Child health development

To support the development of children’s health and to ensure continuous monitoring of the health of children, the pediatricians, family doctors, family nurses and medical specialists have agreed in the regulation of the Minister of Social Affairs to regular health checks of children. Subject to monitoring is the child’s growth and development, hearing, vision and speech. Information can be obtained about infectious diseases and vaccination. In addition, assistance for developing healthy dietary, exercise habits and family counseling is provided.

The first seven years at the family doctor

A healthy infant is monitored during the first year of life prophylactically on a monthly basis. Three visits must be made to the family nurse. In these visits, children are weighed and measured. In addition, the nurse’s job is to advise the parents on child nutrition, hygiene, care, prevention of accidents and the like. Visits to a pediatrician of healthy infants have not been provided for. If necessary, the family doctor will refer the child to the appointment of a medical specialist such as a neurologist or orthopedist. With a 6-7-year-old child, pre-school health checks should be passed by the family doctor. The doctor will evaluate the development and school readiness of the child. Among other things, the child’s vision and auditory acuity and speech development is checked. In case of discrepancies, the doctor may refer the child for additional examination to a speech therapist, or to an ophthalmologist. Medical examinations should be passed well before the beginning of school, as early as in the spring. Then there will be time to solve the problems. For example, if necessary to acquire glasses or if a child needs extra help or any special conditions, it is possible to arrange for that in a good time. The project of integration of children with diabetes in school, in which the disease is detected before the school and specialists provide the school staff with the necessary training and support.

Dental health care

The best means for the prevention of dental care is particularly domestic hygiene. It is advisable to visit the dentist at least at three years of age. Constant checkups should begin as early as the first signs of teething. The most important thing is to create a good start for regular dental checks and build the child’s trust in the doctor. The children who are already familiar with the dentist and have positive experiences will feel more comfortable at the dentist later.

Studies have shown that when at the end of adolescence the teeth are strong and healthy, no treatment is needed for several more decades. Thus, with the right hygiene habits of children and with preventive checks, situations can be avoided where in the adult age a large part of savings is absorbed by dental care.

Also, school nurses cooperate with dentists in the referral of children to preventive screening at 7, 9 and 12 years of age. If a child needs dental treatment, it must surely take place with the knowledge and on the approval of the family. It should, however, be observed if the dentist has a contract with the Health Insurance Fund. Only then, the service is free for parents.

The Health Insurance Fund finances the dental care of less than 19-year-old children and youth. Therefore, the latest at 18 years of age, teeth must be checked. Free treatment can be obtained from the contractual partners of the Health Insurance Fund.

Independence of school-age children on the consent of the family

For admission to the school, the officially certified transcript of the pupil’s health record must be submitted. It must include earlier vaccinations, chronic illnesses, regularly used medications, as well as drug or food allergies. The information is essential for monitoring the health of the child at school, but also for adjustment of the study load and the way of life. When coming to school, parental consent is asked for the provision of school health care services, in general, including for medical examinations in the 1st, 3rd, 7th and 9th grade.

The concept of consent arises from the Law of Obligations Act. On this basis, the patient can be examined, and healthcare can be provided to him or her only on his or her consent. Equally valid with a written consent is verbal consent. Parental consent is important in situations such as when a student asks for help from the school nurse during the break.

Before each vaccination, the school nurse must ask for a written consent from the parent of the child even if it has already been granted for the child’s admission to the school. Parental consent will help to rule out any contraindications. If the family does not want to vaccinate their children, this must be confirmed in writing.

What kind of health assistance can be received from school?

No treatment takes place at school. The treatment of the sick child is determined and coordinated by a family doctor or a medical specialist. If a child has fallen ill at school or a trauma has occurred, the school nurse must give him or her first aid and inform the parents. A school nurse does not designate examinations or treatment, nor can he or she issue a medical excuse for absence. In case of illness, a family doctor should be contacted. The school nurse can help if for health reasons a pupil needs differences in the organization of study, such as in the period after an illness. The nurse needs to know about the child’s allergies or chronic diseases. Only then, it will be possible to provide quick and appropriate assistance. In small schools, the nurse is not always present, but his or her office hours and the phone number must be available.

Sünnitusjärgne ämmaemandusabi

Statsionaarne sünnitusjärgne ämmaemandusabi

Pärast sünnitust jälgib haiglas ema ja vastsündinut enamasti ämmaemand, koostöös naiste- ja lastearstiga. Ämmaemand jälgib naise füüsilist ja vaimset kohanemist, toimetulekut vastsündinu hoolduse, tema vajaduste mõistmise ja nende rahuldamise ning imetamisega. Samuti jälgib ämmaemand vastsündinu seisundit ja kohanemist.

Sünnitusjärgne koduvisiit

Sünnitusjärgsete koduvisiitide korraldus on piirkonniti erinev, kuid iga aastaga populaarsust koguv ämmaemandusteenus. Koduvisiidi eesmärk on sünnitanu taastumise ja lapse kohanemise hindamine, toimetuleku toetamine, imetamisnõustamine ja vastsündinu hoolduse õpetamine.

Ambulatoorne sünnitusjärgne ämmaemandusabi

Kuus kuni kaheksa nädalat pärast sünnitust on soovitatav minna visiidile rasedust  jälginud ämmaemanda või naistearsti juurde. Vajadusel võib loomulikult ka varem pöörduda. Külastuse eesmärk on sünnituskogemuse arutelu, taastumise hindamine ja vajadusel läbivaatus, imetamisnõustamine ning rasestumisvastase meetodi valik. 

Mitmete haiglate juures on käivitatud võimalus sünnitusjärgseks ambulatoorseks pöördumiseks, et varase kojukirjutamise korral või probleemide tekkimisel teha vastsündinule uuringuid, teda vaktsineerida, saada vajadusel lastearsti konsultatsiooni või imetamisnõustamist, keisrilõikejärgset haavahooldust jms.


Rinnaga toitmist puudutavaid nõuandeid vajavad  sünnitusjärgselt kõik naised ning ämmaemand on saanud nõustamiseks vajaliku ettevalmistuse. Ämmaemand saab emasid juhendada ja toetada võimalike imetamisaegsete probleemide tekkimisel ja lahenduste leidmisel enne, kui loobutakse rinnaga toitmisest. Spetsiifilise ettevalmistusega ämmaemand-imetamisnõustaja poole pöördumisel võib enamesinevate probleemidena nimetada lapse ebaõiget asendit, valulikku imetamist, rinnanibulõhesid, mastiiti, seeninfektsiooni jms.

Imetamisnõustamist pakutakse kõikides emadushooldusteenust osutavates haiglates, kuid täpne korraldus võib haiglate lõikes varieeruda. 

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