Country Experiences

(1)

Maternal Practice During Pregnancy

1. Have complete 3 main meals a day for breakfast, lunch, and dinner, including 2-3 nutritious light meals such as milk, fruits or less sweeten Thai desserts.

2.

Receive completed 2 doses of tetanus toxoid vaccination.

3. Take one tablet of iodine, iron, and folate everyday.

4.

See the dentist or have dental check-up by health personnel at least 1 time.

5.

If the following signs display, see health personnel immediately.

High fever Excessive morning sickness

Anxiety or depression Excessive abdominal pain or distension Obstructed urination Vaginal discharge with itching and smelling

Dizziness, fatigue Swelling dorsum of feet

Less fetal movement Water leaking from the vagina

6.

ANC Visit

1st Visit First ANC visit before 12 weeks of gestation 2nd Visit At 20 weeks of gestation

3rd Visit At 26 weeks of gestation 4th Visit At 32 weeks of gestation 5th Visit At 38 weeks of gestation

7.

Exercise is possible but avoid to become too tired. General household chores are allowed but hard work should be avoided.

8.

Seek postnatal visit at 6 weeks.

9.

Make yourself at ease and relax during pregnancy for the baby to be easy to raise. The fatherûs staying close and attention will help the mother become cheerful.

(2)

Objective

To provide surveillance for monitoring the weight of each gestational age of pregnant women so as to give birth to a newborn with no less than 2,500 grams of birth-weight.

Instruction (page 61-62)

The figures in the left and right columns illustrate gestational ages from 12 › 40 weeks.

The figures in the upper row illustrate the heights from 140 › 170 cm. The figures within the table corresponding to the heights in each row illustrate the weights in kilogram.

How to use the table

1.

Place the ruler onto the column corresponding to the height of pregnant woman, then look for the weight in the column to match the gestational age from 12 to 38 weeks, and mark it.

2.

Record the weight obtained for each gestational age in the PregnancyPregnancyPregnancyPregnancyPregnancy Pathway Chart

Pathway Chart Pathway Chart Pathway Chart

Pathway Chart in the box çHealthy fetus, proper weight, the mother should weighÇÇ.kg.é corresponding to the current gestational age (or approximate) from the first ANC visit up until 38 weeks.

3.

Compare the actual weight at the check-up date with the weight obtained from the table. if the actual weight equals to or higher than the weigh recorded in the Pregnancy Pathway Chart, your baby is likely having the birth-weight 2,500 grams or more.

Your baby is healthy with the birth-weight > 2,500 grams.

Table of Minimum Weight for Pregnant Women

to Give Birth to a Newborn of 2,500 Grams.

(3)

Mommy, Daddy Please donût smoke!

Self Care During Pregnancy through Pregnancy Pathway

This pregnancy pathway is used by pregnant women to practice self care during

pregnancy to delivery. Following every step in this pathway will help achieve healthy

mother and fetus and a newbom of > 2,500 grams.

Concept and Artwork by Taweesak Sawetserani Institute for Population and Social Research,

Mahidol University

Address No...Moo...Name of Village...

District...Province...

Mommy, Daddy, you have to talk what the doctor said. Mommy, have you check your teeth?

If you get moming sickness, donût buy the

drug over the counter Itûs great, my mommy

eats all the 5 groups of food everyday Mommy, Just relax

and relieve, frequently talk to me.

●Pregnancy order...

●Date of exam...

●Place of exam...

●Due date...

Thank you Dad and Mom that you will take best care of me while I am inside you Mom.

Your lovely baby.

●Morning sickness dur-ing the first few months is normal, do not worry.

●Follow proper dietary practice (see reverse side).

See health personnel if display the following signs:

●Severe vomiting, lost appetite

●Severe abdominal pain

●Vaginal bleeding

●Pale

Health fetus, proper weight, the mother should weight...kg. Now your weiht is...kg. Date of exam .../.../...

●Drink 2-3 glasses of milk a day.

●Take iron supplement everyday.

●Brush your teeth after meals and before bedtime

●Have dental check-up and dental/gum treatment

Health fetus, proper weight, the mother should weight...kg. Now your weiht is...kg. Date of exam.../.../...

For the first pregnancy, you will fell of guickening at the 5th

month, and for subsequent pregnancies at the 4th

month... Complete recommended doses of BCG vaccination Health fetus,

proper weight, the mother should weight...kg. Now your weiht is...kg. Date of exam.../.../...

●If with abdominal itching, apply olive oil or cream.

●Check the nipples to prepare for breastfeeding, If the nipples inverse, consult health personnel

●Keep good mood and cheerful.

●Have full sleep and rest.

●Exercise as advised by health personnel. Follow dietary practice (see reverse side). Health fetus, proper

weight, the mother should weigh...kg. Now your weight is ...kg.

Daet of exam.../..../.... See health

personnel if exhibit the following signs:

●No abdominal enlargement.

●Vagina bleeding.

●Pale

●Unusual abdominal enlargement. Health fetus,

proper weight, the mother should weigh...kg. Now your weight is ...kg.

Daet of exam .../.../...

●Prepare for breast feeding.

●If with abdominal paln, frequent abdominal tense, go to the hospital right away.

Health fetus, proper weight, the mother should weigh...kg.

Now your weight is...kg. Daet of exam .../.../...

Health fetus, proper weight, the mother should weigh...kg. Now your weight is...kg. Daet of exam .../.../...

Health fetus, proper weight, the mother should weigh...kg. Now your weight is...kg. Daet of exam.../.../...

Happy Birthday my dear baby Your name is ... weigh...kg. Length...cm. Daet of exam .../.../...

●Have you recelve complete doses of BCG vaccination? ●If having problems, consult health personnel. ●less fetal movement

See health

personnel if exhibit the following signs:

●Edema on body, legs and arms, the dorsum of foot sinks with pressed

●Headache, blurred vision with pressed

●Vaginal bleeding, water leakage

●If less fetal movement, see health personnal right away.

●Prepare for delivery.

Start Here

Thank you Mommy to make me health with birt-weight more than 2,500 grams.

Your

babyûs

Photo

Due Date Complete 38 wks.

Appointment date

Appointment date Appointment date Appointment date

Appointment date

Appointment date Appointment date

Complete 33 wks. 9 Months

Complete 32 wks. 8 Months

Complete 28 wks.

7 Months _{Complete 24 wks.} 6 Months

Complete 20 wks. 5 Months

Complete 12 wks. 3 Months

Complete 16 wks. 4 Months

(4)

Weeks 40 39 38 37 36 35 34 33 32 31 30 29 28 27 26 25 24 23 22 21 20 19 18 17 16 15 14 13 12 49.4 49.4 49.1 48.9 48.6 48.3 48.0 47.7 47.3 47.0 46.6 46.3 45.9 45.5 45.1 44.7 44.2 43.8 43.4 43.0 42.6 42.2 41.9 41.6 41.4 41.2 41.0 40.8 40.7 50.1 50.1 49.8 49.6 49.3 49.0 48.7 48.4 48.0 47.6 47.3 46.9 46.6 46.1 45.7 45.3 44.9 44.5 44.0 43.6 43.2 42.8 42.5 42.2 42.0 41.8 41.5 41.4 41.3 50.8 50.8 50.5 50.3 50.0 49.7 49.4 49.1 48.7 48.3 47.9 47.6 47.2 46.8 46.4 45.9 45.5 45.1 44.7 44.2 43.8 43.4 43.1 42.8 42.6 42.3 42.1 42.0 41.9 51.5 51.5 51.2 51.0 50.7 50.4 50.1 49.8 49.4 49.0 48.6 48.3 47.9 47.5 47.0 46.6 46.2 45.7 45.3 44.9 44.4 44.0 43.7 43.4 43.2 42.9 42.7 42.6 42.5 52.3 52.2 51.9 51.7 51.4 51.1 50.8 50.5 50.1 49.7 49.3 48.9 48.6 48.1 47.7 47.2 46.8 46.4 45.9 45.5 45.0 44.6 44.3 44.0 43.8 43.5 43.3 43.2 43.1 53.0 52.9 52.7 52.4 52.1 51.8 51.5 51.2 50.8 50.4 50.0 49.6 49.2 48.8 48.3 47.9 47.5 47.0 46.6 46.1 45.7 45.3 44.9 44.6 44.4 44.2 43.9 43.8 43.7 53.7 53.7 53.4 53.1 52.9 52.6 52.2 51.9 51.5 51.1 50.7 50.3 49.9 49.5 49.0 48.6 48.1 47.7 47.2 46.8 46.3 45.9 45.5 45.3 45.0 44.8 44.5 44.4 44.3 54.5 54.5 54.1 53.9 53.6 53.3 53.0 52.6 52.2 51.8 51.4 51.0 50.6 50.1 49.7 49.2 48.8 48.3 47.9 47.4 46.9 46.5 46.2 45.9 45.6 45.4 45.2 45.0 44.9 55.2 55.2 54.9 54.6 54.3 54.0 53.7 53.4 52.9 52.5 52.1 51.7 51.3 50.8 50.4 49.9 49.4 49.0 48.5 48.1 47.6 47.1 46.8 46.5 46.2 46.0 45.8 45.6 45.5 55.9 55.9 55.6 55.3 55.1 54.7 54.4 54.1 53.6 53.2 52.8 52.4 52.0 51.5 51.1 50.6 50.1 49.7 49.2 48.7 48.2 47.8 47.4 47.1 46.9 46.6 46.4 46.2 46.2 56.7 56.7 56.4 56.1 55.8 55.5 55.1 54.8 54.3 53.9 53.5 53.1 52.7 52.2 51.7 51.3 50.8 50.3 49.8 49.4 48.9 48.4 48.1 47.8 47.5 47.3 47.0 46.9 46.8 57.5 57.4 57.1 56.8 56.5 56.2 55.9 55.5 55.1 54.6 54.2 53.8 53.4 52.9 52.4 52.0 51.5 51.0 50.5 50.0 49.5 49.1 48.7 48.4 48.1 47.9 47.6 47.5 47.4 58.2 58.2 57.9 57.6 57.3 57.0 56.6 56.3 55.8 55.4 54.9 54.5 54.1 53.6 53.1 52.6 52.2 51.7 51.2 50.7 50.2 49.7 49.3 49.1 48.8 48.5 48.3 48.1 48.0 59.0 58.9 58.6 58.4 58.1 57.7 57.4 57.0 56.5 56.1 55.6 55.3 54.8 54.3 53.8 53.3 52.8 52.4 51.9 51.4 50.8 50.4 50.0 49.7 49.4 49.2 48.9 48.8 48.7 59.8 59.7 59.4 59.1 58.8 58.5 58.1 57.8 57.3 56.8 56.4 56.0 55.5 55.0 54.5 54.0 53.5 53.0 52.5 52.0 51.5 51.0 50.7 50.4 50.1 49.8 49.6 49.4 49.3 60.5 60.5 60.2 59.9 59.6 59.2 58.9 58.5 58.0 57.6 57.1 56.7 56.3 55.8 55.2 54.7 54.2 53.7 53.2 52.7 52.2 51.7 51.3 51.0 50.7 50.5 50.2 50.0 49.9 61.3 61.3 61.0 60.7 60.4 60.0 59.6 59.3 58.8 58.3 57.9 57.4 57.0 56.5 56.0 55.4 54.9 54.4 53.9 53.4 52.8 52.4 52.0 51.7 51.4 51.1 50.9 50.7 50.6 62.1 62.1 61.8 61.4 61.1 60.8 60.4 60.0 59.5 59.1 58.6 58.2 57.7 57.2 56.7 56.2 55.6 55.1 54.6 54.1 53.5 53.1 52.6 52.3 52.0 51.8 51.5 51.3 51.2 62.9 62.9 62.5 62.2 61.9 61.5 61.2 60.8 60.3 59.8 59.3 58.9 58.5 57.9 57.4 56.9 56.4 55.8 55.3 54.8 54.2 53.7 53.3 53.0 52.7 52.4 52.2 52.0 51.9 63.7 63.7 63.3 63.0 62.7 62.3 62.0 61.6 61.1 60.6 60.1 59.7 59.2 58.7 58.1 57.6 57.1 56.5 56.0 55.5 54.9 54.4 54.0 53.7 53.4 53.1 52.8 52.7 52.6 64.5 64.5 64.1 63.8 63.5 63.1 62.7 62.4 61.8 61.3 60.9 60.4 59.9 59.4 58.9 58.3 57.8 57.3 56.7 56.2 55.6 55.1 54.7 54.4 54.0 53.8 53.5 53.3 53.2 65.3 65.3 64.9 64.6 64.3 63.9 63.5 63.1 62.6 62.1 61.6 61.2 60.7 60.1 59.6 59.1 58.5 58.0 57.4 56.9 56.3 55.8 55.4 55.0 54.7 54.4 54.2 54.0 53.9 66.1 66.1 65.7 65.4 65.1 64.7 64.3 63.9 63.4 62.9 62.4 61.9 61.5 60.9 60.3 59.8 59.2 58.7 58.1 57.6 57.0 56.5 56.0 55.7 55.4 55.1 54.8 54.7 54.6 67.0 66.9 66.6 66.2 65.9 65.5 65.1 64.7 64.2 63.7 63.2 62.7 62.2 61.7 61.1 60.5 60.0 59.4 58.9 58.3 57.7 57.2 56.7 56.4 56.1 55.8 55.5 55.3 55.2 67.8 67.7 67.4 67.0 66.7 66.3 65.9 65.5 65.0 64.4 63.9 63.5 63.0 62.4 61.8 61.3 60.7 60.2 59.6 59.0 58.4 57.9 57.4 57.1 56.8 56.5 56.2 56.0 55.9 68.6 68.5 68.2 67.9 67.5 67.1 66.7 66.3 65.7 65.2 64.7 64.3 63.7 63.2 62.6 62.0 61.5 60.9 60.3 59.7 59.1 58.6 58.1 57.8 57.5 57.2 56.9 56.7 56.6 120.0 119.9 119.3 118.7 118.1 117.4 116.7 116.0 115.0 114.1 113.2 112.4 111.5 110.5 109.5 108.5 107.5 106.3 105.5 104.5 103.4 102.5 101.7 101.1 100.5 100.0 99.5 99.2 99.0 69.4 69.4 69.0 68.7 68.3 67.9 67.5 67.1 66.5 66.0 65.5 65.0 64.5 63.9 63.4 62.8 62.2 61.6 61.1 60.5 59.8 59.3 58.9 58.5 58.2 57.9 57.6 57.4 57.3 72.0 71.9 71.6 71.2 70.8 70.4 70.0 69.6 69.0 68.4 67.9 67.4 66.9 66.3 65.7 65.1 64.5 63.9 63.3 62.7 62.0 61.5 61.0 60.6 60.3 60.0 59.7 59.5 59.4 70.3 70.2 69.9 69.5 69.2 68.8 68.3 67.9 67.4 66.8 66.3 65.8 65.3 64.7 64.1 63.5 63.0 62.4 61.8 61.2 60.6 60.0 59.6 59.2 58.9 58.6 58.3 58.1 58.0 71.1 71.1 70.7 70.4 70.0 69.6 69.2 68.8 68.2 67.6 67.1 66.6 66.1 65.5 64.9 64.3 63.7 63.1 62.5 61.9 61.3 60.8 60.3 59.9 59.6 59.3 59.0 58.8 58.7 72.8 72.8 72.4 72.0 71.7 71.3 70.8 70.4 69.8 69.2 68.7 68.2 67.7 67.1 66.5 65.8 65.2 64.6 64.0 63.4 62.8 62.2 61.7 61.4 61.0 60.7 60.4 60.2 60.1 Weeks 40 39 38 37 36 35 34 33 32 31 30 29 28 27 26 25 24 23 22 21 20 19 18 17 16 15 14 13 12 %BMI Height 140 (c.m.) Height 141 (c.m.) Height 142 (c.m.) Height 143 (c.m.) Height 144 (c.m.) Height 145 (c.m.) Height 146 (c.m.) Height 147 (c.m.) Height 148 (c.m.) Height 149 (c.m.) Height 150 (c.m.) Height 151 (c.m.) Height 152 (c.m.) Height 153 (c.m.) Height 154 (c.m.) Height 155 (c.m.) Height 156 (c.m.) Height 157 (c.m.) Height 158 (c.m.) Height 159 (c.m.) Height 160 (c.m.) Height 161 (c.m.) Height 162 (c.m.) Height 163 (c.m.) Height 164 (c.m.) Height 165 (c.m.) Height 166 (c.m.) Height 167 (c.m.) Height 168 (c.m.) Height 169 (c.m.) Height 170 (c.m.)

(5)

Interpretation InterpretationInterpretation InterpretationInterpretation

1.

If throughout the pregnancy period, the cross marks are within the green stripe and with increasing weightgreen stripe and with increasing weightgreen stripe and with increasing weightgreen stripe and with increasing weightgreen stripe and with increasing weight along the solid line

along the solid linealong the solid line along the solid line

along the solid line, it is expected that the childûs weight is > 3,000 grams.

2.

If throughout the pregnancy period, the cross marks are within the green stripe and with less increasinggreen stripe and with less increasinggreen stripe and with less increasinggreen stripe and with less increasinggreen stripe and with less increasing weight not along the solid line

weight not along the solid lineweight not along the solid line weight not along the solid line

weight not along the solid line, it is expected that the childûs weight is > 3,000 grams.

3. If throughout the pregnancy period, the cross marks are within the yellow stripe and with increasing weightyellow stripe and with increasing weightyellow stripe and with increasing weightyellow stripe and with increasing weightyellow stripe and with increasing weight along the dash line

along the dash linealong the dash line along the dash line

along the dash line, it is expected that the childûs weight is between 2,500-3,000 grams.

4.

If throughout the pregnancy period, the cross marks are within the pink stripe and with increasing weightstripe and with increasing weightstripe and with increasing weightstripe and with increasing weightstripe and with increasing weight along the dash line

along the dash linealong the dash line along the dash line

along the dash line, it is expected that the childûs weight is > 2,500 grams.

5.

If in the early pregnancy period, the cross marks are within the pink stripe and with very steep increasingpink stripe and with very steep increasingpink stripe and with very steep increasingpink stripe and with very steep increasingpink stripe and with very steep increasing weight

weightweight weight

weight, it is expected that the childûs weight may be > or < 2,500 grams due to poor nutritional status of the mother before pregnancy.

Suggestions SuggestionsSuggestions SuggestionsSuggestions

❏ Normal weight during pregnancyNormal weight during pregnancyNormal weight during pregnancyNormal weight during pregnancyNormal weight during pregnancy: Follow the dietary practice in the illustration of sets of food exchange.

❏ Low weight during pregnancyLow weight during pregnancyLow weight during pregnancyLow weight during pregnancyLow weight during pregnancy: Increase food intake for rice-starch, meat, milk, egg, vegetables, and fruits.

❏ Obesity before pregnancyObesity before pregnancyObesity before pregnancyObesity before pregnancyObesity before pregnancy (percentage of standard value over 120): Control the weigh gain over the pregnancy period to be within approximately 9 kg.

Advantage of the nutritional graph Advantage of the nutritional graphAdvantage of the nutritional graph

Advantage of the nutritional graphAdvantage of the nutritional graph: The mother uses it for watching nutritional: The mother uses it for watching nutritional: The mother uses it for watching nutritional: The mother uses it for watching nutritional: The mother uses it for watching nutritional status and monitoring the trend of motherûs status and monitoring the trend of motherûsstatus and monitoring the trend of motherûs status and monitoring the trend of motherûsstatus and monitoring the trend of motherûs weigh change during pregnancy, for the baby weigh change during pregnancy, for the babyweigh change during pregnancy, for the baby weigh change during pregnancy, for the babyweigh change during pregnancy, for the baby to have between 3,000-3,900 grams of to have between 3,000-3,900 grams ofto have between 3,000-3,900 grams of to have between 3,000-3,900 grams ofto have between 3,000-3,900 grams of birthweight.

birthweight.birthweight. birthweight.birthweight.

(6)

Use this graph to record BMI

3 month 4 month 5 month 6 month 7 month 8 month 9 month

Mother's Weight (kg.) Gestational Age

Week 2,500 grams Child's Weight

3,000 grams Child's Weight

(7)

80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 31.1 31.5 31.9 32.2 32.6 33.0 33.4 33.8 34.2 34.6 35.0 35.3 35.7 36.1 36.5 36.9 37.3 37.7 38.1 38.5 38.8 39.2 39.6 40.0 40.4 40.8 41.2 41.6 41.9 42.3 42.7 43.1 43.5 43.9 44.3 44.7 45.1 45.4 45.8 46.2 46.6 47.0 47.4 47.8 48.2 48.6 48.9 49.3 49.7 50.1 50.5 50.9 51.3 51.7 52.0 52.4 52.8 53.2 53.6 54.0 54.4 31.5 31.9 32.3 32.7 33.1 33.5 33.9 34.3 34.7 35.1 35.5 35.9 36.3 36.7 37.1 37.4 37.8 38.2 38.6 39.0 39.4 39.8 40.2 40.6 41.0 41.4 41.8 42.2 42.6 43.0 43.4 43.8 44.1 44.5 44.9 45.3 45.7 46.1 46.5 46.9 47.3 47.7 48.1 48.5 48.9 49.3 49.7 50.1 50.5 50.8 51.2 51.6 52.0 52.4 52.8 53.2 53.6 54.0 54.4 54.8 55.2 32.0 32.4 32.8 33.2 33.6 34.0 34.4 34.8 35.2 35.6 36.0 36.4 36.8 37.2 37.6 38.0 38.4 38.8 39.2 39.6 40.0 40.4 40.8 41.2 41.6 42.0 42.4 42.8 43.2 43.6 44.0 44.4 44.8 45.2 45.6 46.0 46.4 46.8 47.2 47.6 48.0 48.4 48.4 49.2 49.6 50.0 50.4 50.8 51.2 51.6 52.0 52.4 52.8 53.2 53.6 54.0 54.4 54.8 55.2 55.6 56.0 32.5 32.9 33.3 33.7 34.1 34.5 34.9 35.3 35.7 36.1 36.5 36.9 37.3 37.7 38.1 38.5 39.0 39.4 39.8 40.2 40.6 41.0 41.4 41.8 42.2 42.6 43.0 43.4 43.8 44.2 44.6 45.0 45.4 45.8 46.3 46.7 47.1 47.5 47.9 48.3 48.7 49.1 49.5 49.9 50.3 50.7 51.1 51.5 51.9 52.3 52.7 53.2 53.6 54.0 54.4 54.8 55.2 55.6 56.0 56.4 56.8 32.9 33.3 33.8 34.2 34.6 35.0 35.4 35.8 36.2 36.6 37.0 37.5 37.9 38.3 38.7 39.1 39.5 39.9 40.3 40.7 41.2 41.6 42.0 42.4 42.8 43.2 43.6 44.0 44.5 44.9 45.3 45.7 46.1 46.5 46.9 47.3 47.7 48.2 48.6 49.0 49.4 49.8 50.2 50.6 51.0 51.5 51.9 52.3 52.7 53.1 53.5 53.9 54.3 54.7 55.2 55.6 56.0 56.4 56.8 57.2 57.6 33.4 33.8 34.2 34.7 35.1 35.5 35.9 36.3 36.7 37.2 37.6 38.0 38.4 38.8 39.2 39.7 40.1 40.5 40.9 41.3 41.8 42.2 42.6 43.0 43.4 43.8 44.3 44.7 45.1 45.5 45.9 46.3 46.8 47.2 47.6 48.0 48.4 48.8 49.3 49.7 50.1 50.5 50.9 51.4 51.8 52.2 52.6 53.0 53.4 53.9 54.3 54.7 55.1 55.5 55.9 56.4 56.8 57.2 57.6 58.0 58.5 33.9 34.3 34.7 35.1 35.6 36.0 36.4 36.8 37.3 37.7 38.1 38.5 39.0 39.4 39.8 40.2 40.7 41.1 41.5 41.9 42.3 42.8 43.2 43.6 44.0 44.5 44.9 45.3 45.7 46.2 46.6 47.0 47.4 47.8 48.3 48.7 49.1 49.5 50.0 50.4 50.8 51.2 51.7 52.1 52.5 52.9 53.4 53.8 54.2 54.6 55.0 55.5 55.9 56.3 56.7 57.2 57.6 58.0 58.4 58.9 59.3 34.4 34.8 35.2 35.6 36.1 36.5 36.9 37.4 37.8 38.2 38.6 39.1 39.5 39.9 40.4 40.8 41.2 41.7 42.1 42.5 42.9 43.4 43.8 44.2 44.7 45.1 45.5 45.9 46.4 46.8 47.2 47.7 48.1 48.5 49.0 49.4 49.8 50.2 50.7 51.1 51.5 52.0 52.4 52.8 53.2 53.7 54.1 54.5 55.0 55.4 55.8 56.3 56.7 57.1 57.5 58.0 58.4 58.8 59.3 59.7 60.1 34.8 35.3 35.7 36.1 36.6 37.0 37.4 37.9 38.3 38.8 39.2 39.6 40.1 40.5 40.9 41.4 41.8 42.2 42.7 43.1 43.5 44.0 44.4 44.9 45.3 45.7 46.2 46.6 47.0 47.5 47.9 48.3 48.8 49.2 49.6 50.1 50.5 50.9 51.4 51.8 52.3 52.7 53.1 53.6 54.0 54.4 54.9 55.3 55.7 56.2 56.6 57.0 57.5 57.9 58.4 58.8 59.2 59.7 60.1 60.5 61.0 35.3 35.8 36.2 36.6 37.1 37.5 38.0 38.4 38.9 39.3 39.7 40.2 40.6 41.1 41.5 41.9 42.4 42.8 43.3 43.7 44.2 44.6 45.0 45.5 45.9 46.4 46.8 47.2 47.7 48.1 48.6 49.0 49.5 49.9 50.3 50.8 51.2 51.7 52.1 52.5 53.0 53.4 53.9 54.3 54.7 55.2 55.6 56.1 56.5 57.0 57.4 57.8 58.3 58.7 59.2 59.6 60.0 60.5 60.9 61.4 61.8 35.8 36.3 36.7 37.2 37.6 38.0 38.5 38.9 39.4 39.8 40.3 40.7 41.2 41.6 42.1 42.5 43.0 43.4 43.9 44.3 44.8 45.2 45.7 46.1 46.6 47.0 47.4 47.9 48.3 48.8 49.2 49.7 50.1 50.6 51.0 51.5 51.9 52.4 52.8 53.3 53.7 54.2 54.6 55.1 55.5 56.0 56.4 56.8 57.3 57.7 58.2 58.6 59.1 59.5 60.0 60.4 60.9 61.3 61.8 62.2 62.7 36.3 36.8 37.2 37.7 38.1 38.6 39.0 39.5 39.9 40.4 40.8 41.3 41.7 42.2 42.7 43.1 43.6 44.0 44.5 44.9 45.4 45.8 46.3 46.7 47.2 47.6 48.1 48.6 49.0 49.5 49.9 50.4 50.8 51.3 51.7 52.2 52.6 53.1 53.5 54.0 54.5 54.9 55.4 55.8 56.3 56.7 57.2 57.6 58.1 58.5 59.0 59.4 59.9 60.4 60.8 61.3 61.7 62.2 62.6 63.1 63.5 36.8 37.3 37.7 38.2 38.6 39.1 39.6 40.0 40.5 40.9 41.4 41.9 42.3 42.8 43.2 43.7 44.2 44.6 45.1 45.5 46.0 46.5 46.9 47.4 47.8 48.3 48.8 49.2 49.7 50.1 50.6 51.1 51.5 52.0 52.4 52.9 53.4 53.8 54.3 54.7 55.2 55.7 56.1 56.6 57.0 57.5 58.0 58.4 58.9 59.3 59.8 60.3 60.7 61.2 61.6 62.1 62.6 63.0 63.5 63.9 64.4 37.3 37.8 38.2 38.7 39.2 39.6 40.1 40.6 41.0 41.5 42.0 42.4 42.9 43.4 43.8 44.3 44.8 45.2 45.7 46.2 46.6 47.1 47.6 48.0 48.5 49.0 49.4 49.9 50.4 50.8 51.3 51.8 52.2 52.7 53.1 53.6 54.1 54.5 55.0 55.5 55.9 56.4 56.9 57.3 57.8 58.3 58.7 59.2 59.7 60.1 60.6 61.1 61.5 62.0 62.5 62.9 63.4 63.9 64.3 64.8 65.3 37.8 38.3 38.7 39.2 39.7 40.2 40.6 41.1 41.6 42.1 42.5 43.0 43.5 43.9 44.4 44.9 45.4 45.8 46.3 46.8 47.3 47.7 48.2 48.7 49.1 49.6 50.1 50.6 51.0 51.5 52.0 52.4 52.9 53.4 53.9 54.3 54.8 55.3 55.8 56.2 56.7 57.2 57.6 58.1 58.6 59.1 59.5 60.0 60.5 61.0 61.4 61.9 62.4 62.8 63.3 63.8 64.3 64.7 65.2 65.7 66.2 38.3 38.8 39.3 39.7 40.2 40.7 41.2 41.7 42.1 42.6 43.1 43.6 44.1 44.5 45.0 45.5 46.0 46.4 46.9 47.4 47.9 48.4 48.8 49.3 49.8 50.3 50.8 51.2 51.7 52.2 52.7 53.1 53.6 54.1 54.6 55.1 55.5 56.0 56.5 57.0 57.5 57.9 58.4 58.9 59.4 59.9 60.3 60.8 61.3 61.8 62.2 62.7 63.2 63.7 64.2 64.6 65.1 65.6 66.1 66.6 67.0 38.8 39.3 39.8 40.3 40.8 41.2 41.7 42.2 42.7 43.2 43.7 44.2 44.6 45.1 45.3 46.1 46.6 47.1 47.5 48.0 48.5 49.0 49.5 50.0 50.5 50.9 51.4 51.9 52.4 52.9 53.4 53.9 54.3 54.8 55.3 55.8 56.3 56.8 57.3 57.7 58.2 58.7 59.2 59.7 60.2 60.6 61.1 61.6 62.1 62.6 63.1 63.6 64.0 64.5 65.0 65.5 66.0 66.5 67.0 67.4 67.9 39.3 39.8 40.3 40.8 41.3 41.8 42.3 42.8 43.3 43.8 44.2 44.7 45.2 45.7 46.2 46.7 47.2 47.7 48.2 48.7 49.2 49.7 50.1 50.6 51.1 51.6 52.1 52.6 53.1 53.6 54.1 54.6 55.1 55.5 56.0 56.5 57.0 57.5 58.0 58.5 59.0 59.5 60.0 60.5 61.0 61.4 61.9 62.4 62.9 63.4 63.9 64.4 64.9 65.4 65.9 66.4 66.9 67.3 67.8 68.3 68.8 39.8 40.3 40.8 41.3 41.8 42.3 42.8 43.3 43.8 44.3 44.8 45.3 45.8 46.3 46.8 47.3 47.8 48.3 48.8 49.3 49.8 50.3 50.8 51.3 51.8 52.3 52.8 53.3 53.8 54.3 54.8 55.3 55.8 56.3 56.8 57.3 57.8 58.3 58.8 59.3 59.8 60.3 60.8 61.3 61.8 62.3 62.8 63.3 63.7 64.2 64.7 65.2 65.7 66.2 66.7 67.2 67.7 68.2 68.7 69.2 69.7 40.4 40.9 41.4 41.9 42.4 42.9 43.4 43.9 44.4 44.9 45.4 45.9 46.4 46.9 47.4 47.9 48.4 48.9 49.4 49.9 50.5 51.0 51.5 52.0 52.5 53.0 53.5 54.0 54.5 55.0 55.5 56.0 56.5 57.0 57.5 58.0 58.5 59.0 59.5 60.0 60.5 61.0 61.6 62.1 62.6 63.1 63.6 64.1 64.6 65.1 65.6 66.1 66.6 67.1 67.6 68.1 68.6 69.1 69.6 70.1 70.6 40.9 41.4 41.9 42.4 42.9 43.4 44.0 44.5 45.0 45.5 46.0 46.5 47.0 47.5 48.0 48.6 49.1 49.6 50.1 50.6 51.1 51.6 52.1 52.6 53.1 53.7 54.2 54.7 55.2 55.7 56.2 56.7 57.2 57.7 58.3 58.8 59.3 59.8 60.3 60.8 61.3 61.8 62.3 62.9 63.4 63.9 64.4 64.9 65.4 65.9 66.4 66.9 67.5 68.0 68.5 69.0 69.5 70.0 70.5 71.0 71.5 41.4 41.9 42.4 43.0 43.5 44.0 44.5 45.0 45.6 46.1 46.6 47.1 47.6 48.1 48.7 49.2 49.7 50.2 50.7 51.2 51.8 52.3 52.8 53.3 53.8 54.4 54.9 55.4 55.9 56.4 56.9 57.5 58.0 58.5 59.0 59.5 60.0 60.6 61.1 61.6 62.1 62.6 63.2 63.7 64.2 64.7 65.2 65.7 66.3 66.8 67.3 67.8 68.3 68.8 69.4 69.9 70.4 70.9 71.4 72.0 72.5 41.9 42.5 43.0 43.5 44.0 44.6 45.1 45.6 46.1 46.7 47.2 47.7 48.2 48.8 49.3 49.8 50.3 50.9 51.4 51.9 52.4 52.9 53.5 54.0 54.5 55.0 55.6 56.1 56.6 57.1 57.7 58.2 58.7 59.2 59.8 60.3 60.8 61.3 61.9 62.4 62.9 63.4 64.0 64.5 65.0 65.5 66.1 66.6 67.1 67.6 68.2 68.7 69.2 69.7 70.2 70.8 71.3 71.8 72.3 72.9 73.4 42.5 43.0 43.5 44.1 44.6 45.1 45.7 46.2 46.7 47.3 47.8 48.3 48.8 49.4 49.9 50.4 51.0 51.5 52.0 52.6 53.1 53.6 54.2 54.7 55.2 55.7 56.3 56.8 57.3 57.9 58.4 58.9 59.5 60.0 60.5 61.1 61.6 62.1 62.6 63.2 63.7 64.2 64.8 65.3 65.8 66.4 66.9 67.4 68.0 68.5 69.0 69.5 70.1 70.6 71.1 71.7 72.2 72.7 73.3 73.8 74.3 43.0 43.5 44.1 44.6 45.2 45.7 46.2 46.8 47.3 47.8 48.4 48.9 49.5 50.0 50.5 51.1 51.6 52.1 52.7 53.2 53.8 54.3 54.8 55.4 55.9 56.4 57.0 57.5 58.1 58.6 59.1 59.7 60.2 60.7 61.3 61.8 62.4 62.9 63.4 64.0 64.5 65.0 65.6 66.1 66.7 67.2 67.7 68.3 68.8 69.4 69.9 70.4 71.0 71.5 72.0 72.6 73.1 73.7 74.2 74.7 75.3 43.5 44.1 44.6 45.2 45.7 46.3 46.8 47.4 47.9 48.4 49.0 49.5 50.1 50.6 51.2 51.7 52.3 52.8 53.3 53.9 54.4 55.0 55.5 56.1 56.6 57.2 57.7 58.2 58.8 59.3 59.9 60.4 61.0 61.5 62.1 62.6 63.1 63.7 64.2 64.8 65.3 65.9 66.4 67.0 67.5 68.0 68.6 69.1 69.7 70.2 70.8 71.3 71.9 72.4 72.9 73.5 74.0 74.6 75.1 75.7 76.2 44.1 44.6 45.2 45.7 46.3 46.8 47.4 47.9 48.5 49.1 49.6 50.2 50.7 51.3 51.8 52.4 52.9 53.5 54.0 54.6 55.1 55.7 56.2 56.8 57.3 57.9 58.4 59.0 59.5 60.1 60.6 61.2 61.7 62.3 62.8 63.4 63.9 64.5 65.0 65.6 66.1 66.7 67.2 67.8 68.3 68.9 69.4 70.0 70.5 71.1 71.6 72.2 72.7 73.3 73.9 74.4 75.0 75.5 76.1 76.6 77.2 45.7 46.3 46.9 47.5 48.0 48.6 49.2 49.7 50.3 50.9 51.5 52.0 52.6 53.2 53.7 54.3 54.9 55.5 56.0 56.6 57.2 57.7 58.3 58.9 59.5 60.0 60.6 61.2 61.7 62.3 62.9 63.5 64.0 64.6 65.2 65.7 66.3 66.9 67.5 68.0 68.6 69.2 69.8 70.3 70.9 71.5 72.0 72.6 73.2 73.8 74.3 74.9 75.5 76.0 76.6 77.2 77.8 78.3 78.9 79.5 80.0 44.6 45.2 45.8 46.3 46.9 47.4 48.0 48.5 49.1 49.7 50.2 50.8 51.3 51.9 52.4 53.0 53.6 54.1 54.7 55.2 55.8 56.4 56.9 57.5 58.0 58.6 59.1 59.7 60.3 60.8 61.4 61.9 62.5 63.0 63.6 64.2 64.7 65.3 65.8 66.4 67.0 67.5 68.1 68.6 69.2 69.7 70.3 70.9 71.4 72.0 72.5 73.1 73.6 74.2 74.8 75.3 75.9 76.4 77.0 77.6 78.1 45.2 45.8 46.3 46.9 47.4 48.0 48.6 49.1 49.7 50.3 50.8 51.4 52.0 52.5 53.1 53.7 54.2 54.8 55.4 55.9 56.5 57.0 57.6 58.2 58.7 59.3 59.9 60.4 61.0 61.6 62.1 62.7 63.3 63.8 64.4 65.0 65.5 66.1 66.6 67.2 67.8 68.3 68.9 69.5 70.0 70.6 71.2 71.7 72.3 72.9 73.4 74.0 74.6 75.1 75.1 76.3 76.8 77.4 77.9 78.5 79.1 46.3 46.9 47.5 48.0 48.6 49.2 49.8 50.3 50.9 51.5 52.1 52.7 53.2 53.8 54.4 55.0 55.6 56.1 56.7 57.3 57.9 58.4 59.0 59.6 60.2 60.8 61.3 61.9 62.5 63.1 63.7 64.2 64.8 65.4 66.0 66.5 67.1 67.7 68.3 68.9 69.4 70.0 70.6 71.2 71.8 72.3 72.9 73.5 74.1 74.6 75.2 75.8 76.4 77.0 77.5 78.1 78.7 79.3 79.9 80.4 81.0 Ht. 136 (cm) (kg) Ht. 137 (cm) (kg) Ht. 138 (cm) (kg) Ht. 139 (cm) (kg) Ht. 140 (cm) (kg) Ht. 141 (cm) (kg) Ht. 142 (cm) (kg) Ht. 143 (cm) (kg) Ht. 144 (cm) (kg) Ht. 145 (cm) (kg) Ht. 146 (cm) (kg) Ht. 147 (cm) (kg) Ht. 148 (cm) (kg) Ht. 149 (cm) (kg) Ht. 150 (cm) (kg) Ht. 151 (cm) (kg) Ht. 152 (cm) (kg) Ht. 153 (cm) (kg) Ht. 154 (cm) (kg) Ht. 155 (cm) (kg) Ht. 156 (cm) (kg) Ht. 157 (cm) (kg) Ht. 158 (cm) (kg) Ht. 159 (cm) (kg) Ht. 160 (cm) (kg) Ht. 161 (cm) (kg) Ht. 162 (cm) (kg) Ht. 163 (cm) (kg) Ht. 164 (cm) (kg) Ht. 165 (cm) (kg) Ht. 166 (cm) (kg) % Of Value Ht. 135 (cm) (kg) 46.9 47.4 48.0 48.6 49.2 49.8 50.4 51.0 51.5 52.1 52.7 53.3 53.9 54.5 55.1 55.6 56.2 56.8 57.4 58.0 58.6 59.2 59.7 60.3 60.9 61.5 62.1 62.7 63.3 63.8 64.4 65.0 65.5 66.2 66.8 67.4 67.9 68.5 69.1 69.7 70.3 70.9 71.5 72.0 72.6 73.2 73.8 74.4 75.0 75.6 76.1 76.7 77.3 77.9 78.5 79.1 79.7 80.2 80.8 81.4 82.0 Ht. 167 (cm) (kg) 47.4 48.0 48.6 49.2 49.8 50.4 51.0 51.6 52.2 52.8 53.3 53.9 54.5 55.1 55.7 56.3 56.9 57.5 58.1 58.7 59.3 59.9 60.5 61.0 61.6 62.2 62.8 63.4 64.0 64.6 65.2 65.8 66.4 67.0 67.6 68.2 68.8 69.3 69.9 70.5 71.1 71.7 72.3 72.9 73.5 74.1 74.7 75.3 75.9 76.5 77.1 77.6 78.2 78.8 79.4 80.0 80.6 81.2 81.8 82.4 83.0 Ht. 168 (cm) (kg) 48.0 48.6 49.2 49.8 50.4 51.0 51.6 52.2 52.8 53.4 54.0 54.6 55.2 55.8 56.4 57.0 57.6 58.2 58.8 59.4 60.0 60.6 61.2 61.8 62.4 63.0 63.6 64.2 64.8 65.4 66.0 66.6 67.2 67.8 68.4 69.0 69.6 70.2 70.8 71.4 72.0 72.6 73.2 73.8 74.4 75.0 75.6 76.2 76.8 77.4 78.0 78.6 79.2 79.8 80.4 81.0 81.6 82.2 82.8 83.4 84.0 Ht. 169 (cm) (kg) 48.6 49.2 49.8 50.4 51.0 51.6 52.2 52.8 53.4 54.0 54.6 55.2 55.8 56.4 57.0 57.7 58.3 58.9 59.5 60.1 60.7 61.3 61.9 62.5 63.1 63.7 64.3 64.9 65.5 66.2 66.8 67.4 68.0 68.6 69.2 69.8 70.4 71.0 71.6 72.2 72.8 73.4 74.0 74.6 75.3 75.9 76.5 77.1 77.7 78.3 78.9 79.5 80.1 80.7 81.3 81.9 82.5 83.1 83.8 84.4 85.0 Ht. 170 (cm) (kg) 30.6 31.0 31.4 31.8 32.1 32.5 32.9 33.3 33.7 34.1 34.4 34.8 35.2 35.6 36.0 36.4 36.7 37.1 37.5 37.9 38.3 38.7 39.0 39.4 39.8 40.2 40.6 41.0 41.3 41.7 42.1 42.5 42.9 43.2 43.6 44.0 44.4 44.8 45.2 45.5 45.9 46.3 46.7 47.1 47.5 47.8 48.2 48.6 49.0 49.4 49.8 50.1 50.5 50.9 51.3 51.7 52.1 52.4 52.8 53.2 53.6

(21 is BMI value defined as standard value for Thai woman egual to 100) Percentage of Standard BMI Value = Weight (kilogram) 100

Height 2 (meters) 21

66

65

(8)

Rice 3 Scoops Rice 3 Scoops Rice 3 Scoops

1Egg Chicken Meat2 Teascoops

Liver 2 Teascoops

Whole little Fishes 2 Teascoops

Plain Milk 1 Box

Vegetable Oil 1 Teascoops

Plain Milk 1 Box

Glutenous Rice

1 1/2_Scoops Chainese Noodles_{3 Scoops} Thai Noodles_{3 Scoops} Yellow Noodles_{3 Scoops}

Chainese Mustard 2 Scoops

Bean Sprout 2 Scoops

1 Mango 4 Rose Apples

Can Fish 2 Teascoops

Beef 2 Teascoops

Hard Beans Curd 2 Teascoops Boiled Green

Beans 2 Teascoops

Mussel 2 Teascoops

Fish Meat 2 Teascoops

Hard Green Beans 2 Teascoops Boiled Green

Beans 2 Teascoops

Milk Powder 3 Teascoops

Soy Milk 1 Glass

Plain Milk 1 Can

Animal Oil 2 Teascoops

Concentrated Coconut Milk

1 Teascoops 1 TeascoopsButter Margarine

1 Teascoops

Vegetable

1 Teascoops

Milk

3 Glasses

Meat

12 Teascoops

Fruits

6 Portions

*

Vegetables

6 Scoops

Rice-Starch

9 Scoops

Food for Pregnant Women

Lunch

Dinner

Food Exchage

Plain Milk 1 Bag Cow-pea

2 Scoops

Ivy Gourd 2 Scoops

Pumpkin 2 Scoops

Papaya 12 Pieces 2 Bananas 2 Oranges

Pineapple 12 Pieces

Vegetable Oil 1 Teascoops

Luffa Gourd 2 Scoops

Morning Glory 2 Scoops

1 Guave

Breakfast

Food Group/

Amount Per

Day

Mackerel 2 Teascoops

Plain Milk 1 Box Pork

2 Teascoops

Dietary Practice

for Pregnant

Women

Have all the 5 group of

food but with greater

amount than usual.

Rice alternated with

starch such as

Chinese noodles,

Thai noodles

Milk, egg, all kinds of

meat, offal, seafood,

dry nuts.

All kinds of vegetables

especially green

vegetables.

Seasoning fruits.

Vegetable oil or

coconut oil

Have clean food, avoid

spicy food and

fermented food.

Refrain form alcohol,

tea, coffee, and

smoking.

1

3

2 *

Portion refers to a unit of fruit amount: 1 portion of fruit equals to 1 banana or 2 medium oranges or 4

rambutans or half a guava. For large fruits, it equals to 6 or 8 bites or pieces of papaya, pinapples.

Guide to the Use of

Food Exchange for

Pregnant Women

2

1

P

3

1 regnant women should

have adequate amount

and variety of daily food

intake. This recommended

food exchange for pregnant

women represents

appropri-ate kinds for 3 meats and

other alternated food choices

as needed for pregnant

women are recommended to:

H a ve a l l g r o u p s o f

food(in the left columns)

for each meal

If prefer other kinds of

food, chose the food

exchange (in the right

c o l u m n s ) f r o m a n y

co rr es po nd in g fo od

group.

This recommended food

e x c h a n g e p r o v i d e s

guide to having

ad-equate daily food intake

with both the quantity

and quality. Pregnant

women may choose

theor own local food

Exchange

for Pregnant Women

(9)

1 11 11ststststst

Month Month Month Month

Month Zygote develops in a shrimp-like shape, an early stage of development of all major body organs.

2 22 22ndndndndnd

Month Month Month Month

Month Major organs begin to form with the heart as an important structure beating strong and fast, the head is larger than other organs, and the body is 4 cm. long.

3 33 33rdrdrdrdrd

Month Month Month

Month Month Development of all major organs is com-plete with differentiated gender, the body is 9 cm. long and weighs 15 gm. 13 Weeks (91 Days)

4 44 44ththththth

Month Month Month Month

Month Legs and arms are at equal length, skin is transparent with blood vessels, the fetus begins to swallow amniotic fluid, begins to hear the motherûs voice and heartbeat, the body is 16 cm. long.

5 55 55ththththth

Month Month Month Month

Month Fine hairs is developed to cover the body and over the head, the nervous system is complete, immune system begins to develop, the body is 16 cm. long. 17 Weeks (119 Days)

6 66 66ththththth

Month Month Month Month

Month Fetal movement is stronger, the mus-cles are complete, legs are at propor-tionate length, the fetus is ble to recog-nize the father-motherûs voices, the body is 30 cm. long and weigh around 600 grams.

7 77 77ththththth

Month Month Month Month

Month The nervous system develops rapidly, fetal kick and movement are strong to respond loud noise, the body is 35 cm. long and weigh 1,000 › 1,200 grams. 21 Weeks (147 Days)

8 88 88ththththth

Month Month Month Month

Month Weight is around 2,500 grams, the body is pinkish, the fetus is able to sense of dark and light, opens eyes to observe around in the amniotic fluid, the body is 40-45 cm. long and weigh 2,000 grams

9 99 99ththththth

Month Month Month Month

Month The fetus is preparing for birth, lung and skin completely developed, prepar-ing for the first breath, the head is movprepar-ing down toward the birth canal, the body is 45-50 cm. long. 35 Weeks (245 Days)

Fetal Development

13 Week (91 Days)

17 Week (119 Days)

21 Week (147 Days)

(10)

Thalassemia

Thalassemia is one type of anemia caused by blood

disorder genetically inherited from parents

Thalassemia is of 2 types

Thalassemia is of 2 types:

1. 1. Being a carrier

Being a carrier

: Displays no symptoms, with normal

physical health, except for abnormal hemoglobin, and

inherits to offspring.

2. Having the disease

: Present symptoms such as

pale and yellow skin, enlarged liver or spleen, darken

skin, slowed growth, required regular treatment, and

in-herits to offspring.

3 Types of Thalassemia cases

- Most severe

Most severe

: Stillbirth or neonatal death

- Severe

Severe

: exhibits no symptoms at birth

but obvious at 3 › 6 months. Major

symptoms include pale skin, fatigue, enlarged

abdomen, enlarged liver and spleen, often

with very pale skin that requires regular blood

transfusion.

- Moderate or mild

Moderate or mild

Moderate or mild:

Skin turns very pale

if with fever.

A carrier A carrier A carrier A carrier A carrier

Frontal bossing Flatten nasal bridge

Abdominal expansion due enlarged spleen and liver chronic wound at the leg

jaundice high cheekbone

darken skin due to iron overload pale, anemia under-height

potentially impaired sexual growth

mild mild mild mild

mild moderatemoderatemoderatemoderatemoderate severeseveresevereseveresevere

A Thalassemic A Thalassemic A Thalassemic A Thalassemic A Thalassemic

(11)

çThalassemiaé examination is available free-of-charge

at every government community health center and hospital.

Risk Opportunity to having a Thalassemic Child

Both the father and mother are carriers

How to know if the fetus has thalassemia?

1. Seek ANC soon after recognizing of pregnancy.

2. Together with the husband, come to receive advice and counseling from health personnel.

3. Receive the blood test, if with abnormal test result, bring the husband for the blood test immediately.

4. If the pregnant woman and the husband have a chance of having a fetus with severe and moderate thalassemia, the pregnant woman should undergo fetal examination to investigate if the baby is thalassemic.

Carrier CarrierCarrier Carrier Carrier Carrier

CarrierCarrier Carrier Carrier Thalassemic

ThalassemicThalassemic

ThalassemicThalassemic NormalNormalNormalNormalNormal Children

Children Children Children Children Father Mother Father MotherFather Mother Father Mother Father Mother

Carrier Carrier Carrier Carrier Carrier Carrier

CarrierCarrier Carrier Carrier

If both the father and mother are carriers

, the baby will have a 25% chance or 1 in 4 to have the disease, 50% chance or 2 in 4 to be a carrier, and the mother will have 25% chance or 1 in 4 to have a normal baby.

(12)

What is Hypothyroidism?

Hypothyroidism HypothyroidismHypothyroidism

HypothyroidismHypothyroidism is a congenital disease caused by abnormal thyroid hormone level, posing a chance that the baby has mental retardation or dull brain or so called by people as çRoke Ueré. Major causes are abnormal thyroid hormone level, iodine deficiency during pregnancy. In Thailand about one in every 2,500- 3,000 newborns is with hypothyroidism.

How to know if the baby has hypothyroidism How to know if the baby has hypothyroidismHow to know if the baby has hypothyroidism How to know if the baby has hypothyroidism

How to know if the baby has hypothyroidism It is difficult to observe the symptom in the newborn, and the only one method is the blood test. If left for a period of time, it may be observed that the baby displays exaggerated jaundice longer than in normal case, accompanied with drowsiness, excessive sleeping, less suckling, easy to care, no weeping, constipation, umbilical hernia, dry skin, and hoarse cry.

Hypothyroidism can be prevented by giving thyroid

hormone to the baby within 1 month after birth

Though the re-test result is abnormal, the doctor suggests that çIt can be treated and the pills are not expensive, only 30 Satang each.

blood taken from the babyûs heel blood taken from the babyûs back of

the hand

How to prevent your baby form having hypothyroidism

Important information that you should give to the nurse are the current address Important information that you should give to the nurse are the current address Important information that you should give to the nurse are the current address Important information that you should give to the nurse are the current address Important information that you should give to the nurse are the current address

and home/mobile phone number for convenient contact and home/mobile phone number for convenient contactand home/mobile phone number for convenient contact and home/mobile phone number for convenient contactand home/mobile phone number for convenient contact

collected the blood on a piece of filter peper

sent to the Department of Medical Science

Once receiving a contact by phone or letter from

the hospital or health center, for a re-test

Taking the baby to the hospital at earliest

(13)

Transmission of HIV (HIVS) can take place in 3 periods:

1. Pregnancy: HIV/AIDS is transmitted from the mother through the placenta into the blood circulation system of the fetus.

2. Delivery: The newborn can become infected with HIV through contact with the blood, amniotic fluid, and vaginal secretions of their HIV (AIDS) infected mother during delivery.

3. Postpartum: The baby is infected with HIV through breastfeeding from HIV(AIDS) infected mother.

Prevention of Mother-to-Child Transmission of HIV

1. Use condom at every sexual intercourse over the pregnancy period. 2. Take anti-HIV drugs as prescribed by the doctor.

3. Give anti-HIV drugs to the baby as prescribed by the doctor. 4. Stop breastfeeding the baby.

5. Receive an examination on every appointment by the doctor.

Blood screening for HIV(AIDS) is helpful to mother and child

1. Receive advice on proper self practice.

2. Receive knowledge on how to prevent HIV (AIDS) transmission.

3. Receive adequate services over the pregnancy, delivery, and postpartum periods.

Prevention of Mother-to-Child

Transmission of HIV

(14)

A couple should plan in advance how many children to have, when to have, and how many years to space out between each child by using temporary or permanent contraception.

Temporary contraceptive methods

After stopping any of these methods, the mother can conceive more children.

1. Oral pillOral pillOral pillOral pillOral pill: Suitable for women already had or had no children. It has to be taken continuously everyday.

2. InjectionInjectionInjectionInjectionInjection: Suitable for the woman already had children or women during postpartum breastfeeding. Each shot offers 3 months of pregnancy prevention.

3. ImplantImplantImplantImplantImplant: Suitable for women already had children, each implantation offers 5 years of pregnancy prevention.

4. IUDIUDIUDIUDIUD: Suitable for women already had children. Each insertion of IUD provides 5 years of pregnancy prevention.

5. CondomCondomCondomCondomCondom: For male use, easy and convenient, prevent pregnancy, STIs, and AIDS.

Does the mother have breast self-exam this month?

Oral pill Injection Implant IUD Condom

Family Planning

Permanent contraceptive methods

Female and male sterilizations are available for a couple who desire for no more children.

(15)

Self Assessment and Analysis of Stress

During the past 2 months, to what extent have you experienced

any of the following symptoms, behaviors or feelings?

Please mark

ç

7 é

into the box corresponding to the level of

occurrence of the symptoms you actually experienced.

Level of Occurrence Level of Occurrence Level of Occurrence Level of Occurrence Level of Occurrence Symptom, Behavior, or Feeling

Symptom, Behavior, or FeelingSymptom, Behavior, or Feeling Symptom, Behavior, or Feeling

Symptom, Behavior, or Feeling Regu-Regu-Regu-Regu- Regu-larly larly larly larly larly Never

NeverNever NeverNever Occa-Occa-Occa-Occa-

Occa-sionally sionallysionally sionallysionally

Fre-Fre- Fre-Fre- Fre-quently quently quently quently quently 1. Sleepless due to persistent thought or anxiety.

2. Irritable, annoyed.

3. Unable to accomplish anything due to tension 4. Feeling nervous

5. Antisocial

6. Having either a migraine or a headache at both sides of the temporal.

7. Unhappy and sad 8. Hopeless in life

9. Losing sense of self-value 10. Feeling disturbed at all time 11. Unable to concentrate

12. Fatigue, low energy to do anything 13. Feeling bored, uninterested to do anything 14. Strong heartbeat

15. Shaking voice, mouth, and hands when feeing dissatisfied.

16. Fear of mistake with doing things.

17. Painful and tight muscles around the occiput, back, and shoulder

18. Easily excited with unfamiliar situation 19. Confused and dizzy

(16)

Once you complete responding to all of the 20 items, score each item as follows.

Interpretation of the scores

Scores 0 › 5 Scores 0 › 5 Scores 0 › 5 Scores 0 › 5

Scores 0 › 5: Your stress is below average level. Your life goes smooth and easy without struggling for the living. Ask yourself whether you are satisfied with what are going on, if yes and without suffering in life, you can go on living your happy life, but if no, you may make some adjustments in your lifestyle by such as reading books, meeting with friends, or planning for appropriate goals in life and move towards such goals.

Scores 6 › 17 Scores 6 › 17 Scores 6 › 17 Scores 6 › 17

Scores 6 › 17: Your stress is at average level. You cope well with stress in daily life. and adjust properly with various situations. You should maintain this level for long.

Scores 18 › 25 Scores 18 › 25 Scores 18 › 25 Scores 18 › 25

Scores 18 › 25: Your stress is slightly higher than the average level. You might have faced some disturbing problems, hence with somewhat unusual physical and mental expressions. Having some rest and relaxation, you will be improved, but if it does not work, you should talk or consult the disturbing matters with trusted people.

Scores 26 › 29 Scores 26 › 29 Scores 26 › 29 Scores 26 › 29

Scores 26 › 29: Your stress is moderately higher than the average level. You might have some problems in life that is insoluble, hence with obviously unusual physical and mental expressions. Despite with rest and relaxation, the stress persists. You should find the cause of such disturbing problems, and seek for resolution and improvement.

Scores 30 › 60 Scores 30 › 60 Scores 30 › 60 Scores 30 › 60

Scores 30 › 60: Your stress is extremely higher than the average level. You might have been facing with the crisis in life or your stress accumulated for a prolonged period. You should release the stress by placing your thought aside, then doing some stretching to relax your body, and going for relaxation such as seeing movies, listening to music. You should think about resolving and rectifying the problems, if without improvement, seek counseling from health personnel.

Add up the scores of all 20 items

to obtain the total scores ranged

between 0 › 60. Your scores can

be interpreted below.

Never Never Never Never

Never = 0= 0= 0= 0= 0 Occasionally

Occasionally Occasionally Occasionally

Occasionally = 1= 1= 1= 1= 1 Frequently

Frequently Frequently Frequently

Frequently = 2= 2= 2= 2= 2 Regularly

Regularly Regularly Regularly

Regularly = 3= 3= 3= 3= 3 Your response is scored: Your response is scored:Your response is scored: Your response is scored: Your response is scored:

(17)

PART 4 Related Knowledge For Bringing Up A

Healthy, Brilliant, Good, And Happy Child

™ Breast-milk is the first drop of Family love bond.

™ Food for infant at birth to 12 months old.

™ Adequate amount of daily food intake for a child 1 › 5 years.

™ Caring for your child

™ Caring for your childûs teeth

™ Vaccinations Guide

™ Guide to bring up a brilliant, good, and happy child

™ Instruction for recoding child develop-ment by parents and guardian.

™ Child development promotion

™ Risks and guide to prevent injuries in early childhood

™ Immunization record

™ Appointment date for the next health exam

(18)

Breast-milk is the First Drop of Family Love Bond

The first 6 months are important as the foundation for brain growth. Breast-milk is superb for it contains more than 200 nutrients, including elements to form brain cells, cranial nerve, retina, immune system that promotes healthy baby and prevents frequent illnesses. Breast-milk also foster greater level of development, intelligence, and IQ than formula milk. All other food rather than breast-milk given to the baby are foreign matters as the baby is unable to digest them, and may cause diarrhea or allergy to cowûs milk protein. The mother should exclusively breastfeed the baby for 6 months, and continue breastfeeding together with other age appropriate food until the baby reach 2 years or more.

Mother at work can feed the baby with breast-milk.

Consult Miss Breast-milk,

Breast-milk clinic at every hospital.

Milk Bottle Milk BottleMilk Bottle Milk BottleMilk Bottle Breast-milk bag

Breast-milk bag Breast-milk bag Breast-milk bag

Breast-milk bag Expressing milkExpressing milkExpressing milkExpressing milkExpressing milk

Picture 1 Picture 1Picture 1

Picture 1Picture 1 Picture 2Picture 2Picture 2Picture 2Picture 2 Picture 3Picture 3Picture 3Picture 3Picture 3 Picture 4Picture 4Picture 4Picture 4Picture 4

Feeding baby Feeding babyFeeding baby Feeding babyFeeding baby

Picture 5 Picture 5Picture 5 Picture 5Picture 5

Milk refrigerator Milk refrigerator Milk refrigerator Milk refrigerator Milk refrigerator

(19)

Food for Infant, Birth - 12 Months

Amount of Daily Food Intake for Infant

1. Staring with one type

of food in very small

amount at a time, when

the baby eat with no

problem of allergy, than

gradually increase to

the recommended

amount of food.

2. Arrange avariety of

food in each group for

the child to become

fa-miliar with them.

3. It is not necessary to

grind the food for

chil-dren 7 months old or

more, but provide them

with more rough food

to practice chewing

4. Do not prepare strong

flavor but natural taste

of food.

5. Raw materials and

utensil for food

cook-ing and containcook-ing must

be clean and safe

Age

(month)

Number

of

Meal/day

Types and Amount of Food

Meat Group

Vegetable Group

Fruit Group

Oil Group

Guide to Food

Management

Birth

-6 Months

6 Months

7 Months

8-9

Months

10-12

Months

-1

1

2

3 3 tbs. of finely ground

cooked rice

4 tbs. of ground

cooked rice

4 tbs./meal of roughly

ground, soft

cooked rice

4 tbs./meal of roughly

ground, soft

cooked rice

/

egg yoke or

2 tbs. of fish, or

1 tbs. of liver paste

/

boil egg alternated with

1 tbs. of liver paste, or fish,

or pork, or chiken

/

boil egg alternated with

1 tbs./meal of liver paste, or fish,

or pork, or chiken

/

boil egg alternated with

1 tbs./meal of liver paste, or fish,

or pork, or chiken

/

tbs. of finely ground,

soft cooked vegetables

such as lvy gourd,

pumpkin

1 tbs. of cooked vegetables

such as star gooseberry,

lvy gourd,

pumpkin

1 tbs./meal of cooked

vegetables such as star

gooseberry, lvy gourd,

Chinese cabbage

pumpkin

1 /

tbs./meal of cooked

vegetables such as star

gooseberry, lvy gourd,

Chinese cabbage

pumpkin, carrot

1-2 pieces of ground fruits

such as ripe Banana, papaya

1-2 pieces/meal of ripe fruits

such as 2 pieces of papaya

or 2 pieces of ripe mango

2-3 pieces/meal of ripe fruits

such as 3 pieces of papay,

1 banana

3-4 pieces/meal of ripe fruits

such as 4 pieces of ripe

mango, 1 orange

/

teaspoon

/

teaspoon

/

teaspoon/meal

/

teaspoon/meal

Exclusively breastmilk without other kinds of food even water

Nutrition Division, Department of Health, Minstry of Public Health

Rice Group

(20)

Less than 3 teaspoons

Sugar

Avoid excessive intake as the baby may be

thin or obese, and with tooth decay. Avoid

giving the baby sugary desserts and drinks

such as candy, jelly, sweet drink, soft drink.

Less than 3 teaspoons

Less than 4 teaspoons

Oil

Coconut milk

Avoid excessive intake as it may

cause obesity.

2 glasses

3 glasses

Milk

Fresh milk, powered milk, or yogurt

1 glass of milk

=

Yogurt (150 g.) or

1 /

₂

cup

3 tablespoons

Meat

Cooked and cut in small pieces for easy

chewing and taken alternately with fish, egg,

seafood, whole little fishes and shrimps, tofu,

liver and curdled blood of pig, chicken, duck.

Amount

Food Groups

Adequate Amount of Daily Food Intake

For a Child 1-5 Years

3 scoops

5 scoops

2 scoops

3 scoops

3 portions

Rice-Starch

Vegetables

Fruits

Cooked rice (boiled or steamed), cooked

glutenous rice, noodles, bread, Taro,

po-tato, alternately served.

Remarks

Dark green, yellow-orange vegetables, and

other vegetables taken alternately.

Seasoning fruits, thoroughly washed (1

portion for each kind of fruit may vary

which equals to, for example, 1 banana,

2 medium oranges, 4 rambutans, half a

guava, half a mango, 6 bites of papaya,

6 bites of pineapple.

3 tablespoons

Avoid crunchy/crispy snacks but replaced with nutritious snacks such as milk,

fruits, low sugar Thai desserts, and taken around 1 › 2 hours before meals

Caring for Your Child

Caring for your child at different ages as follows.

Birth › 1 Month

™ If the cord stump has not yet fallen off, keep the cord clean and dry with alcohol pad every after bath, do not apply any talcum or powder onto it. ™ Breastfed baby may have loose stools, if the child defecates frequently,

and has poor suckling, consult the doctor right away.

™ If display yellowish skin, bring the child to the doctor or health personnel.

Month › 6 Years

™ Weight the child every 3 months, measure the height every 1 year, and compare results with those in the child growth chart.

™ Bring the child for physical check-up and vaccination on appointments at the ages of 1, 4, 6, 9 -12 months, 1 1

/

, 2 1

/

2 years, after that every year until the age of 6.

Notes

™ Bring the child to the doctor or health personnel if displayed drowsiness, high fever, convulsion, flatulent, vomiting, fast breathing, apnea, obstructed breathing.

™ If the child exhibits high fever, high body temperature, sponge the childûs body with tepid water before seeing the doctor or health personnel.

™ Be careful of any accidents possibly happen to your child such as burns from heat and flame, electric shock, drown-ing, swallowing toxic substance, road accident, etc.

™ Do not apply mandle paint to you child as it might allow germs to pass into the throat.

™ A 6-year-old or 72-month-old child should be able to swim (aquatic survival skill).

1-3 yrs.

(21)

Children 1-5 years frequently get flu. Parents can take care by having the child drink water frequently, eat normally, and take antipyretic every 4-6 hours. For cough, give the child mucolytic but antibiotic (disinfectant/ anti-inflammatory) is not needed. Fever, nasal discharge, cough are exhibited in the first few days, with cough continues for 1 › 2 weeks, then the child will be recovery.

If with persisting cough, abnormal breathing, fast and strong breathing, wheezing, apnea, inactive, refuse suckling, potential pneumonia, bring the child to the doctor promptly.

Caring for the child suffering from diarrhea

Having diarrhea means:

™ Passing loose stools for 3 or more times a day.

™ Passing stools containing bloods or pus, for at least 1 time.

™ Passing watery stools more than once a day.

For young children with diarrhea, if without proper care and prompt treatment, it may lead to sudden shock, coma, and loss of life.

Primary home treatment for the child with diarrhea.

1. Give oral rehydration solutions to replace lost fluids and electrolytes as follows.

™ Oral rehydration solutions or ORS (ORS produced by The Government Pharmaceutical Organization is recommended, follow instruction on the sachet)

™ For children less than 2 years, give 50-100 cc. of ORS (1

/₄ to 1

/₂ glass) every after passing stools.

Use a spoon in stead of feeding bottle, as too rapid intake may cause vomiting.

™ For children 2 › 10 years, give 100-200 cc. of ORS (1

/₂ to 1 glass) every after passing stools.

2. Do not stop feeding the child during having diarrhea. If with breastfeeding, encourage the child for increased suckling.

Mommy, please tell stories for me again today

(22)

Caring for Your Childûs Teeth

Primary teeth are important for the childûs health. Failure to take proper care, it will easily lead to tooth decay, and if it spreads, the child will suffer from toothache, sleeplessness, and eating problem. This effects the childûs growth and development. Parents are encouraged to take care of your childûs teeth as follow.

1. Breastfeed your child for 6 month exclusively, and if after that breastfeeding cannot be continued, choose plain milk to feed your child. Never put the child to bed with a feeding bottle. Do not use feeding bottle for any sugary drinks. Wean off the bottle when your child reach 1 › 1 _ years.

2. About 6 months old when the primary teeth appears, brush the child's teeth with fluoride toothpaste twice a day in the morning and before bedtime.

3. At 6 months, begin to feed the child 1 meal a day and add to 3 meals at the age of 1 year. Between meals, give the child plain milk and

fruits.

4. Parents should lift the childûs lips at least once a month to check for whitish lines, if found, bring your child to the dentist or health personnel for application of fluoride to prevent cavities.

How to brush your childûs teeth

Apply a small pea-sized amount of fluoride toothpaste on the toothbrush. Sit your child on your lap with the head facing you, then use your fingers to open the childûs cheek pouch allowing you to see the teeth clearly. Place the toothbrush vertically onto the teeth, move gently and shortly to clean the teeth. If the teeth are clean, no yellow white spots remain on the teeth.

At 2 › 3 years of age, train your child how to brush the teeth by him/herself but parents have to repeat brushing the childûs teeth to make sure they are clean until the child can do it well at the ages of 7 › 8.

Source SourceSource

(23)

Vaccinations Guide

™

Some vaccines

have to be given more than once to activate the body to develop immunity at the level effective to prevent the disease. Parents are thus encouraged to bring the child to receive vaccinationbring the child to receive vaccinationbring the child to receive vaccinationbring the child to receive vaccinationbring the child to receive vaccination on schedule

on scheduleon schedule

on scheduleon schedule as described in this handbook.

™

_{A child with minor illness}

A child with minor illness

_{A child with minor illness}

A child with minor illness

such as common cold, cough, or low temperature are allowed to be vaccinatedto be vaccinatedto be vaccinatedto be vaccinatedto be vaccinated.

™

After injected with some vaccines

, the child may develop high body temperature, fever, which will be gone shortly. Sponge the childûs body, have the child drink plenty of water, give antipyretic as guided by the doctor or health personnel.

™

If the child had a history

of allergy or experienced severe condition after being vaccinated such as conversion, high fever, please notify the doctor orplease notify the doctor orplease notify the doctor orplease notify the doctor orplease notify the doctor or health personnel

health personnelhealth personnel

health personnelhealth personnel prior to vaccination.

™

_{The wound developed from BCG}

The wound developed from BCG

_{The wound developed from BCG}

The wound developed from BCG

vaccination may form a small abscess to be appeared for 3 › 4 weeks which requires no medication or dressing, just use a cotton pad soaked with cooled boiled water to clean around the wound. ™

Please keep this handbook

for your childûs benefit to monitor what vaccines were given and whether the child received completed doses. This handbook can also be used as an important evidence for various occasions, for example, for the childûs enrollment in primary school and travelling abroad.childûs enrollment in primary school and travelling abroad.childûs enrollment in primary school and travelling abroad.childûs enrollment in primary school and travelling abroad.childûs enrollment in primary school and travelling abroad.

(24)

Miracle of Reading

In addition to physical food including breast-milk and age-appropriate food, your child needs intellectual food, mental food, and Dhamma food. Reading books with your child offers inclusively these 3 kinds of food.

Reading books for the child since 6-month-old everyday for at least 5 › 15 minutes a day will foster the development of the childûs brain that contains 100 billion neurons at birth, with brain cell connection called neural synapses. This connection affects the childûs intelligence at subsequent ages until adulthood, and best enhance the childûs language development.

At the age of 6 months, the child is able to lift the neck steady. Hold the child on your lap, persuade him/her to see the pictures while you read out slowly and clearly, or lying together reading the book. Gentle touch and soft voice full of love and parents-child closeness will promote the childûs mental and emotional security.

Good stories in the book enable the child to progressively learn things and subsequently accumulate good behaviors, and also a wise way to instill the child moral and ethic. Importantly, the child should observe the good role model of parents and surrounding people.

Young children prefer books containing colorful, clear, large, pictures, but less content. The bookûs paper should be durable and allow for easy opening, without sharp corner harmful to the child. During the child ùs first year, persuade him/her to see the pictures while you read out slowly and clearly, talk to your child, allow him/her to touch and hold the book. After 1 year, your child will remember more contents, and better link the pictures with story. Try to read slowly and clearly for your child to imitate your voice. Pictorial books with

rhymes are easy to remember. These books helps extend the childûs thought, imagination, and enjoyment during the grown-up years. Parents can insert more by, for example, teaching about the numbers, shapes, colors, moral and ethic, posing questions for creating imagery, etc.

(25)

Childûs Age DOs for Parents DONûTs for Parents

Fetus

Birth- 1 Yr.

1 › 3 Yrs.

3 › 6 Yrs.

™ Relax, make yourself at ease

™ The father gives close care and helps the mother.

™ Gently hold, snuggle with, caress your child to form the sense of security.

™ While holding, talk and sing a lullaby to your child to sleep.

™ Frequent playing and talking to your child will make him/ her become cheerful, and grow fast.

™ If your child prefers to do things on his/her own, allow him/her to do so and learn from trial and error.

™ Allow your child to do more his/her own routines.

™ If your child turns exagger-ated, draw his/her attention to something else.

™ Talk, tell stories, answer to your childûs questions.

™ If your child refuse, explain to him/her the reason.

™ Teach you child to keep toys in place.

™ Teach your child right from wrong, and dare to say when making mistakes.

™ Teach your child to be ac-customed to using words of thank, apology, and kindness.

™ Encourage your child to play with other children.

™ Teach the child to refuse others from touching personal organ.

™ Become stress, irritable, emo-tional.

™ Become self-indulgent inatten-tive to your baby.

™ Ignore, inattentive, abandon, and be emotionally violent to your child.

™ Be irritable with your childûs crying. If unable to cope with it, try to relax and ask some-one to take care of your child, and calm down for a while.

™ Overprotect and spoil your child, making him/her imma-ture, self-determined, impa-tient.

™ Not allow your child to do things by him/herself.

™ Deceive or scare your child to fear for no reasons.

™ Irritable for the childûs asking question or naughty.

™ Tease your child to get angry.

™ Force the child to stay inactive.

™ Compare your child with those of other siblings, making him/ her feel slighted and value-less.

™ When children are in quarrel, do not determine who are right and wrong, as children will not get angry toward one another for too long.

™ Teach your child while you are unable to be a good role model yourself.

™ Make forceful quarrel between parents in front of your child.

(26)

Suggestion for Parents and Guardian

In Recording the Childûs Development

1. The parents should promote the child to grow up with quality in all physical, intellectual, mental, and social aspects for the child to be good, brilliant, and happy. The parents play good role model, provide care, love, understanding, and give the child opportunities to learn, practice, while observing and promoting the childûs development as guided.

2. The parents or guardian should notice if the child exhibits according to developmental age, by recording your childûs age into the dash spaceÇÇof corresponding developmental age.

3. The method to promote the childûs age-appropriate development should be consistently and regularly practiced by parents.

4. The child development record in this handbook demonstrates some aspects of major developmental age of which rapid or delayed development may vary by each child. If particular age appropriate development is not achieved, the child should be allowed for 1 month to practice.

5. If your child displays the following signs, consult the doctor or health person-nel.

5.1 5.15.1

5.15.1 At 3 months old, displays no eye contact, smiling back, lifting neck inAt 3 months old, displays no eye contact, smiling back, lifting neck inAt 3 months old, displays no eye contact, smiling back, lifting neck inAt 3 months old, displays no eye contact, smiling back, lifting neck inAt 3 months old, displays no eye contact, smiling back, lifting neck in prone position.

prone position. prone position. prone position. prone position. 5.2

5.25.2

5.25.2 At 6 months old, does not follow subjects by the eyes, turn toward theAt 6 months old, does not follow subjects by the eyes, turn toward theAt 6 months old, does not follow subjects by the eyes, turn toward theAt 6 months old, does not follow subjects by the eyes, turn toward theAt 6 months old, does not follow subjects by the eyes, turn toward the voice, pay attention to the one playing with, roll over front and voice, pay attention to the one playing with, roll over front and voice, pay attention to the one playing with, roll over front and voice, pay attention to the one playing with, roll over front and voice, pay attention to the one playing with, roll over front and back.

back. back. back. back. 5.3

5.35.3

5.35.3 At 1 years old, does not walk holding, get thing into theAt 1 years old, does not walk holding, get thing into theAt 1 years old, does not walk holding, get thing into theAt 1 years old, does not walk holding, get thing into theAt 1 years old, does not walk holding, get thing into the mouth with fingers, imitate the gesture and voice. mouth with fingers, imitate the gesture and voice. mouth with fingers, imitate the gesture and voice. mouth with fingers, imitate the gesture and voice. mouth with fingers, imitate the gesture and voice. 5.4

5.45.4

5.45.4 At 1 year and 3 months old, unable to follow simpleAt 1 year and 3 months old, unable to follow simpleAt 1 year and 3 months old, unable to follow simpleAt 1 year and 3 months old, unable to follow simpleAt 1 year and 3 months old, unable to follow simple instruction such as to sit down, say hello, walk toward instruction such as to sit down, say hello, walk toward instruction such as to sit down, say hello, walk toward instruction such as to sit down, say hello, walk toward instruction such as to sit down, say hello, walk toward the mother.

the mother. the mother. the mother. the mother. 5.5

5.55.5

5.55.5 At 2 years old, unable to say 2 words together.At 2 years old, unable to say 2 words together.At 2 years old, unable to say 2 words together.At 2 years old, unable to say 2 words together.At 2 years old, unable to say 2 words together. 5.6

5.65.6

5.65.6 Delayed age appropriate development for playing.Delayed age appropriate development for playing.Delayed age appropriate development for playing.Delayed age appropriate development for playing.Delayed age appropriate development for playing. Underweight and frequent illnesses.

Underweight and frequent illnesses. Underweight and frequent illnesses. Underweight and frequent illnesses. Underweight and frequent illnesses.

(1)

8. Drowning

™

Do not let alone a child in a bathtub or basin even for a short while, as a child

can be drown in the water only 5 cm. high.

™

Limit a safe place for the child to play without self access to water source.

™

A child aged 1 year and 6 months can be taught about water hazard and to avoid

approaching water source.

™

A child aged 2 years should be taught how to float when falling into the water and

how to swim in a short distance.

™

A child aged 6 years or 72 month should be able to swim with water survial skill.

™

Pour the water out of the container and cover with a lid.

9. Drugs, chemical substances, and toxicants

™

Drugs, chemical substances and toxicants in the house that can be poisonous to

the child must be kept completely, with safety lid, and out of reach of the child.

™

Do not put toxicants in food or drink like containers such as soft drink or sport

drink bottle, and never put the toxicants on the same place of food and drinks.

™

The leftover toxicants should be discarded and never keep it in the house.

10. Related aids

™

In case of choking by a particle, bring the child to the hospital immediatelty.

™

First aid for the scald,use cold or clean water to soak and clean the wound and

lower temperature, than dress the wound before bring the child to the doctor Do

not apply fish source, toothpaste or other things on the wound as it could be

infected.

™

First aid for drowning, apply mouth to mouth resuscitation and cardio-pulmonary

resuscitation, then bring the child to the hospital immediately. Do not carry the

child across the shoulder, or jump around the place, or put the child on the

upside-down pan to let out the water, as the child will suffocate even longer.

™

If the child swallowed a toxicant, contact the Posion Center at Tel. 02-201-1083,

02-246-8282 for an advice of proper first aid, and bring the child to the hospital

immediately.

(Compiled from the document prepared by Asst.Prof. Adisak Plitpongganpim, Faculty of

Medicine, Ramathibodi Hospital).

100 Focus on Safety, No Injuries for Thai Children

PART 4 Related Knowledge For Bringing Up A Healthy, Brilliant,

(2)

Vaccine

Recommended Age for

vaccination

™

BCG

At Birth

™

Hepatitis B

At Birth

1 month (specific for

the child whose

mother is a carrier)

™

OPV

2 Months

™

Combined dose of DTP,

4 Months

Hepatitis B

6 Months

™

MMR

9 Months

7 Years

(grade .1)

™

OPV

1 /

Years.

™

Combined dose of DTP

4 /

Years.

™

JE

1 /

₂

Years (2 shots

with 1 month apart)

™

dT

2 /

Years.

(grade 6)

™

Vaccine

™

Vaccine

™

Vaccine

™

Vaccine

™

Vaccine

101 Childûs Vaccination Record (recorded by health personnel)

Notes Notes Notes Notes Notes

1. If unable to have the child for vaccination on schedule, please later bring the child along with this handbook to see health personnel soonest.

2. According to the program recommended by Ministry of Public Health, additional vaccination to the above table will be provided for every student as follows:

2.1 The 1st

grade students receive the 2nd

dose of combined MMR vaccines. 2.2 The 6th_{grade students receive combined dose of dT vaccines.}

3. Please constantly keep this handbook for the use of disease prevention, school enrollment and employ-ment application in the future.

Source: Bureau of General Communicable Disease

Date, Month, Year/ Place of vaccination Date, Month, Year/ Place of vaccination Date, Month, Year/ Place of vaccination Date, Month, Year/ Place of vaccination Date, Month, Year/ Place of vaccination

1

ststststst

Time

2

ndndndndnd

Time

3

rdrdrdrdrd

Time

PART 4 Related Knowledge For Bringing Up A Healthy, Brilliant,

(3)

102

Appointment Date for the Next Health Exam

Make every visit on appointment date for your healthy, smart child

Date/Month/

Year

Time

Activities

Place

■

Hepatitis B

■

OPV

■

Combined dose of DTP and

Hepatitis B

■

Combined dose of MMR

■

OPV

■

Combined dose of DTP

■

JE

■

Combined dose of dT

■

...

■

...

■

...

■

...

■

...

■

...

■

...

..

...

..

...

..

...

..

...

..

...

..

...

..

...

..

...

..

...

..

...

..

...

..

...

..

...

..

...

..

...

..

...

..

...

..

...

(4)

Birth Certificate

place of issues A. Name of Health facility... B. Address...Street...Moo...Tambon...District...Province...

Date...Month...Year...

1 The child

1.1 Name...Surname... Identification number...

1.2 Gender

Male Female

1.3 Nationality

Thai Others (specify)

1.4 date of birth...Month...B.E... Birth at...

Time...hr Date on fullmoon Date on newmoon

Month Year

1.5 Place of Birth... Address...Moo... Soi...Street...

Tambon/District/province

2 Family

Status

Father Mather 2.1 Name...Surname... Identification number... 2.3 Ordering number of the child 2.4 Number of children...

Alive...Pers. Stillbirth...pers. Dead fetus...pers. Child

2.1 Name...Surname... Identification number...

3 Delivery

officer

3.1 As. Other...(specify)

3.2 Name...Surname... Address...Moo...Soi...Street...Tambon/District/province TBAs Midwife Nurse Health Register M.D.

nurse Personnel

4 Child Birth

4.1 Single child birth 4.3 Ordering of birth

4.4 Duration of pregenancy...Month...Weeks. 4.5 Weight of the child...Grams 4.2 Twin

Twin 3 children 4 children first second third forth

4.6 Birth trauma none

yes (specify)...

4.7 Malformation none

yes (specify)... 5

compli-cation of

mother

5.1 Complication from pregnancy none

yes (specify)...

5.2 Complication from other cause none yes (specify)... 5.3 Complication from delivery pregnancy none

yes (specify)...

5.4 Special delivery method none yes (specify)... Signature...Delivery officer

(...)

Signature...Registration officer (...)

Signature...Birth registration officer (...)

Signature...household person who assign someone to inform the birth

(...)

Signature...Person who assigned to inform the birth

(...)

Number Province

Day/month/year Control Number

Tr.1/1

Sample

105

○○○○○○○○○○○○○○○○○○○○○○○○○○○ ○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○

(5)

Birth Certificate

place of issues A. Name of Health facility... B. Address...Street...Moo...Tambon...District...Province...

Date...Month...Year...

1 The child

1.1 Name...Surname... Identification number...

1.2 Gender

Male Female

1.3 Nationality

Thai Others (specify)

1.4 date of birth...Month...B.E... Birth at...

Time...hr Date on fullmoon Date on newmoon

Month Year

1.5 Place of Birth... Address...Moo... Soi...Street...

Tambon/District/province

2 Family

Status

Father Mather 2.1 Name...Surname... Identification number... 2.3 Ordering number of the child 2.4 Number of children...

Alive...Pers. Stillbirth...pers. Dead fetus...pers. Child

2.1 Name...Surname... Identification number...

3 Delivery

officer

3.1 As. Other...(specify)

3.2 Name...Surname... Address...Moo...Soi...Street...Tambon/District/province TBAs Midwife Nurse Health Register M.D.

nurse Personnel

4 Child Birth

4.1 Single child birth 4.3 Ordering of birth

4.4 Duration of pregenancy...Month...Weeks. 4.5 Weight of the child...Grams 4.2 Twin

Twin 3 children 4 children first second third forth

4.6 Birth trauma none

yes (specify)...

4.7 Malformation none

yes (specify)... 5

compli-cation of

mother

5.1 Complication from pregnancy none

yes (specify)...

5.2 Complication from other cause none yes (specify)... 5.3 Complication from delivery pregnancy none

yes (specify)...

5.4 Special delivery method none yes (specify)... Signature...Delivery officer

(...)

Signature...Registration officer (...)

Signature...Birth registration officer (...)

Signature...household person who assign someone to inform the birth

(...)

Signature...Person who assigned to inform the birth

(...)

Number Province

Day/month/year Control Number

Tr.1/1

Sample

106

(6)

Sample

107 Birth Certificate

place of issues A. Name of Health facility... B. Address...Street...Moo...Tambon...District...Province...

Date...Month...Year...

1 The child

1.1 Name...Surname... Identification number...

1.2 Gender

Male Female

1.3 Nationality

Thai Others (specify)

1.4 date of birth...Month...B.E... Birth at...

Time...hr Date on fullmoon Date on newmoon

Month Year

1.5 Place of Birth... Address...Moo... Soi...Street...

Tambon/District/province

2 Family

Status

Father Mather 2.1 Name...Surname... Identification number... 2.3 Ordering number of the child 2.4 Number of children...

Alive...Pers. Stillbirth...pers. Dead fetus...pers. Child

2.1 Name...Surname... Identification number...

3 Delivery

officer

3.1 As. Other...(specify)

3.2 Name...Surname... Address...Moo...Soi...Street...Tambon/District/province TBAs Midwife Nurse Health Register M.D.

nurse Personnel

4 Child Birth

4.1 Single child birth 4.3 Ordering of birth

4.4 Duration of pregenancy...Month...Weeks. 4.5 Weight of the child...Grams 4.2 Twin

Twin 3 children 4 children first second third forth

4.6 Birth trauma none

yes (specify)...

4.7 Malformation none

yes (specify)... 5

compli-cation of

mother

5.1 Complication from pregnancy none

yes (specify)...

5.2 Complication from other cause none yes (specify)... 5.3 Complication from delivery pregnancy none

yes (specify)...

5.4 Special delivery method none yes (specify)... Signature...Delivery officer

(...)

Signature...Registration officer (...)

Signature...Birth registration officer (...)

Signature...household person who assign someone to inform the birth

(...)

Signature...Person who assigned to inform the birth

(...)

Number Province

Day/month/year Control Number

Tr.1/1 ○○○○○○○○○○○○○○○○○○○○○○○○○○○