IMCI Huong Dan Xu Tri Long Ghep Cac Benh Thuong Gap O Tre Em

C6 ma't n6c hoac mdt nu6c neng TIEU CHAYKEo oArNANG > Didu tri mdt nu6c tru6c khi chuydn trlr trudng hop c6 phan loai ndng khec > Chuydn di bAnh vien.. MOt trong cac da'u hieu: ho, chay

Il1 ll 11 tl rt

2^^.)

sAr.rH crAvA euAu r-o4r rnE egNH

Denh gie, phan lo?i va xAc dinh ali6u tri

Kidm tra cac ddu hi6u nguy hidm toan then .2

Sau d6 h6i vd cac tri6u chfng chinh: Tre c6 ho ho5c kh6 thA khong? 2

T16 c6 bi tiCu chay kh6ng? 3

T16 c6 sdt khong? 4

Phan loai sdt c6 nguy co s6t 161 4

Phan loai s6t kh6ng c6 nguy co sdt 161 4

Phan loais6i 4

Phan loai sdt xudt h uydt 5

T16 c6 vdn d6 6 tai khong? 5

Kidm tra suy dinh dudng ve thi6u meu 6

Kidm tra tinh trang ti6m ch0ng c0a tr6 6

Danh gi6 cac vdn afd kh6c 6

DIEU TRI TRE BENH Hudng den ba mg cho tr6 u6ng thu6c tai nha Kheng sinh aludng u6n9 7

Thudc s6t r6t u6n9 8

Vitamin A 9

Vi6n sit 9

Mebendazo|e 9

Vion kem 9

Sirlbutamol 9

Tlom chring cho tet ca kd bCnh theo llch 10

llrrdno d6n bA mg didu tri nhi6m khudn t?i ch5 6 nhir I )lOI lll nlridnr klrLrCn rnit bing llrir rr:11 l('lrix)yrlir] 10

l)iOu klvliII lilL , 1 0 l)ll1ll lrl l(xll nUi)n(, l);'1 (l xi]nh methylen 1% lrrr'tr lllyxr,rrr lxniii il'y, .10

I i'rr ulrirr lx' l,n|rt r:ir: llll/ir; :Ur loin 10

Nlrlltl0 llllr0r: l:hi rhrnU (i (:n(: co rri y t6 llrll|r lriilrhlr,i ll .,irtlt .11 otEu rnq rnE BENH (ri6p theo) Di6u tri phdng ha dudng huy6t .11

Paracetamol - - 1 1 Thu6c sdt ret cho sdt r6t n5n9 12

Bar thom dlch diiu tr! ti6u chay ve ti6'p tuc cho en Phac ir6 A: Di6u tri ti6u chay tai nha 13

Phac dd B: DiAu tri c6 m6't nu6c bing ORS 13

Phac dd C: Nhanh ch6ng di6u tri mdt nudc neng14 Bir dich at6i v6iti6u chay mdt nddc nang hoec Benh rA ndng c6 s6c hoac HOi chung so'c sdt xudt huydt Dengue 14

Chim s6c tr6 khi kh6m lai ViCm phdi 15

Ti6u chey k6o dai 15

1v 15

sdt r6t hoac s6t-gi6ng s6t r6t 16

S6t - Khong gi6ng s6t ret 16

Sdt - Kh6ng c6 nguy cd sdt r6t 17

C6 kha nang dang m5c s6i .17

s6i c6 bidn chfng mit vaihoac micng 17

S6t - C6 kha nang sdt xua't huy6t Dengue 18

Sdt - Kh6ng gidng sdt xudt huydt Dengue 18

Viom tai 19

Vdn dd nu6i dddng chda hop |y 19

Thi6um6u 19

Nhe can 'l 9 THAM VAN CHO BA ME Dinh dudng O6nh gi6 ch6 al6 nu6i dudng 116 20

C6c hudng dAn nuOi duong tr6 21

Tham vdn cho ba me vd vdn dd nu6i dudng .22

Cic loai nu6c u6ng Tdng cudng nddc u6'ng trong khi bi b6nh 23

Khi nao dua tr6 de'n kh6m Khuyen ba me khi ndo dua tr6 d6n kham 23

86 Y tA- Vi6t Nam -* TRE BENH TU O DEN 2 THANG TUOI DANH GIA, PHAN LOAI VA DIEU TR! D6nh gia, phan lo?iva xiic dinh diiu tr! Ki6m tra b6nh rat nang hoec tinh trang nhi6m khudn tai cho 24

Kidm tra vanq da .25

UNICEF T16 c6 bi ti6u chay kh6ng? 26

Ki6m tra vdn dd nu6i dudng ve nhe can .27

Kidm tra tlnh trang tiOm chring c0a tr6 28

Danh gia cac vdn dA kh6c .28

Di6u tr! tr6 nh6 va tham ven cho ba me Cho li6u kheng sinh tiCm bdp deu tiCn 29

Didu tri phdng ha afudng huy6t 29

Hrr6ng din bir me gitr dm tr6 trcn dddng t6i b6nh vi6n 30

Cho kh6ng sinh dudng u6ng diau tri nhi6m khudn tai ch6 30

Di6u ki nhi6m khudn tai ch6 6 nh2r 31

oidu tritiou chay, xem hLr6ng dAn DlEu TRtTRE aENH 1s-t+ Ti6m ch0nq cho ta-t ce tr6 nh6 bi bonh theo |ich 31

Hudng da;cach bd tr6 va ng;im b;t vu dung 32

Hu6ng dan bA me cach v5t s.ra 32

Hu6ng dAn ba me c6ch cho 5n bing c6c 33

Hddng dan ba me gif dm tr6 nhe can tai nha 33

Hd6ng dan ba me chem s6c k6 tai nha 34

chSm s6c tr6 nh6 b! bcnh khi kh6m hi Ki6m tra dd-phat hi n "BOnh ra't ndng" trong qua trlnh theo d6i 35 Nhi6m khuen tai ch6 35

Nhe can so v6i tudi, ndm mi6ng 37 CAC PHIEU GHI

x0rnirnE eEu ruo oE'r z rnArc rudr sa

xrlrni rnE eENx rUz raArc sEru s ru6r +o BIEU OO CAN NANG THEO TUOI '.,.', ,.,,42 _ 43

THANG 6 -2014

H6r BA ME LY Do oUA rRE Dr KHAM

Xec d nh xem day a kharn len dau hay kh6m ai vi ),, do nay

- N€iu day la 6n kham lai s0 dung cac hudng dan lrong phan KHAN,I LAI

' N6u day le khAm len dau, d6nh gie tr6 nhu sau:

vot cAc ,., rRrEu cHrJr.ro vA cAc vAru sE

CUA TRE DE PHAN LOAI BENH

4^r

KIEM TRA CAC DAU HIEU NGUY HIEM TOAN THAN

T16 c6 thd udng hoic bu me dfoc kh6ng? T.6 c6 ngt ti bi hay kh6 denh thrc khdng?

T16 c6 n6n tet ca rnoi thii kh6ng?

T16 c6 co giat khOng?

M9t tra c6 bdt ct, da-u hieu nguy hidm loan than neo cdn dudc ttru y Cap CUU; hoen thinh ngay

viec d6nh gie vA c6c diiu tr! tru6c khi chuydn dd viQc chuydn vien kh6ng bi chim rra

T16 c6 ho hoic kh6 th6 kh6no?

CAC DAU HIEU PHAN LOAI DIEU TRI

(Cac didu lricap cft trudc khich'ryan vien dudc in dam)

NEU co, nor xuAM:

Trong bao leu? O€rm nhip th6 kong m6t phnt

Tim diu hieu r[1 l6m l6ng ngqc

Tim nghe tidng thd rit va ti-6n!l

thd kho ktrar' )

TREPHAI

> Cho fieu deu khilng sinh thich hqp vd vihn

pholi neng ho?c binh rdt neng,

> chuydn cAP di benh viin.*

Th6 nhanh

NC'u trd: Tha nhanh la

Tii 2 thafq darr > 50 fh p

< l2lhin{r lnrra 1 lhr'il

> aho Salbuldmol ,re.r Lre LU lho kno kne

> Liinr !i:irrl ho banq ciic thu.jc an toan

> l)ilf l)ii nrL, klr n:ro (j,in (,uir tre ci6'n kham ngay

> Klrillrr iri srrLr 2 |qiry

Kh6nq c6 cac da-u hieLr cia

vi6m phdi ho5c bonh rdlning xx6rc vrEm pxdr:

Ho HoAc cAMLANH

> Ndu ho tr6n 30 ngdy, chuydn di benh vi6n

> Cho Saburamol ndu kd c6 thd khd khd

> Lem glam ho blng cac thu6c an toan

> D5n ba me khi nao cdn dda tr6 ddn khem ngay

> Khem lai sau 5 ngey, n6'u kh6ng ti6n tridn t6t

> X& tri va'n dd hong ndu c6 "**

tl

II

*" Nei khong the'chuyeh td benh di benh vien, bey xu tti theo cec huong ddn trcng phtl ttlc E "Khi

kh6ng thd chuyeh te bqnh di benh vi6n duoc" trong hi fieu Di6u tr! trd benh

*" Ne;J trd co hach c6 suhg, dau vit c6 chAi xudi ti6i mdu teng dtlc 6 hang, ding khdng sinh

Penicilline V uc;ng tong 1O ngey ve paracetamot nei ti co dau honq

f

f

I f,

t;

J J

t

I

ii, ii, 1., il, ll, ii l,i i.l ii lj ij, ii it, ii, li, lj, ij i,, l: ij li, i l,r lJ li l{ lj, l.l, l"l 11

li,

' Ji lj, l.

Trd c6 bi ti6u chiy kh6ng?

Quan s6t tlnh trang chung cl]a tre ddphat hi6n:

- Li bi hodc kh6 danh thaic?

- Vat va, kich thich?

Xem mit tr6 c6 trinq khonq?

Cho tr6 u6ns nr;dc xem tr6 c6:

- Kh6ng udng dudc hodc udng kem?

- U6ng heo hirc khat?

> Kham laisau 2 ngay

Trong bao lau?

N6p v6o da mdt rdt cham

MAr Nu6c

NANG

> N6:u tricdcdc phdn loAl blt r l gkhdc:

- chuyCn cliP dt b*nh vtfln Nhdc bl ng choudng ien fiJc tihg thla ORS trdn dudng ttlvefidp tuc cho bi.

> Ndu tr6 kh6ng c6 c6c phan loai benh nlng khec:

- Bi dich ddiv6i ma't nu6c ning (Ph6c dd C)

> Ndu tr6 2 tudi hodc l6n h@ ve dang c6 dich ti talitla phltu g, cho mat li6u khdng sinh ti.

Haitrong cac deu hi6u sau:

Valve, kich thich [,45r lrnng Udng h6o hL?c, kh6t Ndp v6o da me't cham

NuOc

> Ndu te c.t mit phen loqi ndng khAc:

- chuyAn cAP di banh vi6n Nhic be me chou6ng li6n tUc ti/,g thia ORS tran dudng di ve

tidp tuc cho bi.

> Bi dich ve cho en theo ph6c d6 B

> Bd sung k6rr

> Dan be me khi nao cen dlta tre ddn kh6rn ngay.

> Kham lai sau 5 ngayli)ndu kh6ng ti6n tridn l6t

Kh6ng di cec ddu hieu dd

phan loai c6 met nu6c hodc

C6 ma't n(6c hoac mdt

nu6c neng

TIEU CHAYKEo oArNANG

> Didu tri mdt nu6c tru6c khi chuydn trlr trudng hop c6 phan loai ndng khec

> Chuydn di bAnh vien Kh6ng mdt nu6c.

TIEU CHAYKEO DAI

Khuy6n ba me cech nu6i dudng h6 bitieu chey k6o

darl

Kh6m laisau 5 ngay

(1) TtA ddn khem bi danh gie phen bai vd di6u tri nhLt kh^m 6n deu

T16 co b! sdt kh6ng?

(sdt tU mdy hOm trLJdc hodc dang c6 nhi6t dO i 37,5'C (1) hoac sd thdy n6ng)

n6t:

Sdt bao lau rdi?

N6u da s6t qu6 7 ngay

c6 phai ngay nao cing

Ban toarn than va

MOt trong cac da'u hieu: ho,

chay mni mil dd

kha nanq danq mic s6i holc di m5c s6i

sot c6 nguy cd sot r6t

so7

sot

c6 khe nang dang mdcsdi hoac dA nrac sdr irongvdng 3 th6nq adn day

Phan loai

SOT XUAT

c6 nguy cd = S6ng trong vrng sot ret(2) hoac deln ving s6t r6t

trong 6 thang gan day

N6u tre c6 nguy co s6t r6t, hay ley am mau dd x6t nghiem

KST s6l ret hoac gui ddn nor c6 kinh h dn vi gdn nhii'1

Xiic dinh nguy co sdt xuii huy6i:

C6 nguy co - S6ng trong vrlng s6t xuat huydl (2) hoac ildn

vung sol ( ,al 'luvpl r,ol.g I rJ;1g.n day

trong vong

Tim dau h 6u ch3y mi mal

Tim deu h 6u mo gizrc mac

Tiri cao v6t o6t mi6ng xenr

co seu ho:c rdnq kh6nq?

s07

Bat ki deu hi6u n0uy lrti[r lr)i\llthan nao hobc

Md giac mac hoa(i

Vet loel nridno silr ln)r(: rlrrl

( l,, rrrLr i r rr llr'.I l),rr rr'l |r, |,1

> Cho 1 li6u dlu kheng sinh thtch hgp

> N6it md gidc mqc holc chdy mi mCt, tra thu6c md met

> Chuy(ii cAP di benh vien

CO KHA NANG DANG

MAC SOt

> Cho vitamin A

> Den ba me khi nalo can dua 116 ddn kham ngay

> Kham laisau 2 ng2ry

S6ihong vdng 3 thang gen day DA MAC SOI > Cho vitanin A n6u chua u6'ng trong holc sau khi mdc s6i

In! r;o sril r;;ro r:r lrrr.

2 T fgay khof(t')

T16 co b ch:ly nra! nrur

hoac chiy rliu loi

kh6ng?

Tre c6 n6n ra meu hoac

di ngoai phan den

kh6ng?

l( (i) lr l)r lro,r virl v,r klr(ir(t Ilr(l (,(, lr rrlr(,t, irrrlr (lriIr tiry

khonq'1 Bat mach: Mach nhanh va y6uL'?

Tlm c6c ch,im, not ho:rc rring

xuat huyet dud da

Tim ddu hi6u chiv meLr rnii ho:c

Hat ky oau nreu nguy nrem

toan than nao hoac

Cd cl-mg hodc

tnop pnong

BENH Rir NANG c6

soT HoAc soT RET NA,NG

> Cho li6u ddu thudc sdt rit phi hlp vd s6t rdt ndng

> Cho 1 li6u ddu kheng sinh thich hqp

> Didu tri phong ha dudhg huyei

> Cho 1 lidu paracetamol ui phong khdm neu f Z38,fC

> chuvdn G,iP di b6nh vi6nX6i nghi6m KSTSR duong

linh v6r:

- P falciparun haac SOT RET

> Cho thu6:c s6i rdt thich hop

> Cho 1 li6u paracetamol tai phdng khiim n4i f 238,5'C

> Dan ba me khi nao cen du'a 116 den kham nqay

> Kham lai sau 2 ngay n6u van con s6t

> Neu tr6 sot hang ngay, k6o daitren 7 ngay, chuydn d benh vien.

Chlra c6 kel qu; x61rlllr,;llr

> Cho thu6l s6i ret thich hop

> Cho 1 lieu paracetamol taiphong hhdm neu f238.5"C

> Dan ba me khi nao can dua tr6 ddn kham ngay

> KhAm la sau 2 ngay ndu van cdn sdt

> N€iu tr6 sot hang ngay, k6o daitren 7 ngay, chuydn d b6nh vien

Chua c6 k6t qua x6t nghiam hoac x6t nghiem KST sdt r6t am tinh yit

C6 nguyen nhan gay s6t khac ()

s6r - xnOr.rc g6rue

s6T RET (')

> Cho 1 lidu paracetamol td phong khem ndu Pa38,YC

> Den bar me khi nao can dLIa tr6 d6n khem nqay

> Kh6m laisau 2 ngay ndu v5n cdn s6t

> N6u tre sot hanq ngay keo dar tr6n / ngay chuydn dr b6nh vi6n

KHONG CO NGUY CA SoT RET Bal hy oau nreu nquy hronr

toan lhan nao hoic

> Di6u tiphdng hq itltdng huydt

> Cho 7 iei patacetamol tqi phdng khdm nei f :38,5C

> Chuydn GiP di benh vien

Kh6nO c6 cac ddu hi6u lrtlrr

HCUV Co S6r nEr

> Cho 7 li€u paracetamol t?i phdng khdm nei f Z38,YC

> Din bd me khi naodua tr6 ddn kham ngay

> Kh,lm lai sau 2 ngay ndu v5n con s6t

> Ndu tr6 s6t hing ngay, keo dai tren 7 ngay, chuydn di

Ir(',t |lI N(lIIIN(i NnN(i

VIF M XII'JNG CFiI]M

VIEM PHOI

KHONG VIEM PHOI: HO HOACCAM LANH

sot co B|EN cHur.rc vA r Honc vrEruc

cO KHA NANG DArc vAc sor

VIEM TAI CAP

cAc NGUYEN NHAN GAy s6T KHAC nhu: vi6m hong,

vi6m mo td bao, ap xe, nhi6m khudn ti6t niou, thddng

han, lao,

( ) Nhiet dd ney dLta theo nhi6t dO nech Nhiet dO hau n'n cao hon 0,5oC

(2) Vdng cb nguy co s6t rd ve sdt xudt huydt dua theo huong den cia Sd Y td tinh

G ) d ni6n Trung, Tey nguyen, DOng Nam b6 ve Ce Mau, ndu khAng co kinh hi6n vi dd x6c dinh sdt r't thi hey di6u tri m fiAu thudc sdt ret.

(4) Kh6ng qucn ki6m trc c;;c nguyAn nhan gey sdt ve di6u tri cha te theo bgnh do:xem b;ng CAC ttcuvett tluAru cAy SOt

i6 Xac Oin'n tte co -ach nhanh khi: mach ; i 6A En tung 1 phlt ddi vdi trA dn1i l tudive> l2OEntrongl ph(tt ddivditr6tit l ddn duoi Studi

(6) CAc bidn chung quan trong khec cia sdi: viem phdi, thA t, tieu chey, viem bi ve suy dinh dudng duoc phen bqi trcng c^c beng kh,c

rcdrvr rRA suy DrNH Du6ttc vA rntEu tvtRu

Gay mdn neng, 16 r6t hoec

Md giac mac hoac

Ldng ban tay rdt nhgt hodc

Phar ca hai bin chen

SUY DINH DUdNGNANG vA/HoAc

THIE,U MAU NANG

> Cho vitamin A

> chuydn cAP di benh vien

lrm diu hreu o;v mon nano rd ret TINH TRANG

llm dau nleu md qlac mac

Trm dau hieu lonq ban lay nhdl I

Ban tay co : I

Ral nh.,t, I

I

Trm diu hr6u phu ce har b;n chan I

xec drnh can nanq lheo tuo'r I

Ldng ban tay nhdt hoecNhe can so vditudi

THIEU MAU VAiHOACNHE cAN

> O6nh gie chd dO 5n c0a tr6 va tham vdn cho cac ba me nudi

dLidng trd lheo o DINH DTJONG trong hdong ddn THAM vANCHO BA ME

- Ndu c6 ve'n dd nu6idudng chda hop l)r, khAm lai sau 5 ngary

> Ndu c6 thi6u meu:

- Bd sung sit

- Cho mebendazole hobc albendazole ndu tr6 tn 12 th6ng tudi

va chda udng thu6c giun trong vdng 6 theng gdn day

> Khem laisau '14 ngay

> N6u nhe c6n so v6itudi, kham lai sau 30 ngey

> Din ba me khi nao nen cho tr6 ddn kham ngay

Kh6ng nhe can so v6i tu6ivakhong c6 cac ddu hi6u c0asuy dinh dudng va thidumeu

KHONG THIEU MAU

vA KHONG NHE cAN

cho bd me nu6i dudng tr6 theo phen DINH DUONG trong hu6ng

dEN THAM VAN CHO BA ME

- Ndu co vdn dd nu6i dddng chua hop ly, khdm lai sau 5 ngay

rcEru rRA TiNH TRANG reM cH0Nc c(lA TRE > Tiem chirng tdt ca tr6 bi bonh n6u c6 thd cho vd nha

bi€it can phai ti6m ch0ng cho tr6 khi nao vd 6 dau

tre ucing vacxin vd dd nghi bar me dua tr6 ddn uong 1 li6u bd sung saud6 1 thang

chuydn vi6n loai vacxin cdn ucing/ticm cho tr6

LICH TIEM CHONG:

Sd sinh 2 thang 3 thang

LAo BAr LIET 1 BAr L|ET 2

I th6ng

s6r r

DANH cll cAc vAr,r gE KHAC fiai mfi! hqrrg/4lg ha!!!rni!, da li6u, m5t, c6c vdlr di vi ngo41!!qq )

oAN/ eAo ruHUlc fR€ co oAu ltru rucuy ltdH,4 toeru THAN DUOC cHUY€N ncnv

"a, khi cho li6u deu khang sinh thich hdp va cac alidu tri cdp cou kh,rc.

TriI trudng hdp: Bar nu6c cho tr6 theo Ph6c dd C c6 thd giai quydt cac ddu hi6u nguy hidm thi khong phai chuydn tr6 noa

DIEU TRI TRE BENH

DIEU TRITRE THEO CAC BUOC

Cho khing sinh drrong uong thich hop

oot vol vtEru pHdt noac vtEtrl rnt cAp

VtEU pgdt, COfntUOXAZOLE trong 3 ngay hoAc AMOXYCILLIN trong 3 ngiry hoic ERYTHROMYCIN trong 5 ngayvtEM TAI: coTRlMoxAzoLE ho-c AMoxYclLLlN ho?c ERYTHROMYCIN trong 5 ngey

> €}6l v6t LY , Dirng khang sinh de dLrdc khuydn nghi dd didu ki ly tai dia phuong ban trong 5 ngary

COTRIMOXAzOLE hoec NALIDIXIC AXIT

Khzrnq sinhthrnhet: cHLoRAMPHENIcoL Khang sinh thd hai: ERYTHRoMYcIN

HU6NG pAr'r eA ME cHo rnE u6tc

THUOC TAI NHA

thudc u6'ng tai nha va theo cac hu6ng din trong bang

lidu ding cho tmg loai thudc:

> X5c dinh thudc vi lidu dtng thich hqp theo can

nlng tro6c tudi cria tr6.

> Gi6i thich cho bi me lf do tr6 cdn udng thudc.

> Hu6ng din vi lim mau ciich ludng lidu thudc.

> D6 nghi ba me tr:r lrrdng li6u thudc vir quan sAt.

> Di nghi ba me cho tr6 udng lidu thudc ddu tiGn.

> Giai thich 16 cho bi me c6ch cho tr6 u6ng thuoc,

ghi nhan l6n tfi thudc vi cho thu6c vio trli.

> Giai thich ring ti't ci cic loqi thudc phai cho

udng trgn vgn ci dqt didu tri, thim chi khi tr6 di

> Dtra thudc cho bi mg DAn ba me dd thudc 6 ndi

kh6 r5o, kh6ng c6 chuQt, c6n trirng vd d|c bial le

> Kidm tra su hidu bidt cfia ba m9 trrr6c khi cho tr6

6 < 10 kg (4 -<12 thang) 1/ -^ ,,^

/2 Vte tan 1vi6n/l6n 1/ ^ ,,^

/2 Vtenllatl

'10 - <19 kg

(12 thang - <5 tudi) 1 vi6n/lan 1Y2 vienE.n 'i vi6n/len

CAN NANG hoac TUOI COTRIMOXAZOLE, vi6n 480 mg2lan 1 ngay, trong 5 ngay

(48 ms/ks/ngdy)

NALIDIXIC AxlT, viCn 500 mg

4len 1 ngay, trong 5 ngay

CAN NANG hoec TUOI CHLORAMPHENICOL vi6n 250 mg

3len 1 ngay, trong 3 ngay

ERYTHROMYCIN vi6n 250 mg

4len 1 ngay, trong 3 ngey(50 mg/kg/ngay)

l vien/lan(3q mq/kq/nqdy)

12 - 19 kg (2 rudi- < 5 tudi)

HudNG oAN eA ME cHo rnE udr.rc ruu6c 14 HuA

Theo c6c hu6ng dAn 6 trang z iho tdt cA c6c loqi thudc u6'ng tai nhi v3r theo i6c hudng o5n trong b6ng li6u ding cho tung loai thudc.

F ,'rn rf ,'il ,Y lf rf rl rt' rf rf t{ r'ft tl tf rf r? tf rf i{ rl rf rf i{ ri r? tf

"no ra't "a c6c loai thu6c udng tai nhi va tneo cac

NHA

tso sung sdt

N6u lA thu6c vi6n, nghi€!n thuoc rcjt nrili t;lriit

TUOI vtrAMrN a, vrEH runruo

100.000 dv

6-<12thang l viOn/lidu

l2theng-<5tudi 2 vi0n/lidu

xil tri tr6 kho khd

> xirtri khd khd trr.r6c khi d6nh giri lai Ho hoic Kho th6 tai cd

s6 y t6:

Ap dung 1 trong c6c phuong phap sau:

> Didu tri khd khd tai nhd:

Vien SALBUTAMOL Ngdy uong 3 lan, trong 5 ngay

> Bd sung k6m

TUOI

KEM (tinh theo mo kem nquven td)

6thanq-<5tudi 20mg/ngay

Udng Mebendazole hoic Albendazole

ndu: T16 tu 12 theng tudi va

DLroc phan loai THIEU MAU va

- Vi6n 200 mg, u6ng 1

vien/ngay trong 3 ngay hoac,

- Vi6n 200 mg, uong lidu

- Vi6n 400 mg, u6ng li€iu

- Vien 100 mg, u6ng lidu

duy nha't 5 vien hoec,

- Vien 500 mg, u6ng mot

HuoNG oAN ee ue srEu rnr ruHrEm xuuAru rer cu6 6 r.rrA

Giai thich cho ba rng cach didu tri vi tai sao phAi didu tri.

M6 ti c5ch didu tri theo tirng bu6c de dugc liet ka trong c5c 6 tddng

rilIlg du6i day.

Quan sAt be me tu alid.u tri ldn ddu t?i co sA y td (trd thu6'c giAm ho vi

dau hong).

Din ba me sd len phii didu tr! tqi nhi.

N61 cen didu tri tai nhir, dua cho ba me mgt 19 thudc ciprofloxacin

nh6 tai hoac dng thudc m6 mit tetracyclin hoAc mot lp nh6 dung dich

xanh methylen hoac glycerin borat.

Kidm tra suhidu bidt cia be mg tru6c khi cho tr6 vd nhi.

TIEM cHtNG cHo rAr cA rnE Br BENH THEo LrcH

neu khong thd dudc

DAN BA ME KHr ruAo cAu DUA TRE euAy LArod rrErvr

Di6u trivi6m tai

> Lam kho tai bang bdc sau kdn it nhdt m6i ngdy 3 ldn

Thay bing m6t bdc s6u kdn m6i vir lam di lam lai cho de'n khi tai khO

> Dieu tri viem tai man bing ciprofloxacin nh6 tai tai ch6 trong it nha't 2 tudn

> Didu tri nhi6m khudn m5t bing thuoc m6 mit

tetracyclin

l r,,l) IllU dreu lri cho den khi mjt het do

glycerin borat 3%

> Didu tri loet micng m6i ngay 2ldn.

mu6i sinh ly

Boi xanh methylen 1% hoac glycerin borat 3% vao vet loet

- Thudc d6ng dLroc : bd phe, be ho

Thuoc nam : hoa hting bach, quet hap dl]dng phen

- CZrc che phdm khang histamin (Phenergan, Theralene )

trn til

id i{

lii' it r.t, i,

lr 1l tr ir

NHUNG THUOG CHIDUNG 6 CAC CO S6 V TE

> Hdy xAc dlnh ll6u lugng cho phi hdp vdi cin nlng hoic Ua tudi c0a tr6.

> Phdl dung bdm va kim ti6m v6 trOng, lrrdng lidu ludng chinh x6c.

> Ndu kh6ng thd chuydn tr6 di b6nh viCn duqc, thi hay x& tri theo chi din

Di6u tri phdng ha dr.rong huy6t

N6u trd co th6 bu me drroc:

NAu tr6 kh6ng bri me duoc nhtrng co thd nudt duoc:

Ndu khOng c6 sla, cho tr6 u6ng nu6c dlldng.

trong 200 ml ntrdc s6i dO nguoi.

N61 tr6 kh6ng nu6t duoc vi ban di drroc dio tao cach

su dung 6ng th6ng da diy:

hodc dau tai

PARACETAMOL

Cin ning hoic tudi Vi6n (100mq) Vion (500m9)

14-19kg(3-<5tudi) 2 vien/ldn 1/z vienllitn

oor vor ruuOruc rnE pHAr cuuvEu cAp ruA xHdruc uottc ouoc oo,

VIEM PHOI NANG HOAC BENH RAT NANG

BENH nAr HANc co sor HoAc sor nEt lrAtto

BENH RAr NANG co sor

s6r erEN cHUNG NANG

VIEM XUONG CHUM

b6nh viCn

r.rdu xHOruc ruE cHuvEH ouoc

trong 5 ngdy

CAN NANG HOAC TUOI

AMPICILIN

dng 1000 mgTh6m 4.7 m nLi6c cdt =

5 ml (200 mg/ml)

GENTAMICIN

dng pha lo5ngTh6m 6ml nutc cdt vao 6ng 2mldng chLla B0 mg = I mltddng dudng 10mg/ml

4 - <6kg (2 <4thAng) 1,25 m (200mg)/lan 3,8 ml/lan

6-<8kg(4-<9thang) 1,75 ml (300m9)/lan 5,3 ml/lan

8-<10k9(9-<12thdng) 2,25 ml (400mct)/len 6,8 ml/l5n

10 - <14 kg (12theng < 3 tudi) 3 ml (500mq)/lan I ml/llen

14 - 19 kq (3 < 5 tudi) 4 ml (B00mg)/lan 12,5 ml/lan

NHUNG rHudc cHi DDNG 6 cAc co s6 v rf,

ciai thich cho bdr mq vi sao phii ding thudc cho tr6.

HAy x6c ttinh liiu lLrdng cho pht hop v6i can nang hoic hira tudi cia tr6.

N6u bqn dirng vi6n dan dit hiu m6n, phii dim bio vi6n dan 6 trong hiu m6n, n6'u rdi ra phiri dnt lai.

Phii d&ng bdm va kim ti6m v6 tring, ludng liiu ludng chinh xec.

Dirng Artesunat ti6m bip (TB) hoic vi6n dan

artesunat ho{c quinin TB* doi v6i sdt r6t ndng

cuo rnE er gENH nAr NANc co sor xoAc sor n6r ruAruc puAt

cuuvdru or BENH vrEN cAp ruA xu6ruc uoruc ouoc rHuoc

chuydn gdp di b6nh viOn

li6u dau va chuydn gdp di b6nh vi6n

rueu xuOruo ruE cHuyEru rne or BENH vtEN

aftesunat

nroi n.tay 1 lan cho d€tn kh tr6 a6 thd u6ng artesunat ihi chuydn sangllrrrijc rrrinq clro clLi idu di6u tri 7 ngay

2.,1 (lr(,nrdt liir r;lro rlen klrL trd c6 thii uong artesunat thi chuydn sang

tll!dc uon(, clro clu lr6u c'liiiLr lr 7 rrgay

N6u ti6m bip quinin: tiem nrili ti6p theo sau B gic, va sau d6 12 gidmot len cho den kh tr6 uong dlldc thi chuydn sang thuoc uong cho drlli6u didu trl 7 ngay Khdng ti6m quinin qud 1 tudn Kh6ng dong quinincho trd du6i 4 thang * Darng quinin cho sc;t r6t neng ndu khdng c6 artesunat t em hoac artesunat vien dan.

ARTESUNAT VIEN DAN HOAC ARTESUNAT TIEM EAP

QUININ-CAN NANGhoec TUOI

ARTESUNATVIEN DAN

ARTESUNAT TIEM BAPLidu d6u: 2,4 mg/kg; Cac li6u ti6'p theo: 1,2 mg/kgilen

o 60 r.g pna-vor 1.0 m Nari b,cdrboldr va 5 0 ml

,lLrou muordang tl/ong tao oJrg o c'l l0 n g/l-nlVi6n dan

50 mg

Vi6n dan

4 < l0kll (2 <l2 llr; r

'(,)

1 v 6n/en 1/ - ,

/2 \tenllar Li6u daur 2,0 ml (20 mg)

C6c i6u ti6p theo: 1,0 ml (10 mq)/len

10 19 ktl(12 th .i 5 [r(jr)

2 vi6n/lan 1 v 6n/1in Lidu deu: 4,0 nr (40 mg)

C,rc lidu t 6p theo: 2,0 ml (20 mg)/ en

CAN NANG ho;c TUOI

QUININ CHLOHYDRAI I II MBAPLidu: 1O mg/kg/lan Ong 500 nrq tr()nrt 2 rrr 2l)o llr(t/rr

'a -r 1 5'a.a.a.a .a5-1 .a-1.-L15t.1 1,-Lra t.1 .i

BU rHEM DlcH Dreu rRrflEu cHAy vA rgp ruc cHo AN

(Xem ldlkhuyan vd otttH DUONG trong htrdng din THAM vAtt CHO BA ME)

llutjng dan cho ba me v6 4 nguy6n tdc didu tri ti6u chay tai nha: Udng thcm dich, Bd

sung kom, Ti6p tuc cho an, Khi neo dlla tr6 ddn kham ngay

t u6nc THEM DlcH (cho tr6 u6ng nhidu hon blnh thLJdng)

dun sOi dd nguOi

nrJ6c sau: dung dich ORS., nudc canh, nu6c chao, nu6c hoa qu5,

> HUONG oAII aA r,Ie CACH PHA VA CHO TRE U6NG ORS., PHAT

> cHi cHo BA ME LUoNG DrcH cAN cHo rRE u6NG rHEM so

v6r LUoNG DrcH u6NG HAttc ttcAv:

DrJ6i 2 tudi 50 ddn 100 ml sau m6i ldn di ph6n l6n9

DAn be me:

- TiSp tuc cho udng them c6c loai nll6c cho ddn khi ngitng ti6u chAy

s rrE'p ruc cHo AN I Xem hu6ns din

Cho udng ludng ORS drroc khuyan nghi trong 4 gid tai cd sd y te.

> xAc orNH LUoNG oRS cHo u6NG TRoNG 4 Gro DAu

t1) Chi ding tu6i cfia tr6 khi ban kh)ng bidt can ndng Sd ludng oRS- uac nh (ml)

cin ding duac tinh bdng cdn ndng c(ta tr, (kd nhan 75

> cHi cHo BA ME cAcH cHo rRE uoNG oRS.

> SAU 4 GIO

LLra chon phac dd thich hop dd tidp tuc di6u tri

> NE'u BAME pHArvE NHArRuoc KHr KErrH0corEu rRr:

Chicho b2r me ludng ORS cen cho tr6 uong dd nodn tdt 4 gio di6u tri tai nha

DLra cho bd me sd g6i ORS dd hoarn tdt viec bi nu6c Cong non ph6t

thCm cho bd me 2 g6i ORS theo phac dd A

3 TIE.P TUC CHO AN

B0 DlcH cHo rrEu cHAy naAr nuoc r,rAr.rc vA ef;run nAr r,rArue c6 soc noAc n6r cnUtrc

Ph5c dd C: Nhanh chong didu tri m6't nu6c ning

rueo cHrEu rr,rUr rEn NEu rnA Lot "co" rHi THEo HitUr rrru rucnnc rueu

"xHotrtc', THEo NI0l reru xu6Nc.

eXrsAu ruoAy Truyen ORS trong khi chLan oi trJyen o;ch ttnn riach ngay Neu t.uyen tre Lt6ng l0O duoc ml/kqdunq drc;hjy Lho Jonq

Rrnger Lactat (ho5c nlr6c mudi sinh lj, ndu kh6ng c6 s6n dungdich Ringer Lactat) Chia s6 lUong vd thdi gian nhd sau:

Tudi (,) Lric ildu trr-rydn

Khi tr6 c6 thd u6'ng dLroc, hay cho udng ORS, (khoang 5 mt/

kg/gid); thLrdng sau 3 - 4 gio (tr6 <12 thang) hodc i - 2 gid (116

>12 th,nq)

Sau 6 gid (tr6 <12 th6ng) hodc 3 gid (tr6: 12 thang) danh gia

lai va phan loai do mal nLroc toi lLia chon phac do thrch 1op(A, B hoac C) dai dieu tn

lco)

Chuydn ngay tr6 benh t6i d6 dd truy6n trnh mach.

Neu trp co thd uong dlroc l-.dv dLtu cho b; me oung diLhORS va h[6ng dan cach cho udng trong khi chuydn tr6

benh vi6n dd truydn

dich ho5c det dng

th6ng da

csuf:

Ndu c6 thd, theo doi tr6 b6nh it nhdt 6 qio sau khi bi dich

de chjc,han ba me co the tiep ruc bu n"rroc banq cno uongORS-

Bi nu6c b5ng dng th6ng da dey (ho5c udng) dung djch ORS':

cho 20 mukg/gid kong 6 gid (tdng c6ng i20 mt/kgj

Cf 1 - 2 gid danh gi6 taitr6:

- N6u n6n nhidu tan hodc bung chu6nq tenq t6n, cho

- N6u sau 3 gid tinh tr?ng mdt nLi6c kh6ng cai thi6n honhey chuy€in trd di b6nh vi6n dd iruy6n dich linh mach

SlLGgiod;nhqatJ trd phjn lodr mat nl/ocva,honphdc

do dieu tr thich hop

tLtc Neju tr6 u6ng dudc, cho

udng tLrng ngum ORS trong khi truydn.

Truydn Ringer Lactat 15-20 ml/

kg trong 'l gid (n6u khdng c6 sin co thd truyiin dung dich

mu0-i sinh ly) tai co sd y te

Chuvdn qdp di benh viCn Cho

udng ORS- theo kh6 nang cta

tr6 tren dudng di

I

XUOtrtC

(*) Xtu5,6n khich su dung ORS at0 thdm thau th{p ndu sin c6 d co so y te tlia phrr<rng

CHAM S6C rNE KHI KHAM LAI

Chlm rdc trl d0n khAm l8l, sridvng tel ce cac khung ll6n quan d6'n

phln lotrl trudc dAy.

NC'u tr6 c6 vt'n dd gi m6i, danh gie, phan loai vir didu tri theo hrr6ng din

Neu c6 rit l6m ldng ngr.rc hoic th6 rit khi nim yen hoic m6t di'u hi6u nguy

hidm toin than, cho mdt li6u khang sinh kh6c ho5c tiem bip 1 lidu ampicillin

vi6n

Neu nhip th6, sot va 5n udng khong tot hon, chuydn khang sinh vd den ba

>LY

Sau 2 ngay:

H6i:

- Sd ldn tiCu chay c6 it di khong?

- N,4au trong phan c6 giam khdng?

C6 do dau bung khong?

DIEU TRI:

> Ndu tr6 bi mit nu6c, di6u tri ma't nu6c

> Ndu so lan tieu chiy, mau trong phin, sot, dau bung vd in u6ng

Tra, trudng hop ndu tr6:

> Ndu so lan tieu chay giim, m6u trong phin it di, dA s6t, d6 dau

- T16 da ngurrg tiou chay chua?

DICU TRI:

> Ndu chua ngimg ti6u ch6y (tr6 v5n di phin l6ng tn 3 lan tr6 len m5i ngay)

danh gia tre toan dien Dieu tri cap cllu sau do chuydn di b6nh vien

> Ndu d6 nging ti6u chiy (tr6 di phin l6ng du6i 3 len m6t ngay), dan ba

Chim s6c tr6 ddn khem lai, s(rdqng tdt ca cec khung lien quan d6n phin loai trrr6c diy.

Ndu tr6 c6 va'n dd gi m6i, d5nh gi6 toirn diQn, phin loai vi tli6u tr! vdn dd m6i theo hu6ng dan DANH GIA VA PHAN LOAI.

DIEU TRI:

> N6u tr6 c6 bdt crir dau hi6u nguy hi6m toin than nao hoac cd critrg hoic

th6p phdng, di6u tri nhu BENH RAr NANG co s6T HoAc sdT RET NANG.

> N6u c6 kdt qua xet nghiem KST sot r6t:

- Ndu tim thdy KST s6t r6t, chuydn di b6nh vi6n Kidm ira xem tr6 c6 uong

thudc sdt ret theo lich kh6ng Ndu cdn, cho uong 1 lidu tru6c khi chuydn.

Ndu x6t nghiem m6u kh6ng tim tha'y KST s6t r6t, tim c5c nguy6n nhAn g6y

> N6u chua c6 kdt qu5 x6t nghiam KST s6t r6t:

N6u tim th6'y c6c nguy6n nhan gay s6t khec ngoai sdt ret, di6u tri benh c6 sot

d6 D6m b6o tr6 duoc u6ng d0 lidu thu6c s6t r6t da cho tu len kh6m diu.

N5u chi c6 sdt ret la nguyon nh6n gAy s6t, chuydn di b6nh vi6n Kiejm tra

xerr tri! c6 u6ng thu6c sdt ret theo lich khong Ndu cdn, cho u6ng 1 lidu truoc

dAu va d5 drldc cho uong chloroquine, phai cho artesunat trong 7 ngay hoac

> N6u khong ph6i chuydn tre di benh vion, dan ba me tiep tuc didu tri vd dua tr6

> Neu sot hang ngay, k6o ddi tr6n 7 ngdy, chuydn di bOnh vi6n.

oIEU TRI:

> Neju tr6 c6 bdt kjr d5u hi6u nguy hidm toirn thAn niro hoic cd

crirng hoic th6p phdng, didu tri nhrJ BENH RAT NANG Co 56T

HoAC 56T RET NANG.

> Neu tr6 c6 bdt k!, c5c nguydn nh6n gAy s6t khec khong phai sdt ret, dreu tn benh do

> Ndu k6t qui x6t nghiCm m6u dr-rong tinh hoec ndu khdng c6 xet

soT-GI6NG 56T RET

',on s6t.

> N6u kdt que x6t nghiem mau am tinh hoac khong co xet nghren]

y! tr6 c6 ciic nguyon nhan gey s6t kh6c, didu trr cac benh do va

> Neju s6t hlno ngay, keo dai tren 7 ngay chuyen di benh vlen.

u I i.r { ,{ ,iil

tal ital tal ,la l' r' {'] i' r' r' l{ rf tfl t{ tfl t{ ll rx rT ilfi

t ll rl i.l i1 ii i.l i"l

N€jr"l sau 2 ngdy vdn con s6't:

orEu rnr

> Ndu tr6 c6 bdt kj dau hi6u nguy hidm toan thdn nio hodc cd

cfng hoec th6p phdng, di6u tri nhd BENH nAf UANC CO SCjr

> Ndu tr6 c6 bdt ki nguyen nhan gay sdt ndo khec, di6u tri b6nh do

> Ndu sdt keo ddi tr6n 7 ngdy, chuydn di b6nh vi6n

> Ndu khdng tim dddc nguyen nhan gay sot khec dan ba me dlra

tr6 d6n kh6m lai ndu sau 2 ngdy v5n con sdt

> CO KHA NANG DANG MAC SOI IION(; S(JI I]II N (:1It'N(; MN I VN/

HOAC MIENG

SirLr 2 ngiry:

IJanh g a cac d:iu hie! nguy llieint toatr tltarlD6nh gia tinh trang kh6 thd:

D€jm nhip tha trong m6t ph0t

- Tim ddu hieu l6m l6nq nqLtcTim va nghe lieng thd nt (hr ram yen

Denh gi6 tri6u ch[hg tiou chayTim ddu hi6u md giec macTlm ddu hi6u m5t d6 va chiy mi mit

Xem v€it lo6t mi6ngNg&i hdi A mi6ng tr6Ddnh gie van dd 6 tai

orEu rnr

khi nam -yen hoac md giac mac ho5c velt lo6t mi6ng sau ho5c r6ng, cho li6u ddu kh6ng sinh thich hdp

va chuydn gdp-di b6nh vi6n N€;u c6 md giac mac hodc ch6y mi mdt, tra thucic mo mit ietracyclinelrudc khi chuydn

N6u rR( co xrA nAruc onNo vAc sdr 6 tan kham d6u:

NeLr NHre[,4 xHuAn H,lir 6 te, kh6m ddu

hrrdng dan, chuydn tr6 deln b6nh vi6n N€iu ba me lam khdng d[ng, hu6ng den ba rne cech am do;g.

N€iu LOET N,4lENG 6len kh6m ddu:

borat 3% dll 5 ngay

cHAM s6c rnE s6r

NGUY CO S6T NEr

KHAM LAI

> Chlm a6c tr6 deh khem lai, sil dung ta't ca

quan d6h phin loai tru6c diy.

> N6'u tr6 c6 vdn di gi m6i, d6nh gi5, phin loai

hu6ng din DANH GA VA PHAN LoAt

> Chim s5c tr6 ddn khim lai, s& dqrng tdl cA cacfhung tien quan d6n phin loai trrr6c diy.

> N6'u tr6 c6 vdn dd gi m6i, alenh gia toan dien, phan loai vd didu tri theo hu6ng d5n DANH GIA VA PHAN LOAI.

> s6r- co KHA NANG scir xuAr HUyEr DENGUE

Kh6m lai tr6 hing ngay cho den khi hai sdt hoan toan trong 2 ngay (khi

otEu rnt,

> Ndu tr6 c6 circ ddu hiCu: chan tay nh6p lanh vat mach nhanh va

y61, xir tri nhLr HOr cHUNG scjc s6r xuAr HUYEr DENGUE

> Ndu tr6 c6 1 trong cec ddu hiCu: li bi hoac vat va; chay m6u moi hobc

chAy m6u ldi; non ra m5u ho6c ia phan den; c6 chdm, n6t hoac m6ng

DENGUE NANG.

> Ndu tr6 c6 cZrc nguydn nh6n gay s6t khac, xfi tri c6c benh d6

> Ndu khong tim thdy ciic nguyen nhan gay sdt khac, kh6m lai hang

ngay cho ddn khi hdt sot trong 2 ngdy li6n tuc (khi khdng cdn dirng

paracetamol).

> Nou s6t keo dai tren 7 ngay, chuydn di b6nh vien.

> SOT KHONG GIONG SOT XUAT HUYET DENGUE

N6u sau 2 ngiy vin con sot :

Diinh gi6 lai tr6 toan dion theo hLr6ng den DANH GIA vA PHAN LoAl.

Irlr , ,r, nguyen nhan gay s6t hhac

DIEU TRI:

> N{)rr rrr! c6 b5t ky ddu hieu nao clra HOI CHUNG S6C s6r xuAr nuvEr

t r v.r, lrryPn gap den bdnh vien

> Nr:rr lr: sijt cao lien tuc trong 3 ngdy hodc hdn va khong co c5c nguyen

rrrr,rrr r;;ry sot khac, dirju tri nhu SciT Co KHA NANG SCiT XUAT HUYET

I)l N( iUI

> Ncrr lrc r;r'r i;ri<; lrguy6n nhan qiy sait klriic, thi phan loai SoI-KHONG (;l( )N( I l;( ) I XtIAT llUYiT DFN(it-lL, rliirrr lri crii: lrarrlr c(l s(it (lo

l)l N(iUI lro.r o() Kl ln NnN(;1,()l

^tln I lltl\l I l)l N(,LIF NANG hoac

clirrtt klltttt liti sittt2 tt<1rty rloll ttr') virtl (:()rl sot

) Chlm e6c trd d6'n kh6m lgl, eridqng tilt cA c6c khung li6n quan ddn

> N6'u trA c6 va'n dd gi mdi, d6nh gia toan dien, phan loai va didu tri theo

hudng dan DANH CtA vA pHAH lOat.

> VIEM TAI

Sau 5 ngay:

or€u tRt,

> Neu c6 surg dau sau tai, di6u tri nhuVlEN/ XUONG CHOM.

> Vidm tai cip: Ndu dau tai hoAc ch2ry nLr6c tai k6o ddi, di6u tri khang

sau 5 ngdy

> Viem tai m?n: Kidm tra xem bd me c6 ldm kh6 tai vd nh6 tai d[ng cach

khOng Khuy6n khich bir me ti6p tuc ldm kh0 tai vd nh6 tai cho tr6

> NCu hei dau tai hoic hdt chiy nu6c tai, khen ba me da didu tri ret tdt

li6u thudc.

Sau 14 nUay:

Cho vien set Den ba me cho tre den klrirnr lai srrrr l,l rrrl,ry rlc l.ry

Sau 30 ngdy:

Denh gia lai vd nuoi dudng tr6 Xem c6c cau h6l 6 phdn ddu c0a hudng dan

DIEU TRI:

> Ndu tr6 kh6ng cdn nhg can so v6i tudi, khen ngdi bd me vd khuydn khrch

ba me tiSp tuc chd do nuoi dLrdng tr6

> Ndu tr6 vAn nhe cAn so v6i tudi, tham vdn cho ba me vd vdn dd nu6i dlldng

kh6ng con nhe c6n so v6i tudi.

Tru trudng hdp:

DUA TREN IAru xHAIv oAu I-IoAc IAru xuAv uny

NEU TRE CAN DEN KHAM THEM NHIEU LAN,

KHUYEN BA ME DEM TRE DEN

KHAM LAN TIEP THEO

CUNG NEN KHUYEN BA ME

KHI NAo DUA TRE DE,N NGAY cO s6 v TE,.

(XEM HUONG DAN THAM VA:N CHO BA MA.

THAIV VAN CHO BA I\4E

datl

> Tham vdn cho bd me vd v6n dd nu6i dlldng chua hdp l! dang tdn tai

hoSc vdn dd m6i Ndu ban tham vdn cho bd me nhitng thay ddi dang kd

> N6u tr6 nhe can so vdi tudi, dd nghi ba me cho tr6 ddn kh6m lai sau 30

tr

H6i c5c cau h6i vd chd d0 nuoi dudng tr6 l0c binh thrldng vd luc bi benh So s6nh cdu tra tOl c0a Oa

me v6i c5c hu6ng d6n nuOi du6ng tr6 theo tudi 6 trang tiSp theo

- Mdy ldn vdo ban d6m?

- Loai th0c 5n hay nu6c udng gi?

Mdy ldn m6t ngdy?

- Chi cho tr6 5n bing gi?

- Ndu tr6 nhe cdn so v6i tudi: Sd ludng cho tr6 en la bao nhi6u? T16 c6 sudt 5n ri6ng kh6ng?

Ai cho tr6 dn vd cho 5n nhUthd ndo?

, Trong khi bi benh, ch6 dO nuOi dudng tr6 c6 thay ddi khong? Ndu c6, thi thay ddi nhuthd nao?

Hutng dAn nudldufing tr6

T16 dtrdl 6 thAng

Cho tre bn me hoan toen ddn 6

thang tudi Cho b[ bdt c0lic nao tr6

mu6'n, c6 ngdy l5n d6m, it nhdt 8

lan m6t ngay

Kh6ng nen cho tr6 an, udng th6m

thoc 5n gi kh6c

Ddi v6i tr6 tir 4 d6n 6 thans tudi, chi

cho tr6 en them ndu thdy tr6:

- van con d6i sau m6i brla b0 hoac

- kh6ng tang can binh thddng

Cho tr6 5n thCm 1 ddn 2 boa bot dec

dan m6i ngay v6i cac loai th0c an nhu

cho tr6 tU 6 ddn 12 th6ng

Ndu me khong c6 soa, cho tr6 an

soa ngoai pha theo c6ng thfc phi

dudng ThrJc hien "tO mau b6t b6t" v6i ddy d0 4nh6m thfc 5n

B6t dac v6i:

- thit (ga, ldn hoSc bd) hoAc c6, cua, t6m, dauphu bdm hoac nghidn nh6 hodc trL?ng y[

- rau xanh nghidn hoac bam nh6 nhd rau ng6t,

bi ng6, ca r6t, rau c3i, rau mudng, b5p cAi, suhao VA

- 1 thia md hoec dau 5n

cho tr6 5n it nh6't 3/4 ddn 1 b6t c6c thrlc 5n ndy:

- 3 btra m6t ngay ndu cdn b0 me

- 5 bia m6t ngay ndu khdng con b[ me

Cho tr6 en them cac loai qu6 s5n c6 tai tliaphudng nhu chudi, hdng xi6m, cam, xoai, du d0,t6o sau khi An va xen gioa c6c bita chinh

Kh6ng cho tr6 b[ chai

Tir 12 th6ng ddn 2 tu6i

Ti6p tuc cho tr6 b( me ba't c0llc nao tr6 mudnCho trA 5n ph6i hdp cec loaith0c An sau:

Ch6o dac hoac cdm niit hoac b[n, ph6, my v6i:

hay thai nh6 ho5c ca, tOm, hoac trrlhg !6

rau mudng, b5p c6i, su hao VA

- 1 thia m6 hoac dau

Cho tr6 en c6c thoc en ney 4 bila mOt ngay, itnha't 1 -1,5 bat m6t b[a.

all r alll

Kh6ns cho tre b[ chai

Th1c dn hdng ngdy cAn phi hgp vd thdnh phdn vit s6 ltnng, gieu ndng l1qng (vi dq b6t ddc thdm dAu hodc mo); Co protein tl thiL ce, trung hodc cec bai dau

Kh6ng nu6i con bing si.ra me n6u viCc nudi dudng bing thoc an thay thd dudc chdp nh6n, kh6thi, d6p rhg alddc lau dai ver an toen

Ndu vi6c drfig bU me gep kh6 khen, tham vdn c6ch nu6i dudng tr6 hdp ly nhdt, chu !r;

- khuyCn cho b[ me hoan toan trong vaithang deu ti6n

- khong nu6i h6n hdp bri m9 + an nhan tao

Ndu tr6 v5n cdn bU me, cho b0 lAu hon vd nhidu hon, ci ngby l5n d6m

Ndu trd dang dudc cho an sOa khac:

- thay sia d6 blng cach cho b0 me tAng lCn hoac

- thay thd bing s0a dau nanh, s0a chua hoac

- thay thd mOt n0a ludng sfa beng cec th0c 5n mdm, d6 tiCu, giau chdt dinh dudng

Ndu tr6 arlldc cho 5n c6c th(rc an kh6c, theo bang " Hu6ng dan nuoi duong tr6".

Trd 2 tutil va ldn

Cho tr6 en 3 b0a cirng gia ifinh, w ti6ncho tr6 th[tc an c6 nhidu che't dinh dudngnhdthit, ca, tdm, tnmg, c6c loai rau xanh

xen gi[a 3 bfa chfnh non cho tr6 en

them it nhdt 2 bila phu bing c6c loaisira, banh

cho tr6 en them c6c loai qu6 sin c6 6dia phudng nhu du di xodi hdng xi6m

chu6i