I. Who and the number of visits
1. Newborns living in the area are all tourists.
2. Normal full-term newborns were visited twice, within 7 days after discharge and 28-30 days after birth.
3. For newborns with high-risk situations at birth, visit them within 3 days after receiving the discharge report of newborns, and increase the number of visits as appropriate.
4. Visit newborns who weigh less than 2000g, have abnormal body temperature and poor living ability once a day, and refer them when necessary. After the situation improves, visit 1 2 times a week.
Two. The content of the visit
1. Ask about the perinatal situation of the parturient: health status during pregnancy, gestational age, delivery mode, birth weight of the child, asphyxia or birth injury, etc. Neonatal lactation, sleep, defecation, etc. ; Whether there are signs of disease; Vaccination situation: ask if you have been vaccinated with BCG and the first dose of hepatitis B vaccine; Neonatal screening: Ask if you have had phenylketonuria, congenital hypothyroidism and neonatal hearing screening at birth. If not, urge parents to take their children to childbirth hospitals or maternal and child health care institutions for screening as soon as possible.
2. Observe the general situation of the newborn, such as complexion, spirit, breathing rhythm, crying and reactivity, and whether there are abnormal manifestations such as drowsiness, irritability, sucking weakness, jaundice, cyanosis, shortness of breath and poor reactivity; Maternal and infant posture, embrace posture and sucking power during breastfeeding; Indoor temperature, ventilation and sanitary conditions, etc.
3. The physical examination doctor washes his hands and checks in the following order: 1) Head and face: anterior fontanel and cranial suture, presence of hematoma, cleft lip and palate, thrush, abnormal eye appearance, and presence of abnormal lump in neck;
2) Skin: whether there is jaundice, rash, scleredema, etc. , and whether there is flushing or erosion in skin folds such as neck, armpit, groin and buttocks;
3) Heart and lung: whether there is murmur in the heart and abnormal breathing sounds in the lungs;
4) Umbilical part: whether the umbilical cord falls off and whether the umbilical fossa is abnormal;
5) Whether the external genitalia and anus are deformed;
6) Limbs: what is the activity, whether there is any abnormality in muscle tension and whether there is congenital dysplasia of hip joint.
4. Measurement test 1) Measure body temperature, 2) Measure body weight and evaluate its growth, and 3) Make up for hearing screening.
5. Handling 1) If thrush, omphalitis, diaper dermatitis, flushing or erosion at skin folds are found, the doctor should handle them in time; 2) If the newborn is found to have any dangerous signs that cannot be handled, parents should be assisted to immediately refer the child to a local hospital with conditions for diagnosis and treatment of neonatal diseases; 3) If the newborn is found to have signs such as heart murmur, rash, neck lump and deformity. It is also recommended to refer to the hospital at another time. 4) Physiological jaundice, physiological weight loss, "horse teeth", "mantis mouth", breast swelling, false menstruation and other phenomena do not need special treatment.
Three. Guidance content
1. Feeding guides pregnant women to master the correct breastfeeding methods, encourages exclusive breastfeeding until 6 months, and breastfeeds full-term newborns on demand. For premature infants with weak sucking ability, breast milk can be squeezed into a cup and fed with a dropper. It is suggested that full-term infants should take vitamin D400IU daily to 2 years old, premature infants should take 800IU daily, and breast-fed newborns should be supplemented with vitamin K after birth. Pay attention to the posture of feeding and the posture after feeding to prevent suffocation and accidental injury.
2. Warm newborn rooms should be quiet and clean, with good air circulation and plenty of sunshine. In winter, the room temperature should be kept at 22 26, and the humidity is appropriate. Don't cover too much in hot season to avoid dehydration, fever and other adverse consequences.
3. The nursing clothes are loose and soft, keeping the skin clean. Before the umbilical cord falls off, try rubbing it with 75% alcohol once a day to keep it dry and clean.
4. Prevent diseases, pay attention to maintaining family hygiene, wash hands before touching newborns, minimize visits, and wear masks when family members have respiratory infections to avoid cross-infection. All utensils used by newborns should be boiled and disinfected frequently, and towels for washing face and buttocks should be separated. For newborns who have not been vaccinated with BCG and the first dose of hepatitis B vaccine, parents should be reminded to replant as soon as possible. If there is no screening for neonatal diseases, parents should be informed to make up the screening in medical and health institutions with screening conditions.
5. Promote mother-to-child communication. Mothers and their families should talk, smile and have skin contact with newborns, so that their hands and feet can move freely, so that children can raise their heads while kneeling and training, and promote the development of neonatal sensory perception and movements.