Importance of Child Birth Weight – Need proper Nutrition
Child Birth weight is significantly correlated with mortality among neonates and health status in the later childhood. Several factors determine weight at birth; most of them can be grouped under three major heads: (1) Maternal nutrition: (2) Socioeconomic conditions: (3) Genetic factors.
In the developing countries, birth weight of the new-born is on an average lower than that in the western world. For international comparisons some definitions have been agreed upon and are in use. But an accurate information on gestational age or weight at birth in home deliveries is not known in the large majority of cases; the management of children mostly depends upon clinical judgement of an experienced health worker.
Weight in the first 10 days. All babies lose weight in the first 3-4 days of_life. This loss can be around 100-200 grams per day. With the improved flow of mother’s milk and increasing intake, the loss is soon compensated and by ten days most of the neonates should have regained their birth weight. In hot climates where milk or fluid has not been given to the baby, dehydration may occur and the baby may show rise of body temperature.
Care of Infants and Under-Five Children
After Child Birth weight, it is significant to care the infant. After the neonatal period the child should continue to be under constant health supervision till its fifth birthday. This health supervision should provide both preventive and curative services. Unlike that in developed countries where the two types of services are often provided from two different sources, in developing countries compartmentalization is not possible. As such simple clinics providing essential services for the young children need to be organized. These clinics are called ‘Under-Five Clinics’ and have replaced the concept of Well Baby Clinic, which was restricted to preventive paediatrics. The Linder-Five Clinics, on the other hand, provide promotive, preventive, and curative services.
The services provided by the Under-Five Clinics for the child care are : (I) General health check-up to identify any ailments; (2) Essential and simple treatment for common illness of early childhood; (3) Monitoring of growth and development; (4) Immunization against common communicable diseases, e.g., diphtheria, (5) Health and nutrition education to mother to ensure improvement in nutritional status and lower incidence of disease.
The simplified approach as listed above has been given the popular name GOBI (G for growth monitoring, 0 for oral rehydration, B for breast feeding and I for immunization). Under-Five Clinics are the points where GOBI is put into action. The usual routine is to have at least one monthly checkup for every under-five child at these clinics which. can be organized either at a static health facility or even at domiciliary level at a selected site. Under- five clinics are useful because they provide ongoing care for both ill and well young children. It is obviously more convenient for the mother to attend the same clinic for several of her children on the- same day, some receiving only immunization and others receiving treatment for their illnesses.
After Birth Weight, its need to monitor Growth and Development
Child birth weight problem can solve by studying some topics.Growth and development are two characteristics which need to be measured to monitor normal progress of the child towards healthy adulthood. Both processes are continuous in the early life and are in fact a continuum of the foetal growth and development. Children do not grow at the same rate throughout childhood. The most rapid growth occurs during the embryonic and foetal period. Although infants obviously grow in size, the actual rate of their growth is slow during the first 3 years of life. From the age of 3 years until the onset of puberty, children’s rate of growth remains relatively steady; at puberty the growth rate again increases.
Growth charts to record information of child’s growth are in use in many countries. However, in the absence of these charts, a physician responsible for child care should be well versed at least with certain ‘rules of thumb’ which are : weight—a normally growing child doubles its weight at around five to six months. and weighs almost three•times its birth weight at one year -length—it increases by about 10 inches in the first year of life. The birth length usually doubles by four years and triples by 13 years of age; height—on an average a child gains about 3 inches (7.6 crns) in height annually between the age of 2 and 5 years; head circumference—increases by around 4 inches (10 cms) in the first year of life; of these 5 ems are added in the first 4 months and the other 5 ems in the following 8 months; arm circumference—arm circumference which is around 10-12,5 ems at birth increases to around 16.75 cms at I year of age; chest circumference—at birth chest circum¬ference is smaller than head circumference. By 9 months of age chest measurements normally equals to that of head circumference, and at I year chest circumference is expected to exceed head circumference.
While growth indicates increase in physical measurements of the child, development refers to progress towards functional maturity of various organs or systems of the body. Development is measured by’rnilestones which are landmarks that include mental, emotional and intellectual aspects. The physicians should have some degree of essential knowledge about development milestones to identify special: cases of development retardation. This is important for timely care.
Growth chart. Constant efforts to make under- five clinics more useful and more acceptable to the people, have resulted in the development of simplified records to be used in the clinics. The growth chart (Fig. 7.1) or ‘road to health card’, initially designed and proposed by David Morley and later modified by WHO, is now in use in more than 80 countries of the world. It is a card printed on a relatively hard paper, usually folded in three sections. It comes in a plastic envelope to protect it from soiling and damage. One one side of the card is a specially designed graph meant to plot the weight for age of the child in kilograms. The card can be used for 50 months i.e., up to five years. Other important features are space for recordng information on siblings, immunization dates and reasons for special care. In some countries information about contraceptive practice of parents can also be written on the card. In this way we can gain child birth weight.
The growth chart helps to record all relevant information in an easy-to-review manner and is basically meant to be kept by the mother. The reasons for making this a ‘take-home’ record are several : (1) It serves as a permanent health record of the child and is available to the mother even if she moves over to another village or town. (2) It provides information to the mother and the family about the progress or otherwise of the child, specially if the health worker has clearly explained it to the mother. (3) It reduces problems of filing, retrieval and lost records at the clinics. (4) At a new clinic a growth chart presented by the mother for her child helps to inform the new health worker about the past history and the health status of the child.
At the under-five clinics the mother is required to bring growth charts for her children.Child birth weight is such important that we should be sincere during mother’s pregnancy . Each child is examined and weighed and findings noted on the card. The health worker should then explain to the mother about her child’s condition and give necessary instructions for any treatment or care needed for the child. Among the other activities carried out at the under-five clinics are immunization of children, demonstration and distribution of oral rehydration solution and demonstration of weaning food preparations.