pediatrics
Health Supervision of the Well Child
Prevention
Preventive counseling is part of every well-child visit and covers a broad spectrum of topics, such as recommendations to have Prevention , injury prevention, nutritional and Recommendations for injury prevention vary by age. Some examples follow. For infants from birth to 6 months: Using a rear-facing car seat Reducing maximum home water temperature to<49°C (<120°F) Preventing falls Using sleeping precautions: Placing infants on their back, not sharing a bed, using a firm mattress, and not allowing stuffed animals, pillows, and blankets in the crib Avoiding foods and objects that children can aspirate For infants from 6 to 12 months: Continuing to use a rear-facing car seat Continuing to place infants on their back to sleep Not using baby walkers Using safety latches on cabinets Preventing falls from changing tables and around stairs Vigilantly supervising children when in bathtubs and while learning to walk For children aged 1 to 4 years: Using an age- and weight-appropriate car seat (infants and toddlers should use a rear-facing car seat until they exceed the rear-facing weight or height limits for their convertible child safety seat; most convertible car seats have limits that will allow children to ride rear-facing for ≥ 2 years) Reviewing automobile safety both as passenger and pedestrian Tying window cords Using safety caps and latches Installing outlet plug covers Preventing falls Removing handguns from the home For children≥5 years: All of the recommendations for children aged 1 to 4 years Using a bicycle helmet and protective sports gear Instructing children about safe street crossing Closely supervising swimming and sometimes requiring the use of life jackets during swimming Excessive caloric intake underlies the epidemic of Children . Recommendations for calorie intake vary by age; for children up to age 2 years, see As children grow older, parents can allow them some discretion in food choices, while keeping the diet within healthy parameters. Children should be guided away from frequent snacking and foods that are high in calories, salt, and sugar. Soda and excessive fruit juice consumption have been implicated as major contributors to obesity. Physical inactivity also underlies the epidemic of obesity in children, and the benefits of exercise in maintaining good physical and emotional health should induce parents to make sure their children develop good habits early in life. During infancy and early childhood, children should be allowed to roam and explore in a safe environment under close supervision. Outdoor play should be encouraged from infancy. As children grow older, play becomes more complex, often evolving to formal school-based athletics. Parents should set good examples and encourage both informal and formal play, always keeping safety issues in mind and promoting healthy attitudes about sportsmanship and competition. Participation in sports and activities as a family provides children with exercise and has important psychologic and developmental benefits. Screening of children before sports participation is recommended. Limits to screen time (for example, television, video games, cell phones and other handheld devices, and noneducational computer time), which is linked directly to inactivity and obesity, should start at birth and be maintained throughout adolescence. The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources. Bright Futures/American Academy of Pediatrics (AAP):Recommendations for Preventive Pediatric Health Care(2022): A resource providing links to the periodicity schedule, to the Bright Futures Guidelines (4th Edition), and to summary links of all updates to the schedule since 2017 Bright Futures/AAP:Periodicity schedule chart: Recommendations for preventive pediatric health care for infants through 21 years of age (2022) Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 4th Edition Centers for Disease Control and Prevention (CDC):Recommended child and adolescent immunization schedule for ages 18 years or younger, United States, 2023 Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F) AAP:Media and children communication toolkit 