Schedule for Well-Care Visits

Schedule for Well-Care Visits

At birth and within 24 h.

Assessment and monitoring of health,

• Measurement and plotting of wt., H & HC
• Signs of birth trauma, alertness, congenital anomalies or skin lesions or jaundice
• assessment of breastfeeding
• hip dislocation

Screening for eye abnormalities

• hearing screening
• neonatal hyperbilirubinemia
• congenital heart disease

Prevention and protection

Immunization

• BCG vaccine
• hepatitis B

Supplementation

• vitamin K supplementation

At 1 Week of Age

• Assessment of danger signs

  • measurement and plotting of wt., H & HC.
  • Signs of birth trauma, alertness, congenital anomalies, skin lesions or jaundice
  • Assessment of breastfeeding
  • Hip dislocation

• Immunization

  • Catch up for missed at birth vaccines

• Newborn screening

  • abnormalities of the eye
  • hearing and vision screening

At 2 Weeks of Age

Breast feeding assessment

• Breastfeeding frequency
• Breastfeeding positioning and attachment
• Other foods or fluids
• Complete physical examination
• Assessment of danger signs
• Measurement and plotting of wt., H & HC.
• Observation for signs of congenital anomalies

Immunization

• Check immunization status as per latest WHO or country recommendations.
• Give catch up missed vaccines as appropriate

Newborn screening

• vision screening

At 6 Weeks of Age

• Exclusive breast feeding assessment

  • other foods or fluids

• Physical examination and growth monitoring

  • assessment of danger signs
  • measurement and plotting of wt., H & HC.
  • Signs of physical anomalies or skin lesions, neurologic tone, strength, and symmetry of movements.

• Immunization

  • Check immunization status.
  • Routine vaccination against:
    • polio,
    • hepatitis B,
    • diphtheria,
    • pertussis,
    • tetanus,
    • Haemophilus influenzae type B,
    • pneumococci and
    • rotavirus.

• Verbal and social language signs (e.g., looks in parent eyes, smiles, makes brief sounds)

  • gross motor and fine motor development (e.g., moves both arms and legs together and slightly opens fingers)
  • sleep and waking patterns.

At 10 Weeks of Age

• Exclusive breast feeding assessment
• Physical examination and growth monitoring
  • assessment of danger signs
  • measurement and plotting of wt., H & HC.
  • Signs of neglect or abuse

Developmental progress and milestones

• gross motor and fine motor development (e.g., lists head and chest, keeps head stead, can bring hands together)

• verbal and social language signs (e.g., makes short cooing, smiles when happy or cries when upset).

• Routine vaccination against:

  • polio, hepatitis B, diphtheria, pertussis, tetanus, Haemophilus influenzae type B, pneumococci and rotavirus

At 14 Weeks of Age

• Exclusive breast feeding assessment
• Physical examination and growth monitoring
  • • assessment of danger signs
  • • measurement and plotting of wt., H & HC.
  • • Signs of neglect or abuse

Immunization

• Routine vaccination against: polio, hepatitis B, diphtheria, pertussis, tetanus, Haemophilus influenzae type B, pneumococci and rotavirus.

Developmental Progress and Milestones

• • Gross motor and fine motor development (e.g., supports self on elbows and wrists, can roll over from stomach to back).
• • Verbal and social language signs (e.g. laughs, responds more strongly, smiles on seeing faces, vocalizes and turns to voices, stays calm with a soothing lullaby).

At 6 Months of Age

• Exclusive breast feeding assessment
• Physical examination and growth monitoring
  • • assessment of danger signs
  • • measurement and plotting of wt for Length Z-Scores.
  • • Signs of neglect or abuse

Immunization

• • Check immunization status.
• • Give catch up missed vaccines as Appropriate.

Developmental progress and milestones.

• look for signs of physical or skin anomalies; pupil opacification or red reflex, heart murmurs.

Developmental monitoring and milestones

• • gross motor (lifts head, sits with support, rolls from back to stomach)
• • verbal and social language (laughs aloud, vocalizes vowels “aa” or “uu” or “ma” or “ba” and looks when name called).
• • recognizes and engages by smiling to faces, makes sounds in response to play, brings objects to mouth.

At 9 Months of Age

• Exclusive breast feeding assessment
• Physical examination and growth monitoring
  • • assessment of danger signs
  • • measurement and plotting of wt. for Length Z-Scores.
  • • Oral health screening

Immunization

• • Check immunization.
• • Routine vaccination against measles containing vaccine (MCV1) and rubella containing vaccine (RCV).
• • Give catch up missed vaccines as Appropriate.

• Developmental monitoring and milestones

• • Gross motor (sits without support, pulls self to stand, crawls)
• • Fine motor (picks small objects with finger and thumb and food to eat).

Developmental monitoring and milestones

• • Verbal and social language (uses basic gestures, looks for dropped objects, non specific words “Dada” or “Mama”, copies sounds)
• • relating and play (reaches out to be picked, plays hide and appear games, waves bye bye).

At 12 Months of Age

Breastfeeding and family foods assessment

• breastfeeding as child wants
• transition to nutritious family foods
  Screening
• dental care and check up
• vision screening

Immunization

• Booster doses of diphtheria-, tetanus and pertussis-containing vaccine, or Pneumococcal.

Developmental monitoring and milestones

• gross motor (stands without support, takes initial walking steps)
• fine motor (picks food to eat)
• verbal and social language (responds to gestures, says at least 1 word or name)
• relating and play (plays hide and appear games, follows directions with gestures).

At 18 Months of Age

• Nutrition and feeding practices assessment.

  • Breastfeeding as child wants
  • Nutritious family foods and snacks
  • Self feeding independence.
  • Screening
  • Developmental screening
  • Hearing or vision screening

• Immunization

  • Booster doses: measles vaccine (MCV2) and diphtheria-, tetanus- and pertussis containing vaccine, or pneumococcal conjugate Vaccine.

Developmental Monitoring and Milestones

• Gross motor (walks without support, carries toys, sits upright)
• Fine motor (throws small objects while standing, scribbles).
• Verbal and social language (names familiar people, objects or body part, helps dress and undress, uses words to ask for help).
• Relating and play (engages with others in play, points at objects or pictures to draw attention).

At 2 Years of Age

Nutrition and feeding:

• nutritious family foods and snacks
• self feeding independence.

Assessment, physical examination and growth monitoring:

• assessment of health problems
• measurement of wt. and H.

Developmental monitoring and milestones:

• observe and assess for running, scribbling, and ability to follow commands
• gross motor (walks, runs and jumps, kicks a ball, climbs)
• fine motor (holds pencil or stick, scribbles on ground or paper).

Immunization:

• check immunization status
• as per latest WHO or country recommendations
• catch up missed vaccines as appropriate

Verbal and social language:

• (combines at least 2 words, responds to command, names body parts).
• Relating and play (imitates and initiates play alongside others, checks how objects or toys work,)
• Self help activities or autonomy (uses finger or spoon for feeding, takes off clothing).

At 3 Years of Age

• Nutrition and feeding practices assessment.
  • Nutritious family foods and snacks
  • Self feeding independence
  • Screening
  • vision screening and eye exam.
  • Blood pressure.

Developmental monitoring and milestones.

• Gross motor (climbs on and off, jumps off a sofa, pedals a tricycle)

• Fine motor (precise 3 finger grip, manipulates small objects, draws a circle).

• Immunization

  • Catch up on missed vaccines as Appropriate.

• Uses 3-word sentence & pronouns like “I”, “me” or “you”, tells a story.

• Relating and play (warm interaction with people, engages in imaginary play and involves others, shares)

• Self help activities or autonomy (feeds self, takes off clothing, washes hands with assistance).

At 4 Years of Age

• Screening
  • Vision screening
  • Hearing screening
  • Dental screening

Immunization

• Booster dose with Td/DT-containing vaccines as per national schedule (4 years between booster doses).

Developmental monitoring and milestones.

• gross motor (hops over pieces of paper, climbs stairs)
• fine motor (holds a pencil properly with 3 fingers, draws a simple cross, unbuttons)
• verbal and social language (asks “why”, “how” or “where”, uses 4-word sentences, tells story in logical sequence)
• relating and play (plays with others, role play, follows rules)
• Dresses and undresses with little help, brushes teeth, uses toilet by self.

At 5-6 Years of Age

• Measurement and plotting of weight, height & body mass index (BMI).

• Screening

  • vision screening
  • hearing screening
  • oral health screening

Immunization

• Check vaccination status as per latest WHO or country recommendations
• Catch up on missed vaccines as appropriate

Developmental monitoring and milestones.

• Gross motor (jumps and stands on one leg, hops and skips)
• Fine motor (holds a pen like an adult, writes letters and numbers, can draw a person with body parts)

Verbal and social language (good articulation & language skills, counts up to 10).

• relating and play (plays with others, willing to share in role playing, tolerates mild disappointment)
• Dresses and undresses without help, follows directions.