“Top 7 Child Care Tips for Infancy: Solving Common Child Healthcare Problems”

“Discover essential child care tips for infancy to tackle common child healthcare problems. Learn expert strategies to ensure your child’s well-being during their critical growth stages.”

Introduction:
Caring for a child in their infancy is crucial to laying a foundation for healthy growth and development. In this post, we’ll discuss child care strategies. We will also present solutions to address common child healthcare problems. These strategies help ensure your baby’s well-being and health during the earliest stages of life.

Child Care:

Child care plays a crucial role in ensuring the well-being of children from birth to 14 years. Infant and child mortality rates are vital indicators of a community’s health and the survival of children. Ensuring the health of children leads to healthy citizens, contributing to overall societal well-being.

Key Childhood Stages:

1. Infancy (Up to 1 year)

• Includes the Neonatal period (first 28 days) and Post-neonatal period (28 days to 1 year).

1. Pre-school Age (1 to 4 years)
2. School Age (5 to 14 years)

Each stage of development requires specific health care to guarantee growth, development, and the prevention of diseases.

Infancy:

Infant care, particularly in the neonatal period (first 28 days), is critical, as many deaths during this time are caused by factors like low birth weight, infections (e.g., respiratory infections and diarrhea), and birth injuries.

1. Immediate Care:

• Resuscitation: After birth, the baby’s airway must be cleared, and they should begin breathing within a minute. If natural breathing doesn’t start, interventions like suction, oxygen, or intubation are required. If the heart has stopped beating for more than 5 minutes, the baby is considered dead.
• Apgar Score: This is a quick evaluation of a newborn’s physical condition. It is based on five clinical signs: heart rate, respiratory effort, muscle tone, reflex response, and color. The score is taken at 1 and 5 minutes after birth.
• Score 0-3: Severe depression.
• Score 4-6: Mild depression.
• Score 7-10: No depression.

Sign	Score 0	Score 1	Score 2
Heart Rate	Absent	<100 bpm	>100 bpm
Respiratory Effort	Absent	Slow, irregular	Good, crying
Muscle Tone	Flaccid	Some flexion of extremities	Active movement
Reflex Response	No response	Grimace	Vigorous response
Color	Blue/pale	Body pink, extremities blue	Completely pink

2. Care of the Cord:

• The cord is clamped and cut about 6-9 cm from the umbilicus. To prevent infections like neonatal tetanus, sterilized instruments are used. An antiseptic is applied to the cord stump, which dries and falls off in 5 to 8 days.

3. Eye Care:

• Clean eyes with sterile wipes. Apply a drop of 1% silver nitrate or tetracycline ointment to prevent infections.

4. Skin Care:

• The first bath is given a few hours after birth. This removes vernix, meconium, and blood clots. Be careful not to wet the umbilical cord. In cold weather, bathing should be quick to avoid chilling.

5. Maintaining Body Temperature:

• Newborns are at risk of cold stress. They should be dried and wrapped immediately after birth and kept in skin-to-skin contact with the mother to maintain body temperature (36.5–37.5°C). Practices like separating the baby from the mother for long periods should be avoided.

6. Breastfeeding:

• Breastfeeding should begin within the first hour. Early breast milk, called colostrum, is nutrient-rich and contains anti-infective factors, providing protection against infections. Regular milk production starts by the third to sixth day, and on-demand feeding helps the baby gain weight.

Neonatal Examinations and Child Health

b. Neonatal Examinations:

1. First Examination:

• Done soon after birth, preferably in the delivery room.
• General condition, color, congenital abnormalities, and temperature are assessed.
• Report promptly to the Medical Officer if the next are observed:
  • Cyanosis (blue discoloration of lips and skin)
  • Birth injuries
  • Bleeding from the cord
  • Pallor
  • Breathing difficulties
  • Persistent vomiting
  • Jaundice
  • Imperforate anus
  • Signs of cerebral irritation (e.g., convulsions, eye rolling, neck rigidity, bulging fontanel)

1. Second Examination:

• Performed by a pediatrician within 24 hours.
• A thorough, head-to-toe examination of the baby.

c. Measuring the Body:

1. Birth Weight:

• Normal weight: 2.7 to 3.5 kg in most parts of India.
• Weighed within the first hour of life before weight loss occurs.
• Babies weighing less than 2.5 kg are classified as low birth weight.
• Babies lose about 10% of weight in the first 4-5 days and regain it by the 10th day.
• Weight gain: 1.2 kg per month in the first 3 months.
• Baby’s weight doubles by 5 months and triples by the end of 1 year.

1. Length (Height):

• Measured using a wooden measuring board for infants under 2 years (recumbent length).
• Taken to the nearest 0.1 cm.

1. Head Circumference:

• Measured at the largest circumference of the head (occipito-frontal diameter).
• Reflects health and development about national/international standards.

d. High-Risk Newborns:

• Low birth weight (< 2.5 kg)
• Twins
• Birth order of 5 or more
• Weight <70% of the expected weight
• Artificial feeding
• Children with PEM (Protein-Energy Malnutrition) and diarrhea
• Failure to gain weight over 3 successive months

e. Common Child Health Problems:

1. Low Birth Weight:

• Defined as <2.5 kg at birth.
• Causes: Premature birth or fetal growth retardation.
• Types:
  • Preterm: Born before 37 weeks.
  • Term: Born between 37 to 42 weeks.
  • Post-term: Born after 42 weeks.

1. Malnutrition:

• Major health issue in children, making them vulnerable to infections.
• Prevent infections like diarrhea and measles to reduce malnutrition.
• Exclusive breastfeeding for the first 6 months is crucial.

1. Infectious and Parasitic Diseases:

• Common infections: Diarrhea, ARI, tuberculosis, diphtheria, pertussis, measles, polio, and neonatal tetanus.
• Poor socio-economic conditions and inadequate sanitation contribute to high morbidity/mortality.

1. Accidents and Poisoning:

• Children are prone to accidents (e.g., burns, falls, drowning, and poisoning) at home.

1. Factors Affecting Child Health:

• Maternal health
• Family composition
• Socio-economic conditions
• Environmental factors

CHILD WELFARE SERVICES

Child welfare services focus on social work to improve the well-being and vocational training of children. These services aim to provide care and support to ensure children grow up in safe environments. Below are some key child welfare services and programs:

1. Child Survival and Safe Motherhood Programme (CSSM):

• Launched on August 20, 1992, as part of a broader safe motherhood initiative that started in 1987.
• Prioritizes improving the health of mothers and children.
• Targets 9 out of the 17 goals of the National Health Policy (1983). These goals are related to maternal and child health.

Services for Children:

• Essential newborn care.
• Immunization.
• Management of diarrhea and acute respiratory infections (ARI).
• Vitamin A prophylaxis.

Services for Mothers:

• Immunization.
• Prevention and treatment of anemia.
• Antenatal care and early identification of maternal complications.
• Trained deliveries and promotion of institutional deliveries.
• Management of obstetric emergencies.
• Birth spacing education.

Components of CSSM (The Three E’s):

• Essential Maternal Care.
• Early identification of complications.
• Emergency obstetric care.

Other Key Components:

• Resuscitation of newborns with asphyxia.
• Prevention of hypothermia and infections in newborns.
• Exclusive breastfeeding.
• Referral of sick newborns.

Goals of CSSM:

• Reduction of infant mortality rate (IMR), maternal mortality rate (MMR), and under-five mortality rates.
• Polio eradication by 2000.
• Elimination of neonatal tetanus by 1995.
• Measles prevention.
• Reduction of diarrhea-related deaths by 70% and cases by 25% by 2000.
• Prevention of 40% of ARI-related deaths by 2000.

CSSM Goals for Newborns:

• Newborn care at home, including warmth and feeding.
• 100% coverage of primary immunization by 12 months.
• Vitamin A prophylaxis with full coverage.
• Proper management of pneumonia and availability of ORS in every village.

CSSM Goals for Pregnant Women:

• 100% immunization against tetanus (TT).
• 100% coverage for anemia prophylaxis and oral therapy.
• At least three antenatal check-ups.
• Referral of complicated cases.
• Promotion of clean deliveries.
• Education on birth timing and spacing.

2. Baby Friendly Hospital Initiative (BFHI):

• Encourages breastfeeding practices and supports mothers to exclusively breastfeed their babies in the early months of life.

3. Immunization:

• Regular immunization campaigns to protect children from preventable diseases such as polio, measles, and tuberculosis.

4. Under-Five Clinics:

• Clinics focus on the health and development of children under the age of five. They offer services such as growth monitoring, immunization, and nutritional support.

5. Integrated Child Development Scheme (ICDS):

• A government program provides food, preschool education, and primary healthcare. It serves children under 6 years of age and their mothers. It aims to improve nutrition and health outcomes.

These services have a collective aim. They seek to improve child health and reduce mortality. The focus is especially on rural and underserved areas. This ensures children grow in safe, healthy environments.

2. Baby-Friendly Hospital Initiative (BFHI)

The Baby-Friendly Hospital Initiative (BFHI) is an effort by WHO and UNICEF. It was launched in 1991. The initiative aims to promote breastfeeding to improve infant and young child nutrition. BFHI aims to create an environment that supports and encourages breastfeeding practices in healthcare settings. BFHI has received support from professional medical and nursing bodies in India. It has proven successful in promoting proper infant feeding practices from birth.

Steps in Global BFHI:

1. Written Breastfeeding Policy: A policy that is regularly communicated to all healthcare staff.
2. Staff Training: Training all healthcare staff to develop skills necessary for implementing the breastfeeding policy.
3. Informing Pregnant Women: Educating pregnant women about the benefits and management of breastfeeding.
4. Initiating Breastfeeding: Helping mothers initiate breastfeeding within 30 minutes of birth.
5. Maintaining Lactation: Showing mothers how to breastfeed and maintain lactation, even if they are separated from their infants.
6. Exclusive Breastfeeding: Ensuring newborns receive no food or drink other than breast milk.
7. Rooming-In: Allowing mothers and infants to stay together 24 hours a day.
8. On-Demand Breastfeeding: Encouraging mothers to breastfeed their babies whenever the baby shows signs of hunger.
9. No Artificial Teats or Pacifiers: Avoiding the use of artificial teats or pacifiers for breastfeeding infants.
10. Breastfeeding Support Groups: Establishing breastfeeding support groups and referring mothers to them after discharge from the hospital or clinic.

3. National Immunization Programme

The National Immunization Programme is a key intervention aimed at protecting children from life-threatening, preventable diseases. Immunization helps reduce child mortality rates by preventing diseases such as polio, measles, and tuberculosis.

Current National Immunization Schedule:

Vaccine	Age
BCG, Hepatitis B, OPV-0	Birth
Pentavalent-1, OPV-1, Rotavirus-1, PCV-1	6 weeks
Pentavalent-2, OPV-2, Rotavirus-2	10 weeks
Pentavalent-3, OPV-3, Rotavirus-3, PCV-2	14 weeks
MR-1, JE-1, PCV-3	9-12 months
MR-2, JE-2, OPV-4	5-6 years
dT	10 and 15 years

4. Under-Five Clinics

Under-Five Clinics focus on comprehensive health care for children under the age of five. These clinics provide preventive, curative, and health supervision services. The clinic concept integrates prevention, treatment, growth monitoring, and education to ensure optimal child development.

Aims and Objectives:

• Prevention and Management: Prevention and treatment of acute illnesses and disorders of growth. This includes both physical and mental health and development.
• Health Education: Helping mothers through health education on how to raise healthy children.
• Growth Monitoring: Weigh children monthly during their first year of life. Weigh them every two months in the second year. Weigh them every three months thereafter up to age five.

5. Integrated Child Development Scheme (ICDS)

The Integrated Child Development Scheme (ICDS) was launched by the Ministry of Women and Social Welfare in 1975. It is aimed at improving the nutritional and health status of children aged 0-6 years. The program also provides health services for mothers and promotes early childhood education.

Objectives:

• Improve the nutritional and health status of children aged 0-6 years.
• Lay the foundation for psychological, physical, and social development.
• Reduce mortality, morbidity, malnutrition, and school dropout rates.
• Enhance the mother’s ability to care for her child through nutrition and health education.

Services Provided by ICDS:

• Health Check-ups: Regular health assessments for children.
• Immunization: Ensuring all children are vaccinated as per schedule.
• Supplementary Nutrition: Providing additional nutrition to children in need.
• Preschool Education: Offering non-formal education to prepare children for school.
• Referral Services: Referring children and mothers to specialized care when necessary.

Measures for Improvement:

• Adequate Budget Allocation: Ensuring enough funds are available to run the program efficiently.
• Community Participation: Encouraging involvement from local communities to increase the reach and impact.
• Promotion of Regularity and Quality: Improving the consistency and quality of services provided.

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FAMILY WELFARE SERVICES

Family Welfare Services encompass health and welfare programs aimed at improving the overall quality of life for families. These services include family planning, maternal and child health services, nutrition education, and more.

Key Aspects of Family Welfare Services:

• Family Planning: Focuses on responsible parenthood, birth spacing, and limiting births.
• Maternal and Child Health (MCH) Services: Offers services like immunization, antenatal care, and health education.
• National Family Welfare Program: Promotes small family norms and contraception to support socioeconomic development.

Family welfare programs play a significant role in improving health outcomes for families. They ensure the well-being of mothers and children.

Reproductive and Child Health (RCH) Programme :

The Reproductive and Child Health (RCH) Programme emphasizes several key objectives. It ensures that people can manage their fertility. The programme also focuses on women experiencing safe pregnancies and childbirth. Additionally, the outcomes should be favorable for maternal and infant health. The programme aims to allow couples to have sexual relations without fear. They should not worry about unplanned pregnancies and sexually transmitted infections.

Key Interventions under RCH:

1. Essential Obstetric Care:

• Early registration of pregnancies within 12-16 weeks.
• Regular antenatal check-ups conducted by ANMs or Medical Officers.
• Provision of safe delivery at home or institutions.
• Three postnatal check-ups to ensure recovery and detect complications.

1. Emergency Obstetric Care:

• Emergency care to reduce maternal morbidity and mortality.
• Support for 1,748 referral units with necessary equipment.

1. 24/7 Delivery Services at PHCs/CHCs:

• Staff provided with additional honorariums to ensure round-the-clock delivery services at health centers.

1. Medical Termination of Pregnancy (MTP):

• Reducing maternal morbidity and mortality caused by unsafe abortions.

1. Control of Reproductive Tract Infections (RTI) and Sexually Transmitted Diseases (STD):

• Linked with the HIV/AIDS control program in collaboration with NACO.
• Support for district labs with technicians for testing RTI/STD cases.

1. Immunization Programme:

• Continuation of Universal Immunization Programme (UIP) under RCH, providing vaccines for polio, tetanus, DPT, measles, and tuberculosis.

1. Essential Newborn Care:

• Key interventions include resuscitation for newborns with asphyxia, hypothermia prevention, infection prevention, exclusive breastfeeding, and prompt referrals for sick newborns.

1. Diarrhoeal Disease Control:

• Introduction of low-osmolarity Oral Rehydration Solution (ORS) in India.
• Zinc supplementation as an adjunct to ORS for managing diarrhea.

1. Acute Respiratory Disease Control:

• Standard case management of Acute Respiratory Infections (ARI) is integrated into the RCH program, with Cotrimoxazole supplied to health workers.

1. Vitamin A Deficiency Prevention in Children:
   • Vitamin A doses are administered to all children under five. Dosing begins at nine months of age. It continues at six-month intervals.
2. Anaemia Control in Children:
   • Infants and children up to 10 years receive iron and folic acid supplementation to prevent and manage anemia.
3. Hepatitis B Vaccination:
   • Hepatitis B vaccine introduced into the National Immunization Programme and administered alongside DPT doses.
4. Training of Traditional Birth Attendants (Dais):
   • A training scheme for Dais was initiated in 2001-02 to ensure safe deliveries, especially in rural areas. It has been expanded to cover all districts in states with high maternal and child health challenges.

This comprehensive approach aims to improve the health of mothers and children across India. It integrates maternal, newborn, and child health services with broader reproductive health interventions.

Empowered Action Group (EAG):

The Empowered Action Group (EAG) was constituted on 20th March 2001. The Ministry of Health and Family Welfare established it. The Union Minister for Health and Family Welfare acts as its chairman. The group was established to tackle health challenges in India’s most vulnerable states. It particularly focuses on reproductive, maternal, and child health.

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Reproductive and Child Health Programme (RCH) Phase II:

RCH Phase II was launched on 1st April 2005. The primary focus is on reducing maternal and child morbidity and mortality. This is especially emphasized in rural areas. The key strategies of this phase include:

1. Essential Obstetric Care:

• Institutional Delivery:
  • Fifty percent of Primary Health Centers (PHCs) were to become operational as 24-hour delivery centers by 2010. All Community Health Centers (CHCs) also aimed to function as 24-hour centers. This initiative sought to promote institutional deliveries.
  • Skilled Attendance at Delivery: WHO emphasizes skilled attendance at every birth to reduce maternal mortality.
  • Policy Decisions: Auxiliary Nurse Midwives (ANMs), Lady Health Visitors (LHVs), and Staff Nurses (SNs) can administer drugs in emergencies. This authorization aims to reduce maternal mortality.

2. Emergency Obstetric Care:

• Operationalization of First Referral Units (FRUs): All FRUs are to be made fully operational to provide emergency obstetric care.
  • Services to be Provided by FRUs:
  • 24-hour delivery services, including normal and assisted deliveries.
  • Emergency obstetric care, including caesarean sections.
  • Newborn care.
  • Emergency care for sick children.
  • Blood storage facilities.
  • Essential laboratory services.
  • Referral transport services.
• Critical Determinants of FRU Status:
  • Surgical interventions.
  • Newborn care.
  • 24-hour blood storage facility.

3. Strengthening the Referral System:

• The referral system in RCH Phase II includes multiple channels. These channels consist of local self-help groups, non-governmental organizations (NGOs), and community groups. They ensure smooth and efficient referrals for maternal and child health services.

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New Initiatives Under RCH Phase II:

1. Training of MBBS Doctors:

• MBBS doctors are trained in life-saving skills for emergency obstetric care.

1. Setting Up Blood Storage Centers:

• Blood storage centers are set up in compliance with the Government of India guidelines to support emergency obstetric care.

1. Janani Suraksha Yojana (JSY):

• Launched on 12th April 2005, this scheme is a modification of the National Maternity Benefit Scheme. Its objective is to reduce maternal and infant mortality. It promotes institutional deliveries and focuses on the healthcare needs of women from below the poverty line (BPL) households.

These strategies and initiatives aim to improve maternal and child health outcomes. They focus on expanding access to essential healthcare services. The goal is to reduce mortality rates in rural areas.

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“Top 7 Child Care Tips for Infancy: Solving Common Child Healthcare Problems”

1. Proper Nutrition for Infants

Good nutrition is essential during infancy. A well-balanced diet that includes breastfeeding or formula provides the necessary nutrients for growth and immunity.

2. Common Health Problems in Infancy

Infants can encounter various healthcare issues, such as colic, reflux, and respiratory infections. Recognizing symptoms early ensures timely treatment and improved outcomes.

3. Regular Medical Checkups

Scheduling regular pediatric appointments allows early detection of any potential health concerns, including developmental milestones and immunizations.

4. Sleep and Rest Patterns

Establishing a sleep routine is crucial for both the infant and parents. It helps regulate the baby’s circadian rhythm and prevents overtiredness, which can lead to crankiness and health issues.

5. Immunizations

Immunization plays a pivotal role in protecting infants from diseases such as measles, mumps, and rubella. Follow the recommended vaccination schedule for optimal protection.

6. Hygiene and Safety

Proper hygiene practices, such as regular hand washing and sanitizing baby items, reduce the risk of infections. Childproofing the home is also essential as infants become more mobile.

7. Emotional Bonding and Care

Emotional care is equally important for infants. Skin-to-skin contact, eye contact, and gentle talking help build trust, ensuring healthy emotional development.

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