Chapter 12.8 Providing follow-up care

Advise all mothers who are taking their children home after assessment in the hospital when to go to a health worker for follow-up care. Mothers may need to return to hospital:

  • for a follow-up visit within a specified number of days (e.g. when it is necessary to check progress or the response to an antibiotic)
  • if signs appear that suggest that the illness or injury (e.g. head injury) is worsening
  • for the child’s next vaccination.

It is especially important to teach the mother the signs that indicate the need to return to hospital immediately. Guidance on the follow-up of specific clinical conditions is given in appropriate sections of this Pocket book.

Follow-up for feeding and nutritional problems

  • If a child has a feeding problem and changes in feeding have been recommended, follow up in 5 days to see whether the mother has made the changes, and give further counselling if needed.
  • If the child has anaemia, follow up in 14 days to give more oral iron.
  • If the child has a very low weight, additional follow-up is needed in 30 days, which involves weighing the child, reassessing feeding practices and giving further nutritional counselling.

When to return immediately

Advise the mother to return immediately if the child develops any of the following signs:

  • unable to drink or breastfeed
  • becomes sicker
  • develops a fever
  • signs of illness return after successful treatment in hospital
  • a cough or cold: fast or difficult breathing
  • diarrhoea: blood in stool or drinking poorly.

Next ‘well-child’ visit

Remind the mother about the child’s next visit for vaccination, and record the date on the mother’s card or the child’s immunization record.