02.22. APPENDIX 04 - MILESTONES AND IMMUNOLOGY

APPENDIX FOUR - MILESTONES AND IMMUNOLOGY

Isn’t it a thrilling experience to see your baby grow and develop into an individual with distinct characteristics of his own? As he grows, you will naturally be anxious to know that he is developing normally, both mentally and physically.

There are no ideal standards that indicate normal development.

Babies differ and if one begins to walk, say, three months later than another, this is no indication that he is in any way abnormal or backward. He can grow up to be just as normal and healthy as the other. So don’t get unnecessarily worried.

However, here are some things that babies usually do at different stages in their growth :

 At 1 month : Baby can usually focus his eyes on objects and his eyes and head will follow slow-moving objects. He can also lift his head while lying on his stomach.

 4 months : He can usually recognise his mother, smile at people, grasp objects and inspect his own hands. He can hold his head erect when carried and may "goo" and laugh.

 7 to 8 months : He can sit without support, lift up his arms to be carried and put objects into his mouth.

 9 to 10 months : Baby can stand with support, wave bye-bye and raise himself to sitting and standing positions.

 1 year : He may walk without support and use a few words with understanding. The soft spot on the top of his head begins to close. He may have 6 teeth by now and can hold a cup to drink.

 2 years : Baby can run, build blocks. He may speak in simple sentences and obey simple instructions (when he feels like obeying!!). This is probably the best time to start the process of subduing his will and teaching him obedience. Bowel and bladder control (in the daytime) is usually established by this time, particularly in girls. Boys may take a few months longer. The most important thing is to let your baby develop and grow naturally.

Don’t keep comparing your child with your neighbour’s! And don’t ever force your child to do something he is not ready for, whether it be sitting, drinking from a cup or walking. Give him freedom to grow at his own pace. Encourage him as he grows to do certain things for himself, like dressing himself. He should also be encouraged to play with other children. Don’t overprotect him.

Immunology Most hospitals follow the following procedure.

 Within the first 3 months - BCG  6 weeks - DPT (Triple antigen) 1st Dose; OPV (Oral Polio Vaccine) 1st Dose  10 weeks - DPT 2nd Dose; OPV 2nd Dose  14 weeks - DPT 3rd Dose; OPV 3rd Dose  18 weeks - OPV 4th Dose  22 weeks - OPV 5th Dose  9 months - Health check  9 - 12 months - Measles Vaccine  18 months - DPT 1st Booster; OPV 1st Booster  5 years - DPT 2nd Booster; OPV 2nd Booster Repeat the appropriate booster dose after any exposure to diphtheria or polio.

After a bad wound, repeat the tetanus booster.

TAB (Anti-typhoid) booster should be repeated every year.

It is advisable to give an injection of Hepatitis B Antigen (0.5 ml.), intramuscularly, in the thigh at some time. The second dose should be given after one month.

Care of Premature and Twin Babies A premature baby is one born before the full-term or whose weight is less than 2 kgs. Twins or triplets, even if full-term, usually weigh less than 2 kgs. and should be treated as premature babies.

Premature babies are not able to maintain normal body temperature and are sometimes unable to breathe, swallow, digest food and withstand infection. They feel tired very quickly too. A premature baby weighing less than 2 kgs. should be kept in a hospital preferably, at least until he weighs 2.5 kgs. If you have to keep him at home, observe the following precautions :

1. The baby should be kept at a constant room temperature of about 28 degrees Celsius, as far as possible. Protect him particularly against draughts. In winter, beds can be heated with hot-water bottles.

2. Watch him closely until his breathing is steady and free. Keep the head low and turned to one side, so that secretions from his throat will come out of his mouth and not flow inwards and choke him.

3. Handle him as little as possible. Too much handling tires him.

4. Feeding. Babies who cannot suck can be fed with a medicine dropper. Those who cannot swallow will need tube-feeding. In the beginning, they may not be able to tolerate milk and can be given sugar-water.(Boil one tablespoon of sugar in 250 to 300 ml. of water.) They can be given diluted milk gradually. Start the baby on Vitamin C drops by the 4th or 5th day, and Vitamin A and D drops after a week.

5. Protect him against infections. Take meticulous care with feeds and in keeping yourself clean. When the baby reaches 2.5 kgs, he can be treated as a normal baby. He may be slow in general development at first, but will soon develop normally. There are special feeds available for weak and undernourished babies. An Absolute Essential You cannot make your baby grow. Only God can do that. But you can provide him with an atmosphere for healthy growth. In fulfilling this responsibility, one absolute "must" is to spend time with your baby. Never get so busy that this gets crowded out of your daily routine. This must be a top priority.

You may perhaps have to give up certain secondary things in order to find this time but it is well worth it.