PRENATAL AND POST NATAL

I. List the ten steps that will improve the women's chances of having a healthy baby?
Ans: TEN STEPS THAT WILL IMPROVE YOUR CHANCES OF HAVING A HEALTHY
BABY:
i.

iii.
iv.
v.

Make an appointment with a maternity care provider to discuss your current state of
health and your plans for pregnancy. Make a dental appointment and have your teeth
checked and cleaned.
Learn about the family health history of both you and your partner, if possible. Find out if
there are any special risks for you or your future baby. If desired, meet with a genetic
counselor.
Stop smoking, drinking alcohol, and using recreational drugs.
Eat well and try to achieve your appropriate weight Start taking a daily prenatal vitamin
or a multi vitamin. Make sure it contains a sufficient amount of folic acid.

Update your immunizations. Ask to be checked for immunity to rubella (German

measles). Get vaccines for measles, mumps, rubella, chicken pox, diphtheria, tetanus and
polio as needed. Note that some immunizations, such as rubella and chicken pox, should
be given at least three months before you are pregnant. Try to avoid exposure to
contagious illness. Wash your hands carefully before eating, do not eat undercooked
meat, and avoid handling cat litter.
vi.
If you have a chronic illness such as diabetes, depression, anemia, epilepsy, multiple
sclerosis, systemic lupus erythematosus, inflammatory bowel disease, high blood
pressure, or cardiac disease work with your doctor to stabilize it as much as possible.
vii. Talk with your caregiver about containing the use of prescription medications. Stop
taking oral contraceptives several months before getting pregnant. If you use medications
known to be harmful in pregnancy, try to avoid them or find safer substitutes_
viii. Avoid exposure to toxic chemicals and substances. Evaluate your home, workplace, and
environment to identify and eliminate potential toxins.
ix.
Remember that the father's health and lifestyle influence fertility. He should evaluate
these factors and make improvements as needed.
x.
Maintain good health and adopt a healthy lifestyle. Exercise regularly, get adequate sleep,
reduce stress, and work toward stabilizing relationships.
Prenatal care comprises a variety of exams and evaluations to ensure your well being
and the health of your baby. Your doctor of midwife, the office or clinic nurse, and other
staff provide this care. They are interested not only in medical aspects of your pregnancy
but also in your health history, your current life situation, and any concerns you may
have. Once you suspect or know you are pregnant, schedule a visit with your doctor or
midwife.

2. What are the steps to be taken to cope with child - birth pain?

Ans: During pregnancy, you and your partner will want to prepare yourselves physically,
emotionally, and intellectually for the extraordinary experience of having a baby. During
labor, you can help yourself immensely by using relaxation techniques, patterned breathing,
and a variety of other comfort measures and body positions. Though these techniques do not
lead to a pain - free child birth, they can help keep the pain and stress manageable in most
labors. They also promote labor progress and give you a greater sense of personal mastery
during the experience. In addition to the support you will have from your partner and others,
these techniques and your adaptations of them are your resources for coping with labor. You
may use them instead of, or along with, pain medications and other interventions. When you
use these techniques and participate fully, the birth of your child can be rewarding, exciting,
and fulfilling - an experience to remember with satisfaction, pride and joy.
BODY AWARENESS TECHNIQUES'
Tensing and releasing Muscles: Sit in a chair or on the floor. Make a tight fist with your
right hand. Pay attention to how the muscles in your forearm feel. They are hard when they
are tense. Touch those muscles with the fingers of your left hand. Now open your right hand
and relax it. Notice how soft the muscles feel when you release the tension. Next, raise your
shoulders toward your ears. Notice how you feel when your shoulders are tense. Relax and
lower your shoulders. Now release even more Really relax. Did you notice a change? Often
you can release residual muscle tension when you become aware of it.
Tensing and Releasing the Whole Body:
Lie down in a comfortable position. Tighten the muscles of you entire body - stiffen your
abdomen, hips and legs, then your back, neck, and arms. Keep the muscles contracted for
about five seconds. Pay attention to how you feel - for example, tense, tight, cramped, or
uncomfortable. Then let your body go limp, releasing the tension all over. You may start by
relaxing your abdomen and releasing outward toward your arms, legs and head_
RELAXATION TECHNIQUES:
PASSIVE RELAXATION:
Once you can recognize tension in your muscles, the next step is to master the art of
releasing tension. By focusing on different parts of your body and by releasing tension in
each part, you can achieve a state of deep relaxation of both body and mind. This takes some
concentration and conscious effort When you start passive relaxation, have your partner read
the following exercise in a calm, relaxed voice. He or she should read slowly allowing you
time to focus on and release each part of your body., if your partner is unavailable, there are
many relaxation audiotapes available for pregnant women. Pleasant relaxing music may also

help. Once you have selected some appealing music, use the same music each time you
practice, and then use it during labor to create a familiar and relaxing environment.
RELAXATION COUNTDOWN:
After you have become aware of body tension and have mastered passive relaxation,
learn the following technique to quickly release muscle tension. This is particularly helpful
when you want to get back to sleep at night, when you are feeling stressed, and when you are
trying to relax after contractions during labor. In addition your organizing breath at the
beginning of each contraction can be used as a rapid relaxation countdown.
TOUCH RELAXATION:
With touch relaxation, you respond to your partner's touch by relaxing or releasing tense
muscles. During pregnancy, touch relaxation is a pleasurable way to practice relaxation.
During labor, you use your companion's touching, stroking, or massaging as nonverbal cue
to relax.
ACTIVE RELAXATION:
If you practice relaxing in many positions and during physical activity, you can prepare
more realistically for labor, because in labor you will probably use many positions and be
physically active. Your goal is to achieve the same relaxed feeling and mental state while
active that you had with passive relaxation, when pillows, the bed or the floor were
supporting your entire body.
3. What are the equipments to be realized before the birth of the child?
Ans: Some parents don't feel like buying anything until they have their baby. There are no
exact rules but here are some suggestions:
A place to sleep you may arrange for a beautiful silk lined thing but the baby doesn't
care. All she needs is sides to keep her from rolling out and something soft_ The baby does
not want a pillow for her head and it is better not to use one. Something to bathe her in and
dress her on the baby can be bathed in the kitchen sink or a plastic tub. One can bathe and
rest the baby on a low table. Convenient is a dressing table with a water proof changing
pad, safety strap and storage shelves. Other equipment needed are safety pins, child's nose
syringe, rectal thermometer, absorber cotton, vitamin drops, soap, diapers, plastic seat
carriers etc.
CLOTHS, BABIES NEED:
Knitted night gowns with mittens on the ends of the sleeves to avoid scratching
themselves

1. Shirts of 1 year size - 3 or 4

2. Stretch suits, sacks and kimovnos - i.e., short jackets and long gowns.
3. Sweaters - used in cold weather
4. Outer clothes - for outings in cold climates.
5, Bibs small round bibs are useful
6. Diapers - disposable diapers that come in various sizes and thickness for day and night
attached adhesive tapes to avoid pins are very much useful. The most popular material for
diapers are gauze cotton
7. Water proof pants - bed or sleep bags and walkers. Knitted wool caps are all right for
going out doors. Bed clothes, blankets. Water proof sheeting pads, sheets etc.
SOME EQUIPMENT, MAY OR MAY NOT BE NECESSARY:
A carriage, a stroller, bottle warmer, bath thermometer, pacifier, playpans,
carryall bassinel, a bed strap a food grinder or blender baby lotion, baby powder, zinc
lotion etc.
FORMULA EQUIPMENT:
Disposable or plastic bottles with nipple - holder.
Nipples - one dozen - for bottle fed; half dozen for breast fed
A container for mixing formula, marked in ounces
Long handled spoon for stirring
Set of measuring spoons
A bottle brush and a nipple brush, can opener
Tongs for handling hot bottles etc.
4. At what period can introduce solid food to the baby. Specify the diet plan of the baby by
the end of the lg year?
Ans: INTRODUCING SOLID FOOD:
A baby usually gets all the calories needed from milk for the first 3 months. So parents
can start solid food at this time to supplement the scanty in milk particularly iron. At first most
parents give the precooked cereals made especially for babies. The only disadvantage is that its
taste does not have great appeal for many babies_ For this, some doctors prefer it as the first solid
food because babies usually take to it so enthusiastically.
For the first 6 pr 8 months of a babies' life the fruit is stewed, except for raw ripe Banana,
Apples, Peaches, Pears, Apricots, and Pine Apple which are the usual fruits. Strained boiled
vegetables are commonly added to the diet 2 to 4 weeks after a baby gets used to cereal or fruit
or both.
The vegetables usually offered are beans, peas, spinach tomatoes, squash carrots, beets,
sweet potatoes etc vegetables such as broccoli, cauliflower, cabbage, turnips, onions are so

strong, tasting that most babies don't like them, however if the baby likes you can offer these
also. Do not keep cooked vegetable without refrigeration. It spoils fairly rapidly.
DIET BY END OF THE FIRST YEAR:
Here is a rough list of what babies are apt to eating by the end of the first year.
BREAKFAST: Cereal (whole wheat or eats) toast milk
Lunch: vegetable (green or yellow in lumps), potatoes, meat or fish, fruit, milk.
Supper: Cereal, fruit milk, fruit juice, including orange juice is given daily between the meals or
at breakfast.
Whole wheat or bread can be given at meals or between, with a little butter or margarine.
The fruit is stowed except for bananas, scrapped apple and pear avocado.
You can remove the sugar from the formula gradually when your baby is about to change
over to fresh milk sometimes between 3 and 6 months of age. The time depends on his appetite
If he goes through a phase of poor appetite at the age of 7, 5, or 6 months or if he is gaining too
much weight that is a good time to take out the sugar.
A 3 meal schedule means about 5 hours between meals. If your baby is starved at the end
of 4 hours and crying with hunger he is not ready for a 3 meal schedule. As long as your are
making a 24 hour formula that contains water, you have to sterilize the formula and bottles.
5. What are the inoculations that are to be given to the child from birth to I year?
Arts: KEEP A RECORD WITH YOU
It is a good idea to keep a record (signed by your doctor) of all your children's
inoculations (and sensitivity to drugs if any) in your home, and to carry it with you when the
family goes on trips It is also valuable when you move or change your doctor.
DIPHTHERIA, PERTUSSIS (WHOOPING COUGH)
Tetanus inoculations (DPT) incoculation for these three diseases are given in a combine
form. They should be started very early. Three shot are given, most commonly 2 months
apart. At 15 to 18 months of age a booster dose is given and again at the age of 4 to 6 years it
is given. Further inoculation against tetanus and diphtheria are given every 10 years
thereafter.
ORAL POLIO VIRUS VACCINE:
It should be given to all babies beginning at 2 months of age or thereafter as soon as
possible. It is a live virus that has been grown on living cells in a laboratory and is taken by

mouth. There are three types for virus that cause polio and a person has to take all three types
of vaccine to be completely protected. First dose at 2 months, second at 4 months and third at
6 months is given. A fourth dose is given a year later, a fifth at entrance to school (4 to 6
years), There should not be a delay between the doses.
MEASLES VACCINE:
This vaccine is made up of live measles virus, which has been rendered mild in its effect
by being grown for a long time on live chick embryo. It is not given until a year of age so
that the immunity which babies may have inherited from their mothers will have a full
opportunity to wear off first. The vaccine stimulates the body its own immunity which it is
hoped, well last for life.
MUMPS VACCINE: It is recommended at the age of 1 year or older.
GERMAN MEASLES: (RUBELLA) VACCINE: It is a relatively harmless disease except in
the 3 months of pregnancy when it fairly often causes fetal abnormalities. To prevent
these tragedies it is recommended that all children to be given rubella vaccine at one year of
age or, if it was not done them, at any age up to adolescence (From adolescence onward,
vaccination itself during the 1" 3 months of a pregnancy, may cause fetal abnormalities. So
this vaccine should not be given from adolescence or if there is any chance of pregnancy).
Giving it below 1 year may do no good if babies have inherited a temporary immunity from
their mothers. The reason for vaccinating males is so that they won't be passing the disease
to their mothers in childhood or to their wives in adulthood. The vaccine for German
measles, mumps and measles are often given together in a combined form.
VACCINATION AGAINST SMALL PDX: It is no longer recommended routinely because
the disease has been almost eradicated from most of the countries
When does teething start? How can help the baby during this period?
Ans: Teething is quiet different in different babies. One baby gets the first tooth at 3 months,
another not till 1 year. In rare occasions certain diseases influence the age of teething. The
average baby gets the first tooth around 7 months. Usually the 1' 2 teeth are lower central
incisors. After a few months come the 4 upper incisors. Generally babies get 20 teeth in their
first 2 1/2 years including the canines and the molars.
Most babies must put things in their mouths, off and on atleast from 6 months to 15
months, Do not resist them, at best you can provide chewable objects, that one dull enough,
so that they won't do too much damage. Specially designed rubber teething rings of various
shapes are good.
The crowns of all baby teeth are made from what the mother eats during pregnancy.
Following food elements are particularly important to make strong teeth:

Calcium and phosphorous milk and cheese

Vitamin D vitamin drops and sunshine
Vitamin C Vitamin drops, oranges other citrus fruits, tomatoes, cabbage
Vitamin A and some of Vitamin B
Babies permanent teeth won't appear until the child is about 6 years old. A minute
amount of fluoride in the diet of the mother while she is pregnant, and in the diet of the baby
and small child while the permanent teeth are being formed make stronger teeth Dentists
believe that the principal causes of tooth decay is lactic acid. This lactic is manufactured by
bacteria that live on sugar and starches that are in contact with the teeth. That is why sucking
of lollipops, eating of sticky candy and dried fruit, drinking of sodas and nibbling of cookies
and crackers are practically liable to cause decay.
The babies should start care of teeth atleast from the age of 2. The logical timing of
brushing is after meals, 3 times a day. Most important is after supper, so that the teeth are
clean for the long night period when the mouth is quiet and the saliva is flowing slowly.
From the age of 3 twice a year dental examination is advisable,

ESSAY TYPE QUESTIONS

What are the nutritional requirements of pregnant women?
A_ns: PROTEIN: All cells are formed from protein. Since pregnancy involves the rapid
growth of the fetus, placenta, uterus, breasts and the volume of blood and amniotic fluid,
your protein requirement increases by about 14 grams over your normal requirement.
Keep in mind that prenatal vitamin and mineral supplements supply no protein. Food is
your only source of protein, as protein supplements are not recommended in pregnancy.
Be sure that any meat, poultry, or fish you eat is well cooked to avoid food borne
illness. In addition, check with your caregiver or local public health department to learn
about possible toxins in your sources of meat or fish.
CALCIUM: Calcium promotes the mineralization of the fetal skeleton and teeth. The
fetus requires approximately 66 percent more calcium during the third trimester than
earlier in his development. Calcium is also stored in the mother's bones as a reserve for
production of breast milk. High caffeine intake can interfere with one's ability to use
calcium..
IRON: Iron is required for the production of hemoglobin. Since blood volume increases
by SO percent during pregnancy, hemoglobin and the other constituents of blood need to
increase accordingly. In addition, during the last six weeks of pregnancy, the fetus stores
enough iron in his liver to supplement his needs for the first three to six months of life.

This is necessary because the main food during that period breast milk or formula
only partially fulfills an infant's iron requirements. Since a healthy person absorbs only
10 20 percent of the iron ingested, the Institute of Medicine recommends a daily
supplement of 30 60 milligrams of iron during pregnancy to ensure absorption of the
iron needed each day.
ESSENTIAL FATTY ACIDS: Essential fatty acids in the diet provide life long health
benefits for everyone. Some essential fatty acids are found in vegetables and plants:
others can be found in oily fish. When consumed by the mother during pregnancy and
lactation, essential fatty acids contribute to the healthy neurological development of the
baby. Since the amount of essential fatty acids found in fish is much larger than the
amount in vegetables, the best advice based on research is to consume only before, during
and after pregnancy. If you do not eat fish, consult your care provider for other ways to
get fatty acids_ Breast milk naturally contains essential fatty acids. Breast milk is the best
source of long chain polyunsaturated fatty acids for infants.
VITAMINS: Vitamins are essential to most life functions. Vitamins are classified by
their solubility; water soluble and fat soluble. The water soluble vitamins can be lost in
cooking. Vegetables high in these vitamins should be eaten raw and briefly cooked in
small amounts of water, stir fried, or steamed. The only way to make sure you get all
the vitamins and minerals you need is to eat a varied, high quality diet. While most
pregnant women take a prenatal vitamin as a supplement to their diet, it is not a good idea
to depend solely on vitamin or mineral supplements to make up for a poor diet.
SALT: For years, pregnant women were told to eliminate or restrict their use of salt_ The
rationale for this policy was based on the tendency of the pregnant woman to retain fluid,
which was assumed to cause pre eclampsia. It is now known that gradual, moderate
water retention in pregnancy is not only normal, it is necessary to ensure an adequate
volume of blood and amniotic fluid. The abnormal, sudden increase in fluid retention
seen in pre eclampsia is not due to excessive salt intake but rather to be impaired
functioning of the liver and kidneys, which normally regulate protein, electrolyte and
fluid balance. Adequate salt intake during pregnancy is now known to be important in
maintaining fluid balance. The wise pregnant woman does as any well nourished person
does; she salts her food to taste
FLUIDS: As stated earlier, water and other fluids are essential elements of a blanced diet.
Fluid retention, a normal part of a healthy pregnancy, ensures the increase in blood and
amniotic fluid volume. As a pregnant woman, you need to retain more fluid for two
reasons:
Your blood volume increases by 50 percent or more (From approximately 2 1/2 to 3
% quarts)

 Toward the end of pregnancy, your baby is immersed in about 1 quart of amniotic
fluid, which is replaced every three hours. Fluid is also retained in your tissues,
shifting across blood vessel walls, to help maintain a healthy balance of fluids. It
is estimated that tissue fluid volume increases by 2 3 quarts during pregnancy.
2. What are the nutrition related problems that commonly arise during pregnancy? How
to tackle it?
Ans: NUTRITION RELATED BIRTH DEFECTS:
Folic acid supplements taken before conception and during early pregnancy have
been shown to dramatically reduce the incidence of neural tube defects and orofacial
clefts (cleft lip and cleft palate). Neural tube defects are due to incomplete prenatal
development of the structures of the central nervous system These defects cause
conditions such as anencephaly, encephalocele, and spina bifida.
Neural tube defects occur in one of every one thousand births. When women take
0.4 milligram of folic acid as a supplement beginning at least one month before
conception and continuing at least until the third month of pregnancy, there is a 72
percent reduction in the incidence of neural tube defects. Women, who have had a child
with a neural tube defect are advised to take 4 milligrams of folic acid at least month
before conception and during the first three months of pregnancy. Taking this amount of
folic acid reduces the risk of recurrence by five times.
Another group of researchers found that women who took a multivitamin
containing folic acid during the period from one month before pregnancy through two
months after conception had 25 50 percent fewer infants with clefts in the lip or palate.
Since ar least 40 percent of all pregnancies are unplanned, the U.S. public health service
and the American College of Obstetricians and Gynecologists have recommended that all
women capable of becoming pregnant should take 0.4 milligram of folic acid daily
throughout their reproductive years.
Vitamin A, taken in amounts above the recommended daily allowance in the first
\seven weeks of gestation, is associated with a higher incidence of defects of the cranial
neural crest tissue. These defects include craniofacial anomalies, defects in the central
nervous system and defects of the thymus gland and heart When pregnant women took
more than 10,000 IU of vitamin A, one in every fifty seven infants of these mothers
had a mal formation attributable to thee supplement_
SPECIAL CIRCUMSTANCES: Good nutrition in pregnancy is always an important
concern, but in some circumstances you need to be even more aware of the foods you eat.
If your pregnancy is a "special pregnancy" or if you are on a special diet, your nutritional
demands will be greater than normal. If you are in one or more of the following

categories, seek nutritional counseling and be particularly conscientious about eating

nutritious foods. Nutritional counseling is available from your midwife, your physician,
or a nutritionist. These professionals can help you plan your diet in a practical and
beneficial way
SPECIAL PREGNANCIES
MULTIPLE PREGNANCIES. If you are carrying two or more babies, you need to
consume more calories and more nutrients.
ADOLESCENT PREGNANCY: If you are a teenager, you are still growing and have
greater - than adult requirements for most nutrients, you need to eat particularly well
known when pregnant to maintain your own growth while nourishing your fetus.
PREGNANCIES CLOSE TOGETHER: Sometimes a pregnancy depletes your reserves
of certain nutrients such as calcium and iron. If you have sufficient time between
pregnancies to replenish those reserves, no nutritional deficiency occurs. However, if
your pregnancies are very close together, your reserves may be depleted and you may
need extra calories and nutrients. The length of time needed between pregnancies to
correct deficiencies depends, of course, on your overall nutritional status and the quality
of your diet. Talk with your midwife or physician about your individual dietary needs.

3. Examine the effects of various drugs and environment agents on the unborn baby')
Ans: At this time, there is little known about how drugs, environmental hazards, or other
influences affect the reproductive capability of the male. Evidence is growing, however,
that the man's health and well being are more important than previously suspected in
producing a healthy baby. Consider the following:
One report concluded that there was a decrease in sperm density and motility
among smokers. Another study of infertility found that men who smoke more
than twenty cigarettes a day and drink more than four cups of coffee a day have a
decrease in sperm motility and more dead sperm than nonsmoking, non - coffee
drinking males.
The age of the father seems to be important for normal fetal development. Just as
the mother's age at conception has been found to be significant as a risk factor for
Down Syndrome, the father's age can be a risk factor for other congenital
disorders such as dwarfism. These disorders are still rare; however, they are more
likely in children born to fathers over forty

A man's exposure to herbicides, pesticides, and solvents before conception is

suspected, but not proven, to cause genetic mutations birth defects in his off spring
Other than a few reports on how certain drugs may alter the reproductive potential
of men, the direct contribution by the father to his unborn infant's health is poorly
understood. However, the indirect contribution of the partner, whether male or
female, is of great significance.
Both before and during pregnancy, a woman is much more likely to control her
use of drugs, tobacco, and alcohol if her partner also controls his or her use of
these agents. If the woman is supported in her concern for a positive pregnancy
outcome and joined in making any change she has to make, she is much more
likely to be successful.
4. What regular exercises and general fitness help during pregnancy?
Ans: Regular moderate exercise during pregnancy maintains muscle tone, strength and
endurance. Exercise also protects against back pain and has a positive effect on your
energy level mood, and self image. If you do not have pregnancy complications such as
pain with exercise, pregnancy induced hypertension (PIM, or preterm labor you can
continue to exercise. To ensure that a fitness program is appropriate for you, check with
your doctor or midwife before starting or continuing to exercise during pregnancy.
Avoid exhausting exercise, which may adversely affect you and your baby. Stop
exercising if you experience pain, headache, nausea, severe breathlessness, dizziness,
vaginal bleeding, or continuing strong uterine contractions. You can let your body be
your guide if you listen to it carefully.
GENERAL GUIDELINES FOR SAFE, EFFECTIVE EXERCISE:
During exercise sessions, follow the guidelines below to avoid injury and to
obtain the most benefit.
Exercise regularly, three or four times a week Always include a warm up and cool
down
For land exercise, use a firm surface.
Wear supportive footwear appropriate to the type of land exercise
Exercise with smooth movements; avoid bouncing or jerking, or high impact
exercises
Do not hold your breath while exercising doing so can increase pressure on your pelvic
floor and abdominal muscles or make you feel dizzy.
Keep track of your pulse rate or use the talk test

Stop the exercise if you feel pain. Your body might be telling you that muscles, joints
or ligaments are being strained.
To avoid strain and fatigue, start with the easiest position, then try others as your
muscles strengthen. Start with a few repetitions, gradually increasing the number Toward the
end of pregnancy, you may need to decrease your level of exercise.
Consider your calorie and liquid intake. You need to eat enough to meet the
caloric needs of pregnancy. Liquids should be taken before, during and after exercise to
replace body fluids lost through perspiration and respiration. You can take a water bottle
along with you.
Avoid vigorous land exercise in hot, humid weather or when you are ill and have a
fever.
.

Check with your doctor or midwife if you have questions about exercise
5 What are the medical and nursing aids needed by 3 year the mother after the birth of
the child?
Ans: THE VISITING NURSE:
Whether or not the mother have help at home, she should try to get a visiting
nurse or public health nurse to come in once or twice in the early days The nurse will
show the mother how to make the formula, bathe the baby and follow other directions of
the doctor.
THE BABY'S DOCTORS: Any baby should have a regular check - up by doctor. The
commonest schedule is once a month for two months, every two months for the next four
months and then every three months through the second year. The doctor will weigh and
measure the baby whether she/he is growing properly and doctors can clear the doubts if
any, from the parents. If the doctors are not easily reachable, they can use phone.
In many cases the family physician who attended the delivery of the baby will go
on seeing her afterward. But if the obstetrician does not want to take care of the baby the parents have to fix a good pediatrician. The parents can and should attend some "child
- health - conference" in hospitals or child health centers to clear their doubts. The
parents should keep a diary and everyday write their doubts there and when they go to the
doctor nothing will be missed.
VISITING TO THE DOCTORS OFFICE: If it is not safe for the patient always, the
parents have to call the doctor in home. But if possible and not un - safe, visit to the
doctor's place is always beneficial for x - ray, sonography and other tests and treatment
If the parents have any doubt about the present treatment, they can very well consult a
second doctor and get his opinion - it is not at all unfair_

As a general rule, consult the doctor if the baby has a temperature of 101 degree
or more. For cold if it is severe or has other symptoms like cough or ear - aches you have
to call a doctor_ Hoarseness of voice, difficulty in breathing should always be reported
immediately. Any kind of pain should be reported immediately.
Sudden and continuous decrease in appetite should be reported promptly. Vomiting of
any unusual type should be reported promptly especially if the child looks sick or
different in any other way. Diarrheas of more serious sort in infants should be reported
immediately.
Blood in bowel movements or blood in vomits should be reported promptly.
Inflammation of the eye or injury to the eye should be reported promptly.
FINDING A DOCTOR IN A STRANGE CITY If somebody needs a doctor in a strange
city for his child, he can find the name of the best hospital, telephone and ask them for
help.
THINGS TO HAVE IN YOUR MEDICINE CABINET: A box of sterile gauze. Two
rolls of sterile bandage - 2 inches wide, two rolls 1 inch wide. A roll of sterile absorbent
cotton. A roll of adhesive plaster 1 inch wide. A box of small prepared bandages. A good
pair of splinter forceps, scissors etc.
Ask your doctor to recommend an antiseptic, a packet of bicarbonate of soda A bottle of
pain killer tablets for babies. An ounce bottle of syrup of ipecac to cause vomiting in case
of poisoning.
A rectal thermometer, a hot water bottle. A rubber nose syringe with a glass tip for
cleaning out baby's nose during a cold.
HOSPITAL IMPRESSION: Now a days most babies are born in a hospital. There, the
doctors are closer at hand when needed and are assisted by interns, nurses, technicians
and consultants. A hospital offers all the complicated equipment, like inculcators and
oxygen tents, to cope with sudden emergencies. All these make the mother feel very safe
and well cared for