Preventive pediatrics has been defined as the prevention of diseases and the promotion of physical, mental, and social well-being for children to reach optimal growth and development.

3. What you have
noticed?

4. Mrs.Dhara Vyas, Assistant Professor,DPCN, Nadiad

5. The structure of the presentation
 Definition
 Aims of Preventive Pediatrics
 Concept of Preventive pediatrics
 Antenatal Aspects of Preventive Pediatrics
 Postnatal Aspects of Preventive Pediatrics
 Social Aspects of Preventive Pediatrics

6. Definition
 Preventive pediatrics has been defined as
the prevention of diseases and the promotion
of physical, mental, and social well-being for
children to reach optimal growth and
development.

7. Aims of Preventive Pediatric
Prevention of Congenital
anomalies
Promotion of Health
Prevention of Diseases
Maintaining psychosocial
well being

8. Concept of Preventive Pediatric
Antenatal Preventive
Pediatrics
Postnatal Preventive
Pediatrics
Social Preventive
Pediatrics

9. Why…?

10. Antenatal Preventive Pediatric
Maternal Age
Maternal Infection(STORCH)
Maternal Nutrition
Maternal Disease
Maternal Disorder
Maternal Drug
Maternal Alcoholism
Maternal Stress
Maternal Exposure to Radiation
Rh or ABO incompatibility

11. Maternal Age
 Less than 18 years of age may cause abortion
because of poorly develop uterus
 More than 35 yeas of age can cause Down’s
Syndrome as the age of ova increase and
spindles becomes more week to separate
chromatides leads Trisomy 21

12. Maternal Infection(STORCH)
 S- Streptococus/ Staphylococcus infection
 T- Toxoplasmosis
 O- Others includes HIV, TB, STDs etc
 R – Rubella
 C- Cytomegalo Virus
 H – Herpes Simplex and Herpes Zoster
Fetal infection are manifested by intrauterine
growth retardation, meningoencephalitis,
hepatitis, congenital malformation, abortion
and still birth

13. Maternal Nutrition
 Folic Acid deficiency can cause Neural Tube
Defect – requirement 400 microgram
 Calorie requirement - 2500kcal
 Protein requirement – 60gm
 Iron requirement -30mg- Severe iron deficiency
anemia up to 5 to 6 month of age
 Iodine requirement – 75microgram
 Zinc requirement – 15mg- deficiency can affect the
fetal growth
 DHA (Docosahexaenoic acid), omega-3 is
recommended for fetal growth

14. Maternal Disease
Maternal Disease Baby Can Affect with
Hypertension / Gestational
Hypertension
Prematurity, IUGR, Fetal Hypoxia,
Preeclampsia/ eclampsia RDS , Meconium aspiration
Syndrom, neonatal infection
Polyhydroamnios Anencephaly, intestinal obstruction,
GI anomalies
Oligohydroamnios Renal agenesis, Renal dysplasia,
limb deformities
Antepartum hemorrhage IUGR, fetal hypoxia
Rh and ABO incompatibility Pathological jaundice
PROM Preterm delivery, perinatal infection

15. Maternal Disorders
 Endocrinal disorders
 Psychiatric Disorders
 Malignant disorder
 Hypothyroidism
 Thrombocytopenia
 Myasthenia gravis
 Pemphigus vulgaris

16. Maternal Disorders
Chronic Disorders Baby can affect
Cardiac disease Abortion, prematurity, IUGR,
asphyxia
Chronic renal disease RDS, septicemia, congenital
anomalies
Viral hepatitis Still birth, prematurity
Maternal
hypothyroidism
Sterility, early fetal death,
neonatal hypothyroidism,
Maternal thyrotoxicosis Fetal goiter, hypothyroidism
Diabetes mellitus Macrosomia, organomeghaly

17. Maternal Drugs
 Thalidomide
 Psychiatric Drugs
 Cancer Drugs
 Cardiac drugs
 Hormonal Treatment
 Live vaccines are contraindicated during
pregnancy
 Iron is Teratogenic drug during 1st Trimester
 Antithyroid drugs
 Vitamine – A,D,K

18. Maternal Alcoholism
 Maternal Alcoholism can
cause IUGR, microcephaly,
slow physical and mental
growth, facial dysmorphism
includes short upturned nose,
thin upper lip, ptosis,
maxillary hypoplasia, cardiac
malformation, ear anomaly,
restricted joint movement

19. Maternal Stress
 High levels of stress that continue for a long
time may cause health problems, like high
blood pressure and heart disease. When
you're pregnant, this type of stress
can increase the chances of having a
premature baby (born before 37 weeks of
pregnancy) or a low-
birthweight baby (weighing less than 5½
pounds).

20. Maternal Exposure to Radiation
 In utero radiation produces microcephaly and
mental retardation. Later in life there is
increased incidence of hematopoietic
malignancies and leukemia

21. Fetal Diagnosis and Treatment
Preventive Fetal Therapy
 Acceleration fetal Maturation –
betamethasone, dexamethasone
 Prevention of Intracranial Hemorrhage –
Vit - K
 Prevention of Fetal Infection-Penicilline
 Prevention of neural tube defect – Folic
acid

22. Fetal Diagnosis and Treatment
Medical therapy
 Cardiac arrhythmias – Digoxin to mother
 Congenital hypothyroidism – iodized salt
 Inborn errors of metabolism – Vitamine B12
 Thyrotoxicosis-Carbimazole Therapy

23. Fetal Diagnosis and Treatment
Surgical Intervention
 Intrauterine blood Transfusion
 Obstructive uropathy- vesico –amniotic shunt
 Congenital hydrocephalus- ventriculo amniotic
shunt
 Pleural effusion- pleuro amniotic shunt

24. Postnatal Preventive Pediatric
GOBIFF
Growth Monitoring
Oral Rehydration Salt
Breast Feeding
Immunization
Female Literacy
Food
Prevention of Accidents and Poisoning

25. Growth Monitoring
 Growth monitoring is
the regular measurement
of your child's size
to monitor his growth.

26. Oral Rehydration Salt

27. Breast feeding
• Complete food,
• Easily digested
and wellabsorbed
• Protects against
infection
• Promotes
emotional bonding
• Better brain growth
• Helps in involution
of uterus
• Delays pregnancy
• Lowers risk of
breast and ovarian
cancer
• Decreases
mother’s work load
• Saves money
• Promotes family
planning
• Decreases need
for hospitalization
• Contributes to
child survival

28. Proper position of baby while
breastfeeding includes
1. Supporting whole of baby’s body.
2. Ensure baby’s head, neck and back are in
same plane.
3. Entire baby’s body should face mother.
4. Baby’s abdomen touches mother’s abdomen.
 Correct positioning will ensure effective
sucking and prevent sore nipples and breast
engorgement.
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29. Attachment of baby on mother’s
breast
 Four signs of good attachment are:
1. Baby’s mouth wide open.
2. Lower lip turned outwards.
3. Baby’s chin touches mother’s breast.
4. Majority of areola inside baby’s mouth.
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31. Causes of poor attachment
Use of feeding
bottles.
Inexperienced
mother.
Lack of skilled
support.
Inverted nipples.
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34. Ten Steps of Baby Friendly Hospital Initiative
 Every facility providing maternity services and
care for newborn infants should:
1. Have a written breastfeeding policy that is
routinely communicated to all health care staff.
2. Train all health care staff in skills necessary to
implement this policy.
3. Inform all pregnant women about the benefits
and management of breastfeeding.
4. Help mothers initiate breastfeeding within half-
hour of birth.
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35. Conti…
5. Show mothers how to breastfeed, and how to maintain
lactation even if they are separated from their
infants.
6. Give newborn infants no food or drink other than breast
milk, unless medically indicated .
7. Practice rooming-in. Allow mothers and infants to remain
together 24 hours a day.
8. Encourage breastfeeding on demand.
9. Give no artificial teats or pacifiers (also called
dummies or soothers) to breastfeeding infants.
10. Foster the establishment of breastfeeding
support groups and refer mothers to them on discharge
from the hospital or clinic.
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36. INDICATORS OF ADEQUATE
BREASTFEEDING
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37. Immunization
 BCG
 OPV
 IPV
 Hep B
 Pentavalent
 Measles – Vitamin A
 MMR
 Vericella

38. Food
 Breast feed
 Weaning
 Nutritive food with different colour and texture
 Serving of food
 Finger food
 Avoid chocolates, cake, sweets with sugar
 Avoid junk food
 Healthy eating pattern to prevent obesity

39. Female Child and Female Literacy
 Objectives
 Prevent gender biased sex selective elimination
 Ensure survival & protection of the girl child
 Ensure education of the girl child

40. Prevention of Accidents and Poisoning
Burns Fall Drowning Electric
shock
Sharps Aspiration Cleansing
agents
Domestic
animals

41. Social Preventive Pediatric

42. Child Welfare
ICDS IMNCI/
F-IMNCI
Mission
Indradhanush
RMNCH+A RCH School Health
Program

43. Child Labour
 Minimum Age for Employment. In accordance with
the Constitution of India, no child below the age
of fourteen years shall be employed to work in any
factory or mine or engaged in any other hazardous
employment. The minimum age for employment
is14 years.

44. Street Children
 “Children of the street” are homeless children
who live and sleep on the streets in urban
areas. They are totally on their own, living with
other street children or homeless adult street
people. On the other hand, “children on the
street” earn their living or beg for money on the
street and return home at night.
 There are 18 million street children in India,
the largest number of any country in the world,
with 11 million being urban.

45. Gender Bias
Female Feticide Nutrition Education
Child labor Sexual
Exploitation
Job opportunity
for handicapped

46. Child Abuse and Neglect
 Physical violence
 Sexual molestation
 Mental and emotional maltreatment
 Deprivation
 Lack of opportunity
 Rape
 Sexual injury
 Death

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49. Healthy Eating Tips
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50. Thank You