Child Health and Development Record
Transcription
Child Health and Development Record
This book belongs to: Child’s name: put my photo here Welcome to your child’s health and development record How to use this record Use it to check and record your child’s: >> health and development >> growth >> vaccinations. Use it for helpful tips to: >> promote your child’s growth and development >> assist with common parenting concerns >> find where to go for help. Bring it with you: >> when attending immunisation appointments >> when you see your Child and Family Health Service nurse, your doctor or other health professional. page 2 About the record The first 5 years of a child’s life are full of special times and important milestones. These years are also the most important for your child’s brain development, which shapes their wellbeing for the rest of their life. There are charts to help you track your child’s growth over time and milestone checklists to help you follow their development. The information you record about their health and development is important if you need to see a health professional. Your Child Health and Development Record has been designed to help you as a mother, father or carer celebrate your child’s growth and development. It includes useful information on feeding, sleeping, settling, safety and how you can help your child grow and learn. This record can also be a place for special memories, photos or other keepsakes. Please keep this important record book in a safe place as it contains valuable health information that your child will need throughout their life. You can show this record to your childcare centre, preschool and Centrelink. You can download a copy of the Blue Book at www.cyh.com/bluebook page 3 About me About me My birth details My name Date of birth Name of place where I was born Time of birth / / Sex M / F Maternal information Mother’s name Father’s name Pregnancy complications Blood group Labour spontaneous / induced – reason Type of birth: (please circle) Normal Caesarean Breech Forceps Ventouse Other Post partum issues Neonatal information Gestation Apgar 1 minute Neonatal Screening Test (NNST) 5 minutes Birth weight (g) Birth length (cm) Birth head circ (cm) Card Number Vitamin K given Injection / Oral 1st dose Hepatitis B given Y / N Date given / / / / 2nd dose HBIG given Y / N / / 3rd dose Blood Group (if required) / / Pentavite (if required) Y / N Neonatal issues Going home Only breastmilk Y / N Infant formula Y / N Breastmilk + infant formula Y / N Additional feeding information Discharge notes Date of discharge / / Discharge weight (g) Discharge length (cm) Head circ (cm) page 5 Newborn examination My name Check Date of birth / / Postnatal day Date of examination / / Comment Head shape Neck Eyes (red reflex) Ears Mouth and palate Cardiovascular Central colour Femoral pulses R/L Respiratory Abdomen and umbilicus Anus Genitalia Testes fully descended R/L Limbs and spine Hips Skin Neurological, including reflexes, responsiveness/tone Healthy term infant Serum Bilirubin >350 (jaundice) AABR required Y / N Pre-term or sick infant Serum Bilirubin >250 (jaundice) AABR required Y / N page 6 My family Fill in the names of the important people in my life. me page 7 My family health Use this page to record information on the health of your child’s family. Mother Father Brothers Sisters Hearing Vision Dental Allergies Asthma Other page 8 Record of my child’s health Use this page to record any illnesses, injuries, surgery. Date Health issue Treatment page 9 Immunisation Immunisation Immunisation What is immunisation and why does my child need it? Immunisation is a simple, safe and effective way to protect children (and adults) from serious diseases. Immunisation involves giving vaccines to use the body’s natural defence mechanism – the immune response – to build resistance to specific infections that can cause serious illness and even death. What vaccinations should my child have and when? The National Immunisation Program recommends a number of vaccines for all children at certain times. These vaccines are listed on pages 14 – 15 and are available free for all Australian children at birth, 2, 4, 6, 12 and 18 months and again at 4 years of age. To provide earlier protection for your baby, vaccines due at 2 months can be given to babies from 6 weeks of age and the vaccines due at 4 years can be given to children from 3½ years of age. Children born prematurely or who have long-term illnesses may need extra vaccines as they are at an increased risk of complications from these illnesses. If you are unsure, check with your doctor, nurse or health care worker. Don’t delay! To offer the best protection, it is important for your child to be vaccinated at the recommended times rather than delaying or only giving some of the vaccines. If these vaccinations are not given at the right time your child may not be protected against harmful diseases. If you miss a date, contact your immunisation provider straight away to discuss and organise your child’s vaccinations. What if my child is Aboriginal? Be sure to tell the doctor, nurse or health care worker if either parent identifies as Aboriginal as your child may need extra vaccinations at 12 and 18 months of age to give them added protection. page 11 Is vaccination safe? Vaccines, like any other medicine can have side effects. Most reactions, such as soreness at the injection site or a slight fever, are mild and short lasting. Your immunisation provider will explain what reactions there might be after a vaccination and what to do if you are worried. Serious side effects are extremely rare but may include allergic reactions (including anaphylaxis). It is important for you to wait 15 minutes after vaccinations so your child can be observed for any reactions. Your immunisation provider is trained to recognise and manage any immediate, severe reactions. Where do I go to get my child vaccinated? Are the vaccines free? Check with your doctor, local council or community health service. The vaccines listed on pages 14 – 15 are free for all Australian children who are eligible to hold a Medicare card. Immunisations provided by local councils and community health services are free. Many doctors also provide childhood immunisations for free, but some may charge a fee for the consultation. For more information about possible side effects: What my immunisation provider will ask me before my child can be vaccinated >> call the SA Health Immunisation Section on 1300 232 272 Monday to Friday 8.30 am – 5.00 pm Before any immunisation takes place your doctor or nurse will ask you some questions: >> call healthdirect Australia outside of business hours on 1800 022 222 >> if you understood the information given to you about immunisation >> read the Immunisation myths and realities booklet www.immunise.health.gov.au >> if you need more information before you decide whether to go ahead with vaccination >> read information on the National Centre for Immunisation Research and Surveillance (NCIRS) website www.ncirs.edu.au >> if you agree for your child to be vaccinated. Discuss any concerns you may have about the vaccines or diseases before your child is vaccinated. page 12 Why do I need to keep a record of my child’s vaccinations? It is important to keep a record of your child’s vaccinations as you may need to provide proof of your child’s vaccination history to enter childcare, kindergarten or school. It may also be useful to your child when they are an adult. Take this book along each time your child is immunised so the vaccines given can be recorded. School-based immunisation program and other vaccinations In South Australia, vaccines on the National Immunisation Program for adolescents are delivered by local government or a health service through a school-based immunisation program. Records of school-based and other vaccines your child may receive, for example annual influenza and / or vaccines required for overseas travel, can be recorded on page 19. For more information >> Call the SA Health Immunisation Section, on 1300 232 272 Monday to Friday 8.30 am – 5.00 pm. >> Outside of these hours, healthdirect Australia is able to offer advice on 1800 022 222. >> Visit www.immunise.health.gov.au and / or www.ncirs.edu.au >> The science behind immunisation www.science.org.au/policy/immunisation >> For travel immunisation advice visit www.smartraveller.gov.au Immunisation records are important to keep for childcare, kindergarten, school, university, travel and employment. page 13 South Australian Childhood Immunisation Schedule July 2013 The National Immunisation Program is subject to change. Your immunisation provider will have the most current information. Age Dose no. Disease Vaccine Birth (0 – 7 days) Birth Hepatitis B HB Vax II Paediatric 6 weeks – 2 months 1st Diphtheria, Tetanus, Pertussis, Haemophilus Influenzae type b (Hib), Hepatitis B, Polio Infanrix hexa 1st Pneumococcal Prevenar 13 1st Rotavirus RotaTeq 2nd Diphtheria, Tetanus, Pertussis, Haemophilus Influenzae type b (Hib), Hepatitis B, Polio Infanrix hexa 2nd Pneumococcal Prevenar 13 2nd Rotavirus RotaTeq 3rd Diphtheria, Tetanus, Pertussis, Haemophilus Influenzae type b (Hib), Hepatitis B, Polio Infanrix hexa 3rd Pneumococcal Prevenar 13 3rd Rotavirus RotaTeq 1st Measles, Mumps, Rubella (MMR) M-M-R ll / Priorix 1st / 4th Haemophilus Influenzae type b (Hib) / Meningococcal C Menitorix 4 months 6 months 12 months page 14 South Australian Childhood Immunisation Schedule Age Dose no. Disease Vaccine 12 months Aboriginal children only 1st Measles, Mumps, Rubella (MMR) M-M-R ll / Priorix 1st / 4th Haemophilus Influenzae type b (Hib) / Meningococcal C Menitorix 4th Pneumococcal Prevenar 13 1st Hepatitis A Vaqta Paediatric 18 months 2nd / 1st Measles, Mumps, Rubella/Varicella (Chicken Pox) MMRV 18 months Aboriginal children only 2nd / 1st Measles, Mumps, Rubella/Varicella (Chicken Pox) MMRV 2nd Hepatitis A Vaqta Paediatric 3½ – 4 years 4th Diphtheria, Tetanus, Pertussis, Polio Infanrix IPV The term Aboriginal is inclusive of Aboriginal and Torres Strait Islander People. page 15 Immunisation record (to be completed by doctor or nurse) My name Date of birth Age Dose No. Immunisation Birth (0 – 7 days) Birth Hepatitis B 1st Diphtheria, Tetanus, Pertussis, Haemophilus influenzae type b (Hib), Hepatitis B, Polio LL/RL 1st Pneumococcal (13vPCV) LL/RL 1st Rotavirus 2nd Diphtheria, Tetanus, Pertussis, Haemophilus influenzae type b (Hib), Hepatitis B, Polio LL/RL 2nd Pneumococcal (13vPCV) LL/RL 2nd Rotavirus 6 weeks – 2 months 4 months / Batch number / Medicare number Date given Next due Provider signature / stamp LL/RL (Oral) (Oral) page 16 Immunisation record (to be completed by doctor or nurse) My name Age 6 months 12 months Date of birth Dose No. Immunisation / Batch number 3rd Diphtheria, Tetanus, Pertussis, Haemophilus influenzae type b (Hib), Hepatitis B, Polio LL/RL 3rd Pneumococcal (13vPCV) LL/RL 3rd Rotavirus 1st Measles, Mumps, Rubella LA/RA/LL/RL 1st / 4th Meningococcal C / Haemophilus influenzae type b (Hib) LA/RA/LL/RL / Medicare number Date given Next due Provider signature / stamp (Oral) page 17 Immunisation record (to be completed by doctor or nurse) My name Age 12 months Aboriginal children only 18 months 18 months Aboriginal children only 3½ – 4 years Date of birth Dose No. Immunisation / Batch number 1st Measles, Mumps, Rubella LA/RA/LL/RL 1st / 4th Meningococcal C / Haemophilus influenzae type b (Hib) LA/RA/LL/RL 3rd Pneumococcal (13vPCV) LA/RA/LL/RL 1st Hepatitis A 2nd / 1st Measles, Mumps, Rubella / Varicella (Chickenpox) LA/RA 2nd / 1st Measles, Mumps, Rubella / Varicella (Chickenpox) LA/RA 2nd Hepatitis A 4th Diphtheria, Tetanus, Pertussis, Polio LA/RA / Medicare number Date given Next due Provider signature / stamp LA/RA/LL/RL LA/RA page 18 Additional vaccinations (for example influenza, travel vaccines) Age Dose No. Immunisation / site given Batch number Date given Next due Provider signature / stamp page 19 Hearing Hearing Things to look for with your baby’s hearing Does your baby: from birth startle to a loud noise? show an awareness of the sound of voices by 2 months? search for sound with their eyes by 4 months? respond to sound by turning their head by 6 months? Remember, if your baby was born prematurely, adjust their age for prematurity to see what you can expect them to be doing. If you are worried about your child’s hearing see your doctor. page 21 Hearing screening and assessment Universal neonatal hearing screening (newborn hearing screen) Hearing screen results Pass (P) Refer (R) Decline (D) No test (N) All babies have a hearing screen soon after birth. It is very important to find out early if your baby has a hearing loss so that they can be treated if needed. Neonatal hearing screening is quick, free and results are available straight away. Please tick OAE AABR Please tick OAE AABR Left ear Left ear Check to see if your baby has had a screen, and what the result was. Your baby should have at least one of the indicated hearing screens. Date Please tick OAE AABR Please tick OAE AABR If your baby has not had a hearing screen, contact the Universal Neonatal Hearing Screening program on (08) 8303 1585 (Monday – Friday office hours). Left ear Left ear It’s best to have the screen as soon as possible after your baby is born. If you miss this, call (08) 8303 1585 to make a time. This screen can be done up to 6 months of age, although younger is better. Right ear / Date / Right ear Date / Date / Right ear / / Right ear / / 12 month Hearing Assessment Service Appointment recommended Yes / No Date / / Signature Please refer to criteria overleaf. page 22 Universal neonatal hearing screening results Pass Your baby showed a clear response to sound in both ears during the screening tests. Refer Follow-up with the Hearing Assessment Service is recommended at 12 – 15 months of age if any of the following risk factors are identified, even if they have passed the universal neonatal hearing screening: If referred on the follow-up screening the Universal Neonatal Hearing Screening program will contact you to arrange for further diagnostic hearing tests for your baby. This test takes anywhere from 2 to 4 hours and testing requires your baby to be asleep for part of the appointment. Please ensure your baby does not have a sleep before the appointment. We recommend feeding your baby upon arrival or just before the appointment to ensure your baby is settled. >> a close relative (child’s parent or sister/brother, child parent’s sisters/brothers or their children) has a congenital hearing impairment >> significant head injury >> any disorder affecting the brain or nerve pathways >> any syndrome known to be related to hearing loss, such as Down Syndrome >> Meningitis/Encephalitis >> Congenital infection during pregnancy (Cyto Megalo Virus (CMV), Toxoplasmosis, Rubella, Herpes Simplex, Syphilis) >> admission to neonatal intensive care unit and ventilated for more than 3 days >> aminoglycoside antibiotics (such as Gentamicin) administered for 3 days or more at the time of screening >> jaundice requiring exchange transfusion >> parental concern about the child’s hearing. Please read the Universal Neonatal Hearing Screening brochure given to you at the first hearing screen. For more information or to make an appointment please contact the Hearing Assessment Service on (08) 8303 1530. Your baby did not show a clear response to sound during the screening tests. If referred on the first newborn screen, the Child and Family Health Service will contact you to arrange follow-up screening. This will occur separately to any other services you may or may not have consented to receive from the Child and Family Health Service. page 23 Growth charts Growth charts Growth charts Babies grow quickly, especially over the first 12 months. Once your baby is a toddler (1 – 3 years) their growth will slow down. turns 2, your health professional may also plot their Body Mass Index (BMI), which gives an indication of healthy weight or if your child is at risk of being overweight. It’s a good idea to record your child’s growth over time. You can plot their weight and height at different ages and see if they follow a growth curve. This is more important than where they are on the chart at any one time. Talk with your health professional Measuring growth You can weigh your baby yourself, at your Child and Family Health Service centre or a chemist. Once a month is usually enough as it is normal for weight to go up and down from day to day. If you need help with this, make a time with your Child and Family Health Service nurse. Until your baby turns 1, weigh them without clothes to give an accurate weight. Plotting growth Your doctor or Child and Family Health Service nurse can explain how to plot the graphs and can pick up on any growth problems (such as underweight or overweight) by looking at your child’s growth chart. After your toddler If you are worried about your child’s weight or height, or if your child seems to be dropping or increasing percentiles, see your health professional to discuss this with them. If your child is sick or has a health problem, this can affect their growth ‘Percentiles’ are and development. If your measurements that show baby was born prematurely, where your child’s growth their age needs to be is compared with others. corrected when plotting on If your child is in the 50th the chart until they turn 2. percentile, it means that 50% of babies of the same age are heavier and the other 50% are lighter. page 24 cm 50 49 48 47 46 45 44 43 42 41 40 39 38 37 36 35 34 33 32 31 30 cm 3 4 5 6 7 8 Age (months) 98th 90th 75th 50th 25th 10th 5th 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Percentiles Girls head circumference-for-age percentiles 2 Birth to 24 months Birth 1 SOURCE: World Health Organisation Child Growth Standards http://www.who.int/childgrowth/en page 25 18 cm 51 50 49 48 47 46 45 44 43 42 41 40 39 38 37 36 35 34 33 32 31 30 cm 3 4 5 6 7 8 Age (months) 98th 90th 75th 50th 25th 10th 5th 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Percentiles Boys head circumference-for-age percentiles 2 Birth to 24 months Birth 1 SOURCE: World Health Organisation Child Growth Standards http://www.who.int/childgrowth/en page 26 cm 100 98 96 94 92 90 88 86 84 82 80 78 76 74 72 70 68 66 64 62 60 58 56 54 52 50 48 46 44 42 40 cm 4 5 6 5th 7 8 10th 25th 50th 75th 90th 98th Birth to 24 months 3 Percentiles 2 Age (months) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Girls length-for-age percentiles Birth 1 SOURCE: World Health Organisation Child Growth Standards http://www.who.int/childgrowth/en page 27 cm 100 98 96 94 92 90 88 86 84 82 80 78 76 74 72 70 68 66 64 62 60 58 56 54 52 50 48 46 44 42 40 cm 3 4 5 6 98th 90th 75th 50th 25th 10th 8 5th 7 Age (months) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Boys length-for-age percentiles 2 Percentiles Birth to 24 months Birth 1 SOURCE: World Health Organisation Child Growth Standards http://www.who.int/childgrowth/en page 28 kg 20 19 18 17 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 3 4 5 6 98th 90th 75th 50th 25th 10th 8 5th 7 2 3 4 5 6 7 8 9 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Girls weight-for-age percentiles 2 Percentiles Birth to 24 months Birth 1 0 kg Age (months) SOURCE: World Health Organisation Child Growth Standards http://www.who.int/childgrowth/en 10 11 12 page 29 1 kg 20 19 18 17 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 0 kg 4 5 6 98th 90th 75th 50th 25th 8 10th 5th 7 Age (months) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Boys weight-for-age percentiles 2 3 Percentiles Birth to 24 months Birth 1 SOURCE: World Health Organisation Child Growth Standards http://www.who.int/childgrowth/en page 30 cm 180 175 170 165 160 155 150 145 140 135 130 125 120 115 110 105 100 95 90 85 80 75 70 cm 2 5 6 98th 90th 75th 50th 25th 10th 5th 7 8 2 9 3 10 4 115 126 13 7 14 8 15 9 1610 17 11 1812 Girls height-for-age percentiles 4 Percentiles 2 to 18 years 3 Age (years) SOURCE: Developed by the National Center for Health Statistics in collaboration with the National Center for Chronic Disease Prevention and Health Promotion (2000) http://www.cdc.gov/growthcharts 13 14 page 31 1 18 cm 190 185 180 175 170 165 160 155 150 145 140 135 130 125 120 115 110 105 100 95 90 85 80 cm 2 5 6 98th 90th 75th 50th 25th 10th 5th 7 8 2 9 310 4 11 5 12 6 13 7 14 815 916 1017 1118 12 Boys height-for-age percentiles 4 Percentiles 2 to 18 years 3 Age (years) SOURCE: Developed by the National Center for Health Statistics in collaboration with the National Center for Chronic Disease Prevention and Health Promotion (2000) http://www.cdc.gov/growthcharts 13 14 page 32 1 18 kg 100 95 90 85 80 75 70 65 60 55 50 45 40 35 30 25 20 15 10 5 0 kg 2 5 6 7 98th 90th 75th 50th 25th 10th 5th 8 9 10 11 122 133 144 155 166 Girls weight-for-age percentiles 4 Percentiles 2 to 18 years 3 Age (years) 177 SOURCE: Developed by the National Center for Health Statistics in collaboration with the National Center for Chronic Disease Prevention and Health Promotion (2000) http://www.cdc.gov/growthcharts 188 9 10 page 33 11 18 kg 105 100 95 90 85 80 75 70 65 60 55 50 45 40 35 30 25 20 15 10 5 0 kg 2 5 6 98th 90th 75th 50th 25th 10th 5th 7 8 9 10 11 12 Boys weight-for-age percentiles 4 Percentiles 2 to 18 years 3 Age (years) 13 14 15 16 17 SOURCE: Developed by the National Center for Health Statistics in collaboration with the National Center for Chronic Disease Prevention and Health Promotion (2000) http://www.cdc.gov/growthcharts 18 page 34 Help me grow and learn Help me grow and learn Help me grow and learn Children need help to grow and learn from their mothers and fathers, grandparents, aunties, uncles and other special people in their lives. Play is an important way in which children learn. You can include play and learning into your everyday activities right from birth. Ideas for play: Children respond well to consistent ways of doing things and being responded to. This will help them understand what is happening and what to expect. Let them know about what is going to happen that day and when plans change. If you need further help or are worried about anything else, visit a Child and Family Health Service nurse or your doctor. >> singing simple songs >> naming and playing with toys >> making games of finding things >> counting things. Children benefit from you talking, reading and sharing picture books with them from birth. Ideas for talking: It’s never too early to start reading to your child. Find out more at www. thelittlebigbookclub. com.au >> when you are bathing them or changing their nappy >> when you are preparing their meals >> when you are out for a walk. page 35 Sleep Babies and toddlers vary a lot in how much they sleep. Newborns wake at night several times for feeds. As they get older they sleep more and wake less at night. Toddlers may still wake and need your help to go back to sleep. Regular quiet activities in the lead up to bedtime can help children of all ages go to sleep. Consider including things like bathing, cleaning teeth, reading a story, singing a song, and having cuddles. Providing a safe sleeping environment is really important – it reduces the risk of SIDS (Sudden Infant Death Syndrome), suffocation, falling and being injured by other hazards. Whenever you put your baby down to sleep make sure they are: >> on their back (never on the front or side) with their head and face uncovered and their feet at the end of the cot >> in a cot that meets Australian Standards without any soft items that could suffocate them (for example pillows, doonas, bumpers, sheep skins and soft toys) >> not exposed to cigarette or other smoke >> in a cot away from curtain and blind cords and other hazards, with light bedding tucked in securely or in a baby ‘sleeping bag’ >> in the same room as the parents for the first 6 to 12 months. Babies Toddlers Preschoolers >> give signs such as eye rubbing, yawning and grizzling when they are tired and need sleep >> may still wake at night, and be unable to get back to sleep without your help >> cry as part of normal development. This seems to increase around 6 to 8 weeks and settle by 12 weeks >> may give up their day sleep around 3 years >> usually grow out of night waking by the time they are 3 or 4 when they feel more secure being by themselves >> can sleep about 5 hours (Midnight to 5.00 am) which is considered to be ‘sleeping through the night’. >> may start climbing out of their cot. Move them to a bed when this happens. >> may find it harder to relax and go to sleep. Avoid exciting or stimulating activities before bed. For information on sleep and helping your child to settle, go to www.cyh.com or www.sidsandkids.org or see your Child and Family Health Service nurse. page 36 Settling Babies often cry more than their parents expect. You may need to try different ways to try and settle your baby. Ways to settle and calm your baby, include: >> feeding >> rocking (in your arms, in a rocker, in a pram, in a baby carrier / sling) >> patting >> gentle talking, humming, singing >> gentle massage >> settling holds such as over the arm or in a ‘C’, see www.cyh.com for examples If you are feeling tense, frustrated and upset place your child safely in a cot, take a break and give yourself time to calm down, or get someone else to help you. See your Child and Family Health Service nurse if you are having problems with settling your baby. STOP! NEVER SHAKE A BABY, it can damage their brain. >> wrapping – make sure the wrap is cotton or muslin and not too tight. Leave enough room for their legs to bend with knees apart to help their hips develop normally. Visit www.sidsandkids.org for more information on how to safely wrap your baby >> a safe infant sleeping bag – these can be used from birth and are recommended when they start to roll from their back to their front (they need to fit the neck well, have armholes, no hood and have enough room for their legs to bend with knees apart). page 37 Healthy eating Children will grow best when they are well fed. Breastmilk is the healthiest way to feed your baby. The only safe alternative is infant formula. Signs that your baby is feeding well are that they are gaining weight, have plenty of wet and pooey nappies each day, have pale wee, and are alert and content at least for some of the time. In hot weather your baby may need more feeds to keep them hydrated. Eating together as a family can help your child learn to enjoy healthy foods. As they grow older encourage them to help you choose fruit and vegetables, watch or help you make meals, or play games and read stories about good food. Choking is a risk at any age. Children under 4 do not have back teeth to chew and grind food. It is important to supervise your child when they are eating. Make sure they don’t eat when they are running or playing, laughing or crying. Babies Toddlers Preschoolers >> Every extra month you feed your baby breastmilk is a bonus for their health. >> The best drinks are breastmilk, cool boiled tap or rainwater, or full cream cow’s milk from a cup. >> Let your child decide when they have had enough to eat – don’t force them to eat or bribe them with dessert as a reward. >> If you are breastfeeding, avoid drinking alcohol. >> For more information on breastfeeding and alcohol visit www.breastfeeding.asn.au >> For information about expressing breastmilk visit www.breastfeeding.asn.au >> Babies need solids from about 6 months. Try different family food types and textures as they grow older. >> If your baby is drinking formula milk, they can stay on their first type and don’t need to change to ‘follow on’ formulas. >> Encourage them to drink about 2 cups of >> Take healthy snacks like fruit and milk (or equivalent yoghurt or cheese) a day. vegetables, sandwiches, cheese and crackers when you’re on the go or for >> Drinking too much milk will take up the childcare or preschool. tummy space they need for healthy food. >> Encourage them to feed themselves, to eat slowly and chew well. >> It is common for them to be fussy with food. >> Avoid fruit juice – offer fresh fruit instead. >> For more information on healthy eating visit www.raisingchildren.net.au/ nutrition/newborns_nutrition.html and www.gofor2and5.com.au >> For information about preventing choking visit www.cyh.com page 38 Safety Babies and children need their mothers and fathers and other important people to keep them safe. Watch out for your baby / child at all times. Smoking around your child can damage their health. One of the best things you can do for your child is to quit smoking. For help call the Quitline on 13 78 48. Babies >> Make sure they sleep on their back (never on the front or side) in a cot. It is recommended that the cot is in the same room as the parents for the first 6 – 12 months. >> Use a correctly fitted capsule / car seat on every car trip. >> Check the cot is safe and meets Australian Standards. >> Protect your baby from burns and scalds from things like hot water, hot drinks and the sun. >> Keep the cot clear of items that could cause suffocation such as pillows, quilts, doonas, bumpers. Less in the cot is best! >> Keep blind cords and other hazards up and away from the cot. >> Never leave them unattended on the change table or any raised surface – they may roll and fall off. >> Never leave them unattended in a bath or with animals such as cats and dogs. Toddlers >> Watch them at all times when they are near water (including baths, buckets, wading pools, swimming pools). >> Keep all medicines and household chemicals (such as those used for cleaning) up high and out of reach in a locked cupboard. >> Empty baths, buckets and wading pools after each use and fence backyard pools. >> Watch them in the driveway. Make sure you know exactly where they are before moving the car. >> Keep hot things out of reach to prevent burns. >> Use a full harness with high chairs, swings and prams. >> Secure TVs and heavy furniture like bookshelves and cabinets so they don’t topple on children. >> Put a safety gate at the top and bottom of stairs to prevent falls. >> Supervise your child with animals / pets. page 39 Safety Preschoolers >> Set up play equipment on a soft surface and close to the ground. >> Teach your child their full name and address and get them to practise it. >> Always supervise your child crossing the road and in car parks, when they are around dogs (especially when the dog is eating) and when they are in the kitchen (keep them away from hot stoves, sharp knives, detergents). >> Make sure your child wears a helmet every time they ride a bike or scooter. >> Children must be in a car seat until they are 7 years old. Use an approved car seat on every trip. >> Young children should not use a stove or microwave as they may burn themselves. Keep matches and lighters out of reach. >> For more information on keeping your child safe visit www.kidsafesa.com.au or www.sidsandkids.org.safe STOP! Never leave your child unattended in the car. It’s not safe. page 40 Caring A child’s brain develops best when someone is there to care and meet their needs. Responding to them lovingly and quickly helps to develop their trust and security – it does not mean you are spoiling them. The involvement of dads and other family members is important for children’s development. They can share the parenting and get involved in play, reading, bathing and settling. Babies Toddlers Preschoolers >> communicate what they want by sounds and movements >> are full of energy, are curious and love exploring their world >> are learning to follow simple rules but may need gentle reminders >> have times when they develop faster. These times are called ‘wonder weeks’ and they can be a bit fussier at this time. Find out more about wonder weeks from www.cyh.com >> like to be active, play games with balls, go for walks, and practice jumping, and running >> are increasing their attention span and can stay ‘on task’ for a while >> love to play – try to fit play times in during your day and while you’re doing everyday activities. >> are interested in other children but don’t really understand how to play together >> need loving care and your attention. Caring for your baby takes a lot of your time but try to find some time for other important people in your life as well. >> like to help with household tasks >> commonly have temper tantrums when they are frustrated or cross >> are generally ready to be toilet trained between 2 and 3 years old. Be patient with accidents as they learn. >> are still learning to manage their feelings and may shift suddenly from being happy to sad >> may show their independence by making demands or bossing others >> may be getting ready to go to school – help them by talking about school and showing them where it is. >> show or tell you what they prefer – give choices that you are happy with, set limits and be consistent. For ideas on fun games and activities for you and your child, visit www.cyh.com or www.raisingchildren.net.au page 41 Teeth and dental health Looking after your baby’s teeth helps give their adult teeth a good start. Care for your baby’s teeth by: >> cleaning their teeth when they first appear with a small soft toothbrush or clean cloth >> avoiding toothpaste until 18 months >> using only breastmilk, water or formula in their bottle. Avoid fruit juice, cordial and fizzy drinks. >> not putting your baby to bed with a bottle – this is the main cause of tooth decay in children under 5 years. If your baby uses a dummy, clean it under running water (not in your mouth) to avoid the transfer of germs that cause tooth decay. For your toddler or preschooler: >> Brush teeth twice a day, after breakfast and before going to bed. Use a low-fluoride children’s toothpaste and a small soft brush. >> Lift your toddler’s lip once a month to check for early signs of tooth decay. White lines on the tooth near the gum line can be the beginning of decay. See your dentist or visit the SA Dental Service if you are concerned. >> Choose food and drinks that are low in sugar. Sugary food and drinks cause tooth decay. Your baby can start to drink from a cup from 6 months and after 12 months can have all drinks from a cup. page 42 Your baby’s tooth chart This chart is a guide but every baby is different and your baby’s teeth may come through in a different order or at a different age. Don’t be concerned if this is the case. At around 12 – 18 months arrange a time with the School Dental Service or your private dentist for their first dental check. To contact the School Dental Service visit www.sadental.sa.gov.au for a list of school dental clinics or telephone (08) 8222 8222. All dental care provided by the School Dental Service for babies, toddlers and preschoolers is free. This material has been reproduced with the permission of the SA Dental Service. page 43 My health and development My health and development Watching your child’s development Children develop at different rates. Some will learn and develop more quickly than others. Some will do more difficult things before simple things. It is important to give your child opportunities to develop. Visit www.raisingchildren.net.au and www.cyh.com for lots of ideas about the things you can do with your child to help them grow and learn. The milestones on the following pages are a guide to what your child should be learning and doing at different stages. You can either tick the box and / or note the age that your child can do these. Around 6 – 9 months and 18 – 24 months are a key age to check your child’s development. You know your child best. If you think your child is not reaching their milestones at any stage or needs a health check, don’t wait, make a time to see your Child and Family Health Service nurse. Take this book with you – it might help you explain why you are worried. Child and Family Health Service supports parents in caring for their child. Any issues can be discussed with your Child and Family Health Service nurse. Telephone Child and Family Health Service on 1300 733 606 for an appointment. Services are free. If your baby was born prematurely, adjust their age for prematurity to see what you can expect them to be doing. For example if your baby was 2 months (8 weeks) premature, at 6 months of age, expect them to be doing the things that a 4 month old baby would do. page 44 Learning to talk and connect Babies Toddlers Preschoolers make different cries for hunger and pain wave bye-bye (12 – 15 months) take turns when talking with others (1 – 5 months) laugh or chuckle (2 – 3 months) make sounds (such as ‘bub-bub-bub’) to people (4 – 7 months) look for their family or pets when named (6 – 8 months) make a sound to get attention (7 – 8 months) recognise their name (9 – 10 months) respond to simple requests like ‘where is the ball?’ (9 – 14 months) move to music (11 – 12 months) talk to themselves when alone (11 – 12 months) use 1 clear word with a meaning such as ‘mama’ or ‘dada’ (11 – 14 months) point or gesture to show what they want (12 – 19 months) point to simple body parts such as nose or tummy when asked (15 – 22 months) use 15 or more words, name some objects and talk more clearly (17 – 21 months) enjoy nursery rhymes and try to sing simple songs (18 – 23 months) use a name to refer to themselves (18 – 24 months) follow 2-step instructions such as ‘put on your shoes and get your hat’ (18 – 24 months) put 2 words together such as ‘go bye-bye’, ‘push car’ (20 – 24 months) say how objects are used for example a cup for drinking (26 – 32 months) enjoy telling stories and reading favourite books (28 – 36 months) (36 – 50 months) use ‘I’, ‘me’ & ‘mine’ (36 – 50 months) understand some ‘time’ words such as ‘morning’, ‘afternoon’, ‘today, ‘tomorrow’ (36 – 50 months) use sentences of about 6 words with mostly correct grammar (42 – 54 months) speak clearly enough to be understood by anyone (42 – 54 months) use language when playing with other children (48 – 60 months) talk about things that are happening, have happened or might happen (54 – 66 months) explain why something happens such as ‘Mum’s car stopped because the petrol ran out’ (54 – 66 months) follow 3 directions such as ‘stand up, get your bag and wait by the door’ (54 – 66 months) say how they feel (54 – 66 months) page 45 Milestones Milestones Learning to move and be active Babies Toddlers Preschoolers kick their legs well (0 – 3 months) kneel on the floor (11 – 13 months) jump off 2 steps and land with feet lift their head up when lying on tummy walk backwards (12 – 21 months) (0 – 3 months) lift their head and shoulders when lying on tummy (2 – 4 months) lie on their back and play with their feet (5 – 6 months) pull themselves around using their forearms while lying on tummy (5 – 7 months) walk by themselves without support (13 – 15 months) bend over to pick up a toy without falling over (16 – 23 months) kick a ball forward (18 – 25 months) jump with both feet off the ground at once (22 – 30 months) together (32 – 50 months) climb on play equipment (36 – 48 months) balance on either leg for 3 seconds (36 – 48 months) hop 3 times on 1 foot (36 – 50 months) run fast outdoors avoiding obstacles (36 – 50 months) roll over from back to tummy (6 – 8 months) catch a large ball with both hands sit on their own (8 – 9 months) (24 – 26 months) jump over low objects without falling crawl forward or bottom shuffle kangaroo hop with 2 feet together (8 – 10 months) pull themselves up holding onto furniture (6 – 11 months) move around holding onto furniture (9 – 13 months) ride a pedal bike or pedal toy (24 – 36 months) walk upstairs using alternate feet (24 – 30 months) get up from kneeling without using hands for support (25 – 32 months) (36 – 50 months) (36 – 54 months) walk down stairs using alternate feet (36 – 54 months) run to kick a medium-sized ball (40 – 50 months) page 46 Learning to use my hands Babies Toddlers Preschoolers use their arms equally (0 – 2 months) put a round piece back in a simple puzzle hold a pencil with their finger and thumb look at their hands (2 – 3 months) reach for a toy and hold briefly (4 – 5 months) shake a rattle (4 – 8 months) transfer a toy from 1 hand to the other (5 – 7 months) practice dropping objects (8 – 10 months) bang objects together (8 – 12 months) poke things with their pointing finger (9 – 12 months) put objects in containers (10 – 11 months) pick up small crumbs or objects with their finger and thumb (10 – 12 months) (12 – 15 months) use their pointing finger to show what they are looking at (12 – 16 months) place 2 blocks or objects on top of one another (12 – 16 months) put an object or water from 1 container to another (18 – 24 months) scribble going round and round (20 – 24 months) feed themselves without help (24 – 28 months) use child-safe scissors with an adult watching (24 – 36 months) draw a circle and cross (24 – 36 months) screw and unscrew bottles and jars (24 – 36 months) build a tower of 8 blocks (28 – 36 months) (36 – 54 months) pour liquid from a small container (36 – 54 months) put on shoes and socks without help (42 – 48 months) string 11 small beads (44 – 50 months) copy a ladder and square (48 – 56 months) use child-safe scissors to cut out shapes (48 – 60 months) fold paper in half with edges meeting (50 – 58 months) wash face and hands without help (50 – 60 months) begin to write the letters of their name (52 – 60 months) draw a recognisable face with eyes, nose, mouth (56 – 64 months) page 47 Learning to work things out Babies Toddlers Preschoolers get upset if their toy is taken from them manage an open cup without help know proper place for own things (2 – 5 months) (15 – 18 months) like playing with tissue paper (2 – 6 months) do puzzles of 1 – 3 pieces (15 – 22 months) begin to hold a spoon (4 – 5 months) open a door (17 – 19 months) pick up a toy and put it in their mouth take off their shoes and socks (4 – 7 months) hold 2 objects at once (6 – 8 months) find a hidden toy or object such as hidden under a cup or blanket (7 – 11 months) know themselves in the mirror, if that’s ok in your culture (7 – 10 months) play with cups, spoons and saucers (9 – 11 months) (18 – 20 months) point to at least 4 body parts on their doll or teddy – hands, hair, feet, eyes, nose and mouth (20 – 24 months) ask for things they want (24 – 26 months) understand what ‘big’, ‘high’, ‘long’, ‘under’, ‘over’, ‘on top’ and ‘around’ mean (30 – 40 months) hold 3 blocks at once (10 – 11 months) count to 4 from memory (36 – 40 months) pick up and drink from a lidded and closed name 6 different colours (40 – 48 months) feeder cup without help (10 – 14 months) count 4 blocks pointing to each block in order (40 – 48 months) (30 – 52 months) state opposites such as ‘big’ and ‘little’, ‘high’ and ‘low’, ‘wet’ and ‘dry’ (36 – 60 months) take the middle block from a line of 5 blocks (45 – 54 months) correctly repeat a number with 4 digits (such as 5816 or 4952) (46 – 50 months) count 10 blocks pointing to each block without any mistakes (48 – 60 months) give a reason why an object or pictured object does not belong with the other 4 (54 – 60 months) place 4 pictures in sequence (54 – 62 months) find 2 objects in a picture and connect them with a line (56 – 62 months) page 48 Learning to be sociable Babies Toddlers Preschoolers smile back when you smile at them play pretend games such as talk on the separate from their parents without crying (1 – 2 months) keep hold of a toy being playfully pulled away (3 – 6 months) lift their arms when about to be picked up (5 – 9 months) get upset when separated from familiar people (6 – 10 months) join in games such as peek-a-boo (8 – 10 months) like being cuddled (8 – 10 months) only like familiar people to feed, dress, change and comfort them (8 – 12 months) show interest in what other people are doing (10 – 12 months) telephone and help with household activities (18 – 28 months) want to do everything themselves even if they can’t (20 – 26 months) show you what they like and don’t like (20 – 26 months) start to undress and help with dressing themselves (21 – 24 months) begin to cooperate in play with other children (22 – 26 months) learn to share their toys (24 – 30 months) learn to be more aware of safety (24 months onwards) (36 – 54 months) understand the meaning of right and wrong (42 – 50 months) dress and undress themselves including buttons, shoes and socks, but not zips (44 – 65 months) eat different types of foods (48 – 54 months) use the toilet independently (48 – 56 months) remain calm if change or disappointment occurs, and no remedy is possible (49 – 55 months) say their name when asked (28 – 32 months) attend to a task for 10 minutes without know whether they are a boy or a girl (32 – 36 months) say how old they are (42 – 46 months) supervision (49 – 60 months) have special friends that they like to play with (50 – 60 months) behave according to the peer group in moderately structured situations (50 – 60 months) page 49 Your baby’s eyesight Here are some stages of development that can help you know if your baby is seeing correctly. Babies can: >> see from birth, but not clearly >> watch a speaker’s eyes and mouth (2 – 3 months) >> recognise the faces of special people like Mum and Dad (2 – 4 months) >> follow noiseless moving objects with both eyes (3 – 4 months) >> search for dropped objects (5 – 7 months). If your child needs to wear glasses tell them that ‘glasses look cool’. If they need to wear a patch for fixing their eyes, help them to keep it on. Toddlers can: >> see objects in the distance such as signs or logos >> point to objects in a book >> match shapes and objects by colour and size >> pick out small detail in pictures. Preschoolers can: >> begin to colour in within the lines >> read without tilting their head >> look at a book without holding it too close or too far away. All children should be able to use their eyes together without them turning inwards or outwards or wobbling. See your doctor or optometrist if you have any worries about your child’s eyesight at any age. page 50 My health checks Health checks provide an opportunity to review your child’s health, growth and development. When your child has a health check your health professional will complete and explain this and record any further comments, follow-up or referral on the summary pages overleaf. Please tick items once assessed Date completed 1 – 4 weeks / / Age Weight 6 – 8 weeks / 6 – 9 months / weeks / / weeks / months 4 years (preschool) 18 – 24 months 3 years / / / months / / years years g % g % kg % kg % kg % kg % Length/Height cm % cm % cm % cm % cm % cm % Head circumference cm % cm % cm % cm % cm % Head shape, including fontanelles Mouth/palate Eyes (appearance, fixation, following, corneal light reflex, distance vision) Skin Neurological Dental – Lift the Lip Femoral pulses Hips Limbs and spine; gait (18 – 24 month and 3 years) Abdomen and Umbilicus Genitalia and Inguinal area Testes fully descended R/L Cardiovascular (doctor only) Hearing (newborns and 4 year olds/preschoolers) Development Immunisation (age appropriate as per schedule) Y/N Y/N Y/N Y/N Breastfeeding Y/N Y/N Y/N Y/N My health checks Y/N Health check summary – your health professional will complete this if any follow-up or referral is required. Refer comment 6 – 8 weeks 1 – 4 weeks Follow-up comment page 52 Health check summary – your health professional will complete this if any follow-up or referral is required. Refer comment 18 – 24 months 6 – 9 months Follow-up comment page 53 Health check summary – your health professional will complete this if any follow-up or referral is required. Refer comment 4 years 3 years Follow-up comment page 54 Notes Notes Notes – for your use and for your health professional Age Date page 55 Notes – for your use and for your health professional Age Date page 56 Notes – for your use and for your health professional Age Date page 57 Notes – for your use and for your health professional Age Date page 58 Notes – for your use and for your health professional Age Date page 59 Notes – for your use and for your health professional Age Date page 60 Where to go for help Where to go for help Mothers and fathers often ask about when they should see their Child and Family Health Service nurse or their doctor. See your doctor if you see any of these signs or if you are worried for any other reason: See your Child and Family Health Service nurse for support with these matters: >> drowsiness (less alert than usual) >> lethargic (less active than usual) >> breastfeeding >> breathing difficulties >> infant feeding >> looks paler than usual >> parenting support >> not feeding well >> settling your baby to sleep >> sudden change in the number of wet/pooey nappies – remember babies can get dehydrated very quickly >> your baby’s growth >> your baby’s development. Your Child and Family Health Service nurse will listen to your concerns and offer some strategies to help. >> fever above 38 degrees C° >> vomiting and diarrhoea >> has an unusual rash >> more crying than usual. You can also see your doctor for immunisations and health checks. If you are unsure about seeing a doctor contact healthdirect Australia (24 hours) on 1800 022 222 for advice. page 61 Where to go for help Help and information is available from many places. Emergency (Ambulance, Fire or Police) 000 Child Abuse Report Line 13 14 78 Crisis Care (after hours and weekends) 13 16 11 Mental Health Emergency (24 hours) 13 14 65 Domestic Violence Helpline (24 hours) for counselling, support, information and referrals 1800 800 098 Breastfeeding Australian Breastfeeding Association www.breastfeeding.asn.au Breastfeeding Helpline (7 days) 1800 686 268 Baby Friendly Health Initiative Australia for information about baby friendly health services www.babyfriendly.org.au SA Breastfeeding Support Services contact list a list of all services available www.cyh.com/breastfeedingservices Childcare Childcare access hotline (free call) free telephone service to help you find a childcare service that meets your needs 1800 670 305 Care for kidswww.careforkids.com.au for information on childcare services page 62 Where to go for help Child health and development Child and Family Health Service (Mon – Fri 9.00 am – 4.30 pm) to make an appointment at your local centre 1300 733 606 www.cyh.com Raising Children Networkwww.raisingchildren.net.au The Little Big Book Club for books, activities and reading programs www.thelittlebigbookclub.com.au Playgroup South Australia 1800 171 882 www.playgroupaustralia.com.au/sa Speech and language fact sheets www.speechpathologyaustralia.org.au Child safety ACCC (Australian Competition and Consumer Commission) for information on product safety and consumer rights www.accc.gov.au Homewww.kidsafewa.com.au/onlinesafetydemohouse.html safety online checklist Kidsafe SA(08) 8161 6318 for information on how to prevent child injuries www.kidsafesa.com.au page 63 Where to go for help Child safety Medicines and Drug Information Centre for information on using medicines in pregnancy, while breastfeeding or for children (08) 8161 7222 Poisons Information Centre 13 11 26 SIDS and Kids1300 308 307 (Mon – Fri 9.00 am – 5.00 pm) www.sidsandkids.org for information on safe sleeping Dental SA Dental Service (08) 8222 8222 www.sadental.sa.gov.au Health and wellbeing beyondblue1300 224 636 for help with depression and anxiety, www.beyondblue.org.au also Dad’s handbook: A guide to the first 12 months Drug and Alcohol Services of South Australia for prevention, treatment, information, education and community-based services 1300 131 340 www.dassa.sa.gov.au page 64 Where to go for help Health and wellbeing healthdirect Australia (24 hours) 1800 022 222 for telephone health advice www.healthdirect.org.au Go for 2&5® www.gofor2and5.com.au for information about healthy eating MensLine Australia www.menslineaus.org.au Quitline13 78 48 for help to quit smoking SHineSA8300 5300 www.shinesa.org.au for information and resources on sexual health Immunisation Immunisation Australia Information Line 1800 671 811 www.immunise.health.gov.au Australian Childhood Immunisation Register for information about your child’s immunisations 1800 653 809 www.medicareaustralia.gov.au SA Health: Immunisation section for South Australian immunisation information 1300 232 272 The Science of Immunisation Questions and Answers www.science.org.au/policy/immunisation.html page 65 Where to go for help Hearing Hearing Assessment Service (08) 8303 1530 Universal Neonatal Hearing Screening (08) 8303 1585 Parenting Children’s centreswww.childrenscentres.sa.gov.au service hubs for parents and children 0 – 8 years Parent Easy Guideswww.parenting.sa.gov.au/pegs fact sheets with helpful information for parents and carers Parent Helpline1300 364 100 for information on child health, behaviour, nutrition, parenting Pregnancy, Birth and Baby Helpline 1800 882 436 South Australian Multiple Birth Association (08) 8342 2330 www.communitywebs.org/samba Raising Children Network Child and Family Health Service www.raisingchildren.net.au www.cyh.com page 66 Where to go for help Other Child Support Helpline child support payments, free legal advice, emotional support (08) 8463 3576 www.lsc.sa.gov.au Multicultural Health Informationwww.mhcs.health.nsw.gov.au/index.asp for information about infant health in many languages SA Healthwww.sahealth.sa.gov.au Vision and hearing Optometrist Association Australia (08) 8338 3100 for advice on optometrists in your areawww.optometrists.asn.au CanDo4Kidswww.cando4kids.com.au Your local council Check out the services and activities for children and Search the name of your council online or ring the families that your local council provides. Local Government Association on 8224 2000 or visit their website at www.lga.sa.gov.au to find out what council area you live in, if you are unsure about this. page 67 Acknowledgements This Child Health and Development Record was developed with the assistance of parents and carers, Child and Family Health Service nurses, doctors and a range of health and education specialists. The SA Health Immunisation section and the SA Dental Service have contributed specific subject content. Victoria and New South Wales governments contributed advice on consumer views on their respective state’s child health records. Victorian Department of Education and Early Child Development provided the artwork for the World Health Organisation 0 – 2 years and the US Center for Disease Control 2 – 18 years growth charts. The Australian Research Alliance for Children and Youth provided advice on wording. Graphic Design by Digital Media, Women’s and Children’s Health Network. page 68