Decoding the red book

Your little one's Personal Child Health Record holds important information on her wellbeing. We guide you through how to use it

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Shortly before or just after your baby is born, your health visitor will give you a free Personal Child Health Record (PCHR), more commonly known as the ‘Red Book’.

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This is an important record of your child’s health and development 
from birth up to 4 years old, 
giving professionals easy access 
to information they may need and simplifying communication between them and you.

For many mums, it is not only a source of vital parenting information, but a unique memento 
of your little one’s early years too, 
and it should take pride of place 
in your changing bag.

How does it work?

The purpose of the book is simple: 
to keep a central record of your baby’s growth, development and measurements, but it can be a bit confusing to know how and when to use it. Health visitors and doctors will need to review it and add to it regularly, so bring it with you to medical appointments as well as emergency hospital visits.

But it isn’t only for professionals to use – parents are actively encouraged to note down any illnesses, allergies and accidents their child suffers. The book is divided into four sections, to make it clear and easy 
for parents to navigate…

Section 1: Child, family and birth details

This lists important personal details, such as your baby’s name, NHS number, and date of birth, as well as your name, her father’s name, home address, birth description, and notes on your discharge from hospital after delivery. You’ll even find information about handy local and national services, such as NHS Direct and SureStart children’s centres.

Section 2: Immunisations

This gives you important information about your baby’s upcoming jabs. 
A vaccination time plan is provided so you know exactly what immunisations your baby needs, when and why. Your nurse will note down each jab, but it’s important to keep the record as up-to-date as possible, as there will be times when you’ll need to show proof of your child’s immunisations, like when she starts school.

Section 3: Screening and routine reviews

Screening and other health checks will be noted in the third section of the Red Book. Everything from her sight to hearing will be tested and the results will need to be noted each time your child is checked. It’s also the part of the PCHR where your health visitor will record the findings of your little one’s yearly and two-yearly review meetings. This is so you and your child’s health professional can keep a good eye on her progress and discuss any areas of concern.

Section 4: Growth charts and other information

The final part is about monitoring your baby’s development in areas such as speech and behaviour, with charts to record her height, weight and head circumference as she grows. Graphs show the average pattern of growth for healthy children, so medics can compare your child’s progress against other children her age. The most important thing for you to grasp is a good understanding of the measuring system.

The graphs are divided into centiles. If your child is 
on the 50th centile for her height, it means that when 100 girls of her age are arranged in ascending order of height, she’s at the 50th position. It means she is shorter than 50 and taller than 49, and her height is within the normal limits. For children with specific health conditions, such as Down’s syndrome or Achondroplasia (restricted growth), inserts are available to ensure any special health needs are taken into account by parents and professionals.

How it all began

Although we think of the Red Book as a traditional part of British family life, it hasn’t always been the case. Nor did the concept even originate in this country. “The first parent-held record developed was in the late 1950s by a paediatrician called Professor David Morley, for use in Nigeria,” says Dr Helen Bedford, chair of the Personal Child Health Records Committee, a medical body which constantly reviews and updates the book. 
“It was a simple book that included a growth chart, space for notes (usually on the birth and immunisations), and a few simple health instructions.” 

In the 1980s, several areas of the UK developed their own version but 
by 1990, a standard record was developed by the British Paediatric Association (now known as the Royal College of Paediatrics and Child Health). “Over the years more and more districts adopted books and although usually red, the colour of the book could vary depending on where you live,” explains Helen. 

A time of change

While the colour of the book can vary, so too can the information contained within, as medicine advances. In May 2009, the PCHR was adapted in England and Wales to incorporate 
the new UK-WHO (World Health Organisation) Growth Charts, as the old ones were based solely on the growth of bottle-fed babies. The new charts now refer to the growth 
of both breast- and bottle-fed babies. These also came into use in Scotland in January 2010.

Did you know? 

An electronic version of the Red Book is being developed. It’ll be similar to the printed version, but will allow parents to book appointments and check results online.

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