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Primary medical patronage of the newborn. Visiting a newborn by a health visitor

Patronage of a newborn is carried out during the first month of a baby's life. Read more in the article.

Patronage of a newborn is the observation of a child in the first month of his life by a doctor and nurse. It is provided free of charge to all children without exception. Such observation is carried out at the place of residence of the mother with the child. It doesn't matter where they are registered, the children's nurse or pediatrician comes to the mother's place of residence.

The first patronage is carried out before childbirth. The purpose of the visits is to collect anamnesis and educate the expectant mother.
At antenatal care, the nurse pays attention to perinatal risk factors, whether a child is desirable, the moral and psychological climate in the family, and material and living conditions.
The expectant mother should attend the school of young parents, make her diet right and lead a healthy lifestyle.
At 31-38 weeks of pregnancy, a second patronage is carried out. Health workers check how the recommendations are being implemented and prepare the mother for the postpartum period: there is a conversation about breastfeeding babies only for the necessary period of time, about preparing the breast for feeding and preparing the place to care for the baby and the necessary medicines that should be in the home first aid kit.

Patronage of newborns is carried out during the first month of a baby's life. This is spelled out in the legislation of the Russian Federation.

All young mothers are wondering what is nursing patronage of a newborn, and why should a nurse or doctor come home? After all, parents can call the clinic and report the state of health of the child.

A newborn needs constant care and protection.
A nurse and a doctor who come home to a mother with a child evaluate whether the baby is feeding correctly, whether the situation in the family is normal.
A medical worker can notice a deterioration in the health of a child in time, and take action. Young parents without experience in raising small children may not pay attention, for example, to an increase in body temperature, or complications after childbirth.

Important: Only through the efforts of a mother who observes a healthy lifestyle, the baby will grow up healthy and strong. Good care and breastfeeding will help him quickly adapt to living conditions, form immunity, and the acquired potential will help develop all vital functions and intelligence.

Mandatory patronage of a newborn is indicated in the Order of the Ministry of Health and Social Development of the Russian Federation dated June 1, 2010. This Order was issued on the basis of Article 37.1 of the Law of the Russian Federation on the Protection of the Health of Citizens, adopted on July 22, 1993.

When a nurse comes home for the first time, where a mother lives with a newborn, she fills out a special form. Entries are made on the basis of the discharge summary issued in the maternity hospital and other documents.

Form of patronage for a newborn and a sample of filling out:

First, the passport part is filled in: date, last name and first name of the baby, date of birth, address and place of work of the mother and father. If there was an admission to the hospital after the maternity hospital, you need to indicate the date and the referral diagnosis.

The next part of the form contains data if there are complaints or the baby was treated in a hospital after the birth. This part of the form must be completed by the primary care physician.

This part of the entry form is made by the nurse. She indicates whether there were threats of termination of pregnancy, past illnesses of the mother, whether there were abortions, miscarriages.

Next, the nurse asks about bad habits during pregnancy and makes an entry on the form. Be sure to indicate complications during childbirth and when the child cried. Data is recorded on the baby's weight, head and chest circumference, and when it was applied to the breast.

The nurse must make a record of the vaccinations given at the maternity hospital. Then the date of discharge is noted, and how the neonatal period passes.

All other entries on this form are made by a doctor in the first year of a child's life. He will note how the psychomotor development goes, the nature of feeding, the timing and sequence of the introduction of complementary foods.

The local children's doctor and nurse, when visiting the mother and child, perform their duties professionally and correctly. In a word, care is being taken about the person who has been born. The goals of patronage include the following:

Baby health assessment. Muscle tone is checked, the fontanel is palpated, the color and condition of the skin is assessed. A visual examination of the child's body is also carried out and symmetry is revealed in the location of all organs, the work of the limbs, the development of the genital organs, the correct shape of the head, and more.
Assessment of the health and psychological state of the mother. The pediatrician can examine the woman's breasts for mastopathy, and have a conversation about how to apply the baby to the breast.
Assessment of social and economic conditions in the family. The conditions must be favorable, and the child must be provided with everything that a baby needs at this age. If the family is dysfunctional, the pediatrician gives an assessment of the situation in writing and also determines the psychology of the parents' behavior towards the baby.
Teaching the mother how to care for the baby, proper care, hygiene procedures.

Terms of the first patronage for a newborn:

In the first three days after discharge, a pediatrician and a nurse come. After health workers receive information about the child, they are required to visit him.
On the first day after discharge, a medical worker comes if the child has health problems or had injuries during childbirth.
The nurse visits the newborn every day for 10 days. Then she will come only on the 14th and 21st days of the child's life.
If development is proceeding normally, there is no need for further visits.

A young mother should remember that she should tell the nurse about all the problems that the baby has. If you do everything right and quickly, it will be easier to deal with problems. Colic in the abdomen, regurgitation and constant crying of the crumbs will disappear.

Many young parents do not understand the importance of patronage of a newborn. When they are discharged from the maternity hospital, they ask themselves the question: “how many times a week is patronage of a newborn carried out, and is it needed?” But as described above, the health visitor will come every day for the first 10 days of the baby's life. Then on the 14th, 21st day and the last visit on the 28th day.

There is an accepted scheme for visiting a newborn by health workers. It is as follows:

1, 3, 10, 14th day - the pediatrician visits the newborn.
2nd, 4th, 5th, 6th, 7th, 8th, 9th, 21st and 28th days - nurse visits.
By the end of the first month of life with a child, you can come to the clinic for an appointment for weighing and consultation.

Important: After the visit on the 14th or other day, if you notice a deterioration in the health of the baby, call the registry of the children's consultation and call the doctor at home.

The nurse must come to the place of residence of the mother and the newborn child within 3 days. Often, health workers come on the first day if the first child is born in the family. An example of nursing care for a newborn, what a nurse should do:

A medical worker congratulates parents on the birth of a baby.
The following questions will follow: who was born, what is the name, what weight, on what day did the umbilical cord fall off, when did you take the breast and was there complementary foods?
Then the nurse asks for information about the mother's health: the birth is normal, was there any surgery. She also monitors the sanitary condition of the apartment, compliance with the daily routine.
After that, the nurse washes her hands, puts on a gown, cap and mask. The child is examined: skin, visible mucous membranes, umbilical wound, and attention is drawn to the stool.
Based on the examination, the nurse talks about caring for the baby, feeding. Teaches parents to swaddle, treat the skin, mucous membranes, umbilical wound and conduct a hygienic bath.

If all goes well, the nurse leaves. If there are any deviations in the child's health or development, she informs the pediatrician about it.

Many parents are not satisfied with the free patronage of a newborn. Therefore, they turn to private clinics. Paid patronage of a newborn is carried out by pediatricians and nurses of these clinics according to certain schemes.

Remember: For which scheme you contributed money, according to that schedule, a medical worker will come.

Therefore, when choosing a clinic (public or private), you should evaluate all the benefits and risks for the child, especially if you have your first child.

A pediatrician and a nurse must visit a premature newborn on the day he is discharged from the hospital. Patronage of a premature newborn is carried out daily in the first 10 days of life and at least 5 times a week thereafter until the child reaches the age of one month. The pediatrician visits the child 3 times a week.

The birth of a child with hereditary diseases requires the urgent intervention of doctors. The newborn may need hospital treatment.

After discharge from the hospital, a newborn with hereditary diseases is patronized. The nurse visits the baby every day for the first 10 days after discharge, then every other day. The pediatrician comes home to the mother with the child 3 times a week.

Every mother needs help caring for a newborn, especially if she has her first child. But many parents do not want to receive patronage assistance in the district medical institution, they register with the child in paid centers. Therefore, the question arises, how to refuse patronage of a newborn?

Patronage literally means patronage, patronage, which very accurately reflects the essence of the procedure. Patronage of a newborn is a mandatory procedure through which infants and young mothers go through. Patronage has an educational function and is designed to help young parents in the first weeks and months of a baby's life.

This is a free service provided by the local health center. Patronage takes place at the address of actual residence, which is indicated upon discharge from the maternity hospital, registration, in this case, does not play a role.

Responsibilities of a Physician

Patronage to the newborn is carried out by two people: a doctor and a nurse. At the first patronage, the doctor is directly responsible for the child - he conducts an examination and assesses the general condition of the baby for compliance with normal indicators.

This inspection includes:

observation of reflexes;
visual assessment of the condition of the skin;
palpation of the abdomen;
examination of the fontanel;
examination of the place of cutting of the umbilical cord.

Also under observation is the activity of the child during feeding.

In the case of dysfunctional family genetics, it is imperative to notify the doctor about the possibility of hereditary diseases.

Responsibilities of a Nurse

The nurse not only assists the doctor when examining the child, but also pays attention to the young mother. An important part of newborn care is to provide the necessary and competent care for the baby.

The nurse in an accessible form gives instructions on all points related to the healthy and comfortable life of the baby in the first days and weeks after birth.

Feeding

The patronage nurse talks about the intricacies of feeding, shows how to properly attach the baby during feeding, how to express milk. It also gives advice that is useful for the well-being of the mother, namely, how to avoid coarsening of the skin of the breast and relieve the resulting heaviness.

Bathing

Daily water procedures necessary for a newborn, as well. The nurse will clarify the duration of bathing, the temperature of the water in the bath, and tell you about the correct position of the child during bathing.

Charger

Physical activity is necessary for the baby from the first days of life to strengthen the muscle corset, proper joint mobility. The fragile and delicate body of the baby needs careful and competent help when performing a special one for newborns. Patronage includes teaching the intricacies of charging with a child.

External care

No less important is the correct implementation of the daily toilet of the child: manicure, pedicure, how to clean the ears, eyes and nose. For experienced parents, all these manipulations are not difficult, and the patronage procedure helps young families learn the important nuances of caring for a child.

Assessment of the child's living conditions

When carrying out patronage, in addition to the physical condition of the baby, an assessment and analysis of the conditions in which the baby's life will proceed is mandatory. The degree of comfort and compliance with the conditions of the accepted norm.

The area of concern for nurses is:

cot;
clean bed linen, a supply of diapers and necessary baby clothes;
cleanliness of the room, daily wet cleaning is welcome;
ventilation - the flow of fresh air into the room is necessary;
the climate in the apartment, the air temperature should be about 21 degrees;
pets are the most obvious allergens and their contact with the newborn should be strictly controlled.

Preparing for patronage

The first patronage of a newborn is carried out as a solemn procedure.

In addition to assessing the condition of the baby and mother, examining the place of residence, the duty of patronage of a nurse involves consultation on all issues that arise for young parents. To avoid fuss during the visit of health workers, you should prepare in advance for the procedure:

Clean up the premises in which patronage is planned;
Prepare a diaper, cotton swabs, hydrogen peroxide and diapers;
Prepare an extract from the hospital and a certificate for vaccinations;
Consider, and it is better to write down the questions that have arisen (you should definitely get recommendations on the mother’s diet, in order to avoid problems with pain in the baby’s tummy);
Prepare a pen and a piece of paper for writing down information (the clinic's working hours, reception phone, emergency phone).

It is obligatory to fill in the form of medical and nursing patronage for a newborn. This is an official and detailed document drawn up based on the results of the examination of the baby. The form is filled out by a medical worker. A sample form is freely available.

Since there is a clear scheme for the primary patronage of a newborn child, a systemic examination is provided that allows the most accurate assessment of the condition of a small patient and mother. The signatures of medical personnel and parents under the document mean that the primary patronage of a newborn child was carried out in accordance with all the rules.

Second and subsequent patronage of a newborn

At the end of the visit, a second visit is scheduled. Usually, to monitor the condition of the newborn and mother, three visits are required in the first ten days, then once a week until the baby reaches the age of one month. If the child is not healthy, or the birth was difficult, with surgery and subsequent complications in the postpartum period, the frequency of visits to specialists increases.

After the newborn is 1 month old, it is necessary to register at the clinic at the place of residence. Further, a visit to the pediatrician once a month is a mandatory procedure that should not be neglected until the moment of the first birthday.

For the convenience of young patients, polyclinics provide special “days for children under one year old”. The schedule can be found on the information board or inquired at the reception.

The Importance of Patronage

Patronage of a newborn is an important procedure that should not be treated formally.

Thanks to timely competent advice, it is possible to avoid further problems arising from incompetent child care. You should use this opportunity, do not hesitate to ask questions, follow the recommendations and advice of experienced professionals.

As a result, young parents feel more confident in their new quality.

Most of the nervous breakdowns and panic attacks in mothers in the first days of a baby's life occur precisely because of the fear of making a mistake and unknowingly harming the child's health. It must be remembered that the well-being and harmonious development of the baby depends primarily on the condition of the mother. . That is why the universal patronage system was developed.

A clear algorithm allows you to provide a useful service of high quality. At the first stage, patronage helps parents and the child to adapt to new living conditions under the supervision of specialists.

Algorithm for the procedure of patronage of newborns

A well-established sequence of actions during the patronage of infants allows parents to understand exactly what will happen and how during the procedure. The atmosphere is always friendly and correct, conducive to communication and obtaining the necessary information.

What happens when nursing a baby:

the first visit of the visiting nurse and pediatrician;
examination of the child and mother;
filling in the necessary documents (form of the first patronage of a newborn);
consultation of parents in the question-answer mode, a demonstrative demonstration of the methods of proper child care;
appointment for the next visit.

The simplicity and accessibility of the newborn patronage procedure in no way detracts from its effectiveness and positive returns from the process.

Thanks to patronage, even inexperienced parents instill self-confidence, which helps to take care of a new person as correctly as possible, making competent decisions, fully aware of the responsibility for a new life.

Service cost

An example of caring for the new generation is the patronage service provided by the professionals of the local polyclinic, free of charge. If you wish, you can turn to paid medicine, if necessary. Patronage of newborns is provided in private clinics of the appropriate profile.

Parental refusal

In case of refusal of parents from patronage, a document is drawn up - a statement in which the reason for the unwillingness to resort to patronage is necessarily indicated. After that, the responsibility for the health and life of the baby lies entirely with the parents, this must be taken into account when refusing the help of specialists.

Newborn care is the careful observation of a child during the first few months of his life. As a rule, patronage is quite active and the doctor or nurse visits you and your child at home on their own. After you are discharged from the hospital, the child's birth certificate will be transferred to the clinic, which is located at the place of residence. If the birth took place at home or in another maternity hospital, then the woman must independently enter a certificate.

Patronage of a newborn should be carried out for all children without exception. It is worth noting that today there are a large number of private clinics that can also offer high quality patronage services. Undoubtedly, all mothers want to return home with the child as soon as possible. When this finally happens, women become nervous that they may be doing something wrong and quite often they simply cannot calm the crying baby. In order for young mothers to gain experience and not make mistakes, it was decided to use a special patronage system.

Who takes care of the newborn

Patronage of a newborn, as a rule, is carried out by a pediatrician or a nurse. These people are responsible for different tasks. For example, a doctor examines a child and assesses his state of health. If necessary, he prescribes treatment. During the first month of a child's life, the doctor should visit and examine him three times. If there are health problems, the number of visits should be increased.

The nurse must, in turn, tell the young mother about how to properly feed the child, bathe, walk and harden. In addition, it helps to adjust the correct diet of the mother and lasts all the necessary information about appointments at the clinic (schedules, phone number, and so on). During the first month of life, a nurse should come to him on average 3-5 times.

How exactly is the inspection

For the first time, a nurse and a doctor should visit the child a few days after arriving home from the hospital. If the child has any health problems, then it must also be examined on the day of discharge. If the child is going to be discharged on a day off, then the doctor on duty at the polyclinic should examine him in order to make sure that everything is in order with him.

As a rule, the next day after discharge, a nurse will come to you and tell you everything you need to know at first. Over the next ten days, she will come to you three more times. The doctor for a month, with the condition that the child is healthy, will examine him once a week.

How to prepare for patronage

The main task of the patronage of a newborn child is to assess the living conditions of life and, of course, the state of health of the baby itself. Therefore, it is advisable to clean the house before the arrival of the doctor. In advance, you need to prepare an extract from the hospital, a certificate for vaccinations and a list of questions that you would like to ask the specialist. Some of the doctors may be more than formal in their patronage, so don't be afraid to ask questions and insist that your baby be carefully examined.

You also need to prepare a diaper and a place where you can examine the child in advance for the examination. You will also need cotton swabs, hydrogen peroxide, a changeable diaper and a notebook where you can write down the answers to questions that are important for you and the doctor's appointment schedule at the clinic.

What does a doctor examine when caring for a newborn

During the examination, special attention is paid to the color of the child's skin, because the child may suffer from jaundice. Which manifested itself after discharge from the hospital. In addition, the doctor will pay attention to muscle tone, evaluate the baby's reflexes. An important point is the examination of the child's head and the condition of the fontanelles. Also, the doctor will examine the umbilical wound and tell you in detail how to care for it, and some doctors or nurses can show you the whole process.

Do not forget during the patronage and the woman. It is necessary to examine the condition of the mammary glands and give all recommendations on feeding that would help to avoid the development of lactostasis and mastitis.

Polyclinic Pediatrics: lecture notes Abstracts, cheat sheets, textbooks "EKSMO"

1. First patronage for a newborn

An anamnesis is collected to identify and clarify risk factors, an objective examination of the child, instructions to the mother and paperwork (form No. 112).

Anamnesis includes the collection of social, biological and genealogical information. The parameters of the social anamnesis are: the completeness of the family and the psychological climate in it, housing and living conditions, material security, the level of sanitary and hygienic conditions for caring for the child and the apartment, lifestyle. The biological history covers the features of the antenatal period, the state of health of the mother and child, the genealogical history - the state of health of parents and relatives (at least 3 generations). The mother gives the doctor the exchange card received upon discharge from the maternity hospital. It contains information about pregnancy and childbirth, the condition of the child at birth (Apgar score), the main parameters of physical development (body weight, body length, head and chest circumference), health group and risk group.

Objective examination

An objective examination is carried out by systems. Congenital malformations, symptoms of intrauterine infection and purulent-septic diseases, birth trauma should not go unnoticed.

The skin of a newborn should be pink, clean and velvety. Changes in the color of the skin (cyanosis, icterus, earthy gray and pallor) require a special examination. Sweating and diaper rash indicate care defects. Turgor and elasticity of the skin matter. With pustules on the skin, purulent discharge from the umbilical wound or hyperemia around the navel, it is necessary to send the child to the hospital for examination and treatment.

The posture of the newborn may be physiological or pathological (posture "frog", "pointing dog"). With a physiological posture, the tone of the flexors of the arms and legs predominates ("embryonic" posture). Forced position indicates pathology.

The head of a newborn is rounded. Sometimes it may have a cephalohematoma (subperiosteal hemorrhage as a result of a birth injury). The size of the large fontanel ranges from 1 to 3 cm in medians. The small fontanel in most newborns is closed. The bulging of the fontanel above the level of the bones of the skull, the pained expression on the face indicate an increase in intracranial pressure (with hydrocephalus, meningitis, cerebral hemorrhage). Such a child should be observed by a neurologist.

When examining the eyes, the pupils should be symmetrical, with a lively reaction to light. Nystagmus, a symptom of the "setting sun" usually indicate a severe pathology of the central nervous system and the need for consultation with a neurologist. Underdeveloped and low-lying auricles can be combined with congenital malformations of the internal organs and deafness. When examining the pharynx, pay attention to the soft and hard palate to identify a hidden cleft and arcuate configuration. The frenulum of the tongue may be shortened, and if this leads to a violation of the act of sucking, its surgical correction is necessary.

The chest is actively involved in the act of breathing, it is symmetrical. Pay attention to the frequency and nature of breathing, percussion and auscultation data during examination of the lungs and heart. It should be remembered that congenital heart defects occupy the first place among other congenital malformations. Their first manifestation may be a coarse murmur detected on au-scultation for the first time in the neonatal period. With auscultation of wheezing in the lungs, the child needs to be examined in a hospital. It should be remembered that percussion data in a newborn are more reliable than auscultation data, since due to the thin chest, breathing is well carried out from one half of the chest to the other, which makes it difficult to fix weakened breathing.

The abdomen is palpated counterclockwise. The edge of the liver can normally be 1-2 cm below the costal arch. When palpation of pathological formations, the child should be sent for an ultrasound scan of the abdominal organs.

The genitals should be shaped according to the sex and age of the child.

Limbs. The legs, bent at the hip joints at an angle of 90 °, can be retracted until they completely touch the table surface. With a congenital dislocation of the hip, a dull click will be heard. Erb-Duchene and Dejerine-Klumpke paralysis indicate a birth traumatic injury to the brachial plexus.

The nervous system and mental development are assessed by observing the child and communicating with him - by activity, look, and the severity of unconditioned reflexes. The reflexes of the greatest diagnostic significance are: sucking, searching, grasping, crawling, protective, support and automatic walking, Babkin's reflex. Tendon reflexes, their symmetry, muscle tone are determined.

briefing

Parental briefing deals with child care, feeding and upbringing.

Recommendations for care. Cleanliness is important for the health of a newborn. The crib should be placed in a bright place in the room, but not in a draft. The newborn is placed in the crib on its side, without a pillow. The air temperature is maintained at 20–22 °C.

Bathing is done daily in a special baby bath, which is not used for washing diapers or baby clothes. The duration of bathing is 10 minutes.

You can bathe your baby in the morning or in the evening. The best time is in the evening, before the last feeding, as this improves the baby's nighttime sleep. Before bathing in the first 2 weeks, the bath should be scalded with boiling water. A newborn should be bathed in boiled water until the umbilical wound has healed. Water temperature 37–38 °C. Water is poured into the bath so that it covers the bottom. It is good to add decoctions of herbs (sequence, chamomile) to the water. The child should be gradually immersed in water, wrapped in a diaper, so as not to cause anxiety. With one hand they support the head of the child, and with the other they wash him.

For washing it is convenient to use an individual soft sponge. Soap is used 2 times a week, only for children. After bathing, the child is laid face down on the palm, clasping the chest, and rinsed with water from a jug. Then you should dry the skin of the child with a towel, while making blotting movements. It is especially important that the skin folds are dry.

They are treated with baby cream, powder or boiled sunflower oil. Each mother chooses her own skin care products for the child. The area of the umbilical wound is treated with a solution of brilliant green or a 5% solution of potassium permanganate, or a 5% solution of iodine.

Morning toilet - every morning after the first feeding, the child is washed with a cotton swab moistened with warm boiled water, eyes - from the outer corner to the inner, with a separate swab for each eye. The nose is cleaned with cotton turundas moistened with vaseline oil.

Swaddling is an important aspect of newborn care. Recommend free and wide swaddling. For free swaddling, the child is put on a vest with sewn-in sleeves. Legs are wrapped in a blanket. The chest remains free, which facilitates breathing and serves as a prevention of lung diseases. For a wide swaddling between the thighs, an additional diaper is laid, due to which the thighs remain in a state of dilution, which contributes to the reduction of the femoral head into the acetabulum and is a conservative treatment for congenital hip dislocation.

Walks in the fresh air should begin immediately after discharge from the maternity hospital. The first time the duration of the walk is 5 minutes at a temperature not lower than -10 °C. In order to adapt to the environment, the duration of walks is increased gradually, adding 5 minutes daily. Walking is contraindicated in case of illness of the child. They should be resumed after recovery, gradually increasing the duration.

Proper feeding of a newborn ensures its timely harmonious development and forms immunity. Attaching the baby to the breast immediately after birth stimulates lactopoiesis. It is necessary to explain to the mother the advantages of breastfeeding and to recommend breastfeeding at the request of the child during the period of lactation. When breastfeeding, a very important emotional contact is established between the mother and the child, which favorably affects the psycho-emotional state of the mother and the development of the child's personality. It is necessary to alternate feeding with each mammary gland. Control weighing is used to determine the amount of milk eaten by a child.

Before feeding, the mother should put on a scarf, wash her hands with soap and express one drop of milk. Most often, difficulties in breastfeeding are due to the irregular shape of the nipples, their cracks. To improve the shape, gently pull the nipples for 2-3 minutes 3-4 times a day. For the treatment of cracks, 1-5% synthomycin liniment, 0.2% furatsilin ointment, calendula ointment can be used. After using these products, before feeding the baby, the breast should be thoroughly washed with warm water and baby soap.

Sometimes breastfeeding is contraindicated. This may be due to the condition of the mother or child. Contraindications to breastfeeding on the part of the mother include kidney, heart failure, malignant tumors, severe blood diseases, severe infectious diseases (such as tuberculosis, meningitis, diphtheria, tetanus, etc.).

The child is not applied to the breast in case of severe intracranial birth trauma, respiratory, heart failure, deep prematurity with the absence of sucking and swallowing reflexes, hemolytic disease of the newborn (if antibodies in high titer are found in the mother's milk), hereditary metabolic disorders (phenylketonuria, galactosemia and etc.). All these conditions are absolute contraindications. Maternal mastitis is a relative contraindication. With the serous nature of inflammation, feeding from a healthy mammary gland is allowed. With purulent mastitis, breastfeeding stops completely.

Sometimes there is a decrease or cessation of lactation in the mother. Hypogalactia can be primary and secondary. Primary hypogalactia is caused by neurohormonal disorders, therefore hormones are prescribed for the development of lactation: lactin 70-100 units. intramuscularly 1-2 times a day for 5-6 days; oxytocin 1.5–2 units. (0.3-0.4 ml) intramuscularly 2-3 times a day daily for 3 days, pituitrin 2.5 units. (0.5 ml) 1-2 times a day intramuscularly for 5-6 days. Secondary hypogalactia is more common. Its occurrence is promoted by insufficient sleep, malnutrition, violation of the rules of breastfeeding, taking medications (antibiotics, diuretics, barbiturates, furazolidone, etc.). Treatment of secondary hypogalactia is to eliminate its causes. Vitamins (A, B 12 , B6 C, PP), apilac (0.01 g 3 times a day under the tongue for 10-15 days), dry brewer's yeast (1-2 g 3 times a day orally for 10-15 days), use phytotherapeutic agents ( hawthorn, lemon balm, strawberry leaves, oregano herb, dill). If it is impossible to restore lactation, then it is necessary to provide the child with donor human milk. Women's milk collection points have been set up at dairy kitchens. The donor woman must be healthy and clean.

In the absence of women's milk, its substitutes can be prescribed - mixtures adapted to women's milk. Unadapted simple mixtures have now lost their value.

Upbringing. From the very beginning, mutual understanding is established between parents and the child with the help of specific signals, a unique form of relationship is formed - attachment. A newborn child has the ability to withstand the adverse effects of a new environment and selectively respond to certain stimuli. The mental structure of the personality of a newborn, the individual characteristics of temperament are visible from the first days of life (“difficult child”, “easy child”). The variability of the child's behavior is due to changes in his emerging consciousness. Breastfeeding plays an important role in the upbringing of a small person. A child who is breastfed feels protected, needed, desired. In conditions of positive mental contact, children grow more obedient.

From the first days of life, the baby needs the correct daily routine (alternation in time of basic physiological needs: sleep, wakefulness, nutrition, walking, hygiene and hardening measures). This contributes to the formation of a certain rhythm of life. Children develop a time reflex, a dynamic stereotype of behavior is formed, biological rhythms are established, which provides them with a calm and quick falling asleep, good appetite, and active behavior during wakefulness. Children who live according to the established rhythm do not need additional sedation (rocking, carrying, using a pacifier).

In the future, such a child easily gets used to the daily routine. This teaches him to be organized and makes life easier for him and his parents. The correct mode of the day should not be imposing. A child can be taught better and faster if you adapt to the level of his mental development, individual biological rhythm, taking into account the physical condition and individual mental characteristics. Deviations from the regime for 30 minutes or, in extreme cases, for 1 hour are allowed.

The leading regime factor is the feeding of the child. Feeding on demand is carried out during the adaptation period in order to establish the optimal feeding regimen for mother and child. The subsequent transition to feeding according to the regimen should be gradual. The criterion for a correctly chosen regimen is the state of health of the child, primarily the functions of the central nervous system. In conditions of impaired adaptation, the child becomes capricious, whiny and irritable.

In accordance with the feeding regime, other regimes are formed: sleep and wakefulness, walks, tempering and hygiene measures.

At the first visit of a newborn, it is necessary to tell the mother about the conditions that require urgent medical attention, and to tell where to go for help with illnesses.

Document execution

Information about the content of the first patronage for a newborn is recorded in the history of the child's development (form No. 112) under the heading "First patronage for a newborn." The record is made according to the scheme: anamnesis, objective examination data, diagnosis indicating the health group and risk group, recommendations for care, feeding and education. If the child belongs to health groups II-V, then recommendations should be given for rehabilitation in accordance with the risk group or nosological form of the disease.

From the book Brain Magic and the Labyrinths of Life author Natalya Petrovna Bekhtereva

From the book Polyclinic Pediatrics author M. V. Drozdov

5. Neonatal period. First patronage for the newborn After the newborn is discharged from the maternity hospital, information is transferred by phone to the children's clinic, where the full name of the mother, address and date of birth of the child are recorded in the log of visiting newborns. During

From the book Polyclinic Pediatrics: Lecture Notes author Abstracts, cheat sheets, textbooks "EKSMO"

6. Second patronage for a newborn The second patronage for a newborn takes place on the 14th day of the child's life. Its purpose is to re-examine the newborn by organs and systems to establish the state of health, monitor the implementation of recommendations, respond to

From the book How to lose weight once and for all. 11 steps to a slim figure author Vladimir Ivanovich Mirkin

7. Third patronage for a newborn The third patronage for a newborn takes place on the 21st day of the child's life. Its goals are to monitor the dynamics of the state of health and developmental conditions of the newborn, feeding, conducting sanitary and educational work, treatment

From the book We and Our Children author L. A. Nikitina

LECTURE № 3. Neonatal period. Patronage to the newborn After the newborn is discharged from the maternity hospital, information is transferred by phone to the children's clinic, where the full name of the mother, the address and date of birth of the child are recorded in the journal of visiting newborns. During

From the book The Easiest Way to Stop Eating author Natalia Nikitina

2. Second patronage for a newborn The second patronage for a newborn takes place on the 14th day of the child's life. Its purpose is to re-examine the newborn by organs and systems to establish the state of health, monitor the implementation of recommendations, respond to

From the book A Practical Guide to Caring for a Newborn author Zhanna Vladimirovna Tsaregeradskaya

3. Third patronage for a newborn The third patronage for a newborn takes place on the 21st day of the child's life. Its goals are to monitor the dynamics of the state of health and developmental conditions of the newborn, feeding, conducting sanitary and educational work, treatment

From the book Get 10 kg younger author Vladimir Ivanovich Mirkin

The First Step Below are self-persuasion to overcome inertia, psychological barrier, fear of starting diet therapy, helping patients to force themselves to begin treatment and take the first step on the path to weight loss. "I completely changed my

From the book All about the child of the first year of life. week after week author Alexandra Stanislavovna Volkova

THE FIRST HOUR, THE FIRST DAY What about the first hour of a newborn's life? Both he and the mother are in the maternity hospital: experienced doctors, midwives, nurses, excellent equipment, caring care - everything you need to accept a new person into life and provide for the mother

From the book Lose Weight is interesting. Recipes for a tasty and healthy life author Alexey Vladimirovich Kovalkov

Step One Now you have a weight problem. Perhaps an extra 10-20 kilograms, and you are a little fatter than you would like to be :-). You have tried various diets and programs, as well as sets of exercises. Most likely, the results disappointed you. Have you managed to lose weight at times,

From the book Yoga and Sexual Practices by Nick Douglas

Visits to the newborn and sanitary and hygienic rules If there is a baby in the house, then certain sanitary and hygienic rules must be observed in order to prevent infectious diseases. These rules are especially relevant during seasonal epidemics.

From the author's book

The first step The following are self-persuasion aimed at overcoming inertia, psychological barrier, fear of starting diet therapy, helping patients to force themselves to begin treatment and take the first step towards losing weight.?

From the author's book

Appendix 1 What does a newborn need? By the time of discharge from the hospital, relatives (mainly a happy father) must thoroughly prepare. To meet a newborn and his mother at the maternity hospital, one must come not only with flowers, but also have a set of baby clothes:

From the author's book

First time There is a first time for everything. In the West, attitudes towards sex are becoming more liberal, the first sexual intercourse is treated as a trifle, but this event has a profound impact on the psyche. Many people find it difficult to overcome feelings of fear or guilt after

Nurse patronage in 1 month Date:

A conversation was held on the prevention of rickets, the features of caring for a child, and a massage complex No. 1 was trained.

Complaints: No; on the_____________________________________________________________

exclusively breastfeeding

mixed

Inspection:

Umbilical wound: clean, wet, under the crust.

NDP: briefly fixes his gaze on a bright object _______, shudders at a sharp sound ________, first smile ________, tries to keep his head lying on his stomach ________.

3. Newborn toilet daily; washing with water 28 0 С;

7. Hypoallergenic diet for mother: exclusion of spicy, fried, fatty, smoked, sweet foods, semi-finished products, canned food, products that increase gas formation. The use of mixtures, herbal teas for nursing mothers - to maintain sufficient lactation.

9.Optional:

Signature m/s

Nurse patronage at 2 months Date:

Social environment

Complaints

Feeding: 1. Breast, 2. Mixed, 3. Artificial

exclusively breastfeeding feeding, lactation sufficient, insufficient. Sucks actively, on demand, after _______ hours, does not burp, burps: rarely, often, not abundantly, in a fountain.

mixed: breast milk + supplementary feeding mixture _________ ml times;

Reason for supplementary feeding: insufficient lactation, mother's desire, going to school, work, other ___________________________________________________________

Artificial: a mixture of _______________ ml times;

The reason for the transfer to artificial feeding: lack of lactation, the desire of the mother, illness, mother, child, going to work, study, other _________.

Inspection:

Muscle tone: physiological hypertonicity of the flexors, hypotonicity.

Nasal breathing is free, the nose is stuffy, sniffs through the nose, the mucous discharge from the nose is copious, not copious.

The abdomen is soft and painless. Chair: changes ________________________;

No change: daily, mushy, yellow, without impurities of blood, greenery, mucus. _____ once a day. Flatulence: yes, no. Urination free, painless _____ times a day. The nature of sleep ___________________________________________________________

NDP: follows with his eyes a toy moving in front of his eyes ______, listens ____

Smiles in response to the speech of an adult _______, holds his head well, 1-2 minutes, in an upright position _____________________________________________________________.

1. Nutrition: exclusively breastfeeding, on demand.

2. Bathing daily t - 37-38 0 C, rinsing t - 36-37 0 C; with baby soap 1-2 times / week.

3.Toilet of the skin, nose, eyes daily; washing with water 27-28 0 С;

4. Spread on the tummy before feeding, maternal (tactile) massage, from 1.5 months - a complex of massage and gymnastics - No. 1;

5. Hardening: sleep in the air at t from -10 to +30 gr., air bath for 5-6 minutes; walks: daily

5. Daily vit. D 3 drops / day.

6. Daily wet cleaning, airing in the child's room;

8. Consultation of specialists: neurologist, ophthalmologist, surgeon, ultrasound in / about + tbs, echocardiography, NSG.

9.Optional:

Signature m/s

Nurse patronage at 3 months Date:

Social environment(underline as appropriate): child care - good, satisfactory, unsatisfactory. Baby underwear - clean: yes, no. Sanitary and hygienic conditions - satisfactory, unsatisfactory. At home with a child: mom, dad, grandmother, other relatives. Recommendations for caring for a child are fully implemented, partially, not implemented. A conversation was held on the features of child care.

Complaints: No; on the_____________________________________________________________

Feeding: 1. Breast, 2. Mixed, 3. Artificial

exclusively breastfeeding feeding, lactation sufficient, insufficient. Sucks actively, on demand, after _______ hours, does not burp, burps: rarely, often, not abundantly, in a fountain.

2.1.mixed: breast milk + supplementary feeding mixture _________ ml times;

Reason for supplementary feeding: insufficient lactation, mother's desire, going to school, work, other ___________________________________________________________

3.1.Artificial: a mixture of _______________ ml times;

The reason for the transfer to artificial feeding: lack of lactation, the desire of the mother, illness, mother, child, going to work, study, other _________.

Inspection:

The child's condition is satisfactory, unsatisfactory; Responds adequately to examination, smiles, cries Skin, mucous membranes: clean, rash _________________________________;

Muscle tone: physiological hypertonicity of the flexors, hypotonicity.

Nasal breathing is free, the nose is stuffy, sniffs through the nose, the mucous discharge from the nose is copious, not copious.

The abdomen is soft and painless. Chair: changes ________________________;

No change: daily, mushy, yellow, without impurities of blood, greenery, mucus. _____once a day. Flatulence: yes, no. Urination free, painless _____ times a day. The nature of sleep ___________________________________________________________

NDP: follows the toy _______ with his eyes, listens ____

complex of "revitalization" ________, holds his head well when lying on his stomach, there is an emphasis on the legs _________, accidentally bumps into a toy with his hand _________, hums _________________.

A s, A s, E, D o, D r -

1. Nutrition: exclusively breastfeeding, after _____ hours.

2. Bathing daily t - 37-38 0 C, rinsing t - 35-36 0 C; with baby soap 1-2 times / week.

3. Toilet skin, nose, eyes daily; washing with water 26 0 С;

4. A complex of massage and gymnastics - No. 2;

5. Hardening: sleep in the air at t from -10 to +30 gr., air bath for 5-6 minutes; walks: daily

5. Daily vit. D 3 drops / day.

6. Daily wet cleaning, airing in the child's room;

8. Consultation of specialists: neurologist, orthopedist, ZRT, KLA, OAM.

9.Optional:

Signature m/s

Nurse patronage at 4 months Date:

Complaints: No; on the_____________________________________________________________

Feeding: 1. Breast, 2. Mixed, 3. Artificial

exclusively breastfeeding feeding, lactation sufficient, insufficient. Sucks actively, on demand, after _______ hours, does not burp, burps: rarely, often, not abundantly, in a fountain.

mixed: breast milk + supplementary feeding mixture _________ ml times;

Reason for supplementary feeding: insufficient lactation, mother's desire, going to school, work, other ___________________________________________________________

Artificial: a mixture of _______________ ml times;

Lure: began to introduce, introduced complementary foods No. 1, 2. One-component

Fruit juice _________________________ to ____________________________________.

Inspection:

The child's condition is satisfactory, unsatisfactory; Responds adequately to examination, smiles, cries Skin, mucous membranes: clean, rash ________________________________;

Nasal breathing is free, the nose is stuffy, sniffs through the nose, the mucous discharge from the nose is copious, not copious.

The abdomen is soft and painless. Chair: changes ________________________;

No change: daily, mushy, color __________, no admixture of blood, greenery, mucus. _____ once a day. Flatulence: yes, no. Urination free, painless _____ times a day. The nature of sleep _______________________________________________.

NDP: mother recognizes _____, turns his head to the sound ________, rolls over from his back to his stomach ______, grabs a suspended toy ________, laughs _______ loudly, _______ hums for a long time.

A s, A s, E, D o, D r -

Complementary foods: one-component products ______________________________________________

Complementary food No. 1 _________ with ______ tsp. bring to _________________ gr.

2. Bathing daily t - 37-38 0 C, rinsing t - 36-37 0 C; with baby soap 1-2 times / week.

3.Toilet of the skin, nose, eyes daily; washing with water 25 0 С;

5. Hardening: sleep in the air at t from -10 to +30 gr., air bath for 5-6 minutes; walks: daily

5. Daily vit. D 3 drops / day.

6. Daily wet cleaning, airing in the child's room;

7.Consultation of specialists:

8.Optional:

Signature m/s

Nurse patronage at 5 months Date:

Complaints: No; on the_____________________________________________________________

Feeding: 1. Breast, 2. Mixed, 3. Artificial

exclusively breastfeeding feeding, lactation sufficient, insufficient. Sucks actively, on demand, after _______ hours, does not burp, burps: rarely, often, not abundantly, in a fountain.

mixed: breast milk + supplementary feeding mixture _________ ml times;

Reason for supplementary feeding: insufficient lactation, mother's desire, going to school, work, other ___________________________________________________________

Artificial: a mixture of _______________ ml times;

The reason for the transfer to artificial feeding: lack of lactation, the desire of the mother, illness, mother, child, going to work, study, other __________________________.

Appetite is good, selective.

Lure: began to introduce, introduced complementary foods No. 1,2 single-component, multi-component

Vegetable puree from ________________________ to ___________________________________;

Porridge __________________________________ by _________________________________;

Fruit puree from ______________________ to ___________________________________;

Fruit juice ___________________________ to ____________________________________.

Inspection:

The child's condition is satisfactory, unsatisfactory; Responds adequately to examination, smiles, cries Skin, mucous membranes: clean, rash _________________________________;

Nasal breathing is free, the nose is stuffy, sniffs through the nose, the mucous discharge from the nose is copious, not copious.

NDP: distinguishes strangers from his own _____, distinguishes intonations ______, turns from back to stomach ______, stands without bending his legs, with support under his arms ______, clearly takes a toy ______, continues to walk for a long time ______________________________

A s, A s, E, D o, D r R a -

1. Nutrition: breastfeeding, mixed, artificial (mixture of ___________ by ____gr.) after _____ hours.

Complementary foods: monocomponent, multicomponent ______________________________

__________________________________________________________________________

Complementary food No. 2 _________ with ______ tsp. bring to _________________ gr.

Fruit purees and fruit juices 50 gr. (with the full introduction of complementary foods No. 1 No. 2);

4. Complex of massage and gymnastics - No. 3;

5. Hardening: sleep in the air at t from -10 to +30 gr., air bath for 5-6 minutes; walks: daily

5. Daily vit. D 3 drops / day.

6. Daily wet cleaning, airing in the child's room;

7.Consultation of specialists:

8.Optional:

Signature m/s

Nurse patronage at 6 months Date:

Complaints: No; on the_____________________________________________________________

breast

Artificial: a mixture of _______________ ml times;

The reason for the transfer to artificial feeding: lack of lactation, the desire of the mother, illness, mother, child, going to work, study, other __________________________.

Lure:

Vegetable puree from ________________________ to ___________________________________;

Porridge __________________________________ by _________________________________;

Fruit puree from ______________________ to ___________________________________;

Inspection:

The child's condition is satisfactory, unsatisfactory; Responds adequately to examination, smiles, cries Skin, mucous membranes: clean, rash _________________________________;

Nasal breathing is free, the nose is stuffy, sniffs through the nose, the mucous discharge from the nose is copious, not copious.

The abdomen is soft and painless. Chair: changes ___________________________________;

No change: daily, consistency ____________, color __________, _____ once a day. Urination free, painless _____ times a day.

The nature of sleep is _________________________________________________________________.

NDP: rolls from stomach to back _______, crawls _____________, freely takes toys from various positions ________, pronounces syllables (beginning of babbling) ______________, removes food with lips when feeding ____________________________________________.

D o, D r R a, R p, N -

Complementary foods: single-component and multi-component, vegetable puree up to 150 gr., cereals 160-200 gr., fruit purees and juices 60 gr., meat with ½ tsp. up to 20 gr.

Complementary food No. 3 ______________________ with ______ tsp. bring to _________________ gr.

2. Bathing daily t - 37-38 0 C, rinsing t - 35-34 0 C;

3.Toilet of the skin, nose, eyes daily; washing with water 24 0 С;

5. Hardening: sleep in the air at t from -10 to +30 gr., air bath for 5-6 minutes; walks: daily

5. Daily vit. D 3 drops / day.

6. Daily wet cleaning, airing in the child's room;

7. Consultation of specialists: neurologist, UAC, OAM.

8.Optional:

Signature m/s

Nurse patronage at 7 months Date:

Complaints: No; on the_____________________________________________________________

Feeding: 1. Breastfeeding, 2. Artificial

breast feeding, lactation sufficient, insufficient. Sucks actively, on demand, after _______ hours. Appetite is good, selective.

Artificial: a mixture of _______________ ml times;

The reason for the transfer to artificial feeding: lack of lactation, the desire of the mother, illness, mother, child, going to work, study, other __________________________.

Lure: began to introduce, introduced complementary foods No. 1,2,3, single-component, multi-component

Vegetable puree from ________________________ to ___________________________________;

Porridge _________________________________ by ___________________________________;

Fruit puree from ______________________ to ___________________________________;

Fruit juice ___________________________ to ____________________________________;

Yolk ____________________________________________________________________,

Meat _________________________________ to ___________________________________.

Inspection:

The child's condition is satisfactory, unsatisfactory; Responds adequately to examination, smiles, cries Skin, mucous membranes: clean, rash _________________________________;

Nasal breathing is free, the nose is stuffy, sniffs through the nose, the mucous discharge from the nose is copious, not copious.

The abdomen is soft and painless. Chair: changes ___________________________________;

No change: daily, consistency ____________, color __________, _____ once a day. Urination free, painless _____ times a day.

The nature of sleep is _________________________________________________________________.

NPR: crawls ________, shifts the toy from hand to hand _____________________________

Repeatedly pronounces syllables (babbles) _________, to the question "Where?" - finds an object _______ located in a certain place _________, drinks from a cup held by mother _______.

D o, D r R a, R p, N -

1. Nutrition: breastfeeding, artificial (mixture of ___________ by ____ gr.) after _____ hours.

Complementary foods: one-component and multi-component, vegetable puree up to 150 gr., cereals 160-200 gr., fruit purees and juices 70 gr., yolk ¼ tsp - 1-2 times / week, meat up to 30 gr.

2. Bathing daily t - 37-38 0 C, rinsing t - 35-34 0 C;

3.Toilet of the skin, nose, eyes daily; washing with water 24 0 С;

4. Complex of massage and gymnastics - No. 4;

5. Hardening: sleep in the air at t from -10 to +30 gr., air bath for 5-6 minutes; walks: daily

5. Daily vit. D 3 drops / day.

6. Daily wet cleaning, airing in the child's room;

7.Consultation of specialists:

8.Optional:

Signature m/s

Nurse patronage at 8 months Date:

Complaints: No; on the_____________________________________________________________

Feeding: 1. Breastfeeding, 2. Artificial

breast feeding, lactation sufficient, insufficient. Sucks actively, on demand, after _______ hours. Appetite is good, selective.

Artificial: a mixture of _______________ ml times;

The reason for the transfer to artificial feeding: lack of lactation, the desire of the mother, illness, mother, child, going to work, study, other __________________________.

Lure: began to introduce, introduced complementary foods No. 1,2,3, single-component, multi-component

Vegetable puree from ________________________ to ___________________________________;

Porridge __________________________________ by _________________________________;

Fruit puree from ______________________ to ___________________________________;

Fruit juice ___________________________ to ____________________________________;

Meat _________________________________ to ___________________________________.

Inspection:

The child's condition is satisfactory, unsatisfactory; Responds adequately to examination, smiles, cries Skin, mucous membranes: clean, rash _________________________________;

Nasal breathing is free, the nose is stuffy, sniffs through the nose, the mucous discharge from the nose is copious, not copious.

The abdomen is soft and painless. Chair: changes ___________________________________;

No change: daily, consistency ____________, color __________, _____ once a day. Urination free, painless _____ times a day.

The nature of sleep is _________________________________________________________________.

NPR: sits on his own and sits _________, independently stands at the support and steps over, holding on to the barrier _______________, plays with toys for a long time _________________________,

Loudly pronounces the syllables __________, at the request performs “patties”, “goodbye” _______.

D o, D r R a, R p, N -

1. Nutrition: breastfeeding, artificial (mixture of ___________ by ____ gr.) after _____ hours.

Complementary foods: one-component and multi-component, vegetable puree up to 150 gr., cereals 160-200 gr., fruit purees and juices 80 gr., meat 10-30 gr., yolk ½ hour every other day, meat up to 40 gr. + offal (liver ), cracker 10-15g., peas, dill, onion., kefir for children up to 200g.

Fish food with ______ tsp. bring to _________________ gr.

2. Bathing daily t - 37-38 0 C, rinsing t - 35-34 0 C;

3.Toilet of the skin, nose, eyes daily; washing with water 24 0 С;

4. Complex of massage and gymnastics - No. 4;

6. Walks: daily;

9.Consultation of specialists:

10.Optional:

Signature m/s

Nurse patronage at 9 months Date:

Complaints: No; on the_____________________________________________________________

Feeding: 1. Breastfeeding, 2. Artificial

breast feeding, lactation sufficient, insufficient. Sucks actively, on demand, after _______ hours. Appetite is good, selective.

Artificial: a mixture of _______________ ml times;

The reason for the transfer to artificial feeding: lack of lactation, the desire of the mother, illness, mother, child, going to work, study, other __________________________.

Lure: began to introduce, introduced complementary foods No. 1,2,3, single-component, multi-component

Vegetable puree from ________________________ to ___________________________________;

Porridge __________________________________ by _________________________________;

Fruit puree from ______________________ to ___________________________________;

Fruit juice ___________________________ to ____________________________________;

Yolk ________________________________________________________________________,

Inspection:

The child's condition is satisfactory, unsatisfactory; Responds adequately to examination, smiles, cries Skin, mucous membranes: clean, rash _________________________________;

Nasal breathing is free, the nose is stuffy, sniffs through the nose, the mucous discharge from the nose is copious, not copious.

The abdomen is soft and painless. Chair: changes ___________________________________;

No change: daily, consistency ____________, color __________, _____ once a day. Urination free, painless _____ times a day.

The nature of sleep is _________________________________________________________________.

NPR: walks with the support of both hands ________, acts with objects in different ways ______

Imitates the syllables that are in the babble of ________, finds an object upon request, takes it out of the mass of toys ______, knows his name _______, knows how to drink from a cup holding it with his hands ____. D o, D r R a, R p, N -

1. Nutrition: breastfeeding, artificial (mixture of ___________ by ____ gr.) after _____ hours.

Complementary foods: single-component and multi-component, vegetable puree up to 150 gr., cereals 160-200 gr., fruit purees and juices 90 gr., meat 10-30 gr., yolk 1/2 hour each. every other day, meat (meatballs) + offal up to 50 gr., fish 50 gr. 1-2 times a week, kefir 200 gr.,

2. Bathing daily t - 37-38 0 C, rinsing t - 34-33 0 C;

3.Toilet of the skin, nose, eyes daily; washing with water 23 0 С;

4. Complex of massage and gymnastics - No. 4;

5. Hardening: sleep in the air at t from -10 to +30 gr., air bath for 10-15 minutes;

6. Walks: daily;

7. Daily vit. D 3 drops / day.

8. Daily wet cleaning, airing in the child's room;

9. Consultation of specialists: UAC, OAM

10.Optional:

Signature m/s

Nurse patronage at 10 months Date:

Complaints: No; on the_____________________________________________________________

Feeding: 1. Breastfeeding, 2. Artificial

breast feeding, lactation sufficient, insufficient. Sucks actively, on demand, after _______ hours. Appetite is good, selective.

Artificial: a mixture of _______________ ml times;

The reason for the transfer to artificial feeding: lack of lactation, the desire of the mother, illness, mother, child, going to work, study, other __________________________.

Lure: began to introduce, introduced complementary foods No. 1,2,3, single-component, multi-component

Vegetable puree from ________________________ to ___________________________________;

Porridge __________________________________ by _________________________________;

Fruit puree from ______________________ to ___________________________________;

Fruit juice ___________________________ to ____________________________________;

Yolk ________________________________________________________________________,

Meat _________________________________by ___________________________________,

Fish ______________________, kefir __________________________________________.

Inspection:

The child's condition is satisfactory, unsatisfactory; Responds adequately to examination, smiles, cries Skin, mucous membranes: clean, rash _________________________________;

Nasal breathing is free, the nose is stuffy, sniffs through the nose, the mucous discharge from the nose is copious, not copious.

The abdomen is soft and painless. Chair: changes ___________________________________;

No change: daily, consistency ____________, color __________, _____ once a day. Urination free, painless _____ times a day.

The nature of sleep is _________________________________________________________________.

NPR: climbs on a low surface and gets off it _____________________,

Knows how to open, close, put one object into another _________, imitates different syllables of an adult __________, knows the names of body parts _________, drinks from a cup _________. D o, D r R a, R p, N -

1. Nutrition: breastfeeding, artificial (mixture of ___________ by ____ gr.) after _____ hours.

Complementary foods: single-component and multi-component, vegetable puree up to 150 gr., cereals 160-200 gr., fruit purees and juices 100 gr., meat 20-40 gr., yolk 1/2 hour each. every other day, meat (meatballs) + offal up to 50 gr., fish 50 gr. 1-2 times a week, kefir 200 gr.,

2. Bathing daily t - 37-38 0 C, rinsing t - 32-31C;

3.Toilet of the skin, nose, eyes daily; washing with water 22 0 С;

5. Hardening: sleep in the air at t from -10 to +30 gr., air bath for 10-15 minutes;

6. Walks: daily;

7. Daily vit. D 3 drops / day.

8. Daily wet cleaning, airing in the child's room;

9.Consultation of specialists

10.Optional:

Signature m/s

Nurse patronage at 11 months Date: