Well Child Book - Parent Aid Waitakere

Transcription

CHILD SICKNESS
Danger Signals
General
Temperature
• Feels too cold or hot (temperature is 38.3ºC or higher).
Circulation and skin colour
• Body is much paler than usual or suddenly goes very white.
• Nails are blue, or big toe is completely white, or colour does not return to
the toe within three seconds of a squeeze.
• Has a rash of large red or blue spots or bruising.
• Goes blue around the mouth.
Tamariki Ora
• Cannot be woken or is responding less than usual to what is going on around.
• Has glazed eyes and is not focusing on anything.
• Seems more floppy, drowsy or less alert than usual.
• Has a convulsion or fit.
• Has an unusual cry for one hour or more.
• Has been badly injured.
• There is a bulge in the groin which gets bigger with crying.
WellChild
Get help quickly from a doctor if your baby or young child shows any
of the signs listed below. Learn CPR to be prepared for emergencies.
Breathing
• Goes blue around the mouth or stops breathing.
• Breathes more quickly than normal or grunts when breathing out.
• Wheezes when breathing out.
• There is visible indrawing of the chest with each breath.
Vomiting and diarrhoea
MEDIC ALERT
Allergies/Reactions:
(record here)
EMERGENCY NUMBERS:
National Poisons Centre 0800 764 766
Police/Fire/Ambulance 111
Ministry of Health, Manatü Hauora, New Zealand. Revised December 2010. Reprinted January 2011. Code HE7012
Health Book
• Has vomited at least half the feed after each of the last three feeds.
• Has green vomit.
• Has vomiting and diarrhoea together.
• Has drunk less fluid than usual.
• Has passed less urine than usual (fewer wet nappies).
• Has more than a tiny spot of blood in the nappy.
Your prayer for or greeting to your new baby:
Kia ora koutou katoa, Tälofa lava, Kia oräna, Fakalofa lahi atu,
Täloha ni, Ni sa bula vinaka, Tälofa koutou, Mälö e lelei, Greetings.
This book belongs to you and your child. The words “you”
and “your” mean anyone who will love and care for this child
– father, mother, partner, foster parent, grandparent, whänau,
family, babysitter or childcare worker.
In it, you will find information as well as places to record your
baby’s development in the first 5 years.
Keep it somewhere safe, and use it to write down all the special
and important things that happen to your child.
Take this book with you every time you take your
child to an appointment with a doctor or nurse.
If the meaning of any page in this book is not clear, ask your
health professional to explain it.
• Mehemea käore ngä körero o tënei pukapuka e marama ana, me
pätai atu ki tëtahi nëhi kia whakamäramatia.
• Afai e i ai se faamatalaga o i so‘o se itulau o lenei tusi e te le
malamalama atoatoa i ai, ia fesili i se tasi, e pei o le tama‘ita‘i
tausima‘i, o le a mafai ona ia faamaninoina.
• Me kare te aiteanga ki roto i teia puka e marama ana, e ui atu ki
tetai tangata mei te neti, kia akamarama mai.
• Kaeke kua fai he tau lau he tohi nei kua nakai maama e koe, ti
hühü atu ke he ha tagata tuga e nosi ke fakamaama atu e ia kia
koe.
• Kapau ‘oku ta‘e mahino ha me‘a ‘i he tohi ni, ‘eke ki ha taha
hange ko ha Neesi.
• Kafai he fakamalamalamaga i tenei tuhi e he manino, fehili ki
he tino ve ko te teine tauhi tauale ke fakamatala atili atu.
ISBN 978-0-478-19341-1 (print)
ISBN 978-0-478-19342-8 (online)
Contacts and information
Police/Fire/Ambulance
111
Midwife
Doctor
Well Child provider
www.wellchild.org.nz
Immunisation Advisory Centre
(IMAC) www.immune.org.nz
0800 IMMUNE
0800 466 863
PlunketLine
Healthline
0800 933 922
0800 611 116
PlunketLine nurses provide advice on parenting, nutrition, child development and
behaviour for children from birth to 5 years.
Healthline nurses provide advice on unwell children of any age and health advice for all
the family.
Both services are free and available 24 hours.
National Poisons Centre
0800 POISON/0800 764 766
Other immunisations
Vaccine
Batch
Site
Date given
Sign/stamp
Notes
Contents
Colour reference guide
This colour and tint refer to the health provider
This colour and tint refer to the parent/caregiver
Wherever you see the Help sign in
this book, you will be referred to more
information.
Well Child Tamariki Ora Service......................................................... 4
Well Child Tamariki Ora health appointments................................. 5
Your first 6 weeks together...................................................... 9
Your time together from 6 weeks to 6 months .................. 21
Your time together from 6 to 12 months ............................. 26
Your child between 1 and 2 years ........................................ 32
Safety......................................................................................... 47
Emergencies and other health help ..................................... 55
Growth charts and development checks ............................ 73
Immunisation information ........................................................ 16, 154
Useful telephone numbers .......................................inside back cover
Danger signals ...................................................................... back cover
For recording your child’s development (contents list), see
page 73.
Take this book with you to all health appointments.
Whakapapa/family tree
Whänau/family page
My health book
NHI number
Child’s name:
Birth date:
Birth weight:
Time of birth:
Day of week:
Photos
You might like to stick your baby’s photo on the front of this book
Parents/caregiver:
Address(es):
Telephone:
For important telephone numbers: see inside back cover
3
Well Child Tamariki Ora Service
You and your child have the right to use the FREE Well Child
Tamariki Ora Service. The three parts of the service will support
you to ensure your child grows and develops to their full
potential:
1. Health Education and Health Promotion – providing you with
the knowledge and skills to respond to your child’s needs at
the different stages of their development
2. Health Protection and Clinical Assessment – providing
reassurance that your child is developing normally, through
growth and development assessments; and informing you
about, or providing, immunisation
3. Whänau Care and Support – supporting and helping you
to identify your needs as a parent, and linking you with
community and other services.
There are different providers at
different times
When
Birth
Lead Maternity Carer
First week
2–4 weeks
Lead Maternity Carer provides you with a choice of Well Care providers in your area
4–6 weeks
8–10 weeks
3–4 months
Well Child provider
5–7 months
9 –12 months
General Practice Team, Plunket, Maori
provider,
Pacific provider, or Public Health Service
15 –18 months
2–3 years
B4 School check
4
Health appointments
These are important stages in your child’s life and are time for
checks with Well Child Tamariki Ora health providers. Write
appointment times here. (Dental page 124.)
What happens at
each appointment
Age
Appointment
Date
Birth
See page 91
First week
See page 97
2–4 weeks
See page 99
Time
Lead Maternity Carer completes referral forms (see pages 87 and 89) to Well Child provider
and to General Practitioner
4–6 weeks
See page 103
8–10 weeks
See page 109
3–4 months
See page 115
5–7 months
See page 121
9–12 months
See page 129
15–18 months
See page 135
2–3 years
See page 141
B4 School check
See page 149
5
Visits to hospital, doctors, nurses
when child is unwell
Ask your doctor or nurse to fill in at every visit
Date
6
Reason
Treatment/Medicine
when child is unwell
Ask your doctor or nurse to fill in at every visit
Reason
Treatment/Medicine
Date
7
Vision Hearing Screening record (to be completed by
Vision Hearing Technician, nurse or doctor)
Vision and hearing screening, part of the Well Child Tamariki
Ora service, is designed to identify specific vision and
hearing problems at 4 to 5 years and at 11 years. Your child
will be offered this screening at their B4 School check and
then at school.
Age
Screen
Date
First test
Pass
Birth–
1 month
Newborn
hearing
Red reflex
B4
School
check
Audiology
screening
Tympanometry
screening
Distance
visual acuity
On
request
8
Retest
Retest/
Refer
Pass
Referred to
Refer
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Good to know
Your first 6 weeks together
Spend time talking and singing to your baby
Cuddle and play with them
Breastfeeding is best for baby
Some parents may take time to begin to enjoy their baby
Ask for and accept offers of help
Talk to family, friends, neighbours
Find parent support groups that suit you
If you often feel sad and unable to cope, talk to someone
you trust
Immunisation helps protect your baby from serious
infectious diseases (first due at 6 weeks)
Use a baby car seat in all cars for all trips – they can be
hired
Always take baby with you when you leave the car
A smokefree home and car help protect baby
Test that bathwater and drinks are not too hot for baby
Sleeping baby on their back and in their own cot or
bassinet helps protect against SUDI (sudden unexpected
death in infancy – cot death)
Never shake or smack your baby – if you feel you might
harm your baby, put them in a safe place and walk away
for a short time
0 – 6 weeks
Check the safety section on page 47
9
Ka pai ki te möhio
Ö körua wiki tuatahi e ono
•
•
•
•
Körero, waiata ki tö pëpi
Äwhitia tö pëpi, täkaro tahi ki a ia
Ko te kai pai rawa atu mä pëpi ko te waiü
Mö etahi mätua ka taka ëtahi wiki kätahi anö ka tau te
noho, ka ngahau ki tä rätou pëpi hou
Inoi ki te tangata, tukua te tangata kia äwhina i a koe
0 – 6 ngä wiki
• Körero ki te whänau, ki ö hoa me ngä hoa noho tata
• Kimihia he röpü tautoko mö ngä matua papai möu
• Ki te noho pöuri koe, ki te kore koe e kaha ki te mahi i
ngä mahi, körero ki tëtahi tangata e möhio ana koe ka
äwhina i a koe
• Mä te whängai kano ärai mate ka tiakina tö pëpi i ngä
mate haere ki te tangata kë (te tikanga ka whängaia
tuatahitia i te 6 wiki te pakeke)
• Whakamahia he nohoanga pëpi mö ngä haere katoa
– ka taea ënei te rïhi
• Haria tö pëpi i tö taha ina haere atu koe i tö waka
• Mehemea he auahi kore tö käinga, me tö waka, ka
noho haumaru tö pëpi
• Me äta whakamätau i te wai wera mö te kaukau, me
ngä inu wera, kia möhiotia ai he pai mö tö pëpi
• Äta whakamoe tö pepi i tana tuarä, i töna ake moenga,
he ärai atu i te SUDI (te mate köhungahunga pä
whakarere noa - te mate o te pëpi i töna moenga)
• Kaua rawa e rurerurehia tö pëpi, kaua e päkia
– ki te pënei koe äkuanei ka tükino koe i tö pëpi,
whakatakotoria atu ki te wähi haumaru mö te wä poto,
me hïkoi atu mö te wä poto
Titiro ki te wähanga mö ngä mahi haumaru i te whärangi 47
10
Getting to know your new baby
Becoming a parent is like nothing else you’ll ever do. It’s
a big change in your life. This is a time when you discover
feelings you didn’t know you had. It’s very exciting but it
can also be scary. Looking after baby is hard work, and at the
start that’s enough for you to do. It’s important to look after
yourself as well as the baby.
That means getting the
sleep you need. Rest when
baby is asleep. Make sure
you are eating well and
drinking whenever you are
thirsty, especially if you are
breastfeeding.
Do try not to do too much
too soon. Housework is not
as important as you and your
baby. Ask for help from family,
friends and neighbours.
Share your feelings with your partner, family, a good friend,
your Well Child provider or doctor.
Breastfeed your baby until he or she is ready for and needs
extra food (around six months of age) then continue to
breastfeed until 12 months of age or beyond. Breastfeeding
also helps bond mother and baby.
Breastfed babies get sick less often. Breast milk is more than
a food. It also helps to improve immunity to illness – it can
protect against ear infections in childhood and against
diabetes and obesity in adulthood.
Most women can breastfeed. Breastfeeding usually goes well
and mothers and babies enjoy it. Many mothers need help
when they begin breastfeeding, especially if the baby is their
first. Ask someone for help if you would like advice. Other
breastfeeding women can be very helpful.
Be patient as you and your baby learn to breastfeed. Ask
to feed your baby as soon as possible after birth. Ask your
midwife, nurse or doctor to be with you for the first feed,
0 – 6 weeks
0 - 6 weeks
Breastfeeding is best for baby
11
to help with the best position for your baby to feed for milk
supply and to prevent sore nipples.
Build up your milk supply by letting your baby feed as often
and for as long as they want to. From time to time your baby
will need more than you expect. This does not mean you are
running out of milk. After a few days of extra feeds your milk
supply will grow to meet your baby’s needs. Breastfed babies
who are well do not need other fluids.
Breastfeeding takes a lot of time at first and some new babies
may want to feed often. Make
sure you get plenty of rest – sleep
when your baby does and let your
whänau help with chores.
Ask your midwife, nurse or doctor
for help early if you feel you have
a problem with breastfeeding.
They may seek the advice of a
lactation consultant. Breastfeeding
groups such as La Leche League
also provide help.
Ask for the free booklets
Breastfeeding Your Baby and
Eating for Healthy Breastfeeding Women.
0 – 6 weeks
Make sure you are using an infant formula designed specially
for young babies. Use the baby feed as soon as possible after
it is prepared.
It is important that everything used to make up the formula
is very clean. Feeding equipment must be washed and
sterilised until baby is at least 3 months old (including any
items used with breast milk) and thoroughly washed and
rinsed once baby is over 3 months.
– safe water for baby’s feeds page 63
– or phone PlunketLine 0800 933 922
12
Always wash your hands before preparing bottle feeds.
Follow the instructions on the can/packet carefully.
0 - 6 weeks
If you are not breastfeeding
Use the scoop provided and do not add more water or
powder than directed.
The safest way to heat formula is by placing the bottle in hot
water.
Be careful using a microwave as it can heat the drink
unevenly so it burns baby’s mouth. If you use a microwave,
it is best to heat the feed in a jug and pour it into the bottle.
Shake well and test some on your hand. The drink should
be lukewarm. Ask for the booklet Feeding Your Baby Infant
Formula.
Ask your Lead Maternity
Carer or Well Child provider
about sterilising bottles
and teats.
Smoke is very harmful
for your baby both during
pregnancy and after. Babies
living with smokers get sick
more often.
The arrival of a baby is a
good reason to reduce or stop smoking. If you want help to
stop smoking, ask your Well Child provider or doctor about
smokefree programmes near you or, for advice and support
to help you quit smoking, phone the free Quitline, 0800 778
778. Quitline can also provide an exchange card for nicotine
patches, lozenges and gum to help you quit.
0 – 6 weeks
0 - 6 weeks
A smokefree home and car
helps protect baby from
disease
Many people who do give up find it is a lot easier than they
thought. These tips may help:
• quit smoking or reduce with others for support
• make a smokefree plan and stick to it
• use the money you save on things for you or your baby
(20-a-day smokers will save $3,800 a year at 2010 prices)
• have a smokefree home and car.
13
Help protect your baby against sudden unexpected death
in infancy (SUDI – cot death)
Nobody is sure why SUDI happens, and it can happen to
healthy babies, but there are some things you can do to help
reduce the risks.
• Sleeping baby on their back so they can’t roll onto their
face helps protect against SUDI.
• Having a smokefree pregnancy and a smokefree home
and car helps protect against SUDI.
• Breastfeeding your baby will help protect against SUDI.
• Sleeping your baby in their own cot or bassinet helps
protect against SUDI.
• Sleeping in the same room
as your baby for the first
6 months helps protect
against SUDI (with baby in
their own cot or bassinet).
Make sure the mattress is clean,
dry and fits snugly in your
baby’s bed.
Make sure your baby’s face
is always well clear of the
bedclothes.
If you find baby not breathing,
call for help, and begin rescue
See page 58.
breathing (CPR) immediately.
0 – 6 weeks
Crying – all babies do it
14
Babies can be unsettled for the first
few months.
It usually means hunger,
a dirty or wet nappy, or they may
just need a cuddle,
a song, a walk or a ride
to soothe them.
If there’s no-one to take turns being
with baby and the crying is making
you feel angry or upset:
•
•
•
•
•
put the baby down gently in a safe place
look after yourself
make a cup of tea or coffee
phone a friend or someone in your family or whänau
phone PlunketLine 0800 933 922 or Healthline 0800 611 116.
If baby’s cry is unusual – piercing and
high-pitched – take them to a doctor
straight away. See DANGER SIGNALS
on the back cover.
When a baby cries and cannot be
comforted easily, it might be what is
called “colic”. It usually happens in
the afternoon or evening or after
a feed, and it’s very upsetting for
everyone. If you think your baby
is crying a lot, talk to your Well
Child provider or doctor.
0 – 6 weeks
When will baby sleep?
Newborn babies have varied sleep patterns. Most babies
wake for feeds 1 or 2 times in the night in their first 3
months. From 3 to 9 months they have morning and
afternoon naps, but often reduce their morning nap as they
get more active.
After baby’s daytime feeds, you might like talking, singing,
cuddling and playing with your baby. If night feeds are quiet
with no playing, it helps baby learn sleeping habits.
Sleep baby on their back so they can’t roll over onto their
face.
Check that baby is warm but not too hot. The back of their
neck or their tummy (under the clothes) should feel warm,
not hot or cold. Your baby will be comfortable when their
hands and feet are a bit cooler than the rest of their body.
Talk to your Well Child provider or doctor if you are not sure.
Many parents find that sleeping baby in baby’s own bed in
their bedroom makes care easier. It also helps protect against
SUDI.
15
Good to know
Immunisation – your choice, for your child
The World Health Organization, the New Zealand Ministry
of Health and medical authorities all recommend that
children are fully immunised. This is because the risks
of the diseases are far greater than the very small risks of
immunisation. However it is your choice whether or not to
immunise your child.
If enough people are immunised against diseases, the diseases
can’t spread easily.
Immunisations are offered free to all children in New Zealand.
They help protect against serious diseases. There are seven
immunisation visits for babies and children – at 6 weeks,
3 months, 5 months, 15 months, 4 years, 11 years and 12 years
(girls only).
An immunisation certificate will be needed when you enrol
your child at an early childhood centre, köhanga reo or
primary school (see certificate page 154).
The immunisations are given by injection to protect against:
• polio
• measles
• hepatitis B
• mumps
• pertussis (whooping cough)
• rubella
• Haemophilus influenzae type b (Hib) • tetanus
• pneumococcal disease
• diphtheria
• human papillomavirus (HPV)
0 – 6 weeks
weeks
There are one, two or three injections given at each visit.
Hepatitis B vaccine and hepatitis B immunoglobulin
antibodies are given at birth to babies of mothers who carry
the hepatitis B virus. This is to ensure that the babies do not
become infected with hepatitis B.
In situations where your baby is at higher risk of tuberculosis
(TB), immunisation against TB is offered.
Some babies with chronic health conditions may be offered
influenza vaccine.
The dates when your baby’s immunisations are due should be
written on the appointments page (5) by you, your Well Child
provider or doctor. The first immunisations are usually given
when baby is 6 weeks old. Immunisation starts at this age
because it has been shown to be safe and effective.
16
The National
Immunisation Schedule*
Age
Diseases covered and Vaccines
6
Diphtheria/Tetanus/Whooping cough/Polio/
Hepatitis B/Haemophilus influenzae type b
1 injection (INFANRIX® -hexa)
weeks
Pneumococcal
1 injection (Prevenar®)
3
months
Pneumococcal
5
months
Pneumococcal
15 months
Haemophilus influenzae type b
1 injection (Hiberix™)
Measles/Mumps/Rubella
1 injection (M-M-R® ll)
Pneumococcal
4
years
Diphtheria/Tetanus/Whooping cough/Polio
1 injection (INFANRIX™ -IPV)
11
years
Diphtheria/Tetanus/Whooping cough
1 injection (BOOSTRIX™)
12
years
Human papillomavirus**
3 doses given over 6 months (GARDASIL®)
girls only
* from June 2008 ** from 2009
0 – 6 weeks
Measles/Mumps/Rubella
1 injection (M-M-R® ll)
17
Early protection is important because the younger the baby
the more serious the disease. If your baby misses a dose at
the right age, you can still catch up – you don’t need to
restart.
– refer to fever, cooling, page 71.
Expected reactions
Mild reactions are common after immunisation and may last
up to 2 days. These expected reactions are:
• pain, swelling and redness in the area where the
injection was given
• low-grade fever
• being unsettled and generally unhappy.
What to do
• Give extra fluids to drink.
• Give paracetamol or ibuprofen as advised by your
doctor or nurse.
More serious reactions are very rare.
Children need to wait at the clinic or surgery for 20 minutes
after a vaccine is given. This is to make sure treatment is
at hand if an allergic reaction called anaphylaxis occurs.
Anaphylaxis is very rare and causes dizziness, noisy
breathing and a skin rash. Drugs given by your doctor or
nurse to treat this reaction work quickly and safely.
0 – 6 weeks
If concerned about your child after an immunisation, contact
your doctor.
18
Ka pai ki te möhio
The diseases on the National Immunisation Schedule are:
Diphtheria
Diphtheria bacteria infect the throat. The toxin affects nerves and muscle function
involved in breathing and swallowing, and also affects the heart.
Hepatitis B
Hepatitis B is caused by a virus that attacks the liver and leads to fever, nausea,
tiredness, dark urine and yellow skin (jaundice). Children with hepatitis B disease
usually develop only a very mild illness, but they are more likely to become carriers of
the disease. Carriers are at greater risk of liver disease and liver cancer later in life.
Hib (Haemophilus influenzae type b)
Hib is bacterial, and most often leads to meningitis (an infection of the membrane
around the brain), or infection and swelling in the throat that blocks the entrance to
the windpipe, or pneumonia.
Human Papillomavirus (HPV)
HPV can cause cervical cancer. It is a sexually transmitted infection.
Measles
The measles virus causes fever, a rash, runny nose, cough and eye infection. It can
lead to fits, pneumonia and inflammation of the brain. This inflammation can cause
brain damage or death.
Mumps
The mumps virus causes fever, headache and swelling of the glands around the
face. Mumps may cause meningitis but children usually recover fully. Very rarely,
mumps can cause an inflammation of the brain that can lead to deafness or death.
Pertussis (whooping cough)
Whooping cough is caused by a bacteria which damages the lungs and airways.
This leads to coughing spells so strong it is hard to breathe, and babies may vomit.
Children often gasp for air and some make a “whooping” sound. Pertussis may lead
to pneumonia.
0 – 6 weeks
Pneumococcal disease
The pneumococcal bacteria causes meningitis and septicaemia (blood poisoning).
It may also cause pneumonia and sinus and ear infections.
Polio
Polio is caused by a virus that can lead to a mild or very serious illness. The mild
illness causes fever, nausea and vomiting. The serious illness causes a fever and
stiffening in the muscles. It can also affect the nerves and paralyse different parts
of the body including the breathing and swallowing muscles. Paralysis is usually
permanent.
19
Rubella
Rubella is usually a mild viral illness with a rash in children, but in teenagers
and adults it causes swollen glands, joint pain and a rash. If a pregnant woman
catches rubella, especially early in her pregnancy, it is very likely the disease will
affect her baby and cause one or more serious problems including deafness,
blindness, heart defects and brain damage.
Tetanus
Tetanus bacteria produce toxins that attack the nerves and cause muscles to
become tense and stiff. When the toxins attack the breathing muscles, people
have difficulty breathing.
Your doctor or practice nurse will record your child’s
immunisations on the National Immunisation Register
(NIR). You can choose not to have your child's immunisation
recorded on the NIR but you will need to complete and sign an
opt off form.
0 – 6 weeks
For more information about immunisation
• Talk to your doctor, practice nurse, Plunket nurse or
healthcare provider.
• Order the free booklet Childhood Immunisation: More
Information for Parents (code HE1323) or National
Immunisation Register (NIR) (code HE1501) from
www.healthed.govt.nz or collect from your health
care provider.
• Ministry of Health: www.moh.govt.nz
• Immunisation Advisory Centre (IMAC):
www.immune.org.nz or freephone 0800 466 863
20
Good to know
Your time together from 6 weeks to 6 months
• Spend time talking and singing to your baby
• When baby is awake, watch them have some play time on
their tummy
• Breastfeeding your baby and cuddling helps them feel
loved and secure
• Breastfeeding helps protect your baby’s health
• Immunisation helps protect your baby from serious
infectious diseases (due at 3 months and 5 months)
• Use baby car seats in all cars for all trips
• Test tap-water temperatures are around 50°C
• Test that bathwater and drinks are not too hot for baby
• Having a smokefree home and car helps protect against
SUDI, chest infections and meningococcal disease
• Sleeping baby on their back and in their own bed helps
protect against SUDI
• Keep small toys and objects away from baby to prevent
choking
• Never shake or smack your baby – if you feel you might
harm your baby, put them in a safe place and walk away
for a short time
6 weeks – 6 months
21
Ka pai ki te möhio
6 ngä wiki – 6 ngä marama
Tö körua noho tahi mai i te 6 wiki ki te 6
marama
22
• Körero, waiata ki tö pëpi
• Ina oho mai tö pëpi, mätakina ia, i a ia e täkaro ana i
runga i töna puku
• Mä te whängote ki te waiü, mä te awhiawhi tonu i tö
pëpi, e möhiotia ai te aroha o tana matua ki a ia, e noho
haumaru ai i roto i taua wairua aroha
• Mä te whängote e kaha ake ai te hauora o tö pëpi
mate taumaha, arä, ngä mate haere ki te tangata kë (te
tikanga ka whängaia i te 3 marama me te 5 marama)
• Whakamahia he nohoanga pëpi i ngä motokä katoa mö
ngä haere katoa
• Whakamätauria ngä wai wera o tö käinga ahakoa mö te
kaukau mö te horoi rïhi ränei, me noho i te 50°C te ine
mahana
• Me äta whakamätau i te wai wera mö te kaukau, me ngä
inu wera, kia möhiotia ai he pai mö tö pëpi
• Mä te whakarite käinga me te whakarite motokä noho
auahi kore e äraia atu ai te SUDI, ngä whakapokenga
uma me te mate kiriuhi ua kakä
• Me äta whakamoe tö pëpi i tana tuarä, i töna moenga
ake, e äraia atu ai te SUDI (te mate ohorere o te
köhungahunga)
• Kawea atu ngä taonga täkaro pakupaku i te pëpi kei räoa
• Kaua rawa e rurerurehia tö pëpi, kaua e päkia – ki te
pënei koe äkuanei ka tükino koe i tö pëpi, whakatakotoria
atu ki te wähi haumaru mö te wä poto, me hïkoi atu mö
te wä poto
Getting to know each other
Cuddling, rocking, talking
and singing are some of the
ways you can communicate
with your baby. When your
baby makes sounds, repeat
the sounds back so they learn
to talk with you. Babies are
learning language from birth
– talk and sing to them in
your own language. Move
with your baby to music, to
introduce them to rhythm.
Establishing routines for bedtime, bath time, etc, helps make
baby feel secure.
Breastfeeding is still best for baby. If you are not
breastfeeding, keep using an infant formula until baby is 12
months old.
Remember to give baby plenty to drink in hot weather and
when they are ill. Breastfed babies do not need water or juice
– only breast milk.
If baby has diarrhoea, follow advice on
page 62. If you are worried, phone Healthline
0800 611 116.
Your baby will probably not need solids until about 6
months old. If your baby seems hungry before then, talk to
your Well Child provider or doctor. Turn to page 29 for more
about first foods.
23
Crying
All babies cry. Some cry more than others. Crying worries
some parents more than others. If crying makes you angry or
upset, ask for help.
Phone a friend for a chat if there is no help at hand, or your
Well Child provider, or doctor, or Healthline 0800 611 116.
Keep trying to get help until you make contact with someone,
somewhere. If you feel you might harm your child and have no
phone, put them in a safe place and walk away for a short time.
Postnatal depression
About 1 in 10 mothers will experience postnatal depression.
You may feel weepy, tired or unable to sleep, or that you
are just not coping with your baby. If you have any of these
feelings, talk to your Well Child provider or doctor. They will
be able to help you through this phase.
Teething – teeth start growing before baby is born
24
The first tooth doesn’t usually show until about 5 or 6 months
after birth, and the last one at about 2 1/2 years. The bottom
front teeth usually come first.
Some babies get pain with teething. If they’re upset, gently
rub the gums with a clean finger or the back of a cold spoon.
You can buy special teething lotions and gels from your pharmacy.
Give something to chew on like a clean teething ring.
Teething does not make babies sick. If your baby is unwell,
check with your Well Child provider or doctor.
You can start to brush your baby’s teeth as soon as they
come through. Use a soft brush and a tiny smear of fluoride
toothpaste.
Head shape
Some babies have a preferred position when they sleep on
their back. It is important to vary head position from side
to side to prevent a flat spot from developing. If you have
concerns about your baby’s head shape, talk to your Well
Returning to your other workplace
You can keep breastfeeding. Your Well Child provider or
doctor can give you advice.
Choose the best childcare you can for your baby. If you
decide to use a childcare centre, your local Early Childhood
Development Unit or Citizens Advice Bureau (CAB) will be
able to give you a list of centres in your area (www.cab.org.nz
or see phone book).
Ask for help and support from your partner, family and
friends. Discuss your support needs with your Well Child
provider or doctor.
Babysitting – your sitter must be at least 14 years old
Anyone who looks after young children should learn first
aid and rescue breathing. Talk to your Well Child provider or
doctor about where you can learn this. (See also page 58.)
Leave contact and emergency numbers by the phone.
Family violence and child abuse
If you or your child are being abused in any way, you can
telephone the Child, Youth and Family Service and talk to a
social worker, or you can talk to your Well Child provider or
doctor. They are trained to help. Someone in your family or
whänau may be able to support you.
25
Good to know
6 – 12 months
Your time together from 6 months
to 12 months
• Enjoy time playing with, hugging, and reading to your
baby
• Talk, sing and play music to your baby
• Give baby lots of awake tummy time on the floor to help
them explore their world and develop their muscles
• Breast milk is still the best drink for your baby
• Babies are usually ready for and need extra food around
6 months of age
• Infant car seat should remain rear facing until 12 months
old
• Keep nappy buckets and other water containers covered
and out of reach to prevent drowning
• Always watch your baby in or near water
• Avoid small hard foods (or small toys) because of choking
risks
• Keep household cleaners, dishwasher powder and
chemicals out of reach to avoid poisoning and burns
• Child-resistant lids protect babies and children from
poisoning
• Have a smokefree home and car
• Never shake or smack your baby – if you feel you might
harm your baby put them in a safe place and walk away
for a short time
26
Ka pai ki te möhio
Tö körua noho tahi mai i te 6 marama ki te
12 marama
• Me täkaro märire, me awhiawhi, me körero pukapuka ki
tö pëpi
• Körero, waiata, whakatangitangi püoro ki tö pëpi
• Tukua tö pëpi kia korikori i runga i te papa, kia pai ai tana
whätorotoro haere i roto i töna ao, he mea tënei e pakari ai
ana uaua
• Ko te wai ü tonu te tino kai pai mä tö pëpi
• Me anga whakamuri te nohoanga pëpi i tö motokä, kia
eke rä anö ki te 12 marama te pakeke o tö pëpi
• Mauria atu ngä päkete kope me ërä atu paepae wai ki
wähi kë, kei toromi a pëpi
• Kia mataara tonu te titiro ki a pëpi i roto i te wai, i te
takiwä o te wai ränei
• Kaua ngä kai pakupaku, kai märö nei, mä pëpi, kei räoa
• Kia tüpato ki ngä päura horoi, ki te päura horoi rïhi me
ngä matü, häria ki wähi kë, kei paihanatia a pëpi, kei
wera te tinana ränei
6 – 12 ngä marama
• He tino pai ngä taupoki ärai tamariki, hei tiaki i ngä pëpi
me ngä tamariki i te paihana
• Kia auahi kore te käinga me te motokä
– ki te möhio koe äkuanei ka tükino koe i tö pëpi,
whakatakotoria atu ki te wähi haumaru, me hïkoi atu mö
te wä poto
27
Having fun with baby from 6–9 months
Most of the best “toys” are in your home, like pots and pans
or cardboard boxes.
6 – 12 months
Talk to your baby while you are dressing, bathing, feeding
them, etc. They learn to talk by hearing you – they will
understand what you say before they start to talk.
Baby will enjoy nursery rhymes, waiata, hand games, etc.
(For ideas for action games, ask your local library or early
childhood centre and kòhanga reo.)
Let them hear your own favourite stories, music, and
rhymes.
Bedtime and other routines are important in your baby’s life.
Familiar routines help make them feel secure. They might
become attached to a toy or blanket they like to take to bed,
to keep them company and help them settle.
28
From 9 months to 12 months, babies learn by touching
everything
Sing, tell stories and read books to them.
When you ask them to say the names of things they know,
don’t expect them to say the word clearly!
Praise them when they try to do things right, and try to
ignore the things you don’t like.
Sleeping
By 6 months some children may sleep through the night
without a feed.
You can’t make a child sleep if they don’t want to. But you
can have a regular bedtime. You could leave safe toys and
books with them if they are not sleepy or wake early.
Infant feeding
6 – 12 months
You can keep using breast milk or formula as the main
drink until your baby is 12 months. Some mothers continue
breastfeeding past this time. It’s up to you and your baby
to decide when is the time to stop. Start giving some solids
when baby is ready and needs extra food – this will be at
around 6 months of age. Ask for the flyer Starting Solids.
Give the milk feed first and offer
solids as a “top up”, eg, try 1
teaspoon first and slowly add
more until baby is having about
3 – 4 teaspoons at a meal:
• baby rice or infant cereal
• puréed (smooth with no
lumps) apple, pear, apricot,
peach or ripe mashed banana
• puréed kümara, kamokamo,
pumpkin, potato, carrot,
marrow or avocado
• cooked and finely minced
lean lamb, beef, chicken,
liver or kidney.
Babies do not need added sugar or salt.
29
Vegetarian babies can get iron from dark green leafy
vegetables, egg yolk and wholemeal cereals. If you feed your
baby a vegetarian diet, ask about seeing a dietitian.
By 8 or 9 months you can give solids before their milk feeds.
Give your baby small pieces of food to hold, such as a small
sandwich or a finger of toast.
Always watch them when they
are eating in case they choke.
If you would like to know
more about healthy eating
for your baby, or if you are
worried about how your child
is growing, talk to your Well
A child is not always hungry. Getting upset about this makes
it worse. It could just be time to offer smaller helpings or a
new food.
Teething
6 – 12 months
Your baby may have several teeth by now.
Look after “baby” teeth. Sweetened drinks, foods and fruit
juices can cause tooth decay (holes) and cause your baby
to develop a taste for sweetened foods. Avoid putting baby
to bed with a bottle, as the milk, formula or juice can harm
their teeth as they sleep.
Baby teeth are important in helping your child to eat and
speak properly. As soon as teeth appear, you can start the
habit of gentle brushing with a soft, babies’ toothbrush and a
tiny smear of fluoride toothpaste.
Gently lift your child’s top lip once a month to check inside
their mouth. It’s a quick and easy way to see whether decay
is present in its early, treatable stages. Look for white spots at
the gumline, particularly on the upper front teeth. Also look
for discoloured areas or pieces of missing teeth. Check
that gums look healthy, not puffy or bleeding. Discuss any
concerns with your Well Child provider at the next visit, or
with your doctor, or contact your community dental health
service 0800 TALKTEETH, 0800 825 583.
30
Family relationships
Keep in contact with friends and family.
Take some time to be with your partner and with your other
children.
6 – 12 months
It is good for partners to be involved in some child and
health care too. Other children will want to be involved with
the baby too.
31
Good to know
1 – 2 years
Your child between 1 and 2 years
• Give your child lots of hugs and praise
• Listen and talk to them – notice them when they are good
• Don’t expect too much of them – remember they are still
learning
• Read, sing, tell stories and play together, rather than use
TV/video
• See and talk to friends, family, whänau
• Join play groups, parent groups
• Immunisation (due at 15 months) helps protect your baby
from serious infectious diseases
• Use a child car seat in all cars, for all trips
• Offer safe crawling, walking, running, jumping and
climbing opportunities
• Outside play should be in fenced areas where they can’t
get on the driveway, road or to water
• Always watch your toddler in or near water
• Vertical bars on fences etc make it hard for children to
climb over to dangers
• Toddlers need lots of small meals and healthy snacks
• Avoid small hard foods (or small toys) because of choking
risks – don’t give nuts, popcorn or small hard sweets or
tablets
• To prevent poisoning, ask your pharmacist for childresistant caps on all medicines and store them out of reach
• Talk to your childcare centre about how they will keep
your child safe
• Keep lighters, matches and candles out of reach
• Never shake or smack your toddler – if you feel you might
harm your toddler put them in a safe place and walk away
for a short time
32
Ka pai ki te möhio
Ko tö tamaiti i waenganui i te 1 me te 2 tau
1 – 2 ngä tau
• Kia kaha koe ki te awhiawhi i tö tamaiti, kia kaha hoki ki te
whakapai i a ia
• Whakarongo, körero ki a rätou – kaua e whakaiti i ä rätou mahi
papai
• Kaua e pënei ka taea e rätou ngä mea katoa – kia maumahara,
kei te ako tonu
• Körero pukapuka ki a rätou, waiata, körerotia ngä körero paki,
hei aha te pouaka whakaata/rïpene ataata
• Haere ki te kite otirä ki te körero ki ngä hoa, ki te whänau hoki
• Me tühono ki ngä röpü, ki ngä röpü mätua anö hoki
• Mä te whängai kano ärai mate ka tiakina tö pëpi i ngä mate
haere taumaha (te tikanga ka whängaia i te 15 marama)
• Whakamahia he nohoanga pëpi mö ngä haere katoa, mö ngä
motokä katoa
• Tukua he wähi mö te te äta ngöki, mö te hïkoi ränei, mö te
pekepeke me te pikipiki haere
• Me whakatü taiepa i te wähi täkaro o waho, kia kore ai rätou e
ähei te haere i runga i te ara motokä, i te huarahi tonu ränei
• Kia mataara tonu te titiro ki a pëpi i roto i te wai, i te takiwä o te
wai ränei
• Me tütika ngä rëra taiepa, kia uaua ai te pikipiki haere o te
tamariki, kia uaua hoki te puta atu ki ngä wähi mörearea
• He mea nui kia auau tonu ngä kai iti me ngä paramanawa
hauora, mä te tamaiti pängore
• Kaua ngä kai pakupaku me ngä kai märö nei, mä pëpi, kei räoa
– kaua ngä nati, te känga pähühü, ngä rare iti, ngä rare märö
ränei
• Inoi atu ki tö këmihi kia whakapiringia mai he taupoki ärai
tamariki ki ngä rongoä katoa, hei ärai atu i te paihana, ä,
whakaputuhia i tëtahi wähi käore e taea ake e te tamariki
• Körero ki tö pütahi tiaki tamariki mö ö rätou tikanga e noho
haumaru ai tö tamaiti
• Haria ngä püahi, ngä mäti me ngä känara ki wähi kë, e kore ai e
taea ake e te tamariki
• Kaua rawa e rurerurehia tö pëpi, kaua e päkia – ki te pënei koe
äkuanei ka tükino koe i tö pëpi, whakatakotoria atu ki te wähi
haumaru mö te wä poto, me hïkoi atu mö te wä poto
33
Having fun with a toddler
1 – 2 years
Children learn by trying to do things themselves when
they play. They like to be busy. You can help by:
• letting them make a mess and have fun using water,
sand, clay, pot cupboards
• giving them interesting things to play with –
play dough, textured fabrics, leaves
• giving them ideas for new things to try and do
– pasting, drawing, building
• being pleased when they learn any new skill
• talking, reading and singing together
• letting your toddler be with other children
• encouraging make-believe play, providing
dress-up gear.
For more ideas, ask at your local library, early childhood
centre and köhanga reo.
34
Toddler discovering “me” – good ways to get what you
both want
1 – 2 years
As a baby grows into a toddler, they begin to find out
who “me” is.
Notice them when they are good. Praise makes them want
to do the things that please you.
They like to make simple choices, like which shirt or shoes
they will wear today.
“No” becomes a favourite word. Ask questions that cannot
be answered with “no”.
Children learn a lot by watching you. If you can be kind and
loving with a child, even when you have to be firm, it will
help them learn self-control from you.
When you listen to them, they know you care how they feel.
Don’t expect too much of them. Toddlers are only learning
to understand.
If there is a new baby, spend some time alone with your
toddler. Make them feel proud of being old enough to help
with care of the new baby.
35
Feeding fun
Toddlers can have small amounts of the same food as you
and your family, along with about 2 cups of milk each day.
Don’t worry if your toddler seems to be a “fussy” eater.
As long as they are growing well and have lots of energy,
just keep offering healthy choices. Offer smaller helpings
if they reject food.
Avoid giving fatty or fried foods, sugar or salt.
Food for energy and growth
1 – 2 years
Children need to be offered plenty to drink – more when
they are busy and when it’s hot. If your child is thirsty, water
is the best drink.
Fruit drinks and juice are high in sugar and are harmful for
their general health and teeth. So choose either water or milk.
Children eat small amounts of food, and so they need lots of
small meals and snacks:
• little sandwiches
• pieces of raw or cooked cold vegetables and/or fruit
• cereals – choose cereals low in fat and sugar
• yoghurt, milk or cubes of cheese
• hard-boiled egg, pieces of lean meat or chicken.
Show your child you are physically active, and they will
learn from you – walking to the park, playing with a ball, etc.
36
Teeth – time to help teach brushing twice a day
A small mouth needs a small
toothbrush with soft bristles.
Use just a smear of fluoride
toothpaste to help harden and
protect the teeth. Don’t rinse
the mouth with water, but teach
children to spit out the left-over
toothpaste – it is not for eating!
If you haven’t been enrolled by
the dental service yet, check to
make sure you are enrolled, or
to get an appointment – phone
0800 TALKTEETH, 0800 825 583.
Toddlers get hurt
Your toddler is more likely to be injured between 1 and 2
years of age than at any other time in their life.
See the safety section
on page 47.
1 – 2 years
Toilet training
A child will be ready to start learning to use the toilet any
time between about 20 months and about 3 years.
The right time will be when they:
• know when they are wet and dirty
• are beginning to try to do things without your help.
Every child learns at a different pace.
37
Good to know
• Listen and talk to them, to help promote language
development
• Use words for your and their feelings (eg, happy, sad,
angry)
• Notice when they are good and praise them
• Read to them every day – limit TV/video/electronic
games time
• Young children need lots of small meals and healthy
snacks – keep chippies, sweet biscuits, etc for treats
• Play with them inside and outside – offer safe crawling,
walking, running, jumping and climbing opportunities
• Outside play should be in fenced areas where children
can’t get on the driveway or road
• Always hold your child’s hand to cross the road
• Helmets and shoes protect on trikes
• Use a child car seat in all cars, for all trips
• Keep lighters, matches and candles where children can’t
reach them
• Never shake, smack or hit your child – if you feel you
might harm your child put them in a safe place and walk
away for a short time
2 – 3 years
38
Ka pai ki te möhio
• Whakarongo, körero ki a rätou, kia whanake ai tö rätou
reo
• Whakamahia he kupu mö ö whakaaro, mö öna whakaaro
(inä koa, kei te harikoa, kei te pöuri, kei te riri)
• Me whakamihi rätou mö ä rätou mahi papai
• Körero pukapuka ki a rätou i ia rä, i ia rä – kia iti iho ngä
haora mätakitaki pouaka whakaata, täkaro rorohiko nei
• He mea nui kia auau ngä kai iti me ngä paramanawa
hauora mä te tamariki nohinohi, me waiho ngä taewa
pakapaka me ërä atu mea mö ngä häkari anake
• Täkaro ki a rätou, ahakoa i roto, i waho ränei. Tukua he
wähi mö te äta ngöki, mö te hïkoi ränei, mö te pekepeke,
me te pikipiki haere
• Me whakatü taiepa i te wähi täkaro o waho, kia kore ai
rätou e ähei te haere i runga i te ara motokä, i te huarahi
tonu ränei
• Puritia te ringaringa o tö tamaiti ina whakawhiti i te
huarahi
• He tino pai ngä pötae märö me ngä hü hei tiaki i te
tamaiti eke taraihikara
• Whakamahia he nohoanga pëpi mö ngä haere katoa, mö
ngä motokä katoa
2 – 3 ngä tau
• Haria ngä püahi, ngä mäti me ngä känara ki wähi kë, e
kore ai e taea ake e te tamariki
– ki te möhio koe äkuanei ka tükino koe i tö pëpi,
whakatakotoria atu ki te wähi haumaru, me hïkoi atu mö
te wä poto
39
Having fun and learning
Your child will enjoy going to a play group or other early
childhood group.
Dreaming, pretending and talking to themselves is part of
your child’s play.
Your local library and early childhood centre and köhanga
reo will have more ideas and information about play. They
may also have special toddler reading sessions. These are
fun for your toddler – and for you.
Behaving well
2 – 3 years
Helping children learn the way you want them to behave
is one of the toughest jobs of parenting. Copying you is a
way they learn. Be a positive role model by being active
– walking the dog, swimming, running, going for family
walks. Encourage your child to extend themselves in a safe
way – balancing, jumping etc.
Get agreement and support from partners, family, whänau
and other caregivers on TV time, eating, playing, bedtime
and general expectations.
Children won’t stop loving you if you’re firm with them.
They’ll feel a lot safer when they know what the limits are,
even though they will test them sometimes. Being fair and
consistent makes things easier for them – and for you.
40
Tantrums are normal – some ideas you might like to try
Try to avoid tantrums:
• give them time to say what they want or feel
• tell them what you would like them to do and be
pleased if they do it.
If a child has a tantrum:
• ignore the tantrum and walk away until things have
calmed down
• hold them in a firm but gentle cuddle and take them
to a safe place for “time out”. (“Time out” means time
away from contact with other people for 2–3 minutes
until things calm down.)
If a child’s behaviour is making you feel really angry
and upset:
• put them in a safe place like a bedroom
• walk away from them until things cool down
• call someone you trust if you feel you might hurt them
– remember that words can hurt too.
Bedtime
You can decide to be firm about
having a regular bedtime.
Ask your Well Child provider or
doctor for advice.
Toilet training
2 – 3 years
When a child is staying dry in
the daytime you can begin to talk
about wearing pants at night.
It takes a lot longer for children
to learn control at night.
Remember to teach them
to wash their hands each time
after using the toilet.
Don’t punish them for “accidents”.
Reward them for getting it right.
41
Good to know
•
•
•
•
•
•
•
•
•
•
•
•
•
Your child will enjoy time to play and friends to play with
Let them know they are special – tell them they are great
Notice when they are good and praise them
Listen to them tell you how they feel – spend time talking
together
Spend individual time with each child
Read to them every day – limit TV/video/electronic
games time – an hour a day is plenty
Children need many different foods from the four food
groups every day
– vegetables and fruit
– breads and cereals
– lean meats, chicken, seafood, eggs, dried beans, peas
and lentils
– milk and milk products
Have meal and snack times together – some children need
more food than others
Always hold your child’s hand to cross the road
Bikes and trikes should not be ridden on the road
Helmets and shoes protect when on bikes and trikes
Immunisation (due at 4 years old before starting school)
helps protect your child from serious infectious diseases
Never shake or hit your child – if you feel you might
harm your child ask for help
3 – 5 years
42
Ka pai ki te möhio
3 – 5 ngä tau
• Ka tino pai ki tö tamaiti te wä täkaro me ngä hoa täkaro
• Kiia atu ki a rätou he tamariki tino rangatira rätou – he
tamariki tino ätaahua
• Me whakamihi rätou mö ä rätou mahi papai
• Whakarongo ki ä rätou körero mö ö rätou whakaaro – me
noho tahi ki te körero i ëtahi wä
• Me noho takirua körua ko ia tamaiti, ko ia tamaiti o te
whänau
• Körero pukapuka ki a rätou i ia rä, i ia rä – kia iti iho ngä
haora mätakitaki pouaka whakaata, täkaro rorohiko nei.
• Te tikanga kia nui ngä momo kai mai i ngä wehenga kai e
whä ia rä
– te huawhenua me te hua-räkau
– ngä paräoa me ngä pata kai
– ngä mïti ngako kore, te heihei, te mätaitai, ngä
huämanu, ngä pïni maroke, ngä pï me ngä lentil
– te miraka me te hua o te miraka
• Me kai ngätahi te whänau, me kai tahi i ngä
paramanawa – mö ëtahi tamariki kia nui atu te kai i
ëtahi kë atu
• Puritia te ringaringa o tö tamaiti ina whakawhiti i te
huarahi
• Kaua e ekea ngä paika me ngä taraihikara i runga i te
huarahi
• He tino pai ngä pötae märö me ngä hü hei tiaki i te tamaiti
eke taraihikara
mate haere taumaha (te tikanga ka whängaia i te 4 tau i
mua i te tïmatanga ki te kura)
• Kaua rawa e rurerurehia tö pëpi, kaua e päkia – ki te
möhio koe äkuanei ka tükino koe i tö pëpi, inoi atu ki te
tangata kia äwhina mai i a koe
43
Playing, talking, and listening – your child
needs your attention
Help them learn that everyone is special – no matter what
they look like or whether they are boys or girls.
If your children are watching television programmes, it’s best
to watch with them so you can explain what is happening.
Even some children’s programmes are violent or unsuitable.
Limit TV time – an hour a day is plenty. Encourage active
play and story time. Your local library will have some good
ideas about suitable books. Talking and reading together
helps language development.
Behaviour and needs – developing self-discipline
3 – 5 years
Expectations of your child need to be right for their age and
easy for you to stick to.
Everyone who looks after the child needs to follow the same
patterns.
Check your child is listening to you when you ask them
to do something. Make close eye contact and keep any
directions simple. If you think they can’t hear you, ask your
Well Child provider or doctor for their hearing to be checked.
44
3 – 5 years
When you like the way they behave, tell them you like it.
Try not to take any notice of behaviour you don’t like or
want.
Words can hurt children. They believe what you say, so
saying they are stupid doesn’t help them. Tell them it’s what
they are doing that you don’t like, not them.
Even though you love them, sometimes children make you
feel so angry you’ll shout, or want to smack or hit them.
If you feel really angry or upset, give yourself a couple of
minutes of “time out” – walk away from them until things
cool down. Remember they copy your behaviour.
Children need to know it’s OK to have bad feelings and
show their feelings without hurting themselves or anyone or
anything. It’s not helpful or healthy for anyone to let angry
feelings build up. It’s better to let children find safe ways to
express their feelings, too.
45
Never leave a child at home alone
The law says children must be 14 years old before they can
be left alone.
When it’s OK to say “no”
Children need to learn that sometimes it’s OK to say “no”
to an adult or older child to keep themselves safe.
They need to know:
• never to get in a car or go anywhere with someone
they don’t know
• the difference between “good” touching and “bad”
touching – bad touching is anything that makes them
feel bad, like someone putting their hands inside the
child’s pants
• what to do if something happens that they don’t like
– saying “don’t do that” in a loud voice and running to
somewhere they know is safe where there is an adult
they can trust.
They also need to know that it’s always safe to tell you
things, even if an adult tells them not to. They need to know
you will listen.
Family violence
If you or your child are being abused in any way, you can
telephone the Child, Youth and Family Service and talk to a
social worker or you can talk to your Well Child provider or
doctor. They are trained to help.
Someone in your family or whänau may be able to support
you.
3 – 5 years
Toilet training
About 1 in 10 of all 5-year-olds still can’t help wetting the
bed. Some may have the occasional wetting during the day
too. Boys often take longer than girls. Getting upset and
punishing them for night-time wetting won’t help them to
get dry any quicker. Just show them you are really pleased
when they are dry all night. If you would like more help and
advice, talk to your Well Child provider or doctor.
46
Safety
Page
•
•
•
•
•
Keep a list of emergency numbers by the phone
Learn first aid and rescue breathing
Learn how to save your baby’s life if they choke
Know what to do if your baby gets burned
Know what to do if you think your baby has
been poisoned
57
66
67
68
Check:
• your baby can’t fall off things
• bars on cots, playpens, stairs, verandahs, stairguards
are upright, with gaps less than 85 mm
• stair and door guards are in place
• furniture is away from windows
85 mm
Falls
Safety
• safety catches are on
windows
• playing is well away
from glass doors
and windows
• outdoor play
equipment has a soft
surface, like bark
chips, underneath it
• play equipment
is lower than adult
height.
Crawling backwards is a
safe way for your baby to
get downstairs, if someone
is with them.
Baby walkers are not safe.
It is better not to use them.
47
Cuts
Check:
• for sharp corners on low tables. They might need
rounding off, or covering until your child is bigger
• safety film, wooden bars or safety glass is on glass
doors, and on windows near floor level, especially
upstairs windows. Bright stickers at child’s eye level
on large areas of glass can help
• sharp knives and scissors are out of reach.
Choking/Strangling/Suffocating
85 mm
Check:
• for anything small on floors and furniture
• baby isn’t given small pieces of hard food, like nuts
or popcorn
• they are not left alone when they are eating
• household toys often for small, sharp or loose pieces
• tops on cornerposts of wooden cots – they may need
sawing off so your baby can’t hang themselves by their
clothing
• bars on cots, playpens, stairs, verandahs, stairguards
are secure and vertical, with gaps less than 85 mm
• cot mattresses are clean, dry and fit snugly in the cot
• clothing is close-fitting with no long ribbons or open
weaves
• there are no loose ties on clothing near the neck
• baby’s bib is off for sleeping
• plastic bags are tied in knots and out of reach.
Poisons
Safety
Check:
• for lead paint on older furniture and toys. It can
poison babies and young children. Talk to your health
worker or a health protection officer at your local
public health service before removing paint. They will
find out if it is lead paint and advise about removing it
48
• for child-resistant closures on household cleaners,
poisons and medicines – ask your pharmacist for childresistant closures on all medicines and do them up
tightly (remember they are child-resistant, not childproof)
• that all household products and medicines are in their
original labelled containers – NEVER use drink or food
containers for poisonous products.
Lock all household products and medicines out of sight and
reach of children. Always read the label before using the
product, even if you have used it before. While you are using
anything poisonous, always keep it well out of your toddler’s
reach.
Make sure your child knows not to eat any plants, berries,
mushrooms etc they find. Check for poisonous garden and
household plants and get rid of them.
Keep the phone number for the National Poisons Centre close
to the phone. 0800 POISON / 0800 764 766
Burns/Fires/Scalds
Safety
Check:
• temperature of baby’s food and drink. Take care with
microwave heating as food can heat unevenly
• electric jugs and kettles have a wide base and short or
curly cords
• all hot things are out of reach
• you are not holding baby while you have a hot drink
• a stove guard is fitted and back cooking elements are
used. Turn pot handles away from front
• guards are fitted to walls around fires and heaters
• matches and lighters are out of reach
• heaters can’t tip over. Don’t have clothing near or on
heaters
• bar heaters, or heaters without thermostats, are not left
on where baby sleeps
• safety plugs are in low electric sockets when the sockets
are not being used
49
• nightwear has low fire risk labels. Cotton material
burns very easily
• your hot tap water is around 50°C – see if it’s OK to
hold your hand under the running tap for 5 seconds.
Put cold water in baby’s bath first, then add the hot water.
Test the heat of the water before you put your baby in it.
One way is to use your elbow to check.
Have a fire extinguisher or a special fire blanket in your
home – keep it in the kitchen.
Smoke alarms in your home will help to wake you if there
is a fire. They are recommended in all bedrooms. Make sure
you check their batteries twice a year. Your local fire service
can advise you on the best types to get.
Sun safety
Safety
Because of their delicate skin, all babies and children need
protecting from direct sunlight. Even babies with darker skin
can burn quickly.
It is most dangerous between 11.00 am and 4.00 pm. If you
take them outside during daylight saving months (October to
March), cover with a hat and longsleeved, loose clothing and
try to keep them in warm shade.
Follow the Slip, Slop, Slap and Wrap rule before
you take your baby out into the sun.
• Slip on clothing and slip into some shade
• Slop on some sunscreen
• Slap on a hat
• Wrap on some sunglasses.
Put sunscreen on any skin not covered by clothes. Wipe it on
thickly – don’t rub it in hard. Choose an SPF broad spectrum
sunscreen which is labelled SPF 30+. Avoid the eyes and
remember babies rub their eyes, so sunscreen on their hands
could hurt their eyes. Be cautious about using sunscreen on
babies under 12 months old. Test it on a small part of baby’s
skin first to check for allergies. However, it is best to keep
baby out of strong sunlight.
Safety warning: Baby oil is not a sunscreen. It will fry your
baby!
50
Water safety
Check:
• anything which holds water is safely away. Keep lids
on the nappy buckets and make sure they are up out
of reach. Keep the toilet door closed. Babies of any age
can drown, quickly and silently
• swimming pools and spas are fenced and safely gated.
Most toddler drownings happen in the family’s own
pool or in a pool owned by friends
• an adult is watching children around water at all
times.
If you need to go away from baby’s bath or paddling pool,
take baby with you.
Bath seats and other flotation aids can’t be relied on to keep
your baby or toddler safe.
Teach children to stay away from the edge of pools and
rivers and to wait for you or another adult before getting in
the water. Always use life jackets in boats.
Safety
Road and car safety
Cars are involved in killing and injuring more children than
any other kind of accident.
Car seats must be used in every car, for every trip. Children
need to know this.
51
You can hire a car seat from Plunket, some Well Child
providers, some baby shops, community groups and car
companies. The seat for a new baby must face the back of the
car. It is safest to keep your baby facing the back of the car
until they are a year old. (Check if your car seat will allow
rear facing beyond 9 kg weight.) A front air bag is dangerous
to your baby in the front seat of the car, so have a car seat in
the back – the back seat is safer for all car seats.
At 1 year you can change to a forward-facing child seat.
Safety
At the age of about 4 years (18 kg) they will be ready for
a booster seat used with a harness or a lap and diagonal belt.
The diagonal strap lies across their shoulder only. If your
child is very wriggly, you can buy or hire a safety harness to
fit booster seats.
Fencing outdoor play areas and making sure children can’t
get into the garage, driveway, work areas and roads means
you can relax more.
Always check the driveway is clear before backing your car.
52
Children learn by watching you. Show them how to be safe
on and near the road, and to watch for cars coming in or out
of driveways.
Holding hands with an adult to cross the road is a “must”
rule.
Getting children in and out of a car on the footpath side is
safest. If you are picking your child up from school, it is
best to park and then walk to meet them at the school gate.
Children sometimes rush across to mum or dad without
looking.
Safety
A child under the age of 8 is not ready to cross the road
alone. But it is never too early to start teaching about safe
road crossing and school patrols.
53
Wheeled toys and trikes are for riding only in a fenced
outdoor play area.
Children under 10 should have an adult with them if they
are riding on the road.
You can support a safe community for your child
Safety
Talk to your local council about:
• safe playgrounds
• slow traffic in residential areas
• fenced
– edges above banks
– drains (or piped drains)
– streams
– industrial sites
– swimming pools.
54
Emergencies and other health help
• DRS ABC ........................................................................... 56
• First aid and CPR ....................................................... 57–61
• Diarrhoea and vomiting ................................................. 62
– Treatment ..................................................................... 62
– Prevention ................................................................... 63
• Safe water for baby .......................................................... 63
• Pneumonia and asthma .................................................. 63
• Meningococcal disease ................................................... 64
• Medicine............................................................................ 64
• Injury ................................................................................. 65
• Unconsciousness .............................................................. 65
• Choking ....................................................................... 66–67
• Burns.................................................................................. 67
• Poisoning .......................................................................... 68
• Drowning .......................................................................... 68
• Broken bones .................................................................... 68
• Bad cuts ............................................................................. 68
• Infectious illnesses ........................................................... 69
Help
• Fits and fevers ............................................................ 70–71
• Ear problems .............................................................. 71–72
Danger Signals – when you MUST call the doctor
(see back cover)
55
56
CPR
First aid and CPR
(rescue breathing and chest compressions)
All caregivers should know how to perform CPR. Courses
are run locally by St John, Red Cross and other training
organisations.
Rescue breathing and chest compressions are only for a
child who is not breathing.
This may happen because the child has:
• had an electric shock (turn off the power first
before touching the child)
• breathed in water or smoke.
They may have gone blue in the face.
What should you do first?
• shake (not too hard) and shout to the child to try
to wake them up
• call for help
• open airway.
If they are not breathing, follow the DRS ABC sequence on
the facing page.
Learn before you need it
Dangers – check for any dangers.
Check responsiveness.
Send for help.
Help
D
R
S
57
CPR for BABIES under 1 year
CPR
CPR for babies under 1 year – in an
emergency only
Airway –
• Put the baby on their back on a firm, flat surface,
eg, a table.
• Open the airway with a gentle head tilt and chin lift.
Do not tilt the head back too far. Lift the chin gently
with your fingers.
Breathing –
• Look, listen and feel for breathing (look for chest
movement, listen for sounds of airflow around the
mouth, and feel for air against your cheek).
• If they are breathing, place the baby on their side.
• If they are not breathing and you are alone, leave the
infant or carry them with you to get help. Dial 111 and
ask for an ambulance. Then start chest compressions.
Help
Chest compressions –
58
• Place two fingers just below an imaginary line joining
the nipples. Press down one-third of the depth of the
chest at a rate of 100 times a minute.
• After every 30 compressions, open the airway using the
head tilt and chin lift.
• Form a tight seal with your mouth over the baby’s nose
or around the baby’s nose and mouth and give the baby
2 breaths, just enough to see their chest rise and fall.
• Repeat the cycle of 30 chest compressions and 2 breaths.
• Keep going until help arrives or the baby starts
breathing on their own.
Help
CPR for BABIES under 1 year
Airway and
Breathing
CPR
59
CPR for CHILDREN over 1 year
CPR
CPR for children over 1 year
Airway –
• Place the child on their back on a firm, flat surface,
eg, the floor.
• Open the airway using the head tilt chin lift: tilt the
head back and lift the chin forward with your fingers.
Breathing –
• Look, listen and feel for breathing – look for chest
movement, listen for sounds of airflow around the
mouth and feel for air against your cheek.
• If they are breathing, place the child in the recovery
position.
• If the child is not breathing and you are alone, leave
the child and go and get help. Call 111 and ask for an
ambulance. On return, start chest compressions.
Help
Chest compressions –
60
• Place the heel of one hand over the lower half of the
breastbone, press down one-third of the depth of the
chest at a rate of 100 times a minute.
• After every 30 chest compressions, open the airway
using the head tilt and chin lift.
• Pinch the nose, form a tight seal around the child’s
mouth with your mouth and give two breaths through
the child’s mouth, just enough to see their chest rise
and fall.
• Repeat the cycle of 30 chest compressions and 2
breaths.
• Keep going until help arrives or they start breathing
on their own.
Help
CPR for CHILDREN over 1 year
Airway and
Breathing
CPR
61
Help
Diarrhoea/vomiting
Diarrhoea and vomiting (upset tummies)
62
Diarrhoea can kill babies and children by draining too much
liquid from their bodies (dehydration). It is most important
to give a child with diarrhoea plenty of drinks. A child has
diarrhoea if they have watery, dirty nappies more often
than usual.
You should get medical help quickly if your child:
• will not drink or eat normally
• has several runny, dirty nappies in 1 or 2 hours
• vomits often
• has a fever
• is very thirsty
• has blood in their nappy
• is unusually irritable
• has sunken eyes and dry mouth
• has diarrhoea that lasts longer than 24 hours.
IMPORTANT – as soon as diarrhoea starts, give:
• plenty to drink, to replace the liquid being lost
• light food, if they can keep it down, to keep them
nourished.
If breastfeeding, keep feeding more often than usual.
If baby is having formula, give this as usual and other liquids
as well, such as:
• water that has been boiled and cooled quickly
• oral rehydration fluid from the pharmacy
(Pedialyte or Gastrolyte). No other medicines should
be used for diarrhoea, except on medical advice.
Drinks should be given, from a bottle, cup or spoon, every
time a child with diarrhoea has a dirty nappy. If the child
vomits, wait for 10 minutes and then give small sips often.
Give extra liquids until the diarrhoea has stopped – usually
3 to 5 days.
DO NOT give sugary drinks, such as fruit juice or fizzy drinks
(including flat lemonade). These are dangerous for children
who have diarrhoea and can make the diarrhoea worse.
Children over 6 months with diarrhoea can still be given food.
Food can help to stop the diarrhoea and keep the child’s
strength up.
Safe water for baby
In the first 3 months, all water for baby to drink should be
boiled for 3 minutes and cooled on the day it’s used.
If using an automatic kettle to boil water, wait until the kettle
switches off.
In cities and towns, you can use water from the tap after
baby is 3 months old. If in doubt, boil the water. In rural
areas, water may contain nitrates, which are dangerous for
baby. Check with your local council that your bore water is
nitrate-free. (Boiling does not remove nitrates.) Water from
tanks and bore holes should still be boiled and cooled for
babies and toddlers until they are about 18 months old.
Safe water / pneumonia / asthma
If your child seems fairly well, but has diarrhoea for longer
than 2 weeks, you should get medical help.
Help prevent diarrhoea by:
• breastfeeding – breast milk is germ-free and safe
• cooking food until it is piping hot, storing it covered
and cold, keeping everything clean
• everyone washing hands after using the toilet and
before touching food or baby – including before
and after changing nappies.
If baby is having formula, use it as soon as possible after
preparation. Everything must be clean. Ask your health worker
or pharmacy for advice about sterilising bottles and teats.
It is important that everything used to make up the formula
is very clean. Feeding equipment must be washed and
sterilised until baby is at least 3 months old (including any
items used with breast milk) and thoroughly washed and
rinsed once baby is over 3 months.
Pneumonia and asthma – when coughs and colds
get serious
Help
Your child with a cough or cold may be in danger and must
see a doctor quickly if:
• they are breathing much more quickly than usual,
wheezing or making a grunting noise when breathing
• part of the lower chest sucks inward (instead of
expanding as normal) as baby breathes in
• they are unable to drink anything.
63
Meningitis / medicine
You can help prevent pneumonia and asthma by:
• having a smokefree home and car
• breastfeeding for at least 6 months
• immunising against the serious diseases on the
National Immunisation Schedule.
A child with a cough or cold should have plenty of drinks
and can be offered food. If their breathing is normal, coughs
and colds will get better. Keep them warm – not hot – and in
smokefree air.
Meningococcal disease – a serious infection for babies
If you think your child may have meningitis, contact your
doctor, hospital or after-hours medical centre straight away.
What to look for – not all these symptoms may show at once.
Your child may:
• have a fever
• have high-pitched crying or be unsettled
• refuse drinks or feeds
• vomit
• be sleepy or floppy or harder to wake
• have a stiff neck
• dislike bright lights
• have a rash of large red or blue spots or bruising.
Help
Medicine
64
Always check with your doctor or pharmacist before you
give any medicine to your child. It will only work if it is the
right medicine for your child’s illness and is used correctly.
Make sure you give the right dose. Pharmacies have special
droppers for giving liquid medicines to children.
If medicine is not used correctly, it will not work and may
even cause harm. Medicine that is right for one child may be
wrong for another. It is not safe to give medicine on advice
from friends or family. Medicines must be used only as
directed.
Talk to your doctor or pharmacist on the telephone if you
can’t visit.
If you think your child might have been poisoned, phone
the National Poisons Centre or Emergency Department at
your local hospital.
Keep the number of the National Poisons Centre,
0800 POISON / 0800 764 766, by the phone.
Dial 111 and ask for an ambulance if your baby or young
child has been injured and:
• is, or has been, unconscious (can’t be woken up)
• is being sick or seems sleepy
• has trouble breathing
• has serious burns
• you can’t stop the bleeding
• there is severe pain
• there is bleeding from an ear.
Injury / unconsciousness
Injury
Unconsciousness
If they are breathing, gently move them onto their front or
side so their tongue can’t fall back and stop them breathing.
Stay with them. Watch that they are breathing and not
turning blue.
Help
If they are not breathing, do CPR. (Page 58 for babies under
1 year, page 60 for children over 1 year.)
65
Help
Choking
Choking (the child may not be able to make any noise)
66
Infants up to 1 year
If they are unconscious, do CPR.
• Call for help.
• Firmly support the head by holding
the jaw.
• Hold the infant down lengthwise on
your arm or knee.
• Give 5 back slaps between the
shoulder blades with the heel of
your hand – not too hard.
• Turn the infant over face up with
head lower than the trunk (or body).
• Give 5 chest compressions in the
same place and as for CPR.
• Remove the object only if it can be seen.
Do not try to fish for it as you may push
the object down further.
• Continue back slaps and chest thrusts
until the object comes out. If the infant
becomes unconscious, follow the DRS
ABC on pages 56–58 and perform CPR.
Children over 1 year
If they are unconscious, do CPR.
• If they are coughing or having difficulty
breathing, encourage the child to cough.
Do not do anything further at this stage.
If the airway is completely obstructed and
the child is conscious but not breathing:
• Call for help.
• Stand to the side of and slightly behind
the child and give 5 slaps between the
shoulder blades with the heel of your
hand.
• If the object is not removed, wrap your
arms around the child’s waist above the
navel and grasp one of your fists with the
other hand.
See CPR pages 60–61.
Choking / burns
• Press your fists into the child’s abdomen with a quick
upwards thrust.
• Give up to 5 upward thrusts.
• If the object is not removed, repeat the sequence of 5 back
slaps and 5 upward thrusts.
• If the child becomes unconscious, follow the DRS ABC
and perform CPR.
If you can’t remove the object in these ways, do mouth to nose
(or mouth to mouth) breathing on the child until help arrives.
Burns
Dangers – check for dangers
Help
STOP, DROP and ROLL
• STOP the child running or walking as this will fan the
flames.
• DROP the child to the ground to prevent flames and gases
rising towards the head and airway.
• ROLL – Smother the flames by rolling the child in a blanket
or other non-synthetic material.
• Send for help.
• Ensure a clear airway.
• Check the child is breathing.
• Cool the burn area with water continuously over the area
for at least 20 minutes. DO NOT use iced water. If the burn
area is large, you may need to shorten the cooling period,
as cooling to a large body area can cause hypothermia in
children.
• After cooling, the burned area should preferably be covered
with plastic cling film along the limb or body.
• If appropriate to do so, elevate the burnt limb to reduce
swelling.
• Do not burst any blisters that appear.
• Do not apply any medications or ointment to the burn.
• Get medical help.
67
Drowning
• Call for help.
• If they are not breathing, start CPR immediately they are
out of the water. (Page 58 for babies under 1 year, page 60
for children over 1 year.)
Broken bones
• Don’t move the child unless you have to or are sure you
won’t cause pain. Watch them closely. If they cannot be
moved, you may need to call an ambulance.
• If they don’t need an ambulance, take them to your
nearest Emergency Department.
Bad cuts
• If there is a lot of bleeding, press hard against the cut with
a pad or clean cloth. If there is something stuck in the cut,
do not try to remove the object, just press around the cut.
Just use your hand if you don’t have a clean cloth. Raising
an injured arm or leg (as long as it is not broken) will help
stop the bleeding. Get medical help.
Help
Poisoning / drowning / broken bones / bad cuts
Help
68
Poisoning
Stay calm. Take the product container to the phone if you can.
• If the child is awake, call the Poisons Centre on 0800
POISON / 0800 764 766.
• If the child is sleepy or unconscious, lie them on their side
and call 111 for an ambulance.
• DO NOT make them vomit without advice from the
Poisons Centre or a doctor. Some products (eg, cleaners)
can burn the throat. Vomiting increases the risk of burns
and lung damage.
• GIVE a small drink of water if the product taken is
corrosive or irritating (eg, household cleaners).
• NO OTHER FLUIDS should be given unless advised to by
the Poisons Centre or a doctor.
Early signs
Time from first
contact till first
sign of illness
Measles*
Running nose
and eyes .......... About 7 days
Fever.
Rash ................ About 10 days
Rubella*
A rash and
swollen neck
glands.
Fever.
From first day of
illness to 4 days
after rash begins
Other children who have not
had measles and were not
immunised before, should
be immunised as soon as
possible, within 72 hours.
Pregnant women should
avoid contact with rubella,
but if contact occurs, see
your doctor.
For 3 weeks from first
signs if not treated
with antibiotics. If the
child has antibiotics,
until 5 days of the
treatment completed
If other children in house are
not fully immunised, keep
at home for 2 weeks. Keep
babies and toddlers right away
from patient.
(OR keep home until 5 days
of course of antibiotics
completed)
Mumps*
Pain in jaw then
swelling in front
of ear ................ About 14–21 days
Fever ................ About 18 days
For 1 week before
signs
For 9 days from first
signs
Other children can go
to school.
Chicken pox †
Fever and spots About 14 days
A blister on top
of each spot ..... About 15 days
From up to 5 days
before first lot of
blisters until blisters
have crusted (usually
about 5 days after
last blisters appear)
Other children can go
to school.
Hepatitis B*
Vomiting,
tiredness,
jaundice
6 weeks to
6 months
Months
A few are infectious
for years
See your doctor for testing.
Influenza†
High fever,
muscle aches,
cough,
runny nose
1–3 days
Up to 7 days
Give fluids, cool child down,
see your doctor if concerned.
Cold in nose,
persistent
cough .............. About 7 days
Later ‘whoop’
and vomiting .... About 10 days
Help
What to do
About 16–18 days From 7 days before
rash till 4 days after
rash started
Pertussis
(Whooping Cough)*
†
Infectious
to others
Some babies with chronic health conditions may be offered free influenza vaccine.
You may choose to immunise your healthy child against influenza or chickenpox – however, a charge will
apply. Talk to your doctor for more information.
Help
If you suspect any of these illnesses in your family tell your doctor.
* Immunisation prevents this illness.
Infectious illnesses
Infectious illnesses
69
Fits / fevers
Fits and fevers
Fits (or convulsions)
These sometimes happen when a child has a fever.
They look very scary but usually last only a few minutes.
Short single fits with a fever don’t cause brain damage.
One in 20 children has fits with fever – the most likely age
is from 6 months to 4 years.
A child having a fit may:
• go stiff and jerk or shake uncontrollably
• become unconscious – not knowing what is going on
around them
• have their eyes roll up, breathe noisily and heavily
• vomit, or have froth at their mouth
• clench their teeth tightly
• soil or wet themselves.
Help
Fits – what to do
70
If the child has a fit, put them on their side and stay with
them until it is over.
• You can’t stop a fit once it starts, but you can stop injury.
• Stay with the child. Lie them on their side with face
turned so they can dribble out of their mouth.
• Take off any tight clothing around the neck. Help clear air
passages by keeping the chin away from the chest if you
can.
• Don’t try to jam anything between the gums or teeth.
• Keep the jerking head, arms or legs away from hard
things. Make sure the child can’t fall.
If you are beside a telephone, or someone is with you, call a
doctor. Otherwise, wait till the fit is over before calling the
doctor.
If the fit doesn’t stop after 5 minutes, be sure the child is lying
safely, then call the doctor or ambulance – even if you have to
leave them for a few minutes.
Fevers / ear problems
When the fit is over
• They will be sleepy and will probably go into a deep
sleep. Don’t try to wake them.
• Clear any vomit from their mouth.
• If they are hot, continue to cool them down.
Don’t bundle them up.
Call the doctor.
Fevers – what to do
Treat fevers by cooling the child and
giving them plenty to drink.
To cool a feverish child (even if they
are shivering)
• Take off clothes and blankets, cool the room and wipe
the head and body with a wet, lukewarm cloth (a cold
cloth can make them hotter by making the body try
to warm up).
• Give plenty of water to drink.
• Keep wiping with a lukewarm cloth if the child stays
very hot and restless or if their temperature is still
rising. Place hand on child’s forehead to feel if they are
burning hot.
Ear problems can stop children from hearing and learning
Help
Your child should have the regular ear and hearing checks
offered by your Well Child provider or doctor with the health
checks in this book. These checks can pick up a problem like
glue ear, which doesn’t always cause earache so may not be
noticed.
Glue ear happens when the middle ear is filled with mucus or
fluid. It usually gets better without causing problems but if it
is causing hearing or behaviour problems, talk to your doctor
or ask for an audiology test. After treatment from a doctor or
specialist, their hearing will usually be OK again.
A baby might have glue ear if:
• they don’t seem to be interested in sounds
• they are crying, cross or not sleeping
• they have a cold or fever.
71
Ear problems
A toddler or preschooler might have glue ear if they:
• don’t listen
• are late learning to talk
• are cross, and upset everyone
• have had earache several times before
• snore, and breathe through their mouth
• have a greenish, runny nose.
You can help prevent glue ear by:
• breastfeeding your baby
• making sure baby is in an upright position while bottle
feeding
• having a smokefree home that is warm and dry (and a
smokefree car).
If you think your child might have glue ear, see your health
worker straight away.
Earache is caused by infection and often accompanies a
cold or sore throat
Earache should be treated quickly. Ear infections are
painful.
Help
Your baby may have an ear infection if they keep crying or
are grizzly, they keep touching their ear over and over again
or they get a runny ear. They may also have a cold.
72
If you can’t settle your baby,
phone your Well Child provider
or doctor right away. Lifting your
child’s head up above the level of
their chest will help relieve the pain.
Ears usually stop hurting before
the infection is really gone, but
your child still needs to finish up
all the medicine.
Recording your child’s development
The following pages are for you and your Well Child providers to
record and follow your child’s development.
Your pages
Your copy of referral form............................................................89
Your first week’s notes and things to talk about.......................96
Before the 4–6 weeks check ........................................................101
Before the 8–10 weeks check ......................................................106
Before the 3–4 months check...................................................... 112
Before the 5–7 months check...................................................... 118
Your child’s dental health...........................................................124
Before the 9–12 months check....................................................126
Before the 15–18 months check..................................................132
Before the 2–3 years check..........................................................138
Before the B4 School check .........................................................144
Useful telephone numbers ................................ inside back cover
Health workers’ pages
Graphs for head circumference for boys and girls .............75–76
Graph for weight for girls 0–1 year ............................................77
Graph for length for girls 0–2 years ............................................78
Graph for weight for girls 1–5 years ...........................................79
Graph for height for girls 2–5 years ............................................80
Graph for weight for boys 0–1 year ............................................81
Graph for length for boys 0–2 years ...........................................82
Graph for weight for boys 1–5 years ..........................................83
Graph for height for boys 2–5 years ...........................................84
Referral form to Well Child provider .........................................85
Referral form to General Practitioner .........................................87
Birth check ......................................................................................91
First week check ............................................................................97
2–4 weeks check .............................................................................99
4–6 weeks check ...........................................................................103
8–10 weeks check .........................................................................109
3–4 months check ........................................................................ 115
5–7 months check ........................................................................121
Dental record ................................................................................124
9–12 months check ......................................................................129
15–18 months check ....................................................................135
2–3 years check ............................................................................141
B4 School check ............................................................................149
Immunisation Certificate............................................................154
Immunisation record...................................................................156
73
The following ten growth charts are based on the UK-WHO
growth charts developed by the Royal College of Paediatrics
and Child Health, United Kingdom, copyright © 2009
Department of Health, United Kingdom.
74
75
36
75th
0.4th
2nd
9th
25th
0 2 4 6 8 10 12 14 16 18 20 22 24 26
Weeks
BOYS HEAD
CIRCUMFERENCE (cm)
0–2 years
7
7
Graphs for boys
31
32
33
34
35
37
91st
50th
38
39
40
41
42
43
44
45
46
47
48
49
50
51
98th
99.6th
Head Circumference (cm)
52
50 75 91s 98t 99.
th
th
h
6th
t
th
25
0.4 2n 9th
th d
8
8
10
11
12
13
9
10
11
12
13
15
14
15
Months
Months
14
d
a
e
h
9
16
16
17
17
18
18
19
19
20
20
21
21
22
22
23
0.4th
2nd
9th
25th
50th
75th
91st
98th
99.6th
23
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
DATE
HEAD
CIRCUMFERENCE
(cm)
Head Circumference (cm)
0.4th
2nd
9th
25th
50th
75th
91st
98th
99.6th
9
10
11
12
13
9
10
11
12
13
15
Months
Months
14
16
16
17
17
18
18
19
19
20
20
21
21
22
22
23
0.4th
2nd
9th
25th
50th
75th
91st
98th
99.6th
23
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
31
0 2 4 6 8 10 12 14 16 18 20 22 24 26
14
15
31
32
8
d
a
e
h
8
32
7
7
33
Weeks
GIRLS HEAD
CIRCUMFERENCE (cm)
0–2 years
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
Graphs for girls
25 50 75 91s 98t 99.
th
th
th
h
6th
t
0.4 2n 9th
th d
76
DATE
HEAD
CIRCUMFERENCE
(cm)
77
0.4th
2nd
9th
25th
50th
75th
91st
98th
99.6th
13
2
6
8
10
12
14
16
16
18
20
22
4
18
20
24
6
26
28
7
30
32
34
8
Age in weeks/ months
32
34
8
t
h
g
i
e
5
w
4
36
36
38
38
9
9
40
40
42
42
44
10
10
46
46
11
50
6.5
50
7
0.4th
2.5
3
3.5
4
4.5
5
5.5
6
7.5
2nd
8
8.5
9
9.5
10
10.5
11
11.5
12
12.5
13
52
13.5
9th
25th
50th
75th
91st
98th
99.6th
48
11
4
Graphs for girls
0.5
1
22
5
24
26
6
28
30
7
44
48
0.5
52
1
1.5
3
14
2
1
9th
d
2n h
t
0.4
th
75
th
50
th
25
3
1.5
0
th
98
2
Some degree of weight
loss is common after birth.
Calculating the percentage
weight loss is a useful way
to identify babies who
need extra support.
(kg)
2
2.5
3
3.5
4
4.5
5
5.5
6
6.5
7
7.5
8
8.5
9
9.5
10
10.5
11
11.5
12
12.5
Weight (kg)
GIRLS WEIGHT
0 –1 year
6t
h
13.5
99
.
91
st
DATE
WEIGHT
(kg)
Length (cm)
0.4th
2nd
9th
25th
50th
75th
91st
98th
99.6th
44
46
48
50
52
54
56
58
60
62
64
66
68
70
72
74
76
78
80
82
84
86
88
90
92
94
96
98
0
1
2
3
4
GIRLS LENGTH
0 –2 years
5
(cm)
1/2
1/2
7
7
Graphs for girls
0. 2n 9t 25 50 7 91 98 99
4t d h th th 5t st th .6
h
h
th
78
9
11
8
9
1
13
14
11
1
13
14
Age in months/ years
10
15
15
h
t
g
10
n
e
l
8
16
16
17
17
11/2
11/2
19
19
20
20
21
21
22
22
0.4th
2nd
9th
25th
50th
23
90
44
24
46
48
50
52
54
56
58
60
62
64
66
68
70
72
74
76
78
80
82
84
86
88
92
t
91s
75th
94
h
98t
96
24
98
th
99.6
23
DATE
LENGTH
(cm)
79
Weight (kg)
19 20 21 22 23
2
21/2
3
37 38 39 40 41
31/2
43 44 45 46 47
t
h
g
ei
31 32 33 34 35
w
25 26 27 28 29
4
4
49 50 51 52 53
49 50 51 52 53
41/2
41/2
6th
99.
27
28
55 56 57 58 59 60
29
25 26 27 28 29
Graphs for girls
5
12 13 14 15 16 17
6
0.4th
21/2
31 32 33 34 35
3
31/2
37 38 39 40 41
43 44 45 46 47
5
55 56 57 58 59 60
6
7
8
7
9
9th
2nd
10
11
12
13
8
0.4th
14
15
16
17
18
25th
50th
h
75t
91s
t
h
98t
2nd
9th
25th
50th
9
10
11
12
13
14
15
16
17
18
19
20
19
75th
21
22
23
24
20
t
91s
h
98t
21
22
23
24
25
11/2
2
26
9
(kg)
25
th
9.6
GIRLS WEIGHT
1– 5 years
26
27
28
29
UK-WHO chart 2010 based on DH copyright 2009 reproduced with permission
DATE
WEIGHT
(kg)
104
108
112
116
120
124
st
th
0.4
2nd
9th
th
25
h
50t
th
75
91
th
98
h
.6t
99
24 25 26 27 28 29
76
80
84
88
92
96
100
21/2
GIRLS HEIGHT
2 – 5 years
34 35
31 32 33 34 35
(cm)
3
31/2
43 44 45 46 47
37 38 39 40 41
3
37 38 39 40 41
31/2
43 44 45 46 47
t
h
g
i
e
h
Graphs for girls
Height (cm)
80
4
4
49 50 51 52 53
49 50 51 52 53
41/2
41/2
76
80
84
88
92
96
100
104
108
112
116
120
55 56 57 58 59 60
0.4th
2nd
9th
25th
50th
75th
91st
98th
th
99.6
124
55 56 57 58 59 60
DATE
HEIGHT
(cm)
81
0.4th
2nd
9th
25th
50th
75th
91st
98th
99.6th
Weight (kg)
0
2
8
10
12
14
16
16
18
20
22
4
18
20
24
6
26
28
7
30
32
34
8
32
34
8
t
h
g
ei
5
w
4
36
36
38
38
9
9
40
40
42
42
44
10
10
46
46
11
50
0.4th
2nd
9th
25th
50th
75th
91st
98th
50
99.6th
48
11
2.5
3
3.5
4
4.5
5
5.5
6
6.5
7
7.5
8
8.5
9
9.5
10
10.5
11
11.5
12
12.5
13
52
13.5
4
Graphs for boys
0.5
1
22
5
24
26
6
28
30
7
44
48
0.5
52
1
1.5
6
14
2
3
3
1.5
1
h
9t
d
2n
h
4t
0.
th
75
th
50
th
25
(kg)
2
2.5
3
3.5
4
4.5
5
5.5
th
98
6
2
Some degree of weight
loss is common after birth.
Calculating the percentage
weight loss is a useful way
to identify babies who
need extra support.
BOYS WEIGHT
0 –1 year
6.5
7
7.5
8
8.5
9
9.5
10
10.5
11
11.5
12
12.5
13
13.5
Graphs for girls
99
.6
th
st
91
DATE
WEIGHT
(Kg)
0.4th
2nd
9th
25th
50th
75th
91st
98th
99.6th
44
46
48
50
52
54
56
58
60
62
64
66
68
70
72
74
76
78
80
82
84
86
88
90
92
94
96
98
0
1
2
3
4
BOYS LENGTH
0 –2 years
5
(cm)
1/2
1/2
7
7
8
9
11
1
13
14
10
15
8
9
10
11
1
13
14
15
h
t
g
n
le
Graphs for boys
Length (cm)
Graphs for boys
0. 2n 9t 25 50 7 91 98 99
4t d h th th 5t st th .6
h
h
th
82
16
16
17
17
11/2
11/2
19
19
20
20
21
21
22
22
0.4th
2nd
9th
25th
50th
75th
t
91s
98th
23
th
99.6
23
44
24
46
48
50
52
54
56
58
60
62
64
66
68
70
72
74
76
78
80
82
84
86
88
90
92
94
96
24
98
DATE
LENGTH
(cm)
83
21/2
3
37 38 39 40 41
31 32 33 34 35
31/2
43 44 45 46 47
t
h
g
w ei
25 26 27 28 29
4
4
49 50 51 52 53
49 50 51 52 53
41/2
41/2
th
99.6
26
27
55 56 57 58 59 60
28
23
22
22
t
91s
12
25 26 27 28 29
21/2
4
12 13 14 15 16 17
31 32 33 34 35
3
31/2
37 38 39 40 41
43 44 45 46 47
4
55 56 57 58 59 60
5
6
5
7
8
9
10
11
12
13
14
15
16
17
18
6
0.4th
9th
2nd
25th
h
50t
0.4th
2nd
9th
25th
50th
7
8
9
10
h
75t
h
98t
13
11
6th
99.
14
15
16
17
18
19
20
19
21
20
75th
21
t
91s
23
h
98t
24
2
2
25
19 20 21 22 23
(kg)
24
11/2
BOYS WEIGHT
1– 5 years
25
26
27
28
Graphs for boys
Weight (kg)
Graphs for boys
UK-WHO chart 2010 based on DH copyright 2009 reproduced with permission
DATE
WEIGHT
(Kg)
104
108
112
116
120
124
0.4th
2nd
9th
h
25t
th
50
th
75
t
91s
th
98
h
.6t
99
24 25 26 27 28 29
76
80
84
88
92
96
100
21/2
BOYS HEIGHT
2 – 5 years
34 35
31 32 33 34 35
(cm)
31/2
43 44 45 46 47
37 38 39 40 41
4
3
37 38 39 40 41
31/2
43 44 45 46 47
4
t
h
g
i
e
h
3
Graphs for boys
Height (cm)
84
49 50 51 52 53
49 50 51 52 53
41/2
41/2
76
80
84
88
92
96
100
104
108
112
116
120
55 56 57 58 59 60
0.4th
2nd
9th
25th
50th
75th
91st
98th
th
99.6
124
55 56 57 58 59 60
DATE
HEIGHT
(cm)
Please make sure that your Lead Maternity Carer sends this form to your
Well
Child
provider before
yourbefore
baby your
is a month
General
Practitioner
(doctor)
baby isold
a month old
Mother
Please write firmly
Family name:
Given names:
Birth date:
NHI number:
Address:
Home phone:
Alternative contact:
Ethnicity:
General Practitioner:
Family name:
Given names:
Birth date:
NHI number:
Ethnicity:
Gender:
Male
Female
Baby’s Summary
Gestation:
Breastfeeding:
weeks
exclusive
full
partial
Comments:
Vitamin K: inj.
or 1st oral
2nd oral
Guthrie test
Newborn Hearing Screening (NBHS)
Summary of ongoing needs identified at time of handover:
Date referral sent:
Expected date of discharge from LMC:
Name of referring LMC Practitioner:
Contact details:
artificial
Referral form to Well Child provider
Baby
Please make sure that your Lead Maternity Carer sends this form to your
General Practitioner (doctor) before your baby is a month old
Mother
Family name:
Given names:
Birth date:
NHI number:
Address:
Home phone:
Baby
Family name:
Given names:
Birth date:
NHI number:
Ethnicity:
Gender:
Male
Female
Baby’s Summary
Gestation:
Breastfeeding:
weeks
exclusive
full
partial
Comments:
Vitamin K: inj.
or 1st oral
2nd oral
Guthrie test
Date referral sent:
Contact details:
artificial
Referral form to General Practitioner
Ethnicity:
Please make sure –that
Lead
Maternity
Carer sends
Parents/caregiver
thisyour
is your
copy
of the referral
form this form to your
General Practitioner (doctor) before your baby is a month old
Mother
Family name:
Given names:
Birth date:
NHI number:
Address:
Home phone:
Ethnicity:
Baby
Family name:
Given names:
NHI number:
Ethnicity:
Gender:
Male
Female
Baby’s Summary
Gestation:
Breastfeeding:
weeks
exclusive
full
partial
Comments:
Vitamin K: inj.
or 1st oral
2nd oral
Guthrie test
Date referral sent:
Contact details:
artificial
Referral form – your copy
Birth date:
Comments/progress notes
Date/Age/Weight
90
Birth
Well Child Tamariki Ora check
Birth event (History):
National Health Index No. _________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
Assessment:
APGAR at: 1 min
5 mins
Birth weight (gms):
Head circumference:
Length:
Gestation (duration of pregnancy/completed weeks)
yes/ok
needs comment/action
fontanelles
lungs
back
eyes – red reflex
abdomen
anus
nose/mouth
umbilicus
legs/arms
ears
femoral pulses
reflexes, movements, tone
heart
genitals
skin
Full physical examination:
Skin-to-skin within 30 minutes
Hips – Ortolani/Barlow
Breastfed within 1 hour
– classic signs
Comments/action:
Birth check
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
Health protection ( if done)
Vitamin K:
inj.
or 1st oral
Immunisation (if needed for hepatitis B, TB) record page 156
Baby’s blood group if mother Rh negative
See page 97 for 2–7 day check, including Guthrie.
91
Vision
Birth check continued
Indicators at birth for vision or eye problems
Put an X in the box if true
close relative with eye tumour at birth or during infancy
or close relative with congenital eye malformation
rubella (German measles), contact with rubella, or other
congenital infection such as Toxoplasma during pregnancy
prematurity – less than 32 weeks or birth weight less than 1250 gms
eye malformations (absent red reflex, bulging eye, abnormal pupil),
failure to fix or follow, or abnormal eye movements
newborn seizures, encephalopathy, or metabolic disease
Hearing
trauma to eye or conjunctivitis that worsens or doesn’t resolve
For any with an X, refer to an eye specialist.
Indicators for hearing loss
Put an X in the box if true
close relative with hearing loss from early childhood
serious infection during pregnancy such as CMV, toxoplasmosis,
syphilis or rubella, or contact with rubella during pregnancy
craniofacial anomalies of the head, neck or ears, or other physical
finding known to be associated with hearing loss, such as a
genetic syndrome
jaundice with bilirubin exceeding level for exchange transfusion
serious postnatal infection such as bacterial meningitis
Birth check
admission for neonatal care, and ototoxic medications above
therapeutic levels and/or asphyxia
92
admission for level 3 neonatal care for more than 5 days
Signature:
Print name/designation:
Date:
Date/Age/Weight
93
Date/Age/Weight
94
Date/Age/Weight
95
79
Your notes and/or photo:
Things to talk about
• Infant feeding – ask for the book Eating for Healthy
Babies and Toddlers 0–2 years
• Safe sleeping for baby
• Baby’s behaviour and needs (crying)
• Infant car seat and car safety
• Smokefree baby zone
• Coping with stress and fatigue
• Parent support and education available
• Immunisation information
• Feeling sad
• Other children’s reactions to baby
• Mother’s nutrition – ask for the booklet
Eating for Healthy Breastfeeding Women
• Hearing and vision checklist
• Safety section
Talk to your Lead Maternity Carer about when you
should go to your Well Child provider and doctor.
See referral forms on pages 85 and 87.
96
First week
Progress:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
Assessment:
Weight (gms):
Pass
Vision assessment:
Physical examination
including:
Retest/Refer
Newborn Hearing
Screening/Assessment:
yes/ok
eyes
lungs
femoral pulses
skin
abdomen
genitals
heart
umbilicus
hips – classic signs
Comments/action:
First week check
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
Health protection (✓ if done)
Vitamin K (2nd oral)
Signature:
Heel prick – Guthrie (between 2 and 5 days)
Date:
97
Date/Age/Weight
98
98
2–4 weeks
Progress:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
Assessment:
Weight (gms):
Head circumference:
Pass
Vision assessment:
Physical examination
including:
Retest/Refer
Newborn Hearing
Screening/Assessment:
yes/ok
eyes
lungs
femoral pulses
skin
abdomen
genitals
heart
umbilicus
hips – classic signs
Comments/action:
Signature:
2– 4 weeks check
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
Date:
99
Date/Age/Weight
100
Before the 4–6 weeks check
What is your baby doing at 4–6 weeks?
Can your child see?
Yes
No
Yes
No
Vision
Most babies can see and hear well, but the few who can’t
need help as soon as possible. Your baby’s eyes and ears
should be checked regularly. Fill in this page before you see
your Well Child provider or doctor for the 4–6 weeks Well
Child Tamariki Ora check.
Do they…
close their eyes against a bright light?
stare at people’s faces when they are
up close?
turn towards light?
Can your child hear?
Hearing
smile at you without being touched or
spoken to?
When there is a sudden loud noise, do they…
jump or blink?
stir in their sleep?
stop sucking for a moment?
look up from sucking?
cry?
4– 6 weeks
What else does your baby do?
101
4– 6 weeks
102
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Infant feeding
Baby’s behaviour and needs (crying)
Car seat and car safety
Smokefree baby zone
Coping with stress and fatigue, sad feelings
Parent support and education services
Other children’s reactions to baby
Hearing and vision checklists
Safety section
Infant sleeping
Introduction to other parents
Contraception
Recognition of illness
Immunisation choices – ask for booklet
Immunisations
4–6 weeks
Progress:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
Assessment:
Weight:
Head circumference:
Vision:
Physical examination:
Length:
Hearing:
yes/ok
Development:
skin
heart
hips – Ortolani/Barlow
fontanelle
lungs
eyes – red reflex
abdomen
genitals
nose/mouth
umbilicus
back
ears
femoral pulses
anus
– classic signs
reflexes, movement, tone
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
Health protection (✓ if done)
Vitamin K (3rd oral)
Immunisation choice made
On National Immunisation Register
Immunisation programme commenced Y/N
Signature:
record page 156
Date:
4–6 weeks check
Comments/action:
103
103
Date/Age/Weight
104
Date/Age/Weight
105
Before the 8–10 weeks check
What is your baby doing?
Vision
Fill in this page before the 8–10 weeks Well Child Tamariki
Ora check.
Can your baby see well?
Yes
No
Yes
No
Do they…
stare at people’s faces when they are
up close?
turn towards light?
Hearing
spoken to?
Can your baby hear well?
When there is a sudden noise do they…
jump or blink?
stir in their sleep?
stop sucking for a moment?
look up from sucking?
cry?
8 –10 weeks
What else is your baby doing?
106
Talk to your Well Child provider or your doctor if you think
your baby is not seeing or hearing well.
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Infant car seat and car safety
Smokefree baby zone
Safety section
Infant feeding
Social development and play
Protection from falls
Protection from choking on small objects
Hot water/burn protection
Sunburn protection
Returning to work outside the home
Parent support groups and education services
8 –10 weeks
107
Development questions
How does your baby show what they want?
What do you think your baby understands?
In what way(s) does your baby move?
How does your baby act around family members?
In what way(s) does your baby play?
8 –10 weeks
At your baby’s 3–4 months check, you and your Well Child
provider will complete a simple questionnaire about your
baby’s development. This questionnaire is called PEDS, or
Parents’ Evaluation of Developmental Status.
108
8–10 weeks
Progress:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
Assessment:
Weight:
Head circumference:
Vision:
Hearing:
Development:
Hips – Ortolani/Barlow (abduction only)
Classic signs
Examination
(only if indicated):
yes/ok
8 –10 weeks check
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
Comments/action:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
Immunisation (page 156)
Signature:
Date:
109
Date/Age/Weight
110
Date/Age/Weight
111
79
Before the 3–4 months check
Fill in this page before the 3–4 months Well Child Tamariki
Ora check.
Vision
Yes
No
Yes
No
Do they…
stare at people’s faces when they are up close?
turn towards light?
spoken to?
Hearing
look at own fingers?
Do they…
blink or cry when there is a sudden noise?
stop crying or sucking when you talk?
wake or stir to loud sounds?
coo or smile when you talk?
turn their eyes towards voices?
seem to like a musical toy?
stop moving when there is a new sound?
3–4 months
seem to know your voice?
When baby’s teeth start coming, you might like to record
their arrival on page 125 (teeth diagram).
112
What is PEDS?
PEDS = Parents’ Evaluation of Developmental Status
PEDS is a 10 item questionnaire that asks you (parent or
guardian) about your child. Your Well Child nurse will
explain how and when to complete this.
Why PEDS?
As a parent you know your child better than anyone
else does. You may notice things about your child that
concern you – and even things that no one else has
noticed. Sharing your concerns about your child can help
your Well Child nurse understand your child better, and
may also help pick up any problems early on. The PEDS
contains questions that ask you about any concerns you
have about your child. It is important that you share these
with your nurse so that you can work in partnership with
the nurse towards the best outcomes for your child.
Do you have any concerns about your child’s learning,
development and behaviour? In particular, think about:
• how your child talks and makes speech sounds
• how your child understands what you say
• how your child uses his or her hands and fingers to
do things
• how your child uses his or her arms or legs
• how your child behaves
• how your child gets along with others
• how your child is learning to do things for himself/
herself
• how your child is learning preschool or school skills.
3–4 months
Your child's development
113
3–4 months
•
•
•
•
•
•
•
•
•
•
•
•
•
114
Smokefree baby zone
Parent support and education services
Social development and play
Returning to work outside the home
Childcare options
Car seat upgrade
Protection from poisons
Teething – diagram page 125
Infant feeding (solids) – ask for leaflet Starting Solids
3–4 months
Progress:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
Assessment:
Weight:
Vision:
yes/ok
Hearing:
Development:
PEDS check
Yes
No
PEDS form completed:
Referral required:
Examination
Comments/action:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
Signature:
Date:
3–4 months check
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
115
Date/Age/Weight
116
Date/Age/Weight
117
79
Vision
Ora check.
Yes
No
Yes
No
Do they…
follow a slow-moving, bright-coloured
object with their eyes?
reach out for toys and other things?
hold them firmly and look closely at them?
Do they…
turn towards a sound or someone speaking?
cry when there is a sudden noise?
5–7 months
Hearing
like music?
118
make lots of different babbling sounds?
sometimes copy sounds you make?
Your child’s development
do things
herself
5–7 months
Your notes:
119
5–7 months
Take some time for yourself – do something of your own.
Spend some time just with your partner, as well as shared
family time.
See if you can manage some individual time with each
child.
Talk, together with your family, about bedtimes, food and
other household matters.
Talk to your Well Child provider or doctor about your
family’s health needs.
120
5–7 months
Progress:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
Assessment:
Weight:
Eyes – vision:
Ears – hearing:
Hips – classic signs
Development:
yes/ok
Yes
PEDS check
No
Referral required:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
Comments/action:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
Signature:
Date:
5–7 months check
Examination
121
Date/Age/Weight
122
Date/Age/Weight
123
Your child’s dental health
Enrol your child with a dental therapist at 9 months of
age for free advice and treatment. Call 0800 TALKTEETH,
0800 825 583. Your Well Child provider, doctor or local
primary school can also give advice or make referrals.
Date/Age
Assessment and advice
Oral Health Guidance for Parents
Dental health
Good nutrition is necessary for good teeth
124
Breastfeed your baby until he or she is ready for and needs
extra food (around 6 months) then continue to breastfeed
until 12 months of age or beyond.
If mother is temporarily unable to breastfeed, expressed
breast milk can be given to the infant by bottle or cup
feeding. If bottle feeding, use only expressed breast milk or
infant formula. Make sure that it is prepared and hold the
baby while bottle-feeding: do not put baby to bed with a
bottle. If a pacifier is used, do not dip the pacifier in sugar,
honey or any other sweetened drinks.
Fruit drinks and juices, cordials and other sweetened drinks
are not recommended for infants and toddlers.
Brushing teeth is very important
You should start brushing the baby teeth as soon as they
start to emerge through the gums. Baby teeth are very
important. Use a smear of fluoride toothpaste on a small
soft-bristled brush and brush twice daily. It is very important
to brush baby’s teeth before bedtime.
Baby teeth
The lower front teeth usually come first. These are followed
by the upper front teeth. As each tooth comes, you can write
your baby’s age on that tooth in the picture.
Top teeth
Left side
Right side
Bottom teeth
Toothache
Dental health
If a child is in a lot of pain, and/or swelling or redness
appears on the child’s gum or face, or the teeth do not have a
normal white appearance, contact a dental therapist, dentist
or doctor straight away.
125
Ora check.
Vision
Yes
No
Yes
No
Do they… pick up small things like bits of
fluff from the floor or a pea from a plate?
follow the movement of a dangling ball in
all directions?
look for dropped toys?
watch what people are doing near them?
tilt their head sideways to look at things?
Hearing
have a “lazy” eye, “cross” eye or squint
(when both eyes don’t look straight at you
most of the time)?
Do they… respond to their own name?
look around to find new sounds – even
quiet ones?
understand “no” and “bye-bye”?
listen when people talk?
like copying sounds?
use babbling that sounds like real speech
9–12
months
15
months
try to talk back when you talk?
See pages 71 and 72 for what to do about
ear problems like glue ear and earache.
Have you enrolled your baby with a dental therapist? (See
page 124.)
126
do things
herself
9–12 months
Your notes:
127
9–12 months
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
128
Toddler play needs
Toddler reading
Toddler behaviour
Toddler car seat
Protection from roads/wandering
Safety section
Protection when walking
Smokefree toddler zone
Protection from water
Protection from poisons
Toddler nutrition
Preschool enrolment
Dental therapist enrolment (see page 124)
9–12 months
Progress:
_______________________________________________________
_______________________________________________________
_______________________________________________________
Assessment:
Weight:
Length:
Eyes – vision:
Ears – hearing:
Development:
– gait
yes/ok
PEDS check
Yes
No
Yes
No
Referral required:
Oral health check
Lift the Lip:
Examination
_______________________________________________________
_______________________________________________________
_______________________________________________________
Comments/action:
_______________________________________________________
_______________________________________________________
_______________________________________________________
Signature:
9–12 months check
Referral required:
Date:
129
Date/Age/Weight
130
Date/Age/Weight
131
Before the 15 –18 months check
What is your toddler doing?
Vision
Fill in this page before the 15 –18 months Well Child Tamariki
Ora check.
Can your child see well?
Yes
No
Yes
No
Do they… pick up small objects with their
finger and thumb?
point to interesting things (like birds)?
watch everything that is going on around them?
search with their hands rather than their eyes?
Hearing
bring objects up close to their eye?
have a “lazy” eye or squint (when both eyes
don’t look at you)?
Can your child hear well?
Do they… point to people and things they
know when asked to?
copy or repeat simple words or things?
understand things like “come here”?
use their voice to get attention?
say 2 or 3 words?
15 –18 months
listen when people talk?
132
your child is not seeing or hearing well.
See pages 71 and 72 for what to do about ear
problems like glue ear and earache.
do things
herself
15 –18 months
Your notes:
133
15 –18 months
134
• Behaviour and needs
• Social and play needs
• Feeding your toddler – ask for the booklet Eating for
Healthy Children aged 2 to 12
• Preschool and dental enrolment
• Recognition of illness
• Toileting
• Safety section
• Protection from roads/wandering
• Smokefree child zone
• Hot water protection
• Promoting a safer neighbourhood
(playgrounds, drains, etc)
15 –18 months
Progress:
_______________________________________________________
_______________________________________________________
_______________________________________________________
Assessment:
Weight:
Length:
Eyes – vision:
Ears – hearing:
Development:
– gait
yes/ok
PEDS check
Yes
No
Yes
No
Referral required:
Oral health check
Referral required:
Examination
_______________________________________________________
_______________________________________________________
_______________________________________________________
Comments/action:
_______________________________________________________
_______________________________________________________
_______________________________________________________
Signature:
15 –18 months check
Lift the Lip:
Date:
135
Date/Age/Weight
136
Date/Age/Weight
137
79
Before the 2–3 years check
What is your child doing?
Vision
Vision
Fill in this page before the 2–3 years Well Child Tamariki Ora
check.
Can your child see well?
Yes
No
Yes
No
Do they…
recognise small details in picture books?
Hearing
Hearing
hold objects really close to look at them?
have cross-eye or a squint?
Can your child hear well?
Do they, by two and a half years…
do two things when asked, like “get the ball
and bring it here”?
repeat what you say?
continually learn new words?
say simple sentences with 2 or more words
in them?
use many words which non-family members
can understand?
Do they, by three years…
speak clearly so that everyone can understand?
3
years
2–3
years
ask lots of what or why questions?
138
your child is not seeing or hearing well.
Your child is entitled to free dental care.
do things
herself
years
32–3
years
Your notes:
139
2–3 years
140
•
•
•
•
•
•
•
•
•
•
•
•
•
Behaviour and needs
Social and play needs
Sunburn protection
Nutrition
Protection from roads/wandering
Dental enrolment
Toileting
Smokefree child zone
Reading
Preschool and preparation
Cycle helmet on trike
School options
2–3 years
Progress:
_______________________________________________________
_______________________________________________________
_______________________________________________________
Assessment:
Weight:
Height:
Eyes – vision:
Ears – hearing:
Development:
yes/ok
PEDS check
Yes
No
Yes
No
Referral required:
Oral health check
Lift the Lip:
Referral required:
_______________________________________________________
_______________________________________________________
_______________________________________________________
Comments/action:
_______________________________________________________
_______________________________________________________
_______________________________________________________
Signature:
Date:
2–3 years check
Examination
141
Date/Age/Weight
142
Date/Age/Weight
143
Before the B4 School check
What is your child doing?
Fill in this page before the B4 School check.
Vision
Vision questions – can your child see well? Yes
No
Do they…
point to interesting things (like birds)?
have both eyes working together?
run into things – high or low?
bring objects close to their eyes to look at them?
tilt their head in an unusual way to look
at things?
Hearing
have a “lazy” eye, “cross” eye or squint?
Hearing questions – can your child hear
and speak well?
Yes
No
Do they…
tell a long, clear story about things
they have done?
speak well, with only a few sounds wrong,
like “r” or “s”?
know what things are for (like hat,
apple or plate)?
like books and being read to?
B4 School
understand most of what you say?
Has your child had their 4-year-old immunisations?
Talk to your Well Child provider or doctor if you think your
child is not seeing or hearing well.
Your child is entitled to free dental care.
144
do things
herself
B4 School
Your notes:
145
Has your child spent time in hospital?
Yes
No
If yes, note the details:
Does your child have any of the following?
Condition
Yes
Regular medication
Action plan
Asthma
Food intolerance
Eczema or other
skin condition
Heart condition
Epilepsy or fits
Chronic chesty
cough
Allergies
– What is your child allergic to?
– What was the child’s allergic reaction?
Medication
Is your child on any other medication?
Please list:
Yes
No
Yes
No
Yes
No
Dental health
B4 School
Do you have any concerns about your
child’s teeth?
146
Has your child been to a dental therapist
in the past 1–2 years?
Eye health
Yes
No
Yes
No
Yes
No
Yes
No
Does your child wear glasses?
Ear health
Has your child had grommets or tubes
inserted or is this planned?
Does your child have any other conditions
or disabilities?
If yes, please comment:
Services
The B4 School check might be held at a doctor’s clinic, a
preschool, a kòhanga reo, or other community centre (or
at school).
A registered nurse does the B4 School check, usually with
help from vision and hearing technicians for the vision
and hearing check. (Vision Hearing Screening record
page 8.) You are also involved in the check because you
know your child best.
B4 School
B4 School
Are you or your family getting help
or support from any services?
If yes, which services?
147
B4 School
Things to talk about with the Child Health nurse
148
•
•
•
•
•
•
•
•
•
•
•
•
Behaviour and needs
Positive family relationships
Social and play needs
Feeding your child
Reading
Smokefree child zone
Dental health
Protection from traffic
Promotion of community safety
Preparation for school
4-year-old immunisation
B4 School check
B4 School check completed by:
B4 School check date:
Health questionnaire
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Health questionnaire completed:
Referral required:
Oral health
Lift the Lip:
Referral required:
Growth check
Height (m to 0.1 cm):
Weight (kg to 0.1 kg):
Referral required:
PEDS check
B4 School check
Referral required:
SDQ check
SDQ parent form completed:
SDQ teacher form completed:
Referral required:
149
B4 School check
referral
Referred by:
Referred to:
Date referral sent:
Reason for referral/B4 School check results:
________________________________________________________
________________________________________________________
________________________________________________________
________________________________________________________
________________________________________________________
________________________________________________________
B4 School check
referral follow-up
B4 School check
Appointment date:
150
Appointment location:
Referral outcome:
Date referral complete:
Date/Age/Weight
151
Date/Age/Weight
152
Date/Age/Weight
153
Pneumococcal
Pneumococcal
Immunisation record (to be completed by nurse/doctor)
Age
Vaccine
Batch
Site
Date given
Sign/stamp
Note
Birth
BCG*
Hep B**
156
6 weeks
DTaP-IPVHep B/Hib
3 months
DTaP-IPVHep B/Hib
5 months
DTaP-IPVHep B/Hib
15 months
Hib
4 years
Immunisation record
HBIG**
DTaP-IPV
PCV7
PCV7
PCV7
MMR
PCV7
MMR
* Children at higher risk of TB should
be offered BCG.
** Babies of hepatitis B carrier
mothers need HBIG and
hepatitis B vaccine at birth.
BCG
Bacillus Calmette-Guérin.
DTaP-IPV Diphtheria-Tetanus-acellular Pertussis
-inactivated Polio vaccine.
DTaP-IPV- Diphtheria-Tetanus-acellular Pertussis
Hep B/Hib -inactivated Polio-Hepatitis B/
Haemophilus influenzae type b vaccine.
HBIG
Hepatitis B immunoglobulin.
Hep B
Hepatitis B vaccine.
Hib
Haemophilus influenzae type b vaccine.
MMR
Measles-Mumps-Rubella vaccine.
PCV7
Pneumococcal vaccine.

Well Child Book - Parent Aid Waitakere

Transcription

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