I. Purpose
Through regular health checkups, we monitor and evaluate children’s growth and development, detect abnormalities and diseases at an early stage, intervene in a timely manner, and guide parents in scientific parenting and disease prevention to promote children’s healthy growth.
II. Service targets
Children aged 0 to 6 years old (under 7 years old) in the district.
III. Content and methods
(A) Health examination time
At least 4 times during infancy, recommended at 3, 6, 8 and 12 months of age respectively; at least 2 times a year for children aged 3 years and below, each time at an interval of 6 months, at the age of 1.5, 2, 2.5 and 3 years; at least once a year for children aged 3 years and above. Health checkups can be adjusted appropriately according to the individual child’s situation, combined with the time of vaccination or the actual situation in the region, and increase the number of checkups.
Health check-ups should be conducted before vaccination, and the environment should be arranged in such a way that children can be examined first and then vaccinated, and each health check-up should take no less than 5-10 minutes.
(B) Health check content
1.Consultation
(1) Feeding and dietary history: feeding methods, food conversion (supplement addition), food varieties, meal frequency and quantity, eating behavior and environment, and addition of nutrient supplements.
(2) Growth and development history: previous physical growth and psychological and behavioral development.
(3) Lifestyle habits: sleep, excretion, hygiene habits, etc.
(4) Allergy history: allergies to drugs, foods, etc.
(5) Disease status: disease status between health examinations.
2.Physical measurements
(1)Weight
1. Preparation before measurement: The zero point of the scale should be corrected before each weight measurement. Children should take off their outer clothes, shoes, socks and hats, empty their bowels and urine, and babies should remove their diapers. In winter, pay attention to keep the room warm, let the child wear only single clothes and pants, accurate weighing and remove the weight of clothes.
2, measurement methods: measurement of children can not touch other objects. When using a lever scale for measurement, the weight placed should be close to the child’s weight, and quickly adjust the pendulum so that the lever is right in the middle of the level, add the weights and the pendulum reading shown; when using an electronic weighing scale, wait for the data to stabilize and then read. The weight of the clothes should be removed when recording. Weight is recorded in kilograms (kg) to 1 decimal place.
(2) Length (height)
1.Preparation for measurement: children aged 2 years and below should measure their length, and children aged 2 years and above should measure their height. Children should take off their outer clothing, shoes, socks and hats before measuring their length (height).
2.Measurement method: When measuring the length, the child lies on his or her back in the center of the measurement bed, and the assistant holds the head upright, with the top of the head touching the headboard and both ears at the same level. The measurer stands on the right side of the child, holds the child’s two knees with the left hand so that the legs are straight, and moves the footboard with the right hand so that it touches the heels of both feet, noting that the readings on both sides of the measurement bed should be consistent, and then read the numbers.
When measuring height, the child should be in a standing position, with both eyes looking straight ahead, chest up, arms naturally hanging down, heels together, toes separated by about 60 degrees, heels, hips and three points between the two shoulder blades touching the column at the same time, head maintaining a central position, so that the measuring board is in contact with the top of the head, read the number of the measuring board vertically intersecting the scale on the column, and the line of sight should be parallel to the number of the scale on the column. The child’s length (height) is recorded in centimeters (cm) to 1 decimal place.
(3) Head circumference
The child was placed in a sitting or supine position, and the measurer was located on the right side or in front of the child, and the zero point of the soft ruler was fixed at the upper edge of the brow arch on the right side of the head with the left thumb, and returned to the zero point via the occipital ridge and the upper edge of the brow arch on the left side, so that the soft ruler was close to the scalp, and the girl should loosen the hair braid. The head circumference of the child was recorded in centimeters (cm) to 1 decimal place.
3.Physical examination
(1) General condition: observe the child’s mental state, face, expression and gait.
(2) Skin: whether there is yellowing, pallor, cyanosis (mouth, lips, finger and toe nail beds), rash, bleeding spots, petechiae, hemangioma, and whether there is flushing or erosion in the skin folds of the neck, axilla, groin, buttocks, etc.
(3) Lymph nodes: the size, number, texture, mobility, and presence of pressure pain of superficial lymph nodes throughout the body.
(4) Head and neck: presence of square skull, cranial softening, size and tension of fontanelle, cranial suture, presence of special facial features, limitation of neck movement or neck mass.
(5) Eyes: Any abnormalities in appearance, presence of conjunctival congestion and secretions, and nystagmus. Whether the infant has gaze and pursuit of vision.
(6) Ear: Any abnormalities in appearance and any abnormal discharge from the ear canal.
(7) Nose: Any abnormal appearance and abnormal secretions.
(8) Oral cavity: the presence of cleft lip and palate, and the presence of abnormal oral mucosa. Whether the tonsils are enlarged, the number of milk teeth, the presence of caries and the number of caries.
(9) Chest: whether the thorax is symmetrical, whether there is funnel chest, cockscomb chest, rib crossties, rib cartilage grooves, etc., whether there is cardiac arrhythmia and heart murmur on auscultation, and whether there is abnormal respiratory sound in the lungs.
(10) Abdomen: presence of abdominal distension, hernia, mass, tenderness, and examination of liver and spleen size.
(11) External genitalia: presence of deformities, scrotal edema, masses, and examination of testicular position and size.
(12) Spine and limbs: whether there is scoliosis or retrognathism in the spine, whether the limbs are symmetrical, whether there are deformities, and screening for developmental hip dysplasia if available.
(13) Neurological system: symmetry, mobility and muscle tone of the limbs.
4.Mental behavior development monitoring
Every time infants and toddlers undergo health checkups, they need to be monitored for development in accordance with the motor development indicators of the child growth and development monitoring chart, and to regularly understand the psychological-behavioral development of children to detect developmental deviations in a timely manner. Areas with conditions can carry out screening of children’s psychological and behavioral development.
5.Laboratory and other auxiliary tests
(1) Hemoglobin or routine blood tests: 1 test for children 6 to 9 months of age, and 1 test for children 1 to 6 years of age every year.
(2) Hearing screening: For children with risk factors for hearing loss, portable auditory assessment instruments and screening otoacoustic emission devices are used to screen children’s hearing once at 6, 12, 24 and 36 months of age.
(3) Vision screening: Children are screened once a year starting at age 4 using the International Standard Vision Scale or the Standard Logarithmic Vision Scale light box.
(4) Other examinations: units with conditions can carry out urinary routine, dietary nutrition analysis and other examination items according to the specific situation of children.
(C) Health evaluation
1.Physical growth evaluation
(1) Evaluation indicators
Weight/age, length (height)/age, head circumference/age, weight/ length (height) and body mass index (BMI)/age.
(2) Evaluation method
Data table method
①Divergence method (standard deviation method)
The median (M) was used as the base value plus or minus the standard deviation (SD) to evaluate physical growth, and the five-grade division method and the three-grade division method could be used (Table 1).
Table 1 Grading method
Grade