MN580 Anticipatory Guidance For Neonates To Adolescents Table

MN580 Anticipatory Guidance For Neonates To Adolescents Table

Anticipatory Guidance for Neonates to Adolescents Table

Anticipatory guidance helps family, caregivers, and others know what to expect according to the child’s growth and development. The guidance is done through collaboration between the healthcare provider and the caregiver. It is sometimes thought of as a type of counseling. Nurse practitioners working in pediatric primary care need to be experts on anticipatory guidance. There are excellent resources available and these are being updated as technologies and environments change. MN580 Anticipatory Guidance For Neonates To Adolescents Table.

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This Assignment will demonstrate your ability to describe age-specific anticipatory guidance for the child and the family. Additionally, you will then have a reference table for quick glance created by you for future encounters with pediatric individuals and their families.

This assignment has a template that you will use to fill in the relevant elements of the anticipatory guidance per age group. The columns provide guidance to the specific areas such as safety and immunizations. If there is an area that is not applicable, such as oral health in infancy-newborn group, then place N/A in the box. MN580 Anticipatory Guidance For Neonates To Adolescents Table.

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Age Group Physical Development and Mental Health Nutrition and Physical Activity Oral Health Safety Concerns Immunizations

 

Infancy- Newborn Visit ·    Periods of wakefulness

·    Looks at/studies parents when awake

·    Looks in parent’s eyes when held

·    Calms when picked up or to parent’s voice

·    Responds differently to soothing touch and alerting touch

·    Moves in response to visual or auditory stimuli

·    Reflexively moves arms and legs (observed in the Moro and Tonic neck reflexes)

·    Communicates discomfort through crying and behaviors such as facial expressions, body movements of arms and legs

·    Keeps hands in fists and automatically grasps others’ fingers or objects

·   Keeps hands in fists and automatically grasps others’ fingers or objects

·   Moves head side to side

·   Limp posture with extension of the extremities

·   Breastmilk

·   Iron-fortified formula

·   No cows milk

·   Breastfeed 8-12 feedings in 24 hrs

·   Formula-feeding should be done on cue and at least 9 times in 24 hours

·   Breastfeeding mothers should be encouraged to take Prenatal vitamins with iron, multi-vitamin, or folate supplement while breastfeeding and maintain a healthy diet with lots of fluids for optimal nutrition and health

·   For mothers with a vegan or vegetarian diet, encourage a Vitamin D and B12 supplement.

·   Breastfeeding mothers should refrain from consuming alcohol or should “pump and dump.”

·   Don’t prop bottle

MN580 Anticipatory Guidance For Neonates To Adolescents Table

       N/A ·  Use rear-facing car seat in backseat of car

·  Never put baby in front seat of vehicle with passenger air bag

·  Keep baby in safety seat at all times during travel

·  Always use seat belt

·  Do not drive under the influence of drugs or alcohol

· Prevent heatstroke, never leave baby alone in care

·  Put baby to sleep on back

·  Choose crib with slats less than 2 3/8” apart.

·  Don’t use loose, soft bedding

·  Don’t leave toys in crib while sleeping

·  Have baby sleep in your room in their own crib

·  Don’t co-sleep

·  Learn about pet risks

·  Keep home safe for babe

· Choose plastic bottles made from new, safer plastics or tempered glass baby bottles.

·  Never heat a bottle in a microwave. If you wish to warm a bottle, a hot water bath is  recommended.

· If you bathe your baby in the kitchen sink, do not run the dishwasher at the same time. Hot water from the dishwasher can come up the sink drain and scald the baby.

·   Hepatitis B #1, if not received at birth

·   Encourage family to receive Influenza and Tdap since the child is too young for immunization

Infancy-First Week Visit ·    Sustains periods of wakefulness for feeding

·    Cries with discomfort

·    Calms to adult voice

·    Lifts head briefly when on stomach and turns it to the side

·    Reflecively moves arms and legs, observed in the Moro and Tonic Neck reflexes

·    Keeps hand in a fist

·     Exclusive breastfeeding for 1st 6 months

·    Iron-fortified formula is recommended as a good substitute.

·    Recognize signs of hunger/fullness

·    Develop feeding routine

·    Adequate weight gain is 6-8 wet cloth diapers per day

·    Give no extra fluids

·    Feed every 1-3 hours daytime and every 3hts nighttime for 8-12 feedings per 24 hours.

·    Begin giving baby vitamin d (400IU per day)

·    Mothers should continue prenatal vitamn with iron

·    Eat healthy diet

·    Prepare/store formula safely

·    Feed 2oz every 2-3hrs, more if seems hungry

·    Hold baby semi-upright

·    Don’t prop bottle

·    Clean the gums after feeding to remove bacteria from the mouth, as well as allow the baby to get used to the process. To clean baby’s gums, wrap a clean, damp washcloth around a finger and gently rub the gums. ·  Use rear-facing car seat in backseat of car

·  Never put baby in front seat of vehicle with passenger air bag

·  Keep baby in safety seat at all times during travel

·  Always use seat belt

·  Do not drive under the influence of drugs or alcohol

· Prevent heatstroke, never leave baby alone in care

·  Put baby to sleep on back

·  Choose crib with slats less than 2 3/8” apart.

·  Don’t use loose, soft bedding

·  Don’t leave toys in crib while sleeping

·  Have baby sleep in your room in their own crib

·  Don’t co-sleep

·  Learn about pet risks

·  Keep home safe for babe

· Choose plastic bottles made from new, safer plastics or tempered glass baby bottles.

·  Never heat a bottle in a microwave. If you wish to warm a bottle, a hot water bath is  recommended.

·    If you bathe your baby in the kitchen sink, do not run the dishwasher at the same time. Hot water from the dishwasher can come up the sink drain and scald the baby.

·    Hepatitis B #1, if not previously received

·   Encourage family to receive Influenza and Tdap since the child is too young for immunization

Infancy-1 Month Visit ·     Looks at parent; follows with eyes

·    Has self-comforting behaviors, such as bringing hands to mouth

·    Starts to become fussy when bored

·    Calms when picked up or spoken to

·    Looks briefly at objects

·    Makes brief short vowel sounds

·    Alerts to unexpected sounds

·    Quiets or turns to parents voice

·    Shows signs of sensitivity to environment

·    Different types of cries for hunger, tiredness

·     Moves both arms and both legs together

·    Holds chin up when on stomach

·    Opens fingers slightly when at rest

·     Exclusive breastfeeding for 1st 6 months

·    Iron-fortified formula is recommended as a good substitute.

·    Recognize signs of hunger/fullness

·    Develop feeding routine

·    Adequate weight gain is 6-8 wet cloth diapers per day

·    Give no extra fluids

·    Feed every 1-3 hours daytime and every 3hts nighttime for 8-12 feedings per 24 hours.

·    Begin giving baby vitamin d (400IU per day)

·    Mothers should continue prenatal vitamn with iron

·    Eat healthy diet

·    Prepare/store formula safely

·    Feed 24-27oz per day, more if seems hungry

·    Hold baby semi-upright

·    Don’t prop bottle

Clean the gums after feeding to remove bacteria from the mouth, as well as allow the baby to get used to the process. To clean baby’s gums, wrap a clean, damp washcloth around a finger and gently rub the gums. ·  Use rear-facing car seat in backseat of car

·  Never put baby in front seat of vehicle with passenger air bag

·  Keep baby in safety seat at all times during travel

·  Always use seat belt

·  Do not drive under the influence of drugs or alcohol

· Prevent heatstroke, never leave baby alone in care

·  Put baby to sleep on back

·  Choose crib with slats less than 2 3/8” apart.

·  Don’t use loose, soft bedding

·  Don’t leave toys in crib while sleeping

·  Have baby sleep in your room in their own crib

·  Don’t co-sleep

·  Learn about pet risks

·  Keep home safe for babe

· Choose plastic bottles made from new, safer plastics or tempered glass baby bottles.

· Consider offering pacifier

· Start “tummy time”

·  Never heat a bottle in a microwave. If you wish to warm a bottle, a hot water bath is  recommended.

· If you bathe your baby in the kitchen sink, do not run the dishwasher at the same time. Hot water from the dishwasher can come up the sink drain and scald the baby.

· Keep hand on baby when changing diaper/clothes

· Keep bracelets, toys with loops, strings/cords away

· Learn infant first aid/CPR; know emergency numbers; make emergency plans

·    Hep B #2 (Can be given between 1-2mo)
Infancy-2 Month Visit ·    Smiles responsively

·    Makes sounds that show happiness/upset

·    Makes short cooing sounds

·     Lifts head and chest when on stomach

·    Keeps head steady when held in a sitting position

·    Open and shuts hands

·    Briefly brings hands together

·     Exclusive breastfeeding for 1st 6 months

·    Iron-fortified formula is recommended as a good substitute.

·    Recognize signs of hunger/fullness

·    Develop feeding routine

·    Adequate weight gain

·    Expect 6-8 wet cloth diapers per day or 5-6 wet disposable diaters

·    3-4 stools per day

·    Burp baby at natural breaks in feeding

·    Give no extra fluids

·    Feed every 1-3 hours daytime and every 3hts nighttime for 8-12 feedings per 24 hours.

·    Begin giving baby vitamin d (400IU per day)

·    Mothers should continue prenatal vitamn with iron

·    Eat healthy diet

·    Prepare/store formula safely

·    Feed 24-27oz per day, more if seems hungry

·    Hold baby semi-upright

·    Don’t prop bottle

·   Clean the gums after feeding to remove bacteria from the mouth, as well as allow the baby to get used to the process. To clean baby’s gums, wrap a clean, damp washcloth around a finger and gently rub the gums. ·  Use rear-facing car seat in backseat of car

·  Never put baby in front seat of vehicle with passenger air bag

·  Keep baby in safety seat at all times during travel

·  Always use seat belt

·  Do not drive under the influence of drugs or alcohol

· Prevent heatstroke, never leave baby alone in care

·  Put baby to sleep on back

·  Choose crib with slats less than 2 3/8” apart.

·  Don’t use loose, soft bedding

·  Don’t leave toys in crib while sleeping

·  Have baby sleep in your room in their own crib

·  Don’t co-sleep

·  Learn about pet risks

·  Keep home safe for babe

· Choose plastic bottles made from new, safer plastics or tempered glass baby bottles.

· Consider offering pacifier

· Start “tummy time”

·  Never heat a bottle in a microwave. If you wish to warm a bottle, a hot water bath is  recommended.

· If you bathe your baby in the kitchen sink, do not run the dishwasher at the same time. Hot water from the dishwasher can come up the sink drain and scald the baby.

 

· Dtap #1

· Rotavirus #1 (RV)

· Inactivated Poliovirus #1 (IPV)

· HiB #1

· Pneumococcal vaccine #1 (PCV)

· Hep B #2 (If not already received)

·  Encourage family to receive Influenza and Tdap

Infancy-4 Month Visit ·    Laughs aloud

·    Looks for parent or another caregiver when upset

·    Turns to voices

·    Makes extended coos

·    Supports self on elbows and wrists when on stomach

·    Rolls over from stomach to back

·    Keeps hands unfisted

·    Plays with fingers in midline

·    Grasps objects

·    Exclusive breastfeeding for 1st 6 months

·    Iron-fortified formula is recommended as a good substitute.

·    Delay solid foods until baby is 6 mo old

·    Recognize growth spurts

·    Give Vitamin D (400 IU per day)

·    Begin infant iron supplementation

·    Discuss safe pumping/storing breast milk

·    Report any medications/supplements/herbs/vitamins

·    Prepare/store formula safely

·    8-12 times in 24 hours

·    30-32 oz total

·    Hold baby semi-upright

·    Consider WIC

·    No bottle to bed

·    Don’t share spoons

·    Don’t clean pacifier in your mouth

·    Maintain good hygiene

·    Use cold teething ring to relieve teething pain

·    Don’t prop bottle

·    Clean teeth/gums 2 times per day; use soft cloth/toothbrush with tap water and small smear of flouridated toothpaste no more than the size of a grain of rice

 

·    Continue calming strategies when baby is fussy

·    Spend time talking and playing with baby

·    Create daily routine for feeding/nap/bedtime

·    Avoid tv and other digital media

· Use quiet and active play time.

· Provide safe opportunities to explore

· Use rear-facing car seat in backseat of car

·  Never put baby in front seat of vehicle with passenger air bag

·  Keep baby in safety seat at all times during travel

· Use seat belt

· Don’t drive under the influence of drugs or alcohol

· Put baby to sleep on back

· Choose crib with slats less than 2 3/8” apart

· Don’t use loose soft bedding

· Avoid burn risk while holding baby such as with drining hot liqudis, cooking, ironing, smoking

· Set home water temp less than 120F

· Don’t leave baby alone in tub or in High places

· Avoid small objects, plastic bags away from baby

· Avoid infant walkers

·    DTap #2

·    RV #2

·    IPV #2

·    HiB #2

·    PVC13 #2

·    Encourage family to receive seasonal influenza and Tdap

 

Infancy-6 Month Visit · Pats or smiles at own reflection

· Looks when name is called

· Babbles

· Makes sounds like “ga”, “ma”, or “ba”

· Rolls from back to stomach

· Sits briefly without support

· Passes a toy from one hand to another

· Rakes small objects with 4 fingers

· Bangs small objects on surface

· Exclusive breastfeed for about first 6mo, then breast milk and solid foods from about 6-12 months is ideal; iron-fortified formula is recommended substitute

· Position baby for feeding so you can see/talk to each other

· Determine when baby is ready for solids; introduce single-ingredient foods one at a time

· Provide iron-rich foods

· Respond to hunger, fullness cues

· Wash vegetables and fluids before serving

· Limit juice to 2-4oz per day

· Don’t switch to milk

· Continue vitamin D and iron supplementation

· Assess fluoride source

· Clean teeth/gums 2 times per day with soft cloth/toothbrush and a small smear of fluoridated toothpaste no more than grain of rice

· Dont prop bottle

· Avoid baby foods/juices that baby sucks out of bag or pouch

· Don’t share spoons

· Don’t clean pacifier in your mouth

 

· Use high chair/upright seat so baby can see you

· Engage in interactive, reciprocal play

· Talk/sing, read to, play games with baby

· Avoid tv and digital devices

· Continue regular daily routines

· Put baby to bed awake but drowsy

· Continue calming strategies when baby is fussy

· Use rear facing care safety seat in back seat. Never put baby in front seat with air bag

· Infants who reach maximum height/Weiwei allowed by their rear facing only care seat should use a convertible or 3-in-1 seat approved for rear facing use to higher weights/heights (up to 50lbs and 49”)

· Put baby to sleep on back

· Don’t use loose or soft bedding

· Lower crib mattress

· Never leave baby in crib with drop side down

· Choose mesh playpen with weave less than ¼”

· Do home safety check (baby stair gates, barriers, cleaning products)

· Don’t leave baby alone

· Keep poison control number by all phones

· Keep baby in high chair/playpen when in kitchen

· Avoid burn risk-don’t drink hot liquids, cook, iron, or smoke near baby

· Set water temp less than 120F

· Keep small objects, all plastic bags away

· Limit finger foods to soft bits

· Avoid sun exposure; use hat/infant sunscreen

· DTap #3 (6-18)

· IPV #3 (6-18mo)

· PVC13 #3

· Hep B #3 (6-18mo)

· RV #3 à (NOTE: Rotarix is 2-dose series given at 2,4 mo of age; RotaTeq is 3-dose series at 2, 4, 6 mo) alternative for RV)

· HiB à (NOTE: ActHIB, Hiberix, or Pentacel is a 4-dose series given at 2, 4, 6, 12-15mo; PedvaxHIB: 3-dose series given at 2,4, 12-15mo)

· Seasonal Influenza

Infancy-9 Month Visit · Use basic gestures (holding arms out to be picked up, waving bye-bye)

· Looks for dropped objects

· Plays games like peekaboo and patty-cake

· Turns consistently when name called

· Says “DADA” or “MAMA” nonspecifically

· Lookds around when hearing things like “Wheres your bottle?” or “Where’s your blanket?”

· Copies sounds that parents makes

· Sits well without support

· Pulls to stand

· Transitions well between sitting and laying

· Crawls on hands and knees

· Picks up foods to eat

· Picks up small objects with 3 fingers and thumb

· Lets go of objects intentially

· Bangs objects together

· Gradually increase table foods

· Ensure variety of foods and textures

· Provide 3 meals and 2-3 snacks a day

· Encourage use of cup

· Discuss plans for weaning

· Continue breastfeeding if mutually desired

· Keeps consistent daily routines

· Provide safe exploration

· Be realistic about abilities

· Recognize new social skills, separation anxiety

· Be sensitive to temperament

· Play with cause and effect toys

· Talk/sing/read together

· Respond to baby cues

· Avoid tv, videos, computers, consider making a family media use plan

· Use consistent positive discipline (limit use of “No”, use distraction, be a role model.)

· Avoid heatstroke

· Never leave baby alone in care

· Remove firearms from home; if firearms are necessary, lock away and store unloaded with ammunition locked separately

· Do home safety check for gates, barriers, space heaters, cleaning products and electric courds

· Don’t leave heavy objects or hot liquids on table cloths

· Put poison control number on all phones

· Use touch supervision near water, pools, and bathtubs

· Install operable window guards

· Hep B#3 if not received (May give between 6-18)

· IPV #3 (If not given at 6mo. May give between 6-18mo)

· Seasonal Influenza

Early Childhood-12 Month Visit · Looks for hidden objects

· Imitates new gestures

· Uses MAMA and DADA specifically

· Uses 1 word other than MAMA, DADA, or personal names

· Follows directions with gestures such as motioning and saying “Give me (object).”

· Takes first independent steps

· Stands without support

· Drops an object in a cup

· Picks up small object with 2-finger pincer grasp

· Picks up food to eat

· Encourage self-feeding

· Avoid small, hard foods

· Provide healthy foods and snack and be sure caregivers do the same

· Feed 3 meals and 2-3 snacks a day. Toddlers tend to graze. Trust child to decide how much to eat

· Establish teeth-brushing routine

· Visit the dentist by the time that child is 12 mo old or after first tooth erupts

· Brush child’s teeth twice a day with small smear of fluoridated toothpaste, soft toothbrush

· If child is still using bottle, offer only water. Avoid added sugars

· Discuss child’s medical needs, your own feelings about diet/discipline/oral health/physical activity/media use

· Maintain ties with friends and community

· Use positive discipline as well as time-outs and distractions

· Praise for good behaviors

· Carve out family time every day

· Establish consistent daily routines

· Continue 1 nap a day and follow nightly bedtime routine with quite time, reading, singing, and favorite toy

· Avoid tv and digital media

· Consider making family media plan

· Use rear-facing care safety seat until child is highest weight ir height allowed by manufacturer

· Never place baby in front seat

· Use stair gates

· Keep furniture away from windows/install window guards

· Stay within arm’s reach when near water

· Empty buckets, pools, bathtubs immediately after use

· Use hat/sunscreen

· Avoid sun between 11am-3pm

· Keeps child away from pet feeding area

· Monitor interactions between child and pet

· Remove/lock up poisons/toxic household products

· Keeps poison control number near phone

· IPV (If not given at 6mo. May give between 6-18mo)

· Hep B #3 (If not given at 6mo. May give between 6-18mo)

· Hib #3

· PVC #4

· MMR #1

· Varicella #1

· Hep A #2 (12-23mo)

· Seasonal Influenza

Early Childhood-15 Month Visit · Imitates scribbling

· Drinks from coup with little spiking

· Points to ask for something, get help

· Looks around after hearing things like “Wheres your ball?” or “Wheres your blanket?”4uses 3 words other than names

· Speaks in sounds like an unknown language

· Follows directions that do not include a gesture

· Squats to pick up objects

· Crawls up a few steps

· Runs

· Makes marks with crayon

· Drops object in, takes object out from container

· Schedule dental appt if haven’t seen dentist yet

· Brush twice a day with small smear of fluoridated toothpaste, soft toothbrush

· Prevent tooth decay by food family oral health habits (brushing, flossing), not sharing utensils or cups

· If child uses nighttime bottle, use water only

· Maintain consistent beditime and nighttime routine

· Tuck in when drowsy but still awake

· If night waking occurs, reassure briefly; give stuffed animal or blanket for self-consolation

· Don’t give bottle in bed

· Don’t put tv/computer digital device in child’s bedroom

· Modify child’s environment to avoid conflict/tantrums

· Use distractiosn

· Accept messiness

· Allow child to choose between 2 things per parent choice

· Praise good behavior and accomplishments

· Use discipline for teaching/protecting, not punishing. Use time-outs to avoid negative attention

· Teach child not to hit, bite, use aggressive behavior

· Use rearfacing car seat

· Never place in front seat of car

· Make sure everyone wears a seatbelt

· Remove poisons/toxic products

· Place poison control number near phones

· Install window guards

· Install smoke detector on every level, test monthly/change batters annually

· Make fire escape plan

· Set home water temp less than 120F

· Hep B #3 if not received’

· DTap #4

· HiB #3 or #4

· PCV13 #4

· IPV #3

· Seasonal influenza

· MMR #1 if not already received

· Varicella #1 if not already received

· Hep A #2 (12-23mo)

· Seasonal influenza

Early Childhood-18 Month Visit · Engages with other for play

· Helps dress and undress self

· Points to pictures in book, to object of interest to draw parents attention to it

· Turns, looks at adult if something new happens

· Begins to scoop with spoon

· Uses words to ask for help

· Identifies at least 2 body parts

· Names at least 5 familiar object

· Walks up sets with 2 feet per step with hand held

· Sits in small chair

· Carries toy while walking

· Scribbles spontaneously

· Throws small ball a few feet while standing

· Offer variety of healthy foods/snacks, especially fruits and veggies, lean protein

· Provide 1 bigger meal;, multiple small meals/snacks, trust child to decide how much to eat.

· Provide 16-24oz milk

· Limit juice to 4oz and always serve with meal

· Continue to offer new foods; let toddler experiment by touching and mouthing

·

· Schedule dental appt if haven’t seen dentist yet

· Regular dental visits twice/yr

· Brush twice a day with small smear of fluoridated toothpaste, soft toothbrush

· Prevent tooth decay by food family oral health habits (brushing, flossing), not sharing utensils or cups

· If child uses nighttime bottle, use water only

· Spend time with child everyday; plan for difficult situations, and try to make things easier

· Be consistent with discipline/enforcing limits

· Wait until child is ready for toilet training (dry for periods about 2 hrs, knows wet and dry, can pull pants up/down, can indicate bowel movement

· Read books about using the potty

· Prepare toddle for new sibling by reading books, avoid new developmental demands on toddler, take action to ensure own health

· Encourage language, use simple words and phrases, engagement in reading, playing, talking, and singing.

· Encourage language development by reading, singing, and talking about what you see

· Use words that describe feelings and emotions to help child learn about feelings

· Use simple language to give your child instructions

· Make time for technology free play every day

· Use consistent bedtime routine of reading/songs, not media

·  Use methods other than tv or digital devices for calming

· Limit viewing to 1hr per day

· Use rear-facing care safety seat until child is highest weight ir height allowed by manufacturer

· Never place baby in front seat

· Use stair gates

· Keep furniture away from windows/install window guards

· Stay within arm’s reach when near water

· Empty buckets, pools, bathtubs immediately after use

· Use hat/sunscreen

· Avoid sun between 11am-3pm

· Keeps child away from pet feeding area

· Monitor interactions between child and pet

· Remove/lock up poisons/toxic household products

· Keeps poison control number near phone

· Hep B #3 if not received’

· DTap #4

· IPV #3

· Hep A #2 (12-23mo)

· Seasonal influenza

Early Childhood-2 Year Visit · Plays alongside other children

· Takes off some clothing

· Scoops well with spoon

· Uses 50 words

· Combines 2 words into short phrase or sentence

· Follows 2 step command

· Names at least 5 body parts

· Speaks in words that are 50% understandable

· Kicks a ball

· Jumps off the ground with 2 feet

· Runs with coordination

· Stacks objects; turns book pages

· Uses hands to turn objects like knobs, toys, lids

· Draws lines

· Regular dental visits twice/yr

· Brush twice a day with small smear of fluoridated toothpaste, soft toothbrush

· Prevent tooth decay by food family oral health habits (brushing, flossing), not sharing utensils or cups

· If child uses nighttime bottle, use water only

· Don’t use tobacco/e-cigs/ETOH/drugs

· Spend time with watch child

· Don’t allow hitting, biting, aggressive behavior.

· Encourage self-expression

· Encourage 60min of free play

· Limit tv or digital device

· Model appropriate language

· Read/look at books together daily

· Begin toilet training when child is ready

· Plan for frequent potty breaks

· Teach to wash hands

· Use harness on carseat, and ensure car seat is installed properly

· Never place baby in front seat

· Use bike helmet

· Remove firearms

· Lock up ammunition elsewhere

· Empty buckets, pools, bathtubs immediately after use

· Use hat/sunscreen

· Avoid sun between 11am-3pm

· Monitor interactions between child and pet

· Remove/lock up poisons/toxic household products

· Keeps poison control number near phone

· Seasonal influenza
Early Childhood-2.5 Year Visit · Urinates in a potty or toilet

· Spears food with fork

· Washes and dries hands

· Increasingly engages in imaginary play

· Tries to get parent to watch by saying “Look at me!”

· Uses pronouns correctly

· Walks up steps, alternating feet

· Runs well without falling

· Copies a vertical line

· Grasps crayon with thumb and fingers instead of fist

· Catches large ball

· Regular dental visits twice/yr

· Brush twice a day with small smear of fluoridated toothpaste, soft toothbrush

· Prevent tooth decay by food family oral health habits (brushing, flossing), not sharing utensils or cups

· Maintain family routine

· Encourage family exercise

· Take advantage of museums and zoos

· Maintain social contact outside family

· Read together everyday

· Go to the library

· Listen when child speaks, repeat, using correct grammar

· Play with other children

· Give choices

· Limit tv/digital device use

· Build independence by offering choices between 2 acceptable alternatives

· Consider child care, preschool, playdates,

· Encourage toilet training success by dressing in easy to remove clothes

· Establish daily routine to place on pootty every1-2 hrs

· Be sure car seat is installed properly and harness is snug

· Make sure everyone else uses seatbelt

· Supervise child outside, especially around cars, machinery, or dogs

· Provide “touch supervision” near water, bathtubs, pools, toilet

· Never place baby in front seat

· Stay within arm’s reach when near water

· Empty buckets, pools, bathtubs immediately after use

· Use hat/sunscreen

· Avoid sun between 11am-3pm

· Install smoke detectors on every level

· Monitor interactions between child and pet

· Remove/lock up poisons/toxic household products

· Keeps poison control number near phone

· Seasonal influenza
Early Childhood-3 Year Visit · Enters bathroom and urinates by self

· Puts on coat, jacket, or shirt by self

· Eats independently

· Engages in imaginative play

· Plays in cooperation and shares

· Uses 3-word sentences

· Speaks in words that are 75% understandable to strangers

· Tells you a story from a book or tv

· Compares things using words like bigger or shorter

· Understands simple prepositions, such as on or under

· Pedals a tricycle

· Climbs on and off couch or chair

· Jumps forward

· Draws a single circle

· Draws a person with head and 1 other body part

· Cuts with child scissors

· Have cool water available

· Provide 16-24oz lowfat/fat free milk daily

· Juice is not a necessary drink, limit to 4oz daily with meal

· Offer variety of healthy food, snack, veggies, fruits, lean proteins

· Trust child to decid how much to eat

· Encourage opportunities for physical activity for child, family

MN580 Anticipatory Guidance For Neonates To Adolescents Table

 

 

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· Regular dental visits twice/yr

· Brush twice a day with small smear of fluoridated toothpaste, soft toothbrush

· Prevent tooth decay by food family oral health habits (brushing, flossing), not sharing utensils or cups

· Encourage play with appropriate toys and safe exploration

· Expect fantasy play

· Encourage interactive games with peers; explain importance of taking turns

· Help your children develop good relations with each other

· Read, sing, play, rhyme games together

· Let child tell story

· Practice reading wherever you go

· Encourage child to talk about friends, experiences

· Use rear-facing/forward facing with 5-pt harness

· Never place baby in front seat

· Prevent choking by cutting food into small pieces

· Supervise all play near streets/driveways; don’t allow to cross street alone

· Keep furniture away from windows/install window guards

· Stay within arm’s reach when near water

· Empty buckets, pools, bathtubs immediately after use

· Use hat/sunscreen

· Avoid sun between 11am-3pm

· Teach child about safety around pets

· Monitor interactions between child and pet

· Remove/lock up poisons/toxic household products

· Keeps poison control number near phone

· Lock firearms away

· Keep ammunition in another locked location

· Seasonal influenza
Early Childhood-4 Year Visit · Enters bathroom and has bowel movement by self

· Brushes teeth

· Dresses and undresses without much help

· Engages in well-developed imaginative play

· Answers questions like “What do you do when you are cold?” or “…when you’re sleepy?”

· Speaks in words that are 100% understandable to strangers

· Draws recognizable pictures

· Follows simple rules when playing board/games

· Tells parent a story from book

 

 

· Skips on 1 foot

· Climbs stairs alternating feet

· Draws a person with at least 3 body parts

· Draws simple cross

· Unbuttons and buttons medium sized buttons

· Grasps pencil with thumb and fingers instead of fist

· Always have cool water available

· Provide 16-24oz low/fat free milk daily

· Limit juice to 4oz give with meal

· Offer variety of healthy foods, snack, veggies, fruits, lean protein

· Trust child to decide how much to eat

· Brush teeth twice daily with pea-sized fluoridated toothpaste

 

MN580 Anticipatory Guidance For Neonates To Adolescents Table

· Create calm bedtime ritual

· Be physically active as a family

· Continue size appropriate forward facing care safety seat installed in backseat

· Supervise all outdoor play

· Never leave child alone

· Don’t allow to cross street alone

· Be sure swimming pools are fences

· Use life jacket

· Teach child to swim

· Enjoy meals without tv

· Teach child rules about how to be safe with other adults: Don’t keep secrets, no interest in child’s privates, none should ask for help with their private parts

· Give child time to finish sentences

· Encourage speaking skills; reading/talking together

· Read together daily and ask questions about the story

· Model respectful behavior and apologize if wrong

· Praise when demonstrates sensitivity to feelings of others

· Provide opportunities for your child to play with other children

· Become involved in child’s school

· Never place baby in front seat

· Use stair gates

· Keep furniture away from windows/install window guards

· Stay within arm’s reach when near water

· Empty buckets, pools, bathtubs immediately after use

· Use hat/sunscreen

· Avoid sun between 11am-3pm

· Keeps child away from pet feeding area

· Monitor interactions between child and pet

· Remove/lock up poisons/toxic household products

· Keeps poison control number near phone

· Lock firearms away

· Keep ammunition in another locked location

· Dtap #5 (4-6yrs)

· IPV #4 (4-6 yrs)

· MMR #2 (4-6 yrs)

· Varicella #2

(4-6yrs)

· Seasonal influenza

Middle Childhood-5 and 6 Year Visits · Able to tie a knot

· Can draw a person with 6 body parts

· Prints some letters/numbers

· Able to copy squares and triangles

· Good articulation/language skills

· Can count to 10

· Names 4 colors

· Follow simple directions

· Dresses with minimal assistance

· Balances on one foot, hops, skips

· Limit sugar in drinks and snacks

· Maintain healthy weight through increased vegetable, fruit, whole grain consumption

· Adequate calcium and vitamin d intake

· Healthy foods at school

· Physical activity of 60min/day

· Eat breakfast

· Eat when hungry, stop when satisfied

· Drink milk 2-3 times / day

 

MN580 Anticipatory Guidance For Neonates To Adolescents Table

· Regular visits of twice/year

· Daily brushing (twice) with floss (once)

· Help child if needed

· Adequate fluoride

· Limit sugar drinks and snacks

· Use appropriate safety car seat

· Never place baby in front seat

· Be sure school is safe, positive

· Talk to child about school experiences

· Use properly positioned belt positioning booster seat in backseat

· Teach safe street habits (crossing/riding school bus)

· Ensure child uses safety equipment like helmet and pads

· Teach to swim; supervise around water

· Use hat/sunscreen

· Avoid sun between 11am-3pm

· Keeps child away from pet feeding area

· Monitor interactions between child and pet

· Remove/lock up poisons/toxic household products

· Keeps poison control number near phone

· Teach child rules about how to be safe with other adults: Don’t keep secrets, no interest in child’s privates, none should ask for help with their private parts

· Install smoke detectors and carbon monoxide detectors

· Make fire escape plan

· Lock firearms away

· Keep ammunition in another locked location

· Dtap #5 (4-6yrs)

· IPV #4 (4-6 yrs)

· MMR #2 (4-6 yrs)

· Varicella #2

(4-6yrs)

· Seasonal influenza

Middle Childhood-7 and 8 Year Visits ·  Demonstrates social and emotional competence including self-regulation

·  Engages in healthy nutrition and physical activity behaviors

· Forms caring supportive relations with family members, other adults, and peers

· Ensure child is ready to learn healthy food choices such as breakfast, school foods, and snacks.

· Help child choose healthy eating, provide healthy foods, eat together as a family

· Eat breakfast

· Eat veggies/fruit

· Limit sugar drinks and snacks

· Eat when you’re hungry

· Stop when you’re satisfied

· Drink milk 3 or more times a day
be physically active often during the day

· Regular visits of twice/year

· Daily brushing (twice) with floss (once)

· Adequate fluoride supplementation if needed

· Wear mouth guard during sports

·

· Limit sugar drinks and snacks

· Use appropriate safety seat with belt-positioning booster in the backseat

· Be sure school is safe, positive

· Talk to child about school experiences

· Spend time with child

· Talk to child and get to know child’s friends

· Encourage competence/independence, rules and consequences, temper problems, and conflict resolution

· Discuss rules and consequences

· Be positive role model

· Keep regular bedtime routine

· Ask teacher about evaluation for special help/tutoring; help with bullying

· Show interest in school

· Be aware of pubertal changes

· Use properly positioned belt positioning booster seat in backseat

· Teach safe street habits (crossing/riding school bus)

· Ensure child uses safety equipment like helmet and pads

· Teach to swim; supervise around water

· Use hat/sunscreen

· Avoid sun between 11am-3pm

· Keeps child away from pet feeding area

· Monitor interactions between child and pet

· Remove/lock up poisons/toxic household products

· Keeps poison control number near phone

· Teach child rules about how to be safe with other adults: Don’t keep secrets, no interest in child’s privates, none should ask for help with their private parts

· Install smoke detectors and carbon monoxide detectors

· Make fire escape plan

· Lock firearms away

· Keep ammunition in another locked location

· Seasonal influenza
Middle Childhood-9 and 10 Year Visits · Demonstrates social and emotional competence including self-regulation

·  Engages in healthy nutrition and physical activity behaviors

· Uses independent decision making skills including problem solving skills

· Forms caring supportive relations with family members, other adults, and peers

· Displays a sense of self-confidence and hopefulness

· Ensure child is ready to learn healthy food choices such as breakfast, school foods, and snacks.

· Help child choose healthy eating, provide healthy foods, eat together as a family

· Eat breakfast

· Eat veggies/fruit

· Limit sugar drinks and snacks

· Eat when you’re hungry

· Stop when you’re satisfied

· Drink milk 3 or more times a day
be physically active often during the day

· Limit saturated fats and added sugars

· Regular visits of twice/year

· Daily brushing (twice) with floss (once)

· Adequate fluoride supplementation if needed

· Wear mouth guard during sports

·

· Avoid/limit sugar drinks and snacks

· Teach child non-violent conflict resolution techniques

· If concerns at school, ask help from teacher or principal; discuss bullying

· Put family computer in easily seen place

· Monitor computer use install safety filter

· Discuss concerns about weight

· Encourage new opportunities, activities, helping out at home/in community

· Spend time with your child. Discuss changing responsibilities within family. Clearly communicate rules, expectations

· Get to know their friends

· Anticipate new adolescent behaviors, importance of peers

· Reinforce values; encourage discussion of thoughts/ feelings; appropriate anger management

· Provide person space at home

· Supervise activities with peers

· Answer questions about puberty/sexuality; counsel to avoid sexual activity; teach rules for how to be safe with adults

· Show interest in school performance, activates, and teach for extra help with concerns

· Create quiet space for homework

· Backseat is safest to ride; switch from booster to seat belt in rear seat when child is ready

· Use safety equipment

· Teach child to swim

· Wear hat/sunscreen

· Avoid sun from 11am-3pm

· Remove firearms; unload and lock them up; lock up ammunition in another location

· Seasonal influenza
Early Adolescence-11 to 14 Year Visits · Forms caring and supportive relationships with family members, other adults, and peers

· Engages in positive way with the life of the community

· Engages in behaviors that optimize wellness and contribute to a healthy lifestyle

· Demonstrates physical, cognitive, emotion, social, and moral competencies (including self-regulation)

· Exhibits compassion and empathy

· Exhibits resiliency when confronted with life stressors

· Uses independent decisions making skills (including problem-solving skills)

· Displays a sense of self-confidence, hopefulness, and well-being

· Ensure child is ready to learn healthy food choices such as breakfast, school foods, and snacks.

· Help child choose healthy eating, provide healthy foods, eat together as a family

· Eat breakfast

· Eat veggies/fruit

· Limit sugar drinks and snacks

· Eat when you’re hungry

· Stop when you’re satisfied

· Drink milk 3 or more times a day
be physically active often during the day

· Limit saturated fats and added sugars

· Regular visits of twice/year

· Daily brushing (twice) with floss (once)

· Adequate fluoride supplementation if needed

· Wear mouth guard during sports

· Avoid/limit sugar drinks and snacks

· Discuss depression

· Discuss tobacco, ETOH, and Drug avoidance/ peer pressure

· Discuss self-image and weight concerns

· Teach child nonviolent conflict resolution

· Discuss when to walk away

MN580 Anticipatory Guidance For Neonates To Adolescents Table

· Discuss when to talk with parents, teachers, trusted adult if being bullied

· When dating o in sexual situations, no means no

· Discuss internet safety

· Explain expectations about time with friends/dating

· Community agencies that can help you with your concerns about living situation

· Spend time with your family

· Help out at home, in the community, follow family rules

· Making and keeping friends is an important life skill

· Take responsibility for schoolwork; talk with parent/trusted adult about problems at school

· Pursue interests outside of school

· Get enough sleep

· Find ways to deal with stress

· Recognize hard times come and go; talk to parent or trusted adult

· Discuss suicidal ideation

· Get information about sexuality and sexual feelings

· Discuss physical changes (puberty, menstruation, sexual orientation, gender identity)

· Discuss pregnancy and STDs prevention

· Sexual pressures

· Know child’s friends and activities; clearly discuss rules, expectations

· Talk about relationships, sex, values,

· Encourage abstinence; provide opportunities for safe activities

· Wear hearing protection such as moderate earbud volume or earplugs with loud machinery)

· Wear seatbelts, helmet, protective gear, and life jackets

· Don’t ATV

· Wear hat/sunscreen

· Avoid sun 11am-3pm

· Don’t ride in car with someone under the influence

· Make plan for unsafe situations

· Lock up firearms

· Unload and lock up ammunition in another location

· Menactra #1

· Tdap

· HPV #1 (Only need 2 doses if started before age 15. Otherwise, needs 3 doses. Repeat second dose within 6-12mo)

· Seasonal influenza

Middle Adolescence-15 to 17 Year Visits · Forms caring and supportive relationships with family members, other adults, and peers

· Engages in a positive way with the life of the community

· Engages in behaviors that optimize wellness and contribute to a healthy lifestyle

· Demonstrates physical, cognitive, emotional, social, and moral competencies (including self-regulation)

· Exhibits compassion and empathy

· Exhibits resiliency when confronted with life stressors

· Uses independent decision making skills

· Displays a sense of self-confidence, hopefulness, and well-being

· Ensure child is ready to learn healthy food choices such as breakfast, school foods, and snacks.

· Help child choose healthy eating, provide healthy foods, eat together as a family

· Eat breakfast

· Eat veggies/fruit

· Limit sugar drinks and snacks

· Eat when you’re hungry

· Stop when you’re satisfied

· Drink milk 3 or more times a day
be physically active often during the day

· Limit saturated fats and added sugars

 

MN580 Anticipatory Guidance For Neonates To Adolescents Table

· Regular visits of twice/year

· Daily brushing (twice) with floss (once)

· Adequate fluoride supplementation if needed

· Wear mouth guard during sports

·

· Avoid/limit sugar drinks and snacks

· Discuss depression

· Discuss tobacco, ETOH, and Drug avoidance/ peer pressure

· Discuss self-image and weight concerns

· Teach child nonviolent conflict resolution

· Discuss when to walk away

· Discuss when to talk with parents, teachers, trusted adult if being bullied

· When dating o in sexual situations, no means no

· Discuss internet safety

· Explain expectations about time with friends/dating

· Community agencies that can help you with your concerns about living situation

· Spend time with your family

· Help out at home, in the community, follow family rules

· Making and keeping friends is an important life skill

· Take responsibility for schoolwork; talk with parent/trusted adult about problems at school

· Pursue interests outside of school

· Get enough sleep

· Find ways to deal with stress

· Recognize hard times come and go; talk to parent or trusted adult

· Discuss suicidal ideation

· Get information about sexuality and sexual feelings

· Discuss physical changes (puberty, menstruation, sexual orientation, gender identity)

· Discuss pregnancy and STDs prevention

· Sexual pressures

· Know child’s friends and activities; clearly discuss rules, expectations

· Talk about relationships, sex, values,

· Encourage abstinence; provide opportunities for safe activities

· Wear hearing protection such as moderate earbud volume or earplugs with loud machinery)

· Wear seatbelts, helmet, protective gear, and life jackets

· Don’t ATV

· Wear hat/sunscreen

· Avoid sun 11am-3pm

· Don’t ride in car with someone under the influence

· Make plan for unsafe situations

· Lock up firearms

· Unload and lock up ammunition in another location

· HPV #1 (Only need 2 doses if started before age 15. Otherwise, needs 3 doses. Repeat second dose within 6-12mo)

· Seasonal influenza

Late Adolescence-18 to 21 Year Visits · Forms caring and supportive relationships with family members, other adults, and peers

· Engages in a positive way with the life of the community

· Engages in behaviors that optimize wellness and contribute to a healthy lifestyle

· Demonstrates physical, cognitive, emotional, social, and moral competencies (including self-regulation)

· Exhibits compassion and empathy

· Exhibits resiliency when confronted with life stressors

· Uses independent decision making skills

· Displays a sense of self-confidence, hopefulness, and well-being

· Ensure child is ready to learn healthy food choices such as breakfast, school foods, and snacks.

· Help child choose healthy eating, provide healthy foods, eat together as a family

· Eat breakfast

· Eat veggies/fruit

· Limit sugar drinks and snacks

· Eat when you’re hungry

· Stop when you’re satisfied

· Drink milk 3 or more times a day
be physically active often during the day

· Limit saturated fats and added sugars

· Women: consume foods rich in folate; avoid alcohol/tobacco/drugs if considering pregnancy

· Limit refined grains and foods low in nutrients

· Drink water

· Regular visits of twice/year

· Daily brushing (twice) with floss (once)

· Adequate fluoride supplementation if needed

· Wear mouth guard during sports

·

· Avoid/limit sugar drinks and snacks

· Discuss depression

· Discuss tobacco, ETOH, and Drug avoidance/ peer pressure

· Discuss self-image and weight concerns

· Teach child nonviolent conflict resolution

· Discuss when to walk away

· Discuss when to talk with parents, teachers, trusted adult if being bullied

· When dating o in sexual situations, no means no

· Discuss internet safety

· Explain expectations about time with friends/dating

· Community agencies that can help you with your concerns about living situation

· Spend time with your family

· Help out at home, in the community, follow family rules

· Making and keeping friends is an important life skill

· Take responsibility for schoolwork; talk with parent/trusted adult about problems at school

· Pursue interests outside of school

· Get enough sleep

· Find ways to deal with stress

· Recognize hard times come and go; talk to parent or trusted adult

· Discuss suicidal ideation

· Get information about sexuality and sexual feelings

· Discuss physical changes (puberty, menstruation, sexual orientation, gender identity)

· Discuss pregnancy and STDs prevention

· Sexual pressures

· Know child’s friends and activities; clearly discuss rules, expectations

· Talk about relationships, sex, values,

· Encourage abstinence; provide opportunities for safe activities

· Wear hearing protection such as moderate earbud volume or earplugs with loud machinery)

· Wear seatbelts, helmet, protective gear, and life jackets

· Wear hat/sunscreen

· Avoid sun 11am-3pm

· Don’t ride in car with someone under the influence

· Make plan for unsafe situations

· Lock up firearms

· Unload and lock up ammunition in another location

· Take responsibilities for school, work obligations

· Discuss how to manage healthcare as an adult

· Ensure safe driving

· Seasonal influenza

 

References

 

Bright Futures. (n.d.). Infancy Visits. Retrieved from https://brightfutures.aap.org/Bright%20Futures%20Documents/BF4_InfancyVisits.pdf

Center for Disease Control and Prevention. (2019). Table 1. Recommended Child and Adolescent Immunization Schedule for ages 18 years or

younger, United States, 2019. Retrieved from https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html MN580 Anticipatory Guidance For Neonates To Adolescents Table

Colgate. (2019). Infant oral care. Retrieved from https://www.colgate.com/en-us/oral-health/life-stages/infant-oral-care/four-tips-for-great-infant-oral-care-0714

Hagan, J., Shaw, J. & Duncan, P. (2017). Bright futures : guidelines for health supervision of infants, children, and adolescents : pocket guide. Elk

Grove, IL: American Academy of Pediatrics.

MN580 Anticipatory Guidance For Neonates To Adolescents Table

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