Wright: Pediatric Well Visits

Question 1

When do we start using BMI instead of weight for length?

Answer 1

2 yo

Question 2

What are some supplements that pediatricians recommend for infants?

Answer 2

Vit D

Fluoride (begin at 6 months)

Question 3

What is the first vaccine babies receive in the hospital?

Answer 3

Hep B

Question 4

When to start giving solid foods?

Answer 4

6 months

Question 5

At 1-2 yo, what type of milk should kids be drinking?

Answer 5

whole milk!

Question 6

What is the ideal number of hours of sleep kids should be getting?

Answer 6

11 hours/night

Question 7

If a kid comes in complaining of ADHD, what should you consider?

Answer 7

sleep apnea –> sleep disturbances –> daytime sleepiness –> unable to concentrate

Question 8

What are some things to think about at 2 week well check?

Answer 8

Regain birth weight (5-7 ounces per week)
GERD
Recheck neonatal screening labs
6 week old hip U/S if +Fam hx/breech female

Question 9

Think about some things that should come up at 2 week well visits?

Answer 9

Tummy time
Plan for return to school/work
Pumping/storing breast milk
No propping bottles!
Formula or BM only
Never leave baby alone in the tub.
Keep away from elevated surfaces
Car seat safety
Check hips
Smiles/different types of crying, holds head up, pushes up when prone (gross motor)
Eye exam:  cover test
Exclusive breast feeding:  Vitamin D
1st set of Immunizations

Question 10

What kinds of things should you be looking for at 4 mo well visit?

Answer 10

Smiles spontaneously, self-consolation, babbles, rolling over, lifts head/chest, reaches for toys & brings to mouth, no head lag when pulled to sitting, laughs
Quiet and active playtime
Hip time/check folds
Injury prevention
Teething

Question 11

What are some things to think about at 6mo of age?

Answer 11

Socially interactive with parent, recognizes familiar faces, knows name, visual/oral exploration, sits with support/stands and bounces, may crawl, transfers objects hand to hand, pincer grasp (fine motor)
Start use of high chair/upright seat. DO NOT use a walker.
Reciprocal play
May introduce solids at 6 months
Start cereal, baby foods stage 1. Spoon ONLY (not in a bottle)
One new food per week. Finger foods should be soft. No citric acid products, no whole milk, avoid nuts
Review choking hazards
Solids do not replace breast milk/formula needs.
Begin cup use. Limit juice. May now have water.
Assess for fluoride, clean teeth with wet washcloth or finger brush

Question 12

9 months

Answer 12

Stranger Danger, separation anxiety, responds to name, waves bye-bye, mama/dada babble, points to objects, interactive games (peek-a-boo, pat-a-cake), exploring environment: crawling/cruising, pulls self up
Use consistent, positive discipline (limit use of the word “no”)
Strangulation/fall risks (stairs, gates, cords from drapes/blinds)
Play with cause-and-effect toys
3 meals, 2 -3 snacks daily, decrease BM/formula
Encourage use of cup
*Put Poison Control number at each telephone