, heart, lung, abdomen,

legs, arms, skin, if not possible to complete all, check the heart, abdomen,

interior fontanelle.

...

Oral and dental check-up (advice given by dental officer)

...

Autism screening Normal Suspicious

Problems with child raising and health (ask form the caregiver) include:

...

Advices given:

Giving the child 3 meals, continuing breastfeeding, no milk feeding

after going to bed.

Reading pictorial books with the child, and playing with the child

Accident prevention such as drowning, electric shock, scald, aspiration

No watching T.V., CD, DVD until 2 years old

Effects of television on the child

No Yes, specify

...

31

PART 2: CHILD CARE

(32)

Child Development at 18 Months Old (±1 Month)

Yes

No

Uses spoon to feed him/herself

Follows objects with eyes along the body midline

Makes sound (ask)

Lifts the head (ask)

...

Consult the doctor or health personnel ifConsult the doctor or health personnel if your 18-month-old child tends to exhibits poor developmentany or cannot follow simple instructions such as sayingor cannot follow simple instructions such as sayingor cannot follow simple instructions such as sayingor cannot follow simple instructions such as sayingor cannot follow simple instructions such as saying hello, walking toward the mother.

hello, walking toward the mother.hello, walking toward the mother. hello, walking toward the mother.hello, walking toward the mother.

(33)

Service Activities for Children at 18 Month Old (±1 Month)

Date of examination

...

Weight

...

kg.

Length

...

cm.

Head circumference

...

Physical check-up especially the anterior fontanelle (if with doubts, check

thoroughly)

...

Problems with child raising and health problems (ask from the caregiver) include:

Giving iron supplementation Yes No Advices given:

Giving the child 3 meals, continuing breastfeeding, no milk feeding after going to bed, allowing the child for food self-feeding. Promoting child development in subsequent ages

Reading pictorial books with the child, and playing with the child Accident prevention such as drowning, electric shock, scald, aspiration, falling over the high.

Caring for the childûs teeth twice a day in the morning and before

bedtime

Toilet training, give up disposable diapers.

No watching T.V./CD/DVD until the child is 2 years old Effects of television on the child

No Yes, specify

...

33

Train the child to help with easy household chores such as collecting toys,

sweeping the floor.

(34)

Child Development at 2 Years Old (

±

1 Month)

Yes

No

■ Child development Removes clothes (ask)

Stacks 4 cubes

Points at 6 parts of body organs

Says 2 words together (ask)

Throws a ball

■ Food and nutrition

Food intake

...

Number of meal per day

...

meals

Eating crunchy/crispy snacks Yes No

Having soft drinks Yes No

...

Consult the doctor or health personnel if your 2-year-old child tends to exhibit poor development or cannot speak 2 meaningful words together.

Teach the child about morality such as thoughtfulness, making merit,

giving alms to monks, praying to the Lord Buddha,

(35)

Service Activities for Children at 2 Years Old (

±

1 Month)

Date of examination

...

Weight

...

kg.

Length

...

cm.

Head circumference

...

Physical check-up (if with doubts, check thoroughly)

...

Problems with child raising and health, and behavioral problems

...

Advices given:

Giving the child 3 meals, allowing the child for food self feeding, and

drinking milk from the glass or box about 2-3 times/day.

Reading pictorial books with the child, and playing with the child

Accident prevention such as electric shock, scald, aspiration by food particles, falling from the stairs.

Allowing the child to watch T.V. no more than 1 hour/day Toilet training, give up disposable diapers.

Participation in religious activities.

No Yes, specify

...

35

Do not allow your child to play computer games,

and parents do not play them in presence of the child.

(36)

±

1 Mounth)

(record by parents or caregiver)

Yes

No

Puts on T-shirt by him/herself (ask)

Stacks 8 cubes

Knows at least 2 adjectives

Stands on one leg for 1 second

Imitates in drawing a vertical line

Food intake

...

meals

...

Consult the doctor or health personnel if your child tends to exhibit poor

development or delayed development for age.

■ Cannot follow simple instruction.

(37)

Service Activities for Children at 3 Years Old (±1 Month)

Date of examination

...

Weight

...

kg.

Length

...

cm.

Head circumference

...

Autism screening result

...

Emotional intelligence screening result

...

Problems with child raising and health, and behavioral problems

Advices given:

Giving the child 3 meals, no crispy and crunchy snacks and soda drinks.

Reading pictorial books with the child, and playing with the child Teaching the child to help him/herself.

Teaching the child to collect the toys every time after playing them. Participation in religious activities.

Accident prevention such as electric shock, scald, aspiration by food particles, falling from the stairs.

Allowing the child to watch T.V. no more than 1 hour/day. Referral in case of abnormalities and for care and treatment

No Yes, specify

...

37

PART 2: CHILD CARE

(38)

±

1 Month)

Yes

No

Dresses by him/herself (ask)

Copies a picture

Tells 4 colors

Stands on one leg for 3 seconds

Copies a circle

Food intake

...

meals

...

Consult the doctor or health personnel if your child exhibits delayed development or nutritional disorder or tends to have poor development.

Train your child to do more things every by him/herself such as putting on

clothes, scooping rice, putting the dish into the basin, washing his/her dish,

(39)

Service Activities for Children at 4 Years Old (

±

1 Month)

Date of examination

...

Weight

...

kg.

Length

...

cm.

Head circumference

...

Urine exam Eye exam Hearing exam Check blood pressure

Emotional intelligence screening

...

Additional check with the childûs development in case with doubts

...

Problems with child raising and health, behavioral problems

...

Parental school arrangement Yes No Advices given:

Giving the child 3 meals and 2 boxes of milk per day, no soda drinks and crispy and crunchy snacks.

Reading pictorial books with the child, and playing with the child Accident prevention such as drowning, electric shock, scald, falling from the high, domestic toxicants.

Allowing the child to watch T.V. no more than 1 › 2 hours per day. Effects of television on the child

No Yes, specif

...

39

Teach Your child about disciplines such as eating on regular time,

reading and doing homework on regular time everyday.

(40)

40

55

50

45

40

35

30

0

1

2

3

4

5

6

3

10

25

50

75

90

97

(41)

41

HEAD CIRCUMFERENCE GRAPH (male and female separated)

Reference graph for head circumference, female 0-6 years

55

50

45

40

35

30

0

1

2

3

4

5

6

3

10

25

50

75

90

97

cm.

Age (year)

(42)

Guide to the Use of Child Nutritional Graph

(can be recorded by parents or guardian)

Child nutritional graph is used to continuously monitor the change of childûs weight and height whether the trends of childûs growth follow the standard criteria. The graphs are presented in 3 types:

1.Weight for age graph 1.Weight for age graph 1.Weight for age graph 1.Weight for age graph

1.Weight for age graph presents 5 levels of growth status: 1)

1)1) 1)

1) Under standard weight refers to having malnutritionUnder standard weight refers to having malnutritionUnder standard weight refers to having malnutritionUnder standard weight refers to having malnutritionUnder standard weight refers to having malnutrition. 2)

2)2) 2)

2) Relatively low weight refers to risk of having malnutritionRelatively low weight refers to risk of having malnutritionRelatively low weight refers to risk of having malnutritionRelatively low weight refers to risk of having malnutritionRelatively low weight refers to risk of having malnutrition, a warning sign, if without appropriate care, overweight for age is likely.

3) 3)3) 3)

3) Standard weight refers to well growthStandard weight refers to well growthStandard weight refers to well growthStandard weight refers to well growthStandard weight refers to well growth. It should be promoted to maintain the weight at this level.

4) 4)4) 4)

4) Relatively high weight: refers to risk of having over standard weightRelatively high weight: refers to risk of having over standard weightRelatively high weight: refers to risk of having over standard weightRelatively high weight: refers to risk of having over standard weightRelatively high weight: refers to risk of having over standard weight. It should be check against the weight for height graph.

5) 5)5) 5)

5) Over standard weight does not identify whether the child is obeseOver standard weight does not identify whether the child is obeseOver standard weight does not identify whether the child is obeseOver standard weight does not identify whether the child is obeseOver standard weight does not identify whether the child is obese. It needs to check for obesity against the weight for height graph.

2. Height for age graph presents 5 levels of growth status 2. Height for age graph presents 5 levels of growth status 2. Height for age graph presents 5 levels of growth status 2. Height for age graph presents 5 levels of growth status 2. Height for age graph presents 5 levels of growth status:

1) 1)1) 1)

1) Short refers to having chronic malnutritionShort refers to having chronic malnutritionShort refers to having chronic malnutritionShort refers to having chronic malnutritionShort refers to having chronic malnutrition, reflecting inadequate food in-take for a prolonged period or frequent illnesses, with minor or no increase of height, affecting low intelligence, more frequent illnesses. It requires immediate improvement.

2) 2)2) 2)

2) Relatively short refers to risk of having chronic malnutritionRelatively short refers to risk of having chronic malnutritionRelatively short refers to risk of having chronic malnutritionRelatively short refers to risk of having chronic malnutritionRelatively short refers to risk of having chronic malnutrition, a warning sign, if without appropriate care, the height discontinues and the child is likely to become short.

3) 3)3) 3)

3) Standard height refers to well growthStandard height refers to well growthStandard height refers to well growthStandard height refers to well growthStandard height refers to well growth, reflecting adequate food intake, so it should be promoted to contiue at this level.

4) 4)4) 4)

4) Relatively tall refers to very well growthRelatively tall refers to very well growthRelatively tall refers to very well growthRelatively tall refers to very well growthRelatively tall refers to very well growth. It should be promoted to maintain at this level.

5) 5)5) 5)

5) Over standard age refers to excellent growthOver standard age refers to excellent growthOver standard age refers to excellent growthOver standard age refers to excellent growthOver standard age refers to excellent growth. It should be promoted to continue at this level.

3. 3. 3. 3.

3. Weight for height graphWeight for height graphWeight for height graphWeight for height graphWeight for height graph represents 6 levels of growth status: 1)

1)1) 1)

1) Thin refers to having short term malnutritionThin refers to having short term malnutritionThin refers to having short term malnutritionThin refers to having short term malnutritionThin refers to having short term malnutrition 2)

2)2) 2)

2) Relatively thin refers to risk of having malnutritionRelatively thin refers to risk of having malnutritionRelatively thin refers to risk of having malnutritionRelatively thin refers to risk of having malnutritionRelatively thin refers to risk of having malnutrition, a warning sign, if without appropriate care, the weight will not increase or decrease to the thin level.

3) 3)3) 3)

3) Proportionate refers to well growthProportionate refers to well growthProportionate refers to well growthProportionate refers to well growthProportionate refers to well growth, reflecting appropriate weight for height. The child should be promoted to continue at this level of growth.

4) 4)4) 4)

4) Moderate refers to risk of having obesityModerate refers to risk of having obesityModerate refers to risk of having obesityModerate refers to risk of having obesityModerate refers to risk of having obesity, a warning sign, if without appropriate care, the weight will increase to the level of initiating fat.

5) 5)5) 5)

5) Initiating fat refers to the first degree of obesityInitiating fat refers to the first degree of obesityInitiating fat refers to the first degree of obesityInitiating fat refers to the first degree of obesityInitiating fat refers to the first degree of obesity. The child is likely to become a fat adult in the future if without weight control.

6) 6)6) 6)

(43)

44

43

(44)

(45)

48

47

(46)

(47)

52

51

(48)

(49)

PART 3

ESSENTIAL KNOWLEDGE

FOR SAFE AND QUALITY PREGNANCY

■

Discomforts during pregnancy

■

Maternal practices during pregnancy

■

Minimum weight for pregnant women to give birth to a newborn of

2,500 grams. (VALLOP WEIGHT LOG)

■

Self care during pregnancy through pregnancy pathway

■

Minimum weight for pregnant women to give birth to a newborn of

>2,500 gram.

■

Advantage of the nutritional graph

■

Nutritional graph for pregnant woman

■

Nutrition for pregnant woman: Table for comparison of percentage

of standard BMI values (BMI 21 = 100)

■

Illustration of sets of food exchange for pregnant woman

■

Fetal development

■

Thalassemia

■

Risk opportunity to have a child with thalassemia

■

What is congenital hypothyroidism?

■

Prevention of mother-to-child transmission of HIV

■

Family planning

■

Self assessment and analysis of stress

55

(50)

Morning sickness Morning sickness Morning sickness Morning sickness

Morning sickness is commonly experienced in early period of pregnancy, with nausea and vomiting in the morning. The symptoms can be improved by mental adjustment, avoiding unfavorable food, eating small meal each time but several times, or having soft food and warm drinks. The symptoms will disappear at 4 months of gestation.

Vaginal discharge Vaginal discharge Vaginal discharge Vaginal discharge

Vaginal discharge will commonly increase during pregnancy. Take a usual bath, except if accompanied with itching and smelling, see the doctor.

Constipation Constipation Constipation Constipation

Constipation is found in some pregnant women and can be lessen by drinking more water and eating more vegetables and fruits, if not improved, see the doctor.

Frequent urination Frequent urination Frequent urination Frequent urination

Frequent urination is caused by the expansion of uterus which places more pressure on the bladder. If experiencing burning pain or obstructed urinating, see the doctor.

Fatigue and drowsiness Fatigue and drowsiness Fatigue and drowsiness Fatigue and drowsiness

Fatigue and drowsiness is common early in pregnancy with feeling tired and sleepy.

Varicose veins Varicose veins Varicose veins Varicose veins

Varicose veins usually disappear after delivery. Always change your gesture properly, avoid long period of walking or standing, sit with your feet elevated for 15 › 20 minutes every day after walking or working, use legs support hose to provide compression.

Stretch Masks Stretch Masks Stretch Masks Stretch Masks

Stretch Masks should be applied gently with cream, avoid scratching.

Pigmentation Pigmentation Pigmentation Pigmentation

Pigmentation or darken skin is due to the change of hormone. Try to avoid sunlight. It will be faded after delivery.

Heartburn Heartburn Heartburn Heartburn

Heartburn is caused by the stomach acid refluxing into the esophagus, and delayed functioning of digestive system. Consult the doctor for the use of antacid.