Postnatal Care
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Definitions
  • Term baby – between 37 – 41 weeks
  • Pre-term baby – before 37 weeks
  • Post term baby – after 42 weeks
  • Neonate – <28 days old
  • Stillbirth – dead baby delivered after 24 weeks
  • Perinatal mortality – stillbirths + deaths within first week of life
  • Neonatal mortality – deaths between 1-4 weeks
  • Low birthweight – <2500g
  • Very low birthweight- <1500g
  • Extremely low birthweight – <1000g
  • Small for age – <10th centile
  • Large for age – >90th centile
Post-natal care will vary within the UK, depending on the area, but below is a general outline of care offered. Of course, services are open at any time for concerned parents to attend. Those with identified problems are likely to attend reviews and follow-ups periodically.
For detailed info on immunisations, see Vaccinations

Newborn

Screening

Examination

  • Weight, length, head circumference (all plotted)

Health promotion / advice

  • Offer BCG and hep B vaccination if at risk
    • Hep B vaccination should be repeated at 1, 2 and 12 months
  • Feeding and nutrition advice
  • Preventing SIDSavoid overheating, cessation of parental smoking

5-6 days old

  • Screening
    • Midwife will perform the Guthrie test
    • Detects raised levels of the amino acid phenylalanine; which indicates metabolic disease

12 days old

  • Midwife visits to check general baby and family wellbeing (both physical and mental needs, chance to ask any questions)

8 weeks

  • Screening
    • The GP performs screening – pretty much identical to the new baby screening test
  • Immunisations – 2 jabs:
  • Examination
    • Length, weight, head circumference
    • Ask parents about vision / hearing
  •  General
    • Any parental concerns?

3 Months

  • Immunisations – 2 jabs:
    • [Diphtheria + tetanus +pertussis] + [polio] + [HiB]
    • Men C
  • Examination
    • Length, weight, head circumference
    • Ask parents about vision / hearing
  • General
    • Any parental concerns?
    • Discussion about weaning (should begin at about 6 months)

4 Months

  • Immunisations – 3 jabs:
    • [Diphtheria + tetanus +pertussis] + [polio] + [HiB]
    • Men C
    • Pneumococcus
  • Examination
    • Length, weight, head circumference
    • Ask parents about vision / hearing
  • General
    • Any parental concerns?

8 months

  • Screening
    • Health visit team will asses child’s development (physical, emotional, social)
    • If parents worried, hearing and vision will also be assessed.
  • General
    • Any parental concerns?
  • Examination
    • Length, weight, head circumference
    • Ask parents about vision / hearing

12 Months

  • Immunisations – 1 jab
    • [HiB + Men C]
  • General
    • Any parental concerns?
    • Discussion about weaning
  • Examination
    • Length, weight, head circumference
    • Ask parents about vision / hearing

13 Months

  • Immunisations – 1 jab
    • MMR
  • General
    • Any parental concerns?
  • Examination
    • Length, weight, head circumference
    • Ask parents about vision / hearing

2-3 years

  • Examination
    • If indicated, the health visiting team can visit to check development

3 years 4 months

  • Immunisations – 2 jabs
    • MMR
    • [Diphtheria + Tetanus + Pertussis] + [Polio]
  • General
    • Any parental concerns?
  • Examination
    • Height, weight, head circumference
    • Ask parents about vision / hearing

4-5 years (preschool)

  • Screening
    • Orthoptists for visual problems
  • General
    • Any parental concerns?
  • Examination
    • Height, weight, head circumference
    • Ask parents about vision / hearing

5 years (school entry)

  • Screening
    • Vision
    • Hearing
  • General
    • Any parental concerns?
  • Examination
    • Height, weight, head circumference
    • Furthur examination only if parental concerns

Girls 12-12

  • Immunisations

Age 13-18

  • Immunisations – 2 jabs
    • Diphtheria + Tetanus
    • Polio

References

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Dr Tom Leach

Dr Tom Leach MBChB DCH EMCert(ACEM) FRACGP currently works as a GP and an Emergency Department CMO in Australia. He is also a Clinical Associate Lecturer at the Australian National University. After graduating from his medical degree at the University of Manchester in 2011, Tom completed his Foundation Training at Bolton Royal Hospital, before moving to Australia in 2013. He started almostadoctor whilst a third year medical student in 2009. Read full bio

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