Well Child Visits Flashcards

Question

Oral Health Screening

Answer 1

Referral to dentist at 12 months of age, then every 6 months after When a tooth erupts, child’s teeth should be brushed twice daily with plain water From 2-6 years old, brush teeth twice a day with a pea-sized amount of fluoride toothpaste

Answer 2

First tooth erupts by 6 months with 6 teeth present by the 1st year Delays in tooth eruption beyond 1 year require investigation Topical local anesthetics for teething have been associated with methemoglobinemia

Answer 3

Initial few days postpartum: mothers can attempt 10-15 mins per breast with each feed. The infant should take from both breasts at each feeding. Newborns should not go longer than 4 hrs between feedings. At 2 months of age, most infants will stop one of the middle of night feedings

Answer 4

Soy based formulas have high aluminum levels, do not recommend soy-protein formulas to infants weighting \< 1,800 grams For newborns: 2 ounces every 2 hrs At 2months: 4 ounces every 4 hrs At 6 months: \< 30 ounces a day Most babies can be weaned from bottle to cup at 9 months If there is a documented cows milk protein allergy, switch to hydrolyzed formula

Answer 5

Introduce solids prior to milk before a meal At 4-6 moths of age, infants can start with iron-fortified cereals, then strained vegetables, followed by meats and poultry products. Introduce only one new food at a time and observe for any adverse effects over the next week before adding another item. At 1 year old: Whole milk At 2 year old: 2% skim milk

Answer 6

Vitamin D supplementation 400 IU/day for exclusively and partially breastfed infants Cow milk should be used after 12 months of age Folate deficiency in infants fed with goat’s milk Vitamin B12 deficiency in breastfed infants whose mothers are strict vegetarians

Answer 7

Always recommend iron-fortified formulations if using formula Breastfed babies should begin daily supplementation of 1mg/kg of elemental iron at 4 months of age

Answer 8

No Fluoride supplementation to any child under 6 months of age

Answer 9

Newborns: 18 hours a day 6-15 month olds: 10-12 hours a night with 2 naps during the day 15 months: 1 nap per day By 3-4 months of age, infants can put themselves back to sleep, parents must put the child down drowsy and not yet asleep in their own cribs Stop middle of the night feedings at 6 months of age Encourage a regular daily sleep routine

Answer 10

occurs during REM sleep peak age of onset is 3-5 years old occurs several hours after onset of sleep

Answer 11

occurs during non REM sleep occurs in the first third of the night The child appears to be awake but is unresponsive and unaware of the parent’s presence, difficult to arouse, cries intensely, is diaphoretic, and appears disoriented. The child has no recollection of the episode the next morning Night terrors peak at 5-7 years old Parents should observe night terrors without awaking the child

Answer 12

occurs during stage 4 non REM sleep occurs in children between 4 and 8 years old Encourage parents to ensure the environment is safe, to observe the child and to gently lead the child back to bed

Answer 13

On average, 2 week old infant cries on average 2 hours a day 6 week old infants cries 3 hours a day 3 month old infants cry 1 hour a day Most crying occurs during the evening hours

Answer 14

Colic is excessive unexplained crying greater than 3 hours a day and more than 3 days a week for greater than 3 weeks 30-50% of children have colic, generally cries during the same time during the day, generally starts in the first week of life and goes away by 3 months of age Differential Diagnosis of Colic 1) Anomalous left coronary artery: poor feeder who cries excessively and becomes diaphoretic during feeds 2) Pseudoparalysis of a limb associated with congenital syphilis 3) Caffey disease: infantile cortical hyperostosis

Answer 15

Time out at 12 months of age until 5 years of age Length of time is 1 minute per year of age No discussion during time out After 5 years old, children understand loss of privileges

Answer 16

Infants to 2 year olds: Rear facing car seat 2 year old until school age: Front facing car seat School age children until 8 years old: booster seat 8 years old to 13 years old: back seat

Answer 17

Hot water heater temperature should be 120 degrees F or less