Chowdene Children's Center activities for babies
Healthy children's programThis article is for Medical professionals
Professional reference items are intended for use by healthcare professionals. They are written by British doctors and are based on research, British and European guidelines. You can find one of ours Health items more useful.
Healthy children's program
- Families at risk
- Health and development assessments
- Health promotion
In October 2009 the Ministry of Health launched the "Healthy Child" program.1This gives comprehensive advice on health and social care throughout a child's life. It differs from the previous child health monitoring schedule in a few important ways:
- Greater focus on prenatal care.
- A focus of support for both Parents.
- Early detection of families at risk.
- New vaccination programs.2
- New focus on changing public health priorities.
The program is offered by health visitors, midwifery staff, Sure Start children's centers, general practitioners, and the primary health care team.
The "Healthy Child" program aims to:3
- Help parents develop strong bonds with children.
- Encourage care that will keep children healthy and safe.
- Protect children from serious illness with screening and immunization.
- Reduce obesity in children by promoting healthy eating and physical activity.
- Encourage mothers to breastfeed.
- Identify child health and development issues (such as learning disabilities) and safety (such as parental neglect) so they can get help with their problems as early as possible.
- Make sure the children are prepared for school.
- Identify and help children with problems that can affect their opportunities later in life.
The document contains a detailed schedule of care during pregnancy and at each point in a child's life. It contains basic general recommendations as well as additional preventive elements for children with risk factors.
Families at risk
There is a clear correlation between the number of parental disadvantage and a number of adverse effects on children (Social Exclusion Task Force, 2007).4It is estimated that around 2% of families in the UK experience five or more of the following disadvantages:
- Both parents are unemployed.
- The family lives in inferior or overcrowded apartments.
- Neither parent has an educational qualification.
- Both parents have mental health problems.
- At least one parent has a long history of limiting illness, disability or frailty.
- The family has a low income.
- The family cannot afford a variety of food and clothing.
Protective factors should also be assessed - e.g. B. Breastfeeding and authoritative upbringing combined with warmth and a loving bond between the child and the primary caregiver from infancy.
The Healthy Child program promotes the early identification of families who may have factors that could endanger the health and well-being of children and establishes additional supportive measures in addition to the universal approach at each level.
Health and development assessments
The main purpose of health and development reviews is to
- Assess your family's strengths, needs, and risks.
- Give mothers and fathers opportunities to discuss their concerns and goals.
- Assess growth and development.
- Detect anomalies.
The following are best ways to use screening tests and development monitoring, assessing growth, discussing social and emotional development with parents and children, and connecting children to early childhood care providers:
- Up to the 12th week of pregnancy.
- The newborn examination.
- The new baby rating (approx. 14 days old).
- The 6- to 8-week examination of the baby.
- At the time the child is 1 year old.
- Between 2 and 2 ½ years.
The majority of the children will be fine, but others may need more support and guidance, and a small minority will need intensive preventive care. Reviews can provide an opportunity to plan a support package with local services (e.g. at a Sure Start Children's Center) or for referral to specialized services. The Common Assessment Framework should be used when there are issues that may require assistance from more than one agency.
Health and development reviews require a wide range of topics to assess risk and protective factors and determine where further assistance is needed. These begin in pregnancy and continue with the child and the family after the birth. Topics to be dealt with are listed in the document "Healthy Child". This includes:
- During pregnancy:
- Physical health, mental health, general well-being of both parents.
- Folic acid.
- Attitudes and Concerns.
- Assessment of risks and protective factors.
- In the child:
- Physical health, growth and development (physical, social and emotional).
- Speech and language.
- Developing self-sufficiency skills and independence.
- Judgment on parental ties.
- In the family:
- Parenting ability.
- Contraception recommendation
- Financial advice.
- Housing and employment issues.
- Safety and nutrition issues.
- Family relationships.
- Family health problems.
- Assessment of risk factors within the family.
The family can be supported by initiating a discussion that includes:
- Examining the mother's and father's feelings, attitudes and expectations regarding pregnancy, childbirth and the growing relationship with the baby.
- Listen carefully to mothers and fathers and encourage them to find solutions for themselves as needed.
- Empower parents to develop effective strategies that build resilience, promote infant development, and enable them to adapt to their parenting roles.
- Give parents the opportunity to recognize and use their own strengths and those of their informal networks and, where appropriate, formal services.
The UK's prenatal and postnatal screening protocols are slightly different and can be found on the UK screening portal.5
Prenatal screening for fetal conditions should be performed according to guidelines from the National Institute for Health and Care Excellence (NICE).6This contains:
- The fetal abnormality scan.
- Screening for Down Syndrome.
- Sickle cell and thalassemia screening.
- Screening for infectious diseases (rubella, syphilis, hepatitis B and HIV).
- Immediate physical examination of the newborn after birth.
- Screening test for newborns
- Newborn blood stain. These screens for:
- Cystic fibrosis.
- Phenylketonuria (PKU).
- Sickle cell anemia.
- Congenital hypothyroidism.
- medium-chain acyl-CoA dehydrogenase deficiency (MCADD).
- Physical examination of the newborn. Ideally given around 72 hours and should include:
- Cardiac examination
- All babies should have a clinical examination for developmental dysplasia of the hip. People with a hip abnormality on examination or a risk factor should also have an ultrasound scan.
- General examination
- Caring for the parents.
Six to eight weeks baby check
This is covered in detail in a separate article Six Week Baby Check. It repeats essentially the same tests that were done on the neonatal exam.
- A review by the health visitor after 2-2½ years.
- A check by the school health service after the start of the training. These include height, weight, eyesight and hearing.
All children should have access to the routine child vaccination schedule. A register of children under 5 years of age is kept in the General Practice and Children's Health Register departments, families are invited to vaccinations and all side effects are documented in the GP register. At each contact, members of the team should determine the child's vaccination status.
The parents or caregivers should be provided with well-founded information and advice about good quality vaccinations, as well as information about their benefits and possible side effects. Any contact should be used to promote immunization.
The health promotion and primary prevention activities for young children are mainly aimed at parents as they are responsible for young children. It is still possible for information to be directed directly to children, parents, or other people. Attitudes are often formed at an early age, and even degenerative diseases like atheroma start early in life. Parents are highly motivated to do what is best for their children and so are open minded very early on, before the child is born.
Pregnancy is usually a time of high motivation and women often quit smoking. You must get all the help and support you can to quit smoking. The UK's National Formulary (BNF) states: "Use of nicotine replacement therapy during pregnancy is preferable to continued smoking, but should only be used when smoking cessation fails without nicotine replacement. Intermittent therapy is preferable to patches. Patches are useful, however if the patient experiences nausea and vomiting during pregnancy. If patches are used, they should be removed before bedtime. "7It is also a good time to bring the father to a stop. When couples can quit together, they support each other. You must have a smoke free home for the child and the money saved will be very welcome. Interventions, including psychosocial interventions to promote smoking cessation during pregnancy, are supported by Cochrane reviews.8, 9
An estimated two million children in the UK are exposed to tobacco smoke in their homes.10It is estimated that 6.5-20% are exposed to tobacco smoke in the car. This increases your risk of sudden infant death syndrome, middle ear disease, lower respiratory diseases, and asthma. It increases the prevalence of wheezing and coughing and also makes asthma worse.11
Alcohol / drugs
Alcohol consumption should be kept to a minimum, alcohol consumption should be avoided, and there is much to be commended abstention. Fetal alcohol syndrome is well known in children born to mothers who drank heavily during pregnancy, but fetal alcohol effects are a milder form of the disease and it is not certain that it is a safe level of consumption.
There is also evidence that the use of drugs such as cannabis may affect neurobehavioral and cognitive outcomes with an increased risk of attention deficit hyperactivity disorder (ADHD) and learning disabilities.12The presence of other factors may affect this. Regular participation in obstetrics is beneficial for both mother and baby.
Breastfeeding is to be encouraged because of the numerous benefits it brings.
Eating children healthily is not easy. Processed foods tend to have too much salt and sugar, and the need for coloring is dubious. Not all E numbers are harmful and some, like vitamin C and citric acid, are completely harmless. Some, like tartrazine, can cause temporary hyperactivity in vulnerable young children.13, 14The link between excessive salt consumption and high blood pressure is well established. It cannot manifest itself until later in life, but the baroreceptors can be set early. The separate article Childhood Hypertension examines risk factors for childhood hypertension.
In the past few decades, childhood obesity has gone from an uncommon observation to a national epidemic. The government's strategy to combat obesity includes a comprehensive plan of action to combat the rise in obesity at all levels.15, 16
Parents may not be aware of the fact that their child is overweight and centile charts can be invaluable. The body mass index (BMI) only applies to adults. If a parent or health professional is concerned, the child's growth should be measured and plotted using standard growth charts based on World Health Organization (WHO) standards for children 0-4 years old and UK-based growth charts for ages 2-18 Years based.17The following factors help prevent obesity:
- An assessment after 12 weeks of pregnancy, including advice on healthy weight gain during pregnancy.
- Make breastfeeding the norm for parents - Evidence shows that breastfeeding reduces the risk of obesity later in life.
- Delaying weaning until about 6 months of age, introducing healthy foods to children, and controlling portion sizes.
- Early identification of the children and families who are most at risk (for example, if the mother or father is overweight, obese, or who is experiencing rapid weight gain in the child).
- Promote an active lifestyle
- Some families require qualified professional guidance and support.
As soon as the teeth start breaking out, parents should brush them twice a day. Parents should be advised to use only one toothpaste smear. Children should be taught to brush their teeth early on, but need help and supervision when they are young:
- A good low-sugar diet and dental hygiene will reduce tooth decay.18Sugar should not be added to wean food. If possible, all medicines should be sugar-free.
- From the age of 6 months, infants should be drunk from a cup. Bottle feeding should be discouraged from the age of 1 year.
- Beverages that are sugary, including juice, should be limited and, if consumed, restricted to meal times.
- Adding fluoride to the water can reduce tooth decay by 40-60%. However, only part of the nation's water supply was treated. Toothpaste that contains fluoride should be used and the dentist can provide further advice.
The separate article Accidents and their prevention provides more details. However, some additional features are worth mentioning:
- Vehicle Safety: Ensure that children are adequately restrained in vehicles with correct height restrictions.
- Burns and scalds: Have smoke alarms. Avoid holding hot drinks when holding a baby. If a young child is mobile, use guards, a gate over the kitchen door, cordless kettles, and keep the pan handles away from the front of the range.
- Choking: Avoid toys with small parts.
- Falls: Do not lay babies on tables, beds, etc. Baby walkers should be discouraged. Use playpens instead.
- Choking Hazard: Avoid pillows if they are very small. Do not use pacifiers on a string around your neck. Keep plastic bags out of the reach of children.
- Poisoning: Keep medicines, cleaning agents, etc. inaccessible. Child protection caps help.
- Cuts: keep knife out of reach; Use safety glass in doors.
- Drowning: Do not leave a young child unsupervised in a bath or near water.
These are formed early and while quite young children can be led by word and example to consider drug use, smoking and alcohol use as stupid and undesirable, rather than as adults and advanced learners, they may be more resilient to pressures later in life.
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Further literature and references
State of health of the child in 2017; Royal College of Pediatrics and Child Health, 2017
Trust in child prevention
Sudden Infant Death Syndrome - A Guide for the Professionals; The lullaby trust
Passive Smoking and Children: A Report from the Tobacco Advisory Group; Royal College of Physicians, March 2010
Number of Sure Start Children's Centers - April 2010; Department of Education
Healthy start; GOV.UK
Healthy children's program: pregnancy and the first five years of life; Department of Health
Vaccinations - childhood; NICE CKS, November 2012 (UK access only)
Giving all children a healthy start in life: politics; Department of Health and Education, March 2013
Achieve goal: think family. Analysis and topics from the Families at Risk review; Cabinet Office, School Exclusion Task Force, 2007
UK screening programs; UK screening portal
Pregnancy care for uncomplicated pregnancies; NICE Clinical Guideline (March 2008, updated 2018)
British national formula
Lumley J., Chamberlain C., Dowswell T., et al; Measures to promote smoking cessation during pregnancy. Cochrane Database Syst Rev. 2009 July 8 (3): CD001055. doi: 10.1002 / 14651858.CD001055.pub3.
Chamberlain C, O'Mara-Eves A, Oliver S. et al; Psychosocial interventions to help women quit smoking during pregnancy. Cochrane Database Syst Rev. 2013 Oct 2310: CD001055. doi: 10.1002 / 14651858.CD001055.pub4.
Second-Hand Smoke: Effects on Children: Research Report; ASH (Measures against Smoking and Health), March 2014
Cheraghi M, Salvi S; Tobacco Smoke in the Environment (ETS) and Children's Respiratory Health. Eur J Pediatr. Aug. Aug. 2008 (8), 897-905. doi: 10.1007 / s00431-009-0967-3. Epub 2009 March 20th
Huizink AC, Mulder EJ; Maternal smoking, drinking, or cannabis use during pregnancy and neurological behavioral and cognitive functions in human offspring. Neurosci Biobehav Rev. 200630 (1): 24-41. Epub 2005 August 10th
Bateman B, Warner JO, Hutchinson E, et al; The effects of a double-blind, placebo-controlled, artificial food coloring and preservative for benzoates on hyperactivity in a preschooler population sample. Arch Dis child. June 6 (2004), 506-11.
McCann D., Barrett A., Cooper A., et al; Food additives and hyperactive behavior in 3 year old and 8/9 year old children in the community: a randomized, double-blind, placebo-controlled study. Lancet. September 5, 2007
Healthy life, healthy people. A call to action against obesity in England; Department of Health, October 13, 2011
Reducing Obesity and Improving Diet: Politics; Department of Health, March 2013
UK WHO growth charts; Royal College of Pediatrics and Child Health
Harris R, Nicoll AD, PM Adair et al; Risk factors for tooth decay in young children: systematic literature review. Community Dent Health. 2004 Mar21 (1 Suppl): 71-85.
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