- Length/Height and Weight
- Head Circumference
- Blood Pressure (if risk factors)
- Psychosocial/Behavioral Assessment: Parent Screening Questionnaire (SEEK)
- Developmental Surveillance: DENVER
- Discuss With Parents
- Giving their child opportunities to develop eating skills (chewing, swallowing) by offering a variety of healthy foods and feeding at a family table.
- Serving beverages in a cup. (Children may need help drinking from a cup.)
- Offering their child food every 2 to 3 hours. (Children’s capacity to eat at any one time is limited.)
- Handling their child’s limit-testing behaviors (asking for certain foods and throwing tantrums when refused).
- Imposing limits on their child’s unacceptable mealtime behaviors without controlling the amount or types of foods the child eats.
- Discouraging television viewing and encouraging interactive activities (talking, playing, singing, and reading together).
- Diphtheria may cause a sore throat, suffocation, paralysis, heart failure, coma and even death. Before the vaccine, diphtheria caused more than 15,000 deaths in children each year.
- Tetanus causes severe muscle spasms (including the mouth and jaw), breathing problems, severe heart damage, lung infections, coma and death.
- Pertussis causes “Whooping Cough.” It may lead to severe coughing, pneumonia, seizures, brain damage, and death. Pre-vaccine, over 200,000 cases and up to 9,000 deaths were reported each year.
- Measles (rubeola) causes runny nose, cough, conjunctivitis, rash, pneumonia, ear infections, brain damage, seizures and death. It is estimated that if the measles vaccine were stopped, approximately 2.7 million people would die worldwide.
- Mumps causes swollen glands, headaches, deafness, brain damage, meningitis, swelling of the testicles and sterility in males.
- Rubella (German Measles) causes fever, rash, swollen glands, birth defects such as deafness, blindness, mental retardation and heart defects, and can cause miscarriage and premature birth in pregnant women. Prior to this vaccine rubella affected over 20,000 newborns over half of which were deaf and with many suffering from blindness and mental retardation
- The first priority is to attend to the concerns of the parents. In addition, the Bright Futures Early
- Childhood Expert Panel has given priority to the following topics for discussion in this visit:
- Social determinants of health: Risks (living situation and food security; tobacco, alcohol, and drugs), strengths and protective factors (social connections with family, friends, child care and home visitation program staff, and others)
- Community agencies can help you with concerns about your living situation.
- Programs like WIC and SNAP are available to help you if you have concerns about your food situation.
- Don’t use tobacco/e-cigarettes/alcohol/drugs. Call 800-QUIT-NOW (800-784-8669) for help to quit smoking.
- Discuss with your caregiver your child’s medical needs, your feelings about diet/discipline/oral health/physical activity/media use.
- Maintain ties with friends, community.
- Establishing routines: Adjustment to the child’s developmental changes and behavior; family time; bedtime, naptime, and teeth brushing; media
- 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; follow nightly bedtime routine with quiet time, reading, singing, favorite toy.
- Establish teeth-brushing routine.
- Avoid TV and other digital media with toddler; consider making a family media use plan (healthychildren.org/MediaUsePlan).
- Feeding and appetite changes: Self-feeding, continued breastfeeding and transition to family meals, nutritious foods
- Encourage self-feeding; avoid small, hard foods.
- Provide healthy food and snacks; be sure caregivers do the same.
- Feed 3 meals and 2 to 3 snacks a day. Toddlers tend to graze. Trust child to decide how much to eat.
- Establishing a dental home: First dental checkup and dental hygiene
- Visit the dentist by the time child is 12 months 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.
- Safety: Car safety seats, falls, drowning prevention and water safety, sun protection, pets, safe home environment: poisoning
- Use rear-facing car safety seat until child is highest weight or height allowed by manufacturer; make necessary changes when switching seat to forward facing; never place vehicle safety seat in front seat of car with passenger air bag; backseat safest.
- Use stair gates; keep furniture away from windows; install window guards.
- Stay within an arm’s reach when near water (“touch supervision”); empty buckets, pools, bathtubs immediately after use.
- Use hat/sun protection clothing, sunscreen; avoid prolonged exposure when sun is strongest, between 11:00 am and 3:00 pm.
- Keep child away from pet feeding area; monitor interactions between child and pet.
- Remove/lock up poisons/toxic household
- products; keep Poison Help number (800-222-1222) at each telephone, including cell.
Immunization (Dtap, Hib, PCV13, MMR, VZV, Hep A, Flu)
DTaP (Diphtheria, Tetanus, Pertussis): This vaccine works to prevent three infections.
Hib (Haemophilus Influenzae type b): This infection may lead to breathing problems, meningitis, blindness, brain damage, paralysis, hearing loss and death. Before the vaccine, Hib meningitis killed 600 children each year and left many other children with deafness, seizures and mental retardation.
Prevnar (Pneumococcus):This infection leads to ear infections, sinus infections, pneumonia, meningitis, sepsis (infection of the blood) and brain damage.
MMR (Measles, Mumps, Rubella): This vaccine works to prevent three infections.
Varicella (Chicken Pox): This causes an itchy rash with many sores and may lead to lung damage, brain damage and death. Prior to this vaccine approximately 4 million people got chickenpox, causing 11,000 hospitalizations and 100 deaths each year.
Hepatitis A: This infection causes loss of appetite, nausea, vomiting, stomach pain, jaundice (yellow skin and eyes), bleeding problems, fever and headaches. It may cause prolonged weakness and serious illness in individuals already suffering from liver disease.
Influenza: This infection causes high fever, chills, severe muscle aches, headaches, pneumonia, swelling of the brain and death. There are still thousands of deaths every year in the U.S. from influenza related complications
Lead testing, Anemia, Tuberculosis