|
A. General Information about the well child examination
E. Anticipatory Guidance |
Anticipatory Guidance: Other Items to Ask
|
| Age | Standard subjects discussed | Consider Additional Topics |
| Newborn |
Feeding (breast or bottle), sleeping (back to sleep; put in crib awake – no co sleeping) skin care : (no lotion) jaundice (causes, duration, Rx) circumcision care, umbilicus care, bathing, bowel movements, car seat |
Water heater @ 120 degrees Smoke Detectors No direct sunlight Crib slats 2 3/8 inches apart No Strings around the neck Family support at home; friends; sibs Tobacco and drug free environment |
| 2-4 weeks |
Feeding, (consider Vitamin D for dark skinned breast fed babies);
sleeping, bowel habits, safety: car seats Seems to hear and see normally |
Same as above Breaks for primary caregiver at least once/week Discuss different types of cries Special time for siblings Vary sleeping positions (head shape) Don’t microwave bottles |
| 2 months |
Feeding, sleeping, development, safety issues (car seat, gun safety,
walkers, smoke-free,) bowel habits Immunizations and reactions |
Expectations of development by the next visit: head control, smiling,
cooing Ask about postpartum depression Ask about family/social relationships Sunscreen now started earlier Consider CPR class, use of EMS |
| 4 months |
Same as above; solid food introduction for bottle fed; bowel habits;
normal developmental milestone discussion Immunizations and reactions Interval Medical History |
Reinforce bonding and playing Other family relationships Free time from baby Postpartum depression Others listed in 2 month |
| 6 months |
Same as above: feeding, sleeping, bowel, development, safety (childproof
home) immunizations, Lock up poisons; ipecac, guns, walkers; interval medical history Reading important; fluoride starts |
No feeding at night time awakening EMS use Emergency consent for parents Protect from hot appliances Water safety: never leave alone |
| 9 months |
Feeding, sleeping, development, safety (walkers, water, guns, car
seats), interval medical history Reading important |
Avoid hot, heavy breakable objects Secure small objects, sharp objects Warn about meds, electrical equipment Upgrade car seat for weight and height |
| 12 months |
Feeding, sleeping, bowel habits, development, safety (guns, water, car
seat, sunscreen) Speech development Reading important Off bottle |
Cuddling, talking, singing important Warn about burns from curling irons, hot liquids, food on the stove. No bathroom time without supervision Importance of pretend games, block or ring stacking, imitation Uses spoon; |
| 15 months |
Feeding, sleeping, development, motor, car seats, water safety,
sunscreen, hot objects Importance of reading |
Lower mattress in crib Do not spank; reinforce good behavior Find free time for caregivers Limit TV watching No balloons or plastic bags |
| 18 months |
Feeding, sleeping, development, motor milestones, positive rewards.
Safety: guns, water, electrical outlets; poisonings; Speech evaluation |
Stair and window safety Never leave unattended in car or home Discuss time outs – start to set limits Reassure about nighttime awakenings Potty chair for imitation |
| 2 years | Low fat milk, ready to potty train, sleep: changing nap patterns, Read daily, speech evaluation |
Visit libraries Do not play around cars or other MVs Socialization: sharing |
| 3 years | Feeding; brushing teeth, dental care, toilet trained, speech, development, safety |
Promote out of home activities Use “no” sparingly Pretend play; consider family exercise |
| 4 years | Feeding; bowel and bladder: nighttime wetting is common; Sleep: stay in own bed; age appropriate toys; helmets for tricycles; proper car seat |
Educate to call 911 Allow independence but set clear limits Fire escape plan Inappropriate touch |
| 6 years | Feeding; dental; safety as above |
Active time with children each day Rules for TV, bedtime, chores |
|
© Medical College of Georgia |
Department of Pediatrics |
Medical College of Georgia February 27, 2004 |