Terms of newborn patronage order. Primary care of the newborn. Filling out medical records

29.04.2019

After the newborn is discharged from maternity hospital information is transferred by phone to the children's clinic, where the name of the mother, the address and date of birth of the child are recorded in the newborn visit log. During the first three days after discharge from the maternity hospital, the local doctor and nurse perform the first patronage of the newborn. Children with risk factors congenital anomalies and diseases, premature or post-term, as well as the first child in the family should be examined on the first day after discharge from the maternity hospital.

How is the first patronage of a newborn?

The history includes the collection of social, biological and genealogical information. V exchange card contained

information about pregnancy and childbirth,
the condition of the child at birth (assessed on the Apgar scale),
main parameters physical development(body weight, body length, head circumference and chest),
health group
and the risk group.

Objective examination dj time of the first patronage of the newborn is carried out according to the systems: skin, posture, head, chest, abdomen, genitals, limbs, nervous and mental development... Parents are instructed on child care, feeding and upbringing.

The crib should be placed in a bright place in the room, but not in a draft. The newborn is placed on its side in the crib, without a pillow.

Bathing is done daily in a special baby bath that is not used for washing diapers or baby linen... Bathing duration - 10 min. It is good to add decoctions of herbs (string, chamomile) to the water. The baby should be gradually immersed in water, wrapped in a diaper, so as not to cause anxiety.

Morning toilet- every morning after the first feeding, the baby is washed with a cotton swab dipped in warm boiled water, eyes - from the outer corner to the inner one, with a separate tampon for each eye. The nose is cleaned with cotton wool soaked in vaseline oil.

Swaddling - important point care for the first patronage of a newborn. Recommend free and wide swaddling... For free swaddling the child is put on a jersey with sewn-on sleeves. The legs are laid in a diaper.

Correct feeding the newborn ensures its timely harmonious development and forms immunity. Latching the baby to the breast immediately after birth stimulates lactopoiesis. It is necessary to educate the mother about the benefits breastfeeding and for the period of formation of lactation to recommend breastfeeding at the request of the newborn. In the absence of human milk, substitutes can be prescribed - adapted to breast milk mixtures.

From the first days of life, the baby needs correct mode day (alternation in time of basic physiological needs: sleep, wakefulness, nutrition, walks, hygiene and hardening measures). This contributes to the formation of a certain rhythm of life.

At the first patronage of a newborn, it is necessary to tell the mother about conditions that require urgent medical care, and tell you where to go for help in case of illness.

How does the second patronage of a newborn take place?

It is carried out on the 14th day of the child's life, the second patronage of the newborn. Its purpose is

repeated examination of the newborn for organs and systems to establish the state of health,
monitoring the implementation of recommendations,
answers to the mother's questions in connection with the problems that have arisen,
briefing.

Basic examinations of the newborn during the second patronage

When collecting anamnesis, it is necessary to find out the questions

feeding,
daily routine,
behavior of the newborn.

An objective examination is carried out in stages. With the second patronage of a newborn, it is necessary to assess how the child is gaining weight. If there are spitting up, then the mother should be explained that children under 1 year old have physiological impairment in the work of the sphincter apparatus gastrointestinal tract.

If air is swallowed while feeding, the baby should be held upright for 10 minutes after feeding. If the regurgitation is persistent, constant, there is vomiting in a fountain, the child does not gain weight well, then he must be examined in a hospital.

From the age of two weeks, children may experience cramping abdominal pain (colic), which is due to the adaptation of the gastrointestinal tract to new living conditions. This is manifested by the child's sudden anxiety.

The mother is obliged to report such symptoms to the local doctor, who assesses whether these changes are functional abnormalities or are caused by organic pathology.

Massage, gymnastics for a newborn and their place in the instruction during the second patronage

The mother is instructed on the importance of massage and gymnastics for the newborn. Massage and gymnastics are connected to hardening and health-improving activities.

The main massage techniques are stroking, rubbing, kneading, tapping, vibration. On initial stages massage should be light, of all the techniques, stroking is mainly used, since it helps to relax the muscles.

Exercise 1: The child lies on his back, the mother lets him grasp her thumbs, then spreads the newborn's arms to the sides and brings them together, crossing them on the chest. Exercise helps relax the muscles in your chest and shoulder girdle.

The second exercise: the child lies on his back, the mother raises his arms above his head and lowers him through the sides down. The exercise relaxes the muscles of the shoulder girdle, upper limbs.

The third exercise: the child lies on his back, the mother takes him by the shins and gently bends his knees to the stomach, then extends his legs. Exercise relaxes the muscles in the legs, helps the child to free the intestines from gases.

The fourth exercise: the baby lies on his stomach, the mother props the baby's feet with her hands, this makes the baby straighten his legs and crawl forward ( reflex crawl). Exercise helps develop muscles in the legs, arms and back.

For the upbringing and development of visual concentration of the newborn, toys are hung over the bed at a distance of 40-50 cm from the face.

How is the third newborn patronage going?

It is held on the 21st day of the child's life, the third newborn patronage. Its goals:

monitoring in dynamics the state of health and conditions of development of the newborn, feeding,
carrying out sanitary and educational work,
treatment of identified developmental abnormalities.

Main examinations during the third patronage

When examining a newborn, it is necessary to pay attention to his behavior, health, reaction to the environment. In dynamics, the indicators of body weight, height, head circumference, chest, condition large fontanelle.

On the oral mucosa, there may be thrush with defects in child care. A newborn in the third week of life can already fix his gaze, react positive emotions on affectionate treatment to him.

The skin is normally elastic, velvety, pink, clean. In the presence of abscesses, treatment at home is necessary with a satisfactory condition of the child and the possibility good care.

In a state of moderate severity or an unfavorable sanitary and cultural level in the family, the district doctor gives a referral for examination and treatment in a hospital.

The navel area by the 21st day of the child's life should be epithelialized. With purulent discharge from umbilical wound, hyperemia around the navel should be sent to the hospital.

To determine the condition of the newborn, the doctor re-

evaluates unconditional physiological reflexes(Babkina, sucking, grasping, automatic gait, crawling),
conducts percussion and auscultation of the lungs,
hearts,
palpation of the abdomen.

Objectives of the instruction in the third newborn patronage

In a conversation with the mother, the doctor clarifies the nature of the child's physiological functions, gives recommendations on feeding and caring for the newborn, and answers questions that arose in her during the third week of the child's life.

During the third patronage for a newborn, you should tell the mother about rickets in children and prepare her for the need to prevent this disease, inform about the meaning ultraviolet rays, vitamin D for the vital functions of the body and write a prescription for purchase at the pharmacy oil solution vitamin D at a prophylactic dose of 450 IU / day.

It is necessary to talk about deficiency anemia in children, the importance of breastfeeding and the prevention of anemia. The doctor discusses with the mother the issues of hardening the child's body and strengthening its resistance, introduces the method of teaching swimming.

At the end of the conversation, the district doctor invites the mother and the child to an appointment at the clinic for the performance of the baby one month old, informs the work schedule of the district doctor and specialists and informs about the day healthy child.

By the end of the neonatal period, the local doctor should make a forecast of the child's health for the first year of life. Some at-risk children may be removed from dispensary observation and from the second month to be observed in the same way as healthy children.

Many young mothers, after being discharged from the hospital, begin to become very anxious because of the uncertainty about their actions in caring for a newborn in the first month. After all, there are many questions about breastfeeding and the baby's regimen. Answers to them can be obtained from the district pediatrician or nurse of the children's clinic. For this, a woman does not need to go to a medical facility herself, and even more so to carry a baby there. The fact is that in Russia there is a system of newborn patronage, that is, monitoring newborns at home.

Newborn patronage is carried out by a pediatrician and a nurse from a children's clinic and applies to all babies, regardless of whether their parents have permanent registration and a general health insurance policy.

The main task of doctors in the patronage of a newborn is to assess the state of health of the child, his mother, as well as the socio-economic conditions of the family.

When to wait for a doctor?

From the maternity hospital, information about the discharge of the newborn is reported by phone to the children's clinic, to which the baby will be attached, depending on the address of the family's actual residence. At the reception of the polyclinic in special magazine registration of newborns, the surname, name, patronymic of the mother and the date of birth of the child are recorded.

Primary patronage the newborn is carried out within the first two days after discharge from the hospital. Children who belong to the group high risk for the development of a number of diseases (prematurity, postmaturity, malnutrition, disorders cerebral circulation), the local doctor must visit on the day of discharge from the hospital. If the day of the visit falls on weekends or holidays, then the pediatrician on duty will come to the baby. If the doctor, while conducting patronage, notices any deviations in the child's health or the infant is at risk, the number of visits may be increased.

If the doctor does not come to the newborn in the first two days after discharge from the hospital, then the mother should call the children's clinic at the place of residence and find out the reason for the absence of the visiting doctor.

Primary care of a newborn

During the primary care of a newborn, the doctor will ask the mother many different questions about the course of pregnancy, childbirth, the condition of the child at birth and discharge from the hospital, he will take an interest living conditions, find out if mom, dad or their relatives have any hereditary and chronic diseases etc. All this information helps the doctor to identify the risk group for the development of hereditary diseases in the child.

Then the doctor will examine the child: assess his physical development, the presence or absence of malformations and stigmas of dysembryogenesis (micro-anomalies). Stigmas are a kind of microgenetic background of the family. These are small deviations from the norm that may occur in a particular family member. For example: flattened nasal bridge, protruding ears, large birthmarks, short stature hair, etc. If the doctor discovers more than five or six such stigmas, then the baby is at risk of developing various diseases.

When assessing the neurological state of the child, the doctor takes into account the posture of the newborn, his locomotor activity, muscle tone, severity unconditioned reflexes... Also, the shape and size of the head, the size and degree of tension of the large and small fontanelles, the condition of the seams of the skull bones are assessed.

Further, during the primary care of the newborn, the doctor examines the child's skin: evaluates its color, the presence of prickly heat, diaper rash, etc. Special attention the doctor will pay attention to the condition of the umbilical wound: he will examine the skin around the navel, the degree of healing of the umbilical wound, if there is any discharge from it.

Then the pediatrician uses a phonendoscope to listen to the breathing and heartbeat of the baby to assess the state of the respiratory and cardiovascular systems and exclude congenital defects development. After that, the doctor probes the baby's tummy.

With the primary patronage of a newborn child, the doctor must check the symmetry of the gluteal folds and the separation of the legs to the sides for early detection of hip dysplasia. If this pathology is suspected, the baby should be consulted by an orthopedist and sent for ultrasound of the hip joints. With this disease, it is very important early diagnosis, since with timely treatment started, the function hip joint completely recovers.

At the end of the patronage visit, the pediatrician can answer all questions about caring for a newborn in the first month (bathing, walking, caring for the umbilical wound, daily toilet for the child), daily regimen, and feeding. Particular attention is paid to feeding the newborn in order to help the mother establish proper breastfeeding. The doctor must make sure that the woman has breast milk, examine the mammary glands (the condition of the nipples), observe whether she is correctly applying the baby to the breast, tell her about the feeding regime of the baby and about the nutrition of the nursing woman.

During the primary care of a newborn, the doctor must tell the mother about all the conditions of the baby that require urgent medical attention and about where to go in case of emergency.

The visit lasts on average 15–20 minutes. The doctor can come at any time of the day (as a rule, the visit is made without warning), with or without a nurse.

Second patronage of a newborn

The second patronage of a newborn child is carried out on the 14th day of life. The doctor re-examines the baby, examining all organs and systems to assess adaptation processes and determine his health status. Adaptation processes show how the baby adapts to the external conditions around him. To understand this, a pediatrician needs to find out how a newborn sleeps, how he behaves while awake, what is his daily routine.

Also, the doctor should pay attention to how the baby is gaining weight, whether it bothers him with regurgitation or cramps in the abdomen. If nothing bothers the baby, he eats well and sleeps peacefully, the doctor concludes that the child's adaptation is easy (or good). With a difficult adaptation process (the baby does not gain weight well, regurgitates, often cries for no reason, etc.), the pediatrician gives mom recommendations on how to cope with the problems that have arisen.

In addition, at the second patronage, the doctor monitors compliance with the recommendations for care (skin treatment, the presence of prickly heat or diaper rash, the condition of the umbilical wound, etc.) and feeding, answers the questions that have arisen.

Third newborn patronage

The third patronage of a newborn is carried out on the 21st day of a child's life. Its purpose is to monitor the dynamics of the health and development of the child. The doctor examines the baby, evaluates him neuropsychic development and overall health.

During the visit, the doctor gives the mother recommendations on the prevention of rickets, discusses with her the issues of hardening the baby, shows some massage and gymnastics techniques for the baby's first month of life, which parents can do every day themselves.

After each patronage, the district pediatrician registers the obtained data in the history of the child's development. By the end of the first month, he makes a forecast of the health status of his ward and determines the risk groups. In the presence of deviations, the pediatrician directs the newborn for a consultation with the appropriate specialist (orthopedist, allergist, etc.) for an in-depth examination and treatment.

Nurse patronages

The nurse visits the newborn twice in the first week of life with the doctor or alone, and then weekly during the first month.

During the first patronage, the nurse looks to see if there is everything necessary for caring for the child (crib, bathtub, stroller, etc.), gives recommendations for walking, shows how to bathe the baby correctly, carry out the daily toilet for the newborn, and treat the umbilical wound. On repeat visits, the nurse monitors the mother's compliance with medical prescriptions and care recommendations.

If for some reason the parents of the baby are not satisfied with the nursing staff, you can contact the head of the clinic with a written request to replace the doctor or nurse.

Borderline states

At patronage visit the pediatrician can ask the mother about her complaints and talk about borderline states that can occur in a child in the first weeks of life. They are not a disease and do not require special treatment. The most common in newborn babies are the following borderline states:

Physiological jaundice of newborns(associated with the immaturity of liver enzymes and an increase in the level of bilirubin in the blood). On the 2-3rd day of life, the baby develops an icteric coloration of the skin, which intensifies by the 5th day, and disappears by the 7-10th day.
Erythema of newborns. It is observed on the 2nd day of life and is expressed in reddening of the skin, sometimes accompanied by a rash (papules and vesicles). Disappears on its own by the end of the first week.
Hormonal crisis of newborns. It can manifest itself in engorgement of the baby's mammary glands (begins on the 3-4th day, reaches a maximum by the 7-8th day, then decreases); mucous or bloody issues from the vagina in girls appear in the first week of life and pass by the 14th day.

Patronage is the observation of a small patient at home. The term came from French and literally means "patronage". The very etymology of the word indicates the goals of medical practice: to provide the baby and the necessary conditions for harmonious mental and physical development, as well as timely identify and prevent possible violations.

Benevolent visits and experienced professionals useful for a young mother. The pediatrician will tell you how to organize the child's regimen, give recommendations on the choice of care cosmetics, check the sanitary conditions of the room and answer all your questions.

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Several specialists will monitor the child's health at once:

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In addition to regular check-ups, each of the proposed types of programs includes all the tests necessary for the baby. The procedures are carried out in one place: at the address Moscow, North-Eastern Administrative District, metro Otradnoe, Bibirevo, Vladykino. The center has its own laboratory equipment, which eliminates waiting in queues, which means stress for the parents and the baby.

Conduct complex inspection the baby will be helped by specialists medical center"Human health".

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Goals and objectives of patronage of children of the first year of life

The importance of regular patronage examinations explains the wide range of tasks. The specialist observing the baby should:

collect a medical history of the newborn;
prevent and diagnose the risk in time possible violations development;
conduct preventive actions against common childhood diseases: rickets, anemia, malnutrition, infectious diseases.
assess the compliance of the child's neuropsychological development age norms(for children of the first year of life, this is the ability to concentrate and hold their gaze on moving and stationary objects, to raise and hold the head in a prone position);
help young parents: advise the mother about optimal mode feeding, hygiene procedures, if necessary, help to establish breastfeeding;
give recommendations on how to prepare for.

Based on the examination data, the pediatrician determines the child's health group and prescribes the necessary procedures.

Observation schedule

According to current legislation, a district pediatrician or nurse is required to visit every newborn during the first 10 days of life. Then the frequency of visits is gradually reduced:

newborns up to 1 month old are examined once a week;
infant under the age of six months, the doctor should visit 2 times a month;
from 6 months to one year patronage examinations held once a month.

Alas, in practice, the regime of visits to a doctor from a district polyclinic is far from always possible: due to an increase in the birth rate, physicians do not physically have time to go to all attached families.

Parents often have to wait a long time for an appointment. narrow specialist... A staffed staff of professionals and its own equipment of the children's medical center "Human Health" guarantee: a little patient will receive help needed right on time. The schedule of visits to doctors and the test procedure is drawn up in advance. In addition, unscheduled visits by a pediatrician must be included in the patronage program for children under one year old.

How is the initial examination going?

During the first patronage, the baby is examined at home by a pediatrician and a nurse. The doctor examines the condition of the umbilical wound, carefully checks the cleanliness of the skin and mucous membranes, monitors the speed of reflexes and palpates the abdomen. Also, doctors check the baby's living conditions: the cleanliness of the room, the availability of medicines and clothing necessary for the baby. The first visit should take place within 1-3 days after discharge. Employees of the state polyclinic are obliged to visit the child and young parents, regardless of the presence of a residence permit and a compulsory medical insurance policy.

What is Newborn Nursing Care? Objectives of newborn patronage

The term "patronage" is literally translated from French as "patronage" (patronaqe). In medicine, it means a set of activities carried out by a doctor or nurse at the patient's home, the tasks of which are to treat the patient, prevent various diseases from him, and educate him.

On the first or third day of stay, a pediatrician will come to the newborn's home.

IMPORTANT: One of the most important tasks of state medicine (and medicine in general) is the upbringing of healthy, strong children with strong immunity. District doctors and nurses should not only treat little patients, but also take everything possible measures to warn them possible diseases and developmental disorders

It is important for the staff of the children's clinic to carry out primary prevention various kinds of diseases and developmental disorders in children, which consists of measures of the following nature:

medical
psychological
pedagogical

During visits within antenatal care, as well as the patronage of newborns, the nurse must identify and prevent adverse factors environment(internal and external), which can negatively affect the health and normal development of a baby who has just been born.

IMPORTANT: The first acquaintance of a woman with the staff of the children's clinic takes place during her pregnancy. The first time a pediatric nurse visits her immediately after registration with antenatal clinic to assess the conditions under which the pregnancy will proceed and the baby will be born, as well as to give the pregnant woman some recommendations.

Later, in the middle of the third trimester, the nurse will come back again to check if her recommendations have been followed. She will advise expectant mother on issues of newborn care, breastfeeding, organization postpartum period generally

Patronage - not only medical event, he also aims to support the young mother and help her learn to care for her newborn.

The hospital informs the maternity hospital that a newborn patient has appeared on the territory served by a particular children's clinic
On the first or third day after the mother and baby are discharged, the local pediatrician and health visitor... This visit is called the first pediatric newborn visit.
It is noteworthy that in addition to the fact that the primary patronage must be carried out on time, its solemnity is assumed
Physicians and nurses should never play the role of strict teachers or overseers. A young mother, who afterwards is in physical and psychological stress, should in no case poke her nose into mistakes, if any
The staff of the children's clinic must demonstrate friendliness and readiness to help a woman in any matters regarding a newborn, his health, development and life.

The purposes of the primary care of a newborn are:

assistance to a woman in the postpartum period
advice on caring for a newborn
consultations regarding the organization of the newborn regimen
assistance in organizing and establishing feeding of a newborn
breastfeeding assistance
prevention of common childhood diseases (rickets, anemia, others), including infectious
assessment of the health and development of the child, monitoring them
consultation regarding preventive examinations a child under one year old by a pediatrician and specialist doctors, his vaccination

VIDEO: Patronage of children

Newborn patronage form and sample filling

Newborn patronage form: part 1.

Terms of newborn patronage. How many times is newborn patronage carried out?

The timing of a newborn's patronage and the frequency of visits by a pediatrician and a nurse depend on the state of his health and conditions in the family.
If the baby is developing normally, he is healthy and grows in favorable atmosphere, visits of the staff of the children's clinic are carried out in this way:

first visit - 1-3 days after discharge from the maternity hospital
second visit - 10th day after discharge from the hospital
further up to a month - once a week
further up to 6 months - 2 times a month
further up to 1 year - once a month
from 1 year to 3 years - once every 3 months

IMPORTANT: According to indications, child patronage under one year old is carried out more often

VIDEO: Newborn patronage

Newborn patronage scheme

An example of nursing patronage of a newborn

Nursing care can take place in a different sequence and in a different atmosphere. But there are some general principles... So, the nurse:

Clarifies the course of pregnancy and childbirth. She studies the documents of the newborn, issued in the maternity hospital, starts and fills out the child's card
Examines the child. She assesses the condition of his umbilical wound, checks his fontanel, weighs the baby if necessary, measures his height, chest and head volumes. The baby's skin and mucous membranes are also examined.
Evaluates his neuropsychological state. She fixes the presence of certain reflexes in the crumbs, assesses the work of his analyzers. So, at 10 days it is noted whether the child is able to keep a moving object in his field of vision, at 20 days - to fix his gaze on a motionless object, at 1 - 3 months - to raise and hold his head in a prone position, etc. Gives recommendations regarding the treatment of the umbilical wound. Recommends to visit certain doctors - specialists, if there is evidence for this. Shows how to do massage and gymnastics for babies
Assesses living conditions and the emotional atmosphere in the family. Provides recommendations for improving the living conditions of the newborn
Clarifies the type of feeding of the child. If it is breastfeeding, examines the mother's breast, assesses the correct grip, makes recommendations regarding the feeding regimen, hygiene of the mammary glands, nutrition of the nursing mother, etc. If the child is an artificial, explains the formula for feeding with a formula, feeding hygiene, etc.
Teaches a woman the peculiarities of holding a baby's toilet, treating his ears, nose, eyes. Tells how to bathe a child. Recommends products and cosmetics for baby care
Tells how to do a manicure for babies

IMPORTANT: The nurse is not just a lecturer. She shows various manipulations with the child. infancy and invites the mother to conduct them on her own, but under her control

Patronage of a premature newborn

If a baby born prematurely is discharged to the pediatrician's site, he must visit him on the first day after discharge from the hospital.

Together with the nurse, the doctor conducts patronage according to the scheme, at the same time he develops a scheme for subsequent visits to the child. They will be more often:

the doctor himself must visit the child 4 times in the first month
the nurse carries out patronage of the baby, born ahead of time, twice a week

Doctor and nurse explain to mom premature baby the need to go to the clinic to be checked by specialist doctors, in particular, a cardiologist, neurologist and orthopedist. Important role take away the prevention of rickets in babies born prematurely:

at two weeks they are irradiated with ultraviolet light
prescribe them vitamin D
perform a healed massage
hardening

IMPORTANT: A child born prematurely is under dispensary observation in a polyclinic for up to 7 years

Patronage of a newborn with hereditary diseases

A child with hereditary diseases is transferred from the hospital to a hospital, where he is examined until an accurate diagnosis is made. If necessary, carry out treatment
The baby is discharged only when there is confidence that the parents will be able to organize the necessary care at home.
A child with hereditary diseases is registered in the clinic
In addition to the pediatrician and the nurse, the head of the pediatric department and specialist doctors can take care of such a child.

Refusal of newborn patronage

If parents do not want the staff of the state children's polyclinic at the place of residence to provide patronage for their newborn child, they can write a written refusal, in which they argue the reasons.
V in this case responsibility for the health of the baby and his normal development completely falls on his parents.

VIDEO: Your newborn - School of Doctor Komarovsky

Ideas about the patronage of a newborn in a large number fellow citizens are rather blurry. Especially for those who give birth for the first time. Waiting for the first doctor's visit is stressful for them. But this happens only because they do not know exactly the goals, the procedure, or the scheme of carrying out. But in fact this procedure useful enough, and you should not give it up for no reason.

Special visits medical staff to a mother with a newborn child is called patronage. The word is of French origin and means "patronage". It reveals well the purpose of this procedure: the state helps healthy development and the growth of your little citizen.

Patronage is especially important until the first year of life. It was at this time that the main features of the development of a new person were manifested. Including those that may lead to some kind of problems in the future. Also during this period of life, many vaccinations are made. Making their calendar is one of the main goals of this procedure.

In short, patronage is a thorough examination of the newborn by the district doctor and nurse, during which the mothers are given recommendations regarding proper care, feeding and development of the baby.

The importance of patronage

Patronage is important because it allows you to identify any diseases of a newly born child on the very early stage when they are not yet so dangerous. Or identify pathologies in development and mitigate them as much as possible.

Main goals

Parents sometimes do not quite understand why they are patronizing. The answer is actually simple: the purpose of this procedure is to prevent deviations in the development of the born little citizen.

How many times a month is patronage carried out?

Patronize from four times during the first month of life premature baby up to once every six months, if he has reached the age of three years. Thus, the scheme is drawn up depending on the age and state of health.

Goals and terms of the first patronage of the baby

The primary care of the newborn plays an important role in the subsequent successful development of the baby. The objectives of this activity, led by a GP and a nurse at home with a mother and child, are very simple:

advise a woman on the correct care for the baby;
help her in the postpartum period;
give recommendations regarding the organization of the child's regime;
assist in the organization of feeding the baby, including breastfeeding;
to carry out the prevention of common diseases;
assess the general health of the child;
determine the timing of preventive visits and the schedule of vaccinations.

Such a first examination is carried out in the period from one to three days after the discharge of the woman in labor (from the moment this was reported by the maternity hospital).

How is the first inspection carried out

The first examination of a full-term baby is carried out according to a special algorithm called a scheme.

Responsibilities of a sister

The duties of a nurse in conducting patronage are the most extensive. It is she who deals with most of the procedures. A nurse's responsibilities include the following activities and procedures:

examination of the child;
verification of documents issued at the hospital;
filling out the baby's first card;
assessment of his neuropsychological state;
grade housing conditions and general family atmosphere;
clarification and assessment of the nature of feeding;
recommendations for the care of the newborn, including manicure.

The nurse herself deals with all the necessary manipulations and demonstrates the order to the mother. After that, he allows them to be carried out under his supervision. At the same time, she behaves as friendly as possible, and demonstrates a willingness to help.

Duties of the doctor

The main duty of the doctor during the first patronage is a qualified examination of the little patient. He will carefully check for any alarming symptoms, will compare the development of the baby with normal performance and help the mother to schedule follow-up examinations and immunizations.

Second and subsequent patronages

Children are patronized according to a special scheme. The timing of all procedures is recommended by specialized medical institutions. The frequency of patronage is highly dependent on the age of the child. So, during the first week of his life, doctors visit twice. In subsequent weeks, the frequency is reduced to once a week.

From the moment the child transitions to the category of infants and up to three years, the patronage scheme looks like this:

up to six months - twice a month;
up to a year - once a month;
from one year to two - every 3 months;
from two to three years - every six months;
after three years - once a year.

With satisfactory development of the child, after three years, patronage is often terminated. At the same time, when pathologies are detected, examinations are carried out more often.

Accounting for medical records

During the first patronage visit, the doctor and nurse bring with them a document called a patronage form. There is an established procedure for filling it out, an example of which is easy to obtain at any clinic. The sketch should also be in the hands of the medical staff visiting the mother with the child.

The main job of completing any documents related to the examination lies with the doctor and the nurse. At the same time, there is a number of information that the mother indicates. We are talking about passport data and address, from which the above-mentioned form begins.

Filling out documents by a nurse

The nurse, not the parents or the doctor, fills in the portion of the examination form. It concerns information about the health of the parents and the course of pregnancy. The part of the form for the nurse to complete is called the Obstetric History.

First of all, data is entered here about what diseases the mother suffered, whether she experienced miscarriages. It is reported whether she underwent abortion and whether there were threats of termination of the pregnancy.

Further indicate whether the mother has any bad habits... They also mark whether there are professional risks or whether the parents live in an ecologically unfavorable area. They also enter information about the moment of the child's first cry - it happened immediately or after some time. The nurse is obliged to provide information on vaccinations, as well as on general condition newborn baby.

Filling out the form by a doctor

A certain part of the form is completed, during the first patronage, not by the nurse, but by the doctor. He will have to enter information about the health and well-being of the baby. The first part of the form, completed by the doctor, is titled Complaints and Medical History. All complaints about the well-being of the child, to which his mother points out, are entered here. In addition, information about diseases and their treatment in the hospital, if any, was immediately after birth.

The next part of the document completed by the doctor is called "Life history". All information regarding the nature of feeding the baby, his psychomotor development is entered here.

Features of the procedure

In some cases, patronage with certain characteristics. This may be due to both the specific health condition of the baby (for example, the presence of hereditary diseases), and its prematurity.

The order of examinations in the above two cases implies their greater frequency and attention to the presence of warning signs.

For babies with hereditary diseases

The first weeks of a newborn's life with suspected hereditary diseases are special. Unlike others, he is not immediately discharged from the hospital home. First of all, he is put in a hospital, where he is subjected to a comprehensive examination. The discharge is not made until the moment it becomes clear for certain whether the child is sick or healthy. And if he is sick, then what exactly.

For a child born prematurely

The first feature of the patronage of a premature baby is his compulsory attendance the doctor already on the first day after discharge. Inspection scheme in general outline repeats the one that is provided for an ordinary baby. The main emphasis is placed on the frequency of visits. In the first month of life premature baby the doctor visits him at least four times. And the sister - at least twice a week, visiting every seven days.

Close attention is paid to the prevention of rickets. This disease quite often affects children born earlier. due date... In order to prevent the development of this pathology, vitamin D is administered and carried out therapeutic massages... Hardening procedures are not neglected.

Upon reaching the age of two weeks, they are irradiated with therapeutic ultraviolet light. The period of dispensary observation for such a child is increased to seven years.

Is it possible to refuse patronage

The current legislation allows to refuse patronage. This requires an official application addressed to the head of the clinic to which the child is assigned. The document is written in any form. The emphasis is on a list of reasonable reasons why parents do not want healthcare workers in their home.

It should be understood that after the satisfaction of this statement, all responsibility for the health of the newborn falls on the parents themselves. They are deprived of the opportunity to receive qualified advice at home. At the same time, this does not eliminate vaccinations and other procedures.

Legislative regulation

Patronage is carried out according to the law. Namely, in accordance with the law "On the protection of the health of citizens", article 37.1, and the order of the Ministry of Health and Social Development of 01.06.2010.

Conclusion

Patronage of babies is a responsible procedure. Thanks to her, they reveal in time whole line dangerous diseases. And mothers who have given birth for the first time receive expert advice. But if the parents do not want to see the doctors at home, then they refuse it.