Table 3 Potential concerns to be assessed at 4 months postpartum by a project nurse in the home
From: The childbearing health and related service needs of newcomers (CHARSNN) study protocol
Infant Feeding & Growth • Weight <10th percentile for age or weight decreased 20 percentile points [71] • Not receiving Vitamin D supplements [92] • Cow milk is being given [92] Safety • Blind cords or other unsafe objects within infant's reach of where infant sleeps • Infant sleeps prone • Unsafe crib (space between bars > 6 cm, plush mattress) • Unfinished bottles with curdled milk lying in area where infant sleeps • Car-seat positioned front-facing • Smoke exposure Development • Infant unable to do two or more of the following: turn head side to side to follow a toy, glance from one object to another, turn head toward a sound, make sounds in response to people/looking at toys, respond (i.e., face brightening) to people's voices, laugh and smile, move arms and legs in response to being spoken to, finish feeding within 45 mins, lift head and support self on forearms, bring hands to chest and keep head in midline when lying on back, hold head steady when supported in a sitting position, reach for an object, hold an object briefly when placed in hand General Health • Bowel movements abnormal (blood in stool; no BM for > 5 days) • Bruising or wounds or burn marks or evidence of healing bruises, wounds or burn marks on infant's body • Persistent rash (i.e., broken skin or blisters for > 2 weeks) • Abnormal vital signs (at rest – heart rate >150/min, respirations >45/min, indrawing or increased respiratory effort) • Signs of dehydration including drowsiness, dry mouth, darker than normal urine, sunken fontanel. Immunization • No 2 month vaccination (DPT-Hib-Polio) • No 4 month vaccination (DPT-Hib-Polio) & no planned appointment Psychosocial: • Insufficient clothing (as measured by < 1 change of indoor clothing, inappropriate outdoor wear, < 1 blanket) | Maternal Pain (as measured by VAS pain score > 4/10 in past 24 hours) • Abdominal • Breast or nipple • Back pain • Hemorrhoids • Perineal • Other pain General Health [93] • Any faecal or urinary (as measured by self-report) • Urinary tract infection (urgent, painful, frequent urination) • Perineal infection or STI (vaginal discharge with or without foul odor) • Woman has not received all of her immunizations Psychosocial • Inadequate food (i.e., Woman has missed or reduced meals because of lack of resources to buy food) • No knowledge of tel. # 911 in case of severe health problem or if in danger (self or infant) • Unaddressed birth control needs (as measured by Health Risk Assessment) • Signs of abuse (measured by the Abuse assessment form [94] and as suspected by nurse) • Signs of depression (score ≥ 10 on the Edinburgh Post-natal Depression Scale [91]) • Signs of depression, somatization or anxiety related to trauma (as measured by Hopkins Symptom Checklist) • Signs of PTSD (as measured by Harvard Trauma Questionnaire) |