Becoming a parent in Japan comes with many new experiences, but one of the most unique and helpful tools you’ll receive is the Maternal and Child Health Handbook, known in Japanese as the Boshi Techo (母子手帳). This booklet is given to all expecting parents and serves as a complete record of your child’s health from pregnancy through early childhood. It’s widely used across Japan and is something you’ll take to almost every medical visit involving your child.
This guide walks you through what the Boshi Techo includes, why it’s important, how to use it, and how childhood vaccinations are scheduled in Japan. Since Japan’s cities, towns, and prefectures sometimes have slightly different formats or programs, keep in mind that your local version may not match what friends in another region receive.
What Is the Maternal and Child Health Handbook (Boshi Techo)?
The Boshi Techo is a small booklet issued to pregnant women after they report their pregnancy to their local city hall or ward office. It’s available in Japanese everywhere, and many municipalities also offer English or multilingual versions.
The purpose of the handbook is to track health information before birth, during delivery, and throughout a child’s early years. Think of it as a combination of a medical journal, vaccination card, parenting record, and growth tracker — all in one.
You are expected to bring the Boshi Techo to:
- Pregnancy checkups
- Delivery at the hospital
- Postnatal checkups
- Child health checkups (1-month, 4-month, 18-month, etc.)
- Vaccination appointments
- Any routine visit to a pediatrician
Healthcare providers will record important information directly in your book.
How to Receive the Boshi Techo
You obtain the handbook after filing a Pregnancy Notification Form (妊娠届出書、にんしんとどけでしょ) at your local municipality office. The process is simple:
- Visit your city hall, ward office, or town office.
- Submit the form (staff will help if you’re not fluent in Japanese).
- Receive your Boshi Techo and a package of parenting resources, coupons, or subsidy information.
Some areas provide Maternity Health Checkup Vouchers in the same package, which give discounts or coverage for prenatal medical costs.
What’s Inside the Boshi Techo?
Although the layout differs slightly from place to place, the core sections are similar across Japan. Here’s what you can typically expect.
1 Pregnancy Record Pages
These pages allow obstetricians to track maternal health. They include:
- Expected delivery date
- Blood test results
- Weight, blood pressure, urine tests
- Ultrasound notes
- Risk assessments
- Advice for healthy pregnancy
- Notes on any complications
2 Delivery and Birth Record
This section is completed by hospital staff. It records:
- Date, time, and place of birth
- Mode of delivery (natural, C-section, assisted)
- Baby’s weight, height, and head circumference at birth
- Apgar score
- Any medical care given during or immediately after delivery
3 Newborn and Infant Health Records
This area tracks developmental milestones, including:
- Feeding type (breast milk, formula, mixed)
- Growth curves
- Sleep patterns
- Vision and hearing checks
- Dental development
- Introduction of solid foods
4 Childhood Physical and Developmental Checkups
Japan provides free checkups at major developmental stages. The most common ones include:
- 1-month checkup (Optional)
- 3-4-month checkup (Optional)
- 6-7-month checkup (Optional)
- 9-10-month checkup (Optional)
- 18-month checkup (Legal obligation)
- 3-year checkup (Legal obligation)
(Optional checkups may not always be free, but many municipalities provide financial support. Please check with your local city or ward office for details.
Doctors or health workers check weight, height, motor skills, language development, behavior, and general health.
All of this is recorded inside the Boshi Techo.
5 Vaccination Record Pages
This is where immunization details are entered. It includes:
- Dates of vaccinations
- Vaccine type (e.g., DPT, Hib, polio)
- Lot numbers
- Side notes from doctors
You’ll use these pages frequently during the first few years of your child’s life.
6 Parental Notes and Journaling Pages
Many versions include optional pages where parents can write:
- First smile, first steps, first words
- Daily growth notes
- Photos or mementos
Not every parent uses these pages, but they make great keepsakes.
Regional Differences in the Boshi Techo
While all municipalities follow national guidelines, variations exist:
- Cover design
- Page layout
- Availability of English or multilingual editions
- Inclusion of resource booklets or coupons
- Local public health center information
- Childcare support programs
Because of this, two parents living in different prefectures may receive different versions of the handbook. Regardless of design, the key medical sections remain consistent across Japan.
Childhood Vaccinations in Japan
Japan’s immunization program is divided into:
- Routine Vaccinations (mandatory/strongly recommended) — free
- Optional Vaccinations — paid or subsidized depending on the municipality
Vaccinations typically begin at 2 months of age and continue through early childhood.
1 Main Routine Vaccinations
These include:
- Hepatitis B
- BCG (tuberculosis)
- DPT-IPV (diphtheria, pertussis, tetanus, polio)
- Hib
- Pneumococcal
- Measles-Rubella (MR)
- Chickenpox (Varicella)
- Japanese Encephalitis
- Rotavirus (recently added in many areas as routine)
2 Optional Vaccinations
Availability varies by municipality:
- Mumps
- Influenza
- HPV (free in some cases but still officially “optional”)
3 How to Schedule Vaccinations
You will receive a Vaccination Ticket Pack (予防接種券) from your city. It includes:
- Individual ticket slips for each scheduled vaccine
- A list of participating clinics
- Instructions in English in some cities
You can simply call a pediatric clinic and book appointments. Many clinics allow online booking.
4 Typical Vaccination Schedule (General Guide)
The following is a general schedule; exact timing may vary slightly depending on your child’s health and doctor recommendations. (Click to enlarge)
Tips for Foreign Parents Using the Boshi Techo
1 Bring It Everywhere
Doctors expect to record health information here. Even ER visits may refer to it.
2 Keep the Vaccination Pages Updated
Some international schools request vaccination proof.
3 Ask for the Multilingual Version
Available in many major cities. If not, you may request it from NGO or embassy resources.
4 Don’t Worry About Minor Differences
Your friend may have a different handbook design — both are officially accepted everywhere in Japan.
5 Use Your Local Health Center
They can explain pages, help schedule checkups, and offer support for foreign residents.
Helpful English Resources
These official pages often provide vaccination lists or parenting guidance in English:
- Maternal and Child Health Handbook (English) / JAMCH
- Parenting Support Site for Foreign Residents / Kanagawa International Foundation
Conclusion
Having a baby in Japan can feel confusing at first, but once you get used to the Maternal and Child Health Handbook and the vaccination system, things become much smoother. The handbook helps you keep track of your child’s growth, checkups, and medical history, and although the details differ slightly by city, its purpose is the same everywhere.
Japan’s vaccination schedule is also very organized. Most shots are free, while some optional ones may require a small fee or subsidy—so it’s a good idea to check with your local city or ward office.
For foreign parents, there’s plenty of support out there. Local health centers, city websites, and multilingual services can help you understand what to do and when. With these tools, raising a child in Japan becomes much less stressful and a lot more reassuring.
Thank you for reading!
