Republic of Mauritius

Congratulations
Dear Parents,

The Ministry of Health and Wellness wishes to congratulate you for this special moment and
presents you with this Maternal and Child Health handbook to accompany you along this
amazing journey. This handbook is a personal health record for the mother during pregnancy,
intra-partum, and post-partum periods, and for the child since birth up until 5 years of age.
The handbook contains important information to guide healthcare professionals to provide the
appropriate care to you and your baby.

Advantages
This handbook is a good source of information and knowledge about the care given during
pregnancy. It will also guide you through your child’s health and development. The handbook
will provide you with the necessary information about nutrition and vaccination. It is a personal
record kept by the parents.

Instructions

Read thoroughly all the information given in this handbook. Always bring along this handbook
every time you or your child attend any health facilities.

1
 Parents’ Details 1
SECTION 1: Mother’s Health 5
Antenatal care 6
Maternal Profile 7
Previous Medical History 8
First Antenatal Visit 9
Antenatal Profile 9
Ultrasound Findings 10
Criteria for Special Attention during Pregnancy 11
Antenatal Clinic 12
Contents

Preventive Prenatal Care Services 13

Labour & Delivery 14
Discharge – Postnatal ward 15
Postpartum Visit (6 weeks after delivery) 16
Clinical Notes 17
Health Information 18
Nutrition 19
Exercise in Pregnancy 20
Rest and Sleep 21
Substance use during Pregnancy 21
Benefits of Breastfeeding 22
Diabetes and Pregnancy 24
Hypertension and Pregnancy 25
Anaemia in Pregnancy 26
Warning signs during Pregnancy 27
Maternity bag Checklist 28
Contraception – Family Planning 29
Postpartum Depression 30

2
 SECTION 2: Child’s Health 31
Child’s Details 32
Neonatal Examination 33
Consultation/ Examination (0 – 6 weeks) 34
Physical Examination 35
Consultation/ Examination (7 weeks – 6 months) 36
Consultation/ Examination (7 months – 12 months) 37
Contents

Physical Examination 38
Consultation/ Examination (13 months – 24 months) 39
Consultation/ Examination (as from 24 months) 40
Consultation/ Examination (as from 24 months) 41
Growth Charts 42
Immunisation 47
Health Information 52
Breast Feeding 54
Complementary Feeding 56
Food Chart 58
Kids with Flu - What You Need to know 59
Danger Signs – Baby and Child 60
Immunisation 61
Appointment Schedule Antenatal & Postnatal Clinics 62
Appointment Schedule for Well Baby Clinic and Weighing 63

3
 Parents’ Details

Mother

Surname/ Name:
ID no:
Phone number:
Age:
Religion:
Occupation:
Marital Status:

Father

Surname/ Name:
ID no:
Phone number:
Age:
Religion:
Occupation:
Marital Status:

Next of kin:
Relationship:
Phone number:

4
Section 1: Mother’s Health

5
 Antenatal care
Do Not Miss Your Antenatal Care Appointments!

• You must attend the Antenatal Clinic as soon as you know you are pregnant.
• You must attend regularly your appointments.
• Regular antenatal visits are beneficial for both you and your baby.
- Regular and routine check-up of your health.
- Echography will be done to check your baby.
- Regular blood tests will be carried out.
- Y ou will be given a lot of information to have a healthy pregnancy and a
healthy baby.

6
 Maternal Profile

Age:
Married life (years): Level of education:
Height: Weight: BMI:
LMP: EDD (dates): (Echo):
Gravida: Parity:
Pregnancy: Spontaneous Menarche:
Assisted Menstrual cycle: Regular
Irregular

Previous Medical History

Diabetes Hypertension Anaemia

Others:
Drug History:
Family History:
Past Surgical History:
Drug Allergy:

Genetic History:

Twins Malformations Others:

Contraception Yes No Specify:
Blood Transfusion Yes No

Habits:
Smoking Alcohol Illicit drugs

7
 Past Obstetric History

Date

Place of
Delivery

Gestation

Mother
Pregnancy

Labour

Puerperium

Sex

Weight

Infant Living or
Stillbirth

Feeding

Progress

8
 First Antenatal Visit

Physical Examination
Date: Period of Gestation (POG):

BP: Pulse: Temp:

CVS: Respiratory:

Breasts: Abdomen:

Pelvic Exam:

Antenatal Profile

First Visit Date: POG:

1. FBC Hb: Platelet: WCC:

MCV: Hct:

2. Blood Grouping: Rhesus:

3. Serology: TPHA: VDRL:

Hepatitis profile: HIV Profile:
4. FPG:

5. Urine m/c/s:

Second trimester Date: POG:

1. OGTT

Third trimester Date: POG:

1. GBS

Others:

9
 Ultrasound Findings

CRL
BPD
FL
Date Gestational age
Multiple gestation
Placenta
Liquor

CRL
BPD
FL
Date Gestational age
Multiple gestation
Placenta
Liquor

CRL
BPD
FL
Date Gestational age
Multiple gestation
Placenta
Liquor

CRL
BPD
FL
Date Gestational age
Multiple gestation
Placenta
Liquor

10
 Criteria for Special Attention during Pregnancy

Risk Factors Yes No

1 Age ‹ 18 years

2 Age › 35 years at first pregnancy

3 Diabetes/ Gestational Diabetes

4 Hypertension/ Pregnancy induced Hypertension

5 Anaemia

6 Cardiovascular diseases

7 Epilepsy or any neurological disease

8 History of neonatal deaths or stillbirths

9 History of previous Caesarean Section

10 History of 3 or more spontaneous abortions

11 Twin or Multiple pregnancy

12 HIV/ AIDS

13 Autoimmune Diseases

Any other severe conditions?

14
If so, which condition?

11
 Antenatal Clinic

Date

Period of Gestation

Position of Fetus

Engagement of
presentation

Fetal Heart

Weight

BP

Sugar

Urine Sugar/ Albumin

Pedal Edema

Hb

Remarks

Next Visit

Sig of Midwive

12
 Preventive Prenatal Care Services

1. Folic Acid tablets

Prescribed: Yes No Date:

2. Ferrous Fumarate

Prescribed: Yes No Date:

3. Calcium tablets

Prescribed: Yes No Date:

4. Tetanus injection (tdap) at 27 - 36 weeks’ gestation

Prescribed: Yes No Date:

5. Flu vaccine as from 18 weeks’ gestation

Prescribed: Yes No Date:

6. Rh anti D

Prescribed: Yes No Date:

7. Referral to Dentist
Yes No

Dental care is safe and important during pregnancy

Seek routine and emergency care at any stage of your pregnancy, if needed

13
 Labour & Delivery

Ready to bring your baby into the world?

The moment you have been waiting for is almost here: the birth of your baby!
Childbirth marks the end of pregnancy. But it also marks the beginning of motherhood.

14
 Delivery

Date of Birth: Time of birth:

Place of delivery

Period of gestation

Labour: Spontaneous Induced: C-Section

Antibiotics: Yes No

Name: Duration: Diagnosis:

Birth: Vaginal Vaginal with forceps

Emergency C/S Elective C/S

Indication of C/S:

Anesthesia: None General

Spinal Epidural

Discharge – Postnatal ward

Vitals: Date:

BP: RBS: Temp:

Wound:

Episiotomy wound

Caesarean Section wound

Counselling Checklists:

Breastfeeding postpartum Gestational Diabetes – OGTT 6 weeks

Postpartum Contraception  regnancy induced Hypertension –

P
regular BP check

Calcium/Fefol supplements Nutrition

Wound care  weeks’ review in ANC clinic CHC/ AHC/

6
Mediclinic

15
 Postpartum Visit (6 weeks after delivery)

Postpartum Visit is very important!

Attend the nearest health centre 6 weeks after delivery, during ANC clinic

Date: Place:

General condition

BP: RBS: Weight:

Abdomen (size of uterus):

Vaginal Bleeding (Lochia):

Episiotomy wound:

C-section scar:

Breast Exam:

Pap’s smear done: Yes No

p/s findings:

Counselling Checklists:

• Breastfeeding Yes No
• Postpartum contraception Yes No
• OGTT Yes No

16
 Clinical Notes

Date Clinical Findings Treatment Sig of Dr

17
 Health Information

Exercise
Nutrition

Sleep and Rest Substance use

in Pregnancy

Diabetes
Benefits of Breastfeeding in Pregnancy

Hypertension
in pregnancy Anaemia in pregnancy

Warning Signs Maternity

during Pregnancy Bag Checklist

Contraception – Family Planning Postpartum

Depression

18
 Nutrition
The first 1000 days of life set us up for good health across our lives.

A mother’s nutrition during pregnancy and the nutrition a child receives in the first two years of
life are vitally important. It influences in determining good health both now and into the future.

Dietary Recommendations
• A healthy and well balanced diet is important for a good health and a good pregnancy
and can help reduce some pregnancy symptoms, such as nausea and constipation.
• To maintain a healthy pregnancy, approximately 300 - 350 extra calories are needed
each day in the second half of pregnancy.
• These calories should come from a balanced & varied diet of protein, fruits, vegetables
and whole grains as shown in the plate model below.
• Sweets should be kept to a minimum; avoid bad fats (see page 24).
• Choose 2 -3 servings of non-fat or skimmed milk or plain yogurt per day.
• Have healthy snacks in between meals, for example, fruits.

Plate model

Grains Secs /
poisson /
poulet /
viande maigre

Fruits Riz / pain complet /

et farata de blé /
légumes chapati /
mines / pâtes

Fluid Intake During Pregnancy

• Drink 6 – 8 glasses of water per day
• Restricting your intake of caffeine (coffee, tea, soft drinks).
• Avoid all forms of alcohol during pregnancy

19
 Exercise in Pregnancy
Most women can, and should, engage in mild to moderate exercise during pregnancy. Exercise
can help you stay in shape as well as prepare your body for labour and delivery. Walking,
swimming and cycling are all excellent forms of exercise during pregnancy.

Benefits of Exercise During Pregnancy

• Strengthen muscles in preparation for labour and delivery.

• Help to resolve constipation.
• Relieve back pain.
• Improve your mood.
• Improve your sleep.

How to Exercise Safely

–– Warm up and cool down when exercising.

–– Take 5 to 10 minutes at the beginning of your exercise session to gradually warm up
your muscles and prepare your body.
–– When you finish your exercise session, gradually slow down rather than stopping
abruptly.

Important tips:
• Dress for the weather.
• Wear the appropriate clothing, such as supportive shoes for walking.
• Drink plenty of fluids.
• Eat a healthy, balanced diet.

Safety Tips - DON’T

• Do not overdo it!
• Don’t take risks. Avoid any activity that could cause trauma to your abdomen.
• Don’t perform exercises that involve bouncy, jerky motions.
• Avoid exercises that compress the uterus.
• Don’t do exercises that require you to lie flat on your back. This position is associated
with a decrease in blood flow and oxygen delivery.

20
 Rest and Sleep
• Be consistent with your sleep schedule. Go to bed and wake up at the same time every
day.
• Prioritize sleep. It’s one of the healthiest things you can do for your body.
• Keep daytime naps short.
• Stick to a bedtime routine that relaxes you, and do not vary from it.
• Do not eat at bedtime. Finish eating two to three hours before going to bed.

Substance use during pregnancy

Alcohol
Alcohol during pregnancy can increase the risk of miscarriage, stillbirth,
new-born death and foetal alcohol syndrome (low birth weight, heart
defects, facial defects, learning problems and mental retardation).

Tobacco
Women who smoke during pregnancy are more likely to have babies who
are too small. Smoking also increases the risk of miscarriage, preterm
labour, stillbirth and new-born death.

Drugs: HARMFUL during pregnancy

Cocaine, crack, heroin, marijuana and methadone.
Harmful effects to baby: decreased weight, length and head size, strokes,
or bleeding into their brains.

21
 Benefits of Breastfeeding
You should initiate breastfeeding within 1st hour of birth as far as possible

You should exclusively breastfeed your baby for first 6 months of life

Baby Mother
• Colostrum: essential nutrition along • Emotional support and bonding
with antibodies from mom to baby
• Promotes postpartum emotional
• Builds baby’s immune system and health and postpartum weight loss
fewer episodes of illness
• Costs less to breastfeed
• Increased IQ
• Reduces risk of breast cancer, type 2
• Breastfed babies: lower risk of SIDS diabetes and osteoporosis
(sudden infant death syndrome)
• Reduces the risk of uterine and
• Decreased risks of food allergies. ovarian cancer
• Decreased risks of developing asthma

• Lower risk for ear, throat and nose

infections

• Lower risk for childhood leukaemia

and other cancers

• Reduced risk of hypertension, obesity,

diabetes, asthma.

Lactation Amenorrhea
Temporary natural contraception method for first six months
It is effective if:

• Baby is exclusively breastfeeding for the first six months

of life (neither water nor other fluids).
• Baby is less than 6 months of age.
• No return of menses.

22
A lot of things you will hear people say or suggest about breastfeeding can be out-dated or
incorrect. We have corrected some of the most common myths here.

Myth #1

Women with flat or inverted nipples cannot breastfeed

This is not true. Babies do not nipple feed but breastfeed. Baby needs to suckle on the areola,
and not the nipples, to get milk.

Myth #2

Breastfeeding changes the shape and size of your breast.

Actually, it is pregnancy that changes the structure of breasts.

Try to wear a good support bra during pregnancy and lactating period to support the breasts
and prevent over-stretching.

You can also do some exercises to strengthen the chest muscles.

Myth #3

You do not have enough milk.

This is wrong to think so. Actually, the more your baby suckle at your breast, the more milk you
will produce to feed your baby. You should feed your baby on demand to maintain a good milk
supply.

Myth #4

Formula has more vitamins than breast milk.

In fact, the opposite is true. Formula cannot match the nutrients and vitamins in breastmilk.

More importantly, breastmilk has antibodies, which can only be passed from your body to your
baby. This is what helps protect your baby from getting sick.

Myth #5

Modern milk formulas are almost the same as breast milk.

Breast milk is the Best! No milk can replace that. These claims are incorrect. Modern formulas
are only superficially similar to breast milk.

Formulas don’t vary and are made to suit every baby whereas your own breast milk is just
suited for your baby’s unique needs.

23
 Diabetes and Pregnancy
Gestational diabetes is a condition in which your blood sugar levels become high during
pregnancy at the end of the second trimester.

It almost always goes away as soon as your baby is born. However, if gestational diabetes is not
treated during your pregnancy, you may experience some complications.

Diagnosis Symptoms

1. Fasting blood sugar • Excessive fatigue

2. Oral glucose tolerance test • Increased thirst
• Increased frequency of urine
Values • Headache
Normal : 5.3
1st hour : < 10
2nd hour : < 8.6

Diet
• Avoid sugar and high-sugar foods (desserts, sweets, candy, cookies, soft drinks and fruit
juice).
• Eat fresh fruits (high in natural sugar, limit it to one small serving at a time, 2-3 fruits per
day).
• Eat reasonable portions of high-carbohydrate foods (breads, cereals, rice, pasta, potatoes,
fruits, milk, plain yogurt).
• Avoid bad fats (saturated and trans fat) and choose good fats (poly and monounsaturated
fats).

• Space out the carbohydrate foods you consume throughout the day.
• Eating three smaller meals and three or four healthy snacks between meals can help you
meet your pregnancy diet goals without elevating your blood sugar.

Attend the nearest health centre 6 to 12 weeks after delivery

to repeat the test for diabetes

Continue breastfeeding till the age of 2 years or beyond, this will protect you against diabetes.

24
 Hypertension and Pregnancy
10 to 15% of pregnant women has hypertension. In general, hypertension develops in the
second trimester of pregnancy, between 4th and 6th month.

For pregnant women, having blood pressure checked regularly is essential - even if it is not
high to begin with.

Healthy habits
• A healthy diet.
• Eat at least 5 fruits and vegetables in a day. They add antioxidant and fibres to the diet.
• Limit salt intake to 6g/ day, limit sugar and saturated fats in diet.
• Do not consume alcohol or cigarette.
• Regular physical activity (seek medical advice if needed).

Diagnosis

Blood pressure monitoring at every antenatal visit.

Normal Blood pressure: 130/80 mmHg or less.

Blood Pressure
≤ 130/ 80 mmHg

25
 Anaemia in Pregnancy

Causes Classification:
Mild: 9 - 10.9g/dl
Low intake of iron Anemia
and folate Moderate: 7 - 9g/dl
Blood loss Severe: < 7g/dl

Anaemia occurs when your haemoglobin (Hb) is less than 11g/dl.

Preventing Anaemia
• Eat iron-rich foods such as lean meat, chicken, fish, eggs, dried beans.
• Eat foods high in folic acid, such as dried beans, dark green leafy vegetables, wheat
germ.
• Eat foods high in vitamin C, such as citrus fruits and fresh, raw vegetables.
• Take your prenatal multivitamin and iron supplements which contains extra folate.
• Avoid tea or coffee.

Iron-Rich Foods
The recommended dietary allowance (RDA) of iron during pregnancy is 30 milligrams.

26
 Warning signs during pregnancy

If you ever experience any of the above symptoms, please attend nearest health centres or
regional hospitals with this handbook.

DO NOT WAIT FOR THE NEXT APPOINTMENT!

27
 Maternity bag Checklist

Mother Baby

• 2 or 3 front opening Cotton nighties or • Disposable nappies

pyjamas • Wipes, cream, baby wash, baby cream
• 3 nursing bras • Towels
• Underwear • Face towels
• Maternity pads • Baby clothes
• Loose fitting day clothes • Caps
• Towels • Socks
• Slippers • Vests
• Socks • Onesies
• Going home outfits • Blankets
• Toiletries • 2 going home outfits
–– Toothbrush
–– Toothpaste
–– Soap or gel wash
–– Hairbrush and hairbands
–– Face cream, body cream

28
 Contraception – Family Planning
Contraception is important after pregnancy.

To have healthy mothers and babies, at least 2 years spacing between pregnancies is important.

Visit the family planning clinic in nearby CHC/ AHC/ Mediclinic with your partner and decide
about the method most appropriate for you.

Contraception methods
• Implant.
• Depo Provera injection.
• Progestogen-only pill.
• Condoms.
• Intra uterine device (IUD).
• Combined oral contraceptive pill.

Breastfeeding as contraception
• You are exclusively breastfeeding (no water or fluids to the baby).
• You are not having menses.
• Your baby is less than 6 months’ old.

29
 Postpartum Depression
Feeling low? Feeling sad? You want to cry?

If you even have 1 or 2 of these symptoms, seek medical advice.

• You feel empty and alone, despite just having added a baby to your life.
• You feel completely overwhelmed, as though you will never be a good mom.
• You feel no bond or connection to this new life you helped to create.
• You are constantly irritated or angry and you have no patience. You may even resent
your baby because of how your life has changed.
• You are uncontrollably sad and can’t stop crying or shake off feelings of sadness.
• You feel out of focus and can’t concentrate on anything least of all your new-born.
• You have thoughts of harming yourself or baby.

Postpartum depression is nothing to be ashamed of – it affects about 1 in 7 new moms and

absolutely does not mean you are failing as a parent. And there are several options to treat it.
The first step is recognizing the signs of postpartum depression.

You are not alone in this thing – help is out there!

Don’t hesitate to speak up, seek medical help!

30
 Section 2: Child’s Health

Child Details

Surname:
Name:
Date of Birth:
Sex:
Address:

Your child’s health is your priority!

Protect your child’s right to health care!

31
 Child’s Details

Gestation: Mother’s Blood group:

Illness during Pregnancy:

Delivery: Vaginal Caesarean Section

Duration of Labour:

Antibiotics received before or during labour:

Child’s Blood Group:

Rh Positive Negative

Coombs test D: Vitamin K inj: Yes No

Medical History

Family History

Allergic History

Special Interventions required: Yes No

If yes, please specify

Others:

32
 Neonatal Examination

Weight: Length: Head Circumference:

Apgar Score: at 1 minute: at 5 minutes:

Examination At Birth On discharge

General Condition
• Cyanosis
• Icterus

Head

Neck

Chest

Heart

Lungs

Abdomen

Genitals

Extremities

Skin

Clinical Notes:

Discharge:

Weight on discharge: Date of discharge:

Examined by: Signature:

33
 Consultation/ Examination (0 – 6 weeks)

Date

Age

Weight

Length

Head Circumference

Clinical Examination

Observation
& Prescription

Signature

34
 Physical Examination

6 weeks old 6 months old

Date of examination
Place of exam
Weight (kg)
Length (cm)
Head Circumference
Milestones Social Smile Yes No Sitting Yes No
Head Holding Yes No Stand with support Yes No
Response to light Yes No
Response to sound Yes No

Nutrition Breastfeeding Yes No Breastfeeding Yes No

Complementary feeds Complementary feeds
Yes No Yes No
Reflexes
Fontanelles
Eyes Right Left Right Left
Ears Right Left Right Left
Nose and throat
Neck
Heart
Lungs
Umbilicus
Abdomen
Genitals
Hips & Limbs Right Left Right Left
Signature of Doctor

35
 Consultation/ Examination (7 weeks – 6 months)

Date

Age

Weight

Length

Head Circumference

Clinical Examination

Observation
& Prescription

Signature

36
 Consultation/ Examination (7 months – 12 months)

Date

Age

Weight

Length

Head Circumference

Clinical Examination

Observation
& Prescription

Signature

37
 Physical Examination

1 Year old 2 Years Old 3 Years old

Date of Exam
Place of Exam
Weight
Height
Sitting Yes No
Speech Yes No
Milestones Standing Yes No
Walking Yes No
Eyes
–– Left
–– Right
Ears
–– Left
–– Right
Nose & Throat

Teeth

Heart

Lungs

Abdomen

Umbilicus

Genitals

Hips
Lower limbs

Signature of doctor

Additional notes

38
 Consultation/ Examination (13 months – 24 months)

Date

Age

Weight

Length

Head Circumference

Clinical Examination

Observation
& Prescription

Signature

39
 Consultation/ Examination (as from 24 months)

Date

Age

Weight

Length

Head Circumference

Clinical Examination

Observation
& Prescription

Signature

40
 Consultation/ Examination (as from 24 months)

Date

Age

Weight

Length

Head Circumference

Clinical Examination

Observation
& Prescription

Signature

41
 Growth Charts

Children come in all shapes and sizes, and all babies grow at their own pace.

Baby growth charts are important tools healthcare providers use to check your little one’s overall
health.

The charts are used to assess how your baby is growing compared with other children of the same
age and gender and to see how your child is developing over time.

42
 Weight-for-age BOYS
Birth to 5 years (percentiles)

24 97th 24

22 22
85th
20 20

18
50th 18

16 15th 16

14
3rd 14

43
12 12

Weight (kg)
10 10

8 8

6 6

4 4

2 2

Months 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10
Birth 1 year 2 years 3 years 4 years 5 years
Age (completed months and years)
WHO Child Growth Standards
 Weight-for-age GIRLS
Birth to 5 years (percentiles)

97th
24 24

22 22
85th
20 20

18 50th 18

16 16
15th

14 3rd 14

44
12 12

Weight (kg)
10 10

8 8

6 6

4 4

2 2

Months 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10
Birth 1 year 2 years 3 years 4 years 5 years
Age (completed months and years)
WHO Child Growth Standards
 Length/height-for-age BOYS
Birth to 5 years (percentiles)

120 120
97th
115 85th 115

110 50th 110

105 15th 105

3rd
100 100

95 95

90 90

45
85 85

80 80

75 75

Length/Height (cm)
70 70

65 65

60 60

55 55

50 50

45 45
Months 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10
Birth 1 year 2 years 3 years 4 years 5 years
Age (completed months and years)
WHO Child Growth Standards
 Length/height-for-age GIRLS
Birth to 5 years (percentiles)

120 120
97th
115 85th 115

110 50th 110

105 15th 105

100 3rd 100

95 95

90 90

46
85 85

80 80

75 75

Length/Height (cm)
70 70

65 65

60 60

55 55

50 50

45 45
Months 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10 2 4 6 8 10
Birth 1 year 2 years 3 years 4 years 5 years
Age (completed months and years)
WHO Child Growth Standards
 Immunisation
Vaccines are safe.
Vaccines are effective.
Vaccines save life.

Do not miss appointments for vaccination.

In case of a missed appointment, kindly call to take another appointment.
Always bring this handbook when visiting any health centre for vaccination or other purpose.

LOVE THEM • PROTECT THEM • IMMUNISE THEM

47
 Immunisation Boys

Initial of
Vaccine Age Date Given Next appointment
Nurse

BCG 0-3 Months

Rotavirus Vaccine 1 6 Weeks

Hexavalent 1/ OPV 1 6 Weeks

PCV 1 6 Weeks

Rotavirus Vaccine 2 10 weeks

Hexavalent 2/ OPV 2 10 weeks

PCV 2 14 weeks

Hexavalent 3/ OPV 3 14 weeks

MMR 1 9 months

PCV 3 10 months

MMR 2 17 months

Booster Hexavalent/
18 months
OPV 4

Booster Tdap/ IPV 5 years

Tdap 11 – 12 years

48
 Immunisation Girls

Vaccine Age Date Sig Next appnt

BCG 0-3 Months

Rotavirus Vaccine
6 Weeks
1

Hexavalent 1/
6 Weeks
OPV 1

PCV 1 6 Weeks

Rotavirus Vaccine
10 weeks
2

Hexavalent 2/
10 weeks
OPV 2

PCV 2 14 weeks

Hexavalent 3/
14 weeks
OPV 3

MMR 1 9 months

PCV 3 10 months

MMR 2 17 months

Booster
Hexavalent/ OPV 18 months
4

Booster Tdap/ IPV 5 years

HPV Vaccine 1

HPV Vaccine 2

Tdap 11 – 12 years

49
Current Vaccines
Hexavalent:
• Diptheria
• Pertussis
• Tetanus
• Haemophilus Influenzae Type B
• Polio (Inactivated)
• Hepatitis B
MMR: Measles, Mumps, Rubella
PCV: Pneumococcal Conjugate Vaccine
OPV: Oral Polio Vaccine
HPV: Human Papilloma Virus Vaccine
Tdap: Diptheria, Tetanus, Pertussis
IPV: Inactivated Polio

Additional Vaccinations

Vaccine Age Date Initial of provider

Additional Notes
Date Remarks

50
 Hospital Admissions

Date of Admission Medical Notes Date of Discharge Seen By

51
Health Information

HEALTHY
CHILD
HEALTHY
WORLD

52
 The First 1,000 days
can shape a Child’s Future

If babies get the

right nutrition in
those 1000 days,
they are 10 times
more likely to
overcome life
threatening childhood
diseases
A well-nourished child is
more likely to:
Continue her education
Have a higher IQ
Earn upto 46% more in
lifetime
The first thousand days in a person’s life is most crucial ,
as it establishes a solid platform for a child’s
physical, mental and social health, leading to the rest of their life.

53
 Breastfeeding
Getting started

• Start breastfeeding soon after delivery, ideally within the first hour of birth if you and
your baby’s conditions permit. This is the time when the baby’s suckling instinct is
the strongest.
• Early skin to skin contact with your baby immediately after birth helps in early
initiation to breastfeeding and helps to stimulate milk flow. It also ensures emotional
bonding of mother-baby.
• Colostrum, the milk produced by the mothers during the first few days of life, is the
most superior source of nourishment for your new-born.

54
The How of breastfeeding

• Adopt a relax and comfortable position.

• A good latch is important for your baby to breastfeed.

How often?

• Feed baby frequently on demand - 8-12 times per day for the first months.
• Allow baby to suckle until he is satisfied.
• Empty one breast first, before offering the second breast.
• Most breastfeeding sessions take 20 to 45 minutes. However, because new-born babies
are often sleepy, this length of time may require patience and persistence.
• Feed on the first side until your baby stops suckling, hands are no longer fisted, and
your baby appears sleepy and relaxed

How long?

The World Health Organization (WHO): Exclusive breastfeeding for the first six months.

Mothers are encouraged to continue to breastfeed up to two years or beyond with complementary
feeds to confer the maximum benefits of breastfeeding for mummy and baby.

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 Complementary Feeding
Weaning is the process of gradually introducing solid foods in an infant diet during the first year
of life, starting from 6 months of life.

It requires patience and understanding from both you and your child.
By 12 months of age, family food can be introduced.

Your baby is ready for weaning when…

• Baby is 6 months of age.
• Holds objects (e.g. biscuit) and takes everything to mouth.
• Chewing movements start.
• Tendency to push solids out decreases.
• Eruption of teeth and beginning of biting movements.
• Digestive system and kidneys function well.

Preparation of feeds
• Clean and fresh food, prepared immediately and not stored for more than 3 hours.
• Do not add sugar and salt in food.
• Always use boiled and cooled water to prepare feeds for baby.
• Avoid bottle water as the sodium content is high.
• Easily digestible and palatable.
• High in energy.
• Easy to prepare, well balanced and nourishing.
• Butter, oil, cheese or margarine can be added in small quantity to feeds.

How to wean an infant?

• The baby should be well supported, ideally sitting in a high chair.
• The baby should not be left unattended due to the risk of choking.
• Food should be given using a plastic weaning spoon.
• A few teaspoons should be offered before one feed.
• As more solid food is introduced, milk intake is gradually reduced.

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What food?
• Rice based cereals
–– Prepare and mix with water or milk.
–– Prepare in bowl, and give with spoon, avoid feeding bottles.

• Vegetables
–– Broccoli, courgette, cauliflowers, carrots, cabbage.
–– Cook to soften them, then mash or blend veggies to a suitable texture.

• Fruits
–– Banana, pear, papaya, mango, apple.
–– Mash or blend soft ripe fruits to a suitable texture for your baby, or give them as
finger foods.
–– Harder fruits need to be cooked to soften them. Wash and remove any hard skin.

• Starchy food
–– Rice, potatoes, porridge.

• Protein food
–– Chicken, lean meat, lentils, beans, chickpeas, tofu, fish, eggs.

• Dairy products – yoghurt, cheese.

Do’s Don’ts
• Continue breastfeeding and formula
feeding. • Don’t wean baby in period of sickness.
• Introduce one new food at a time. • Don’t rush to give solid foods.
• Help the baby to hold the food as needed. • Don’t leave baby alone during meal.
• Expect a mess. Self-feeding is • Don’t introduce more than one new food
encouraged. at a time.
• Shorten feedings and space out their • Don’t introduce food that are hard, hot or
frequency. sticky.
• Offer food variety. Offer food of different • Don’t give tea, coffee, aerated beverages,
shapes and colours. sugary drinks, honey, whole nuts.
• Sit with the baby during meals. • Discard unused feed.
• Talk to him and maintain eye contact.

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 Food Chart

Breakfast Lunch Afternoon Dinner Night

Week 1 & 2
Introduce Cereals Breastmilk
Breastmilk Breastmilk Cereal followed
cereals by Then Breastmilk Formula
Formula Milk Formula Milk by milk
spoon Or Formula Milk Milk

Vegetables followed
by milk
Week 3, 4, & 5 Cereals Mashed vegetables
Breastmilk
(chouchou, calebasses, Breastmilk Cereals
Formula
Introduce Then Breastmilk broccoli, carrot, Formula Milk followed by milk
Milk
vegetables Or Formula Milk patisson, courgette)
Introduce a new
vegetable every 3 days.

Fruits followed by
milk
Mashed fruits
Cereals
(Pomme, banana, Breastmilk
Mashed vegetables Cereals
Week 6, 7 & 8 papaya, mangue, Formula
Then Breastmilk followed by milk followed by milk
poire, avocat, melon Milk
Or Formula Milk
d’eau)
Change fruits every
3 days

1.Introduce
carbohydrate
(rice, pasta,
Mix 2 – 3 vegetables
Week 9 till 9 potato, bread)
together.
months
Introduce Mix 2 – 3 fruits 2. Introduce Breastmilk
Fruits with Add pulses 2-3 times
carbohydrates, together, followed fish, chicken or Formula
cereals per week
pulses and by milk fish Milk
protein of
Give boiled and cooled
animal origin. 3. Add
water.
vegetables
Give boiled and
cooled water

1st week: EGG

first 3 days, give white
At 9 months egg 2nd week: Breastmilk
Fruits with
Introduce eggs Next 3 days, give egg Plain yogurt Formula
cereals
and yogurt yolk Biscuits Milk
Then half egg, twice
a week

Introduce Breastmilk
Fruits with Introduce other Introduce other
At 1 year seafoods Formula
cereals vegetables gradually fruits gradually
gradually Milk

58
 Kids with Flu - What You Need to know
Common symptoms of flu:

Sore throat Fever Cough Runny nose

Headache Fatigue Chills

Children with the flu can typically be treated at home with rest and fluids. You can wait to see a
doctor if your child is urinating normally and is playful, eating well and interactive.

If your child has the flu, he/she is contagious as early as one day before symptoms develop – and
up to five to seven days after.

WARNING SIGNS: take your child to the nearest health centre

–– Shortness of breath or difficulty breathing

–– Unresponsive
–– Excessive vomiting
–– Appear dehydrated with decreased urination, or have dry lips or sunken eyes

REMEMBER:

• Fluids
• Rest

• Flu vaccine in adults and children older than 6 months

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 Danger Signs – Baby and Child
If your child shows any symptoms or signs listed below, kindly take him to the nearest health
centre

General

• Less responsive than usual or cannot be woken up

• Glazed eyes and not focusing on anything
• Seems floppy, drowsy or less alert than usual
• Convulsion or fits
• Unusual cry (high pitched, weak or continuous)
• Severe abdominal pain
• Bulge in the groin that gets bigger with crying

Temperature

• Feels cold or hot (temperature below 35°C or above 38.5°C.

Skin colour and circulation

• Blue colour around mouth

• Rash – reddish purple spots or bruises
• Skin: paler than usual or suddenly goes very white
• Nails are blue

Breathing

• Struggles to breathe or stop breathing

• Breathes more quickly than normal or grunts when breathing out

Vomiting and diarrhoea

• Blood in poo
• Not drinking sufficient water
• Fewer wet nappies or visits to toilet
• Vomit is green

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 Immunisation

• Immunisation is the best way to protect your child’s health from diseases that could
cause serious complications and harm.
• Vaccines are safe and effective.
• Children should be vaccinated on time to offer them maximum protection as early as
possible.

Side effects
• Pain, redness and swelling at site of injection.
• Fever.

In case of side effects:

• Cold compress – ice cubes in a towel.
• Medicine to lower temperature if fever › 38.5°C.
• Consult a doctor if fever persists more than 48 hours.

Inform the health personnel if your child:

• Is sick or having fever.
• Has any past history of reaction to any previous vaccine.
• Has received any vaccine in past few days or weeks.
• Has any medical treatment.
• Is on medications such as steroids.

Vaccines protect against diseases

✓ Tuberculosis ✓Pneumonia
✓ Diphtheria • Haemophilus influenzae type b (Hib)

✓ Pertussis (whooping cough) • Pneumococcus

✓ Tetanus ✓Measles
✓ Poliomyelitis ✓Mumps
✓ Hepatitis B ✓Rubella
✓ Meningitis ✓Rotavirus – diarrhoea

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Appointment Schedule for Antenatal & Postnatal Clinics

Date Time Remarks

62
Appointment Schedule for Well Baby Clinic and Weighing

Date Time Remarks

63
Notes :

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Republic of Mauritius