Anticipatory guidance for neonates to adolescents table
| Age Group | Physical Development and Mental Health | Nutrition and Physical Activity | Oral Health | Safety Concerns |
Immunizations
|
| Infancy- Newborn Visit | Sleeps most of the time.
Does not glance at the guardian or parent if awake. Becomes calm when held by a parent or when talked to by a parent. No response to visual or audio stimulus. Expresses pain, hunger, and other discomforts through crying and moving of limbs. Inclined to holding other people’s fingers. |
Grasping or holding other people’s hands, especially fingers.
Head movements. Should feed on breast milk only, no cow milk. Feed 10-12 times a day
|
N/A | When traveling, a baby should always be in a safety belt and should be put in the front seat.
The baby’s bed should not have toys, especially while the baby is sleeping. It’s advisable that the baby sleeps in a crib.
|
Hepatitis B. |
| Infancy-First Week Visit | If experiences discomfort, the baby cries.
Displays respond to visual as well as audio stimulus Shows reflex to stimulus. Calms when held or after hearing parent’s voices. Most times holds a fist. |
Exclusive breastfeeding.
The best feeding formula is the iron-fortifies formula. Develops a feeding pattern. Continuous increase in weight. Feeds only on breastmilk/ no cow milk or other fluids. Baby can be given vitamin D from sunlight. Mothers need a balanced diet to gain more milk for breastfeeding. |
After feeding, the mother can clean the baby’s gums by rubbing a cloth on a finger. | Baby should be carried in the rear seat of the car and always in a safety belt.
House should be safe for baby, sleep under a mosquito net No toys on baby’s crib. The feeding bottle should be cleaned after use. |
Hepatitis B/ Influenza |
| Infancy-1 Month Visit | Observes the parent and is likely to follow them using the eyes
It is likely to display comforting features like smiling at a parent, putting a hand on the mouth, moving hands, and limbs in excitement, etc. Displays boredom by becoming fussy. Responds to parents’ voices by calming down. Response to stimulus. Is alert. Cries to display discomfort. |
Moves both limbs. Increased weight gain has a defined feeding pattern.
Feed breast milk only, can give vitamin D, use the iron-fortified formula, feed after every 3 hours for about eight times a day. |
Clean gums after bread feeding. | Baby to continue using a baby crib.
Use a safety belt while traveling. Baby should not be left alone for long periods. No toys on a baby crib. |
Hepatitis B. |
| Infancy-2 Month Visit | The baby smiles in response.
Makes soft sounds. Makes occasional sounds. |
Handheld to form fists.
Has a defined feeding pattern continues to ain weight. Can poop 3=4 times a day. Ensure baby burps after feeding. Feed baby with breastmilk only and could also add vitamin D.Feed baby frequently, about eight months a day. The mother should continue with iron formula. |
Clean baby’s gums after feeding using a soft wet cloth. | No toys on baby’s crib.
Baby should always be in a safety belt using the rear back seat. Baby should not be left without proper care for long. Baby should not be exposed to pets |
HIB
Hepatitis B Dtap Rotavirus Poliovirus Pneumonia vaccine |
| Infancy-4 Month Visit | Baby can smile and even laugh
Response to stimulus both audio and visual Makes coo voices Stares and parent or guardian. |
Can rollover
Opens hands can play with fingers. Holds objects and parents’ clothes and hands. Continue to breastfeed/no cow milk. No solid food. Continue with the iron-fortified formula. Can give baby vitamin D. |
Clean the baby’s mouth after feeing. | The parent should play and talk to the baby. Play should be active, avoid TVs.
Baby’s environment should b safe for them to explore. When traveling, always use safety belts and safety seats. Bedding should be loose and soft. Baby should sleep in cribs. Baby should never be left alone without supervision.
|
RV
IPV PVC13 DTaP |
| Infancy-6 Month Visit | Baby smiles in response. Smiles when they see themselves in the mirror. Baby starts to make sounds as if to talk.
Is responsive when called. Will look or smile. |
Can roll on the stomach.
Is able to sit for a short period without being supported. Can move an object from one hand to another. Can shake objects or bang them softly on surfaces. Continue to breastfeed. Introduce solid food. Small bites at a time. Feed baby with food rich in iron. Vitamin D and iron supplements.
Baby shows a response to hunger.
|
Clean the baby’s mouth after feeding using a small amount of toothpaste.
No sharing of spoons with the baby. |
Interact with the baby through talking, singing, and play.
Form a regular feeding habit. The baby should be in a safety belt and safety seat while traveling. The baby’s environment should be safe for exploring. Baby should not be left unsupervised. Keep hot drinks/food away from the baby. |
DTap
RV Hepatitis B PVC13 IPV HIB Influenza. |
| Infancy-9 Month Visit | Baby starts to make certain gestures.
Waving hands, The baby responds when called. Consistently picks up dropped objects. Baby picks up sounds he hears from parents. |
Baby can sit without support.
Baby tries to stand. Baby starts to crawl. Picks ups objects to eat can bang them with ease. Breastfeeding, increase solid foods. Introduce foods of different types and textures. Feed at least 3 meals a day. Mostly use a cup. |
Clean the baby’s mouth.
Prevent baby from putting objects in their mouth. |
Establish a defined feeding pattern.
Play and interact with the baby. Toys can be used. Baby should not be left unsupervised. The baby’s environment should be safe for exploring. Hot foods or heavy objects should be kept off the baby’s environment. |
Hepatitis B.
IPV. |
| Early Childhood-12 Month Visit | Picks up new gestures.
Baby can make a few words, such as mama. Picks up objects from the environment. |
Makes their first steps
Can stand without support. Feed baby thrice a day. Feed fresh and healthy foods. Picks up material or food and puts in mouth. |
Clean the baby’s mouth after feeding.
Baby can use a bottle for fluids such as water. Prevent them from putting objects into the mouth. |
Start to discipline a child.
Make time to interact with the baby. Good behavior should be praised. Don’t leave baby unsupervised. The environment should be safe to avoid being knocked over. Baby should nap at least one time a day. Avoid leaving buckets or basins with water. Baby should be in safety belts and safety seats while traveling.
|
IPV
Hepatitis B MMR Hepatitis A. Hib |
| Early Childhood-15 Month Visit | Baby can drink from a cup.
Points when asking to be given something. Baby mumbles Can follow direction |
Bay can walk consistently but crawls after few steps.
Baby can walk fast. Baby can make squats. |
Brush baby’s little teeth with a soft brush.
Avoid sharing cups or plates with the baby. |
Establish sleeping and feeding patterns.
Praise baby when she accomplishes something. Discipline baby lightly. Safety belt/safety seat. Caution baby against bad behavior. Avoid harmful objects in the baby’s environment. |
DTaP
HiB PVC Hepatitis A |
| Early Childhood-18 Month Visit | Socializes with other children in play.
Helps in dressing and undressing. Knows when doing something wrong. Can say a couple of words. Can scoop using a spoon. |
Can sit in small chairs. Can carry a toil while walking.
Can throw an object to a small distance. Feed using a variety of foods. Give oz milk. Give small portions of juice. |
Brush baby’s teeth daily.
Avoid sharing of utensils. |
Interact with the baby.
Read books to baby. Talk, sing to the baby. Implement discipline to the child. Help the child learn about feelings, pain, etc. Can pull out pants when they get nature calls. Introduce electronic entertainment. Baby should be in a safety belt and safety seat always. |
Hepatitis A
DTaP IPV |
| Early Childhood-2 Year Visit | Socializes with other children in play. Can pull out some clothes.
Can make short sentences. Can use a spoon, |
Can walk or run.
Can build stacks. Can make small jumps. Lift and throw objects. |
Brushing of teeth.
Can visit a dentist. |
Implement discipline.
Encourage the baby to speak. Interact and play with baby. Can begin toilet training. Safety seat/safety belt. Supervise baby. Avoid the hot sun. Make the environment safe for baby to play in |
Seasonal influenza. |
| Early Childhood-2.5 Year Visit | Baby can use the potty. Can wash hands.
Can speak a few words well enough. |
Walk and run without falling.
Can hold a pen using hands. |
Brushing teeth, dental checkups. | Mingle with a child.
Take a child to tours like zoos. Read with a baby. Encourage play with other kids. Consider preschool: safety belt and safety seat. Encourage the use of a toilet. Teach how to dress up. Safe environments for a child. |
Seasonal influenza. |
| Early Childhood-3 Year Visit | Can use the toilet by themselves.
Can feed themselves. Can speak more words well enough. Words are understandable Plys with other kids. |
Can climb on things.
Can make jumps, Can draw some shapes such as a circle. Feed healthy foods with vitamins Feed with milk. |
Brush teeth. | Make the environment safe for the baby.
Encourage play with other kids.e Encourage talking, singing, and playing. Use of safety belt and seat. Don’t leave baby unsupervised. Ensure safe environments for a child. Ensure discipline. |
Seasonal influenza |
| Early Childhood-4 Year Visit | Uses the toilet by themselves
Brushes teeth Dresses and undresses themselves Can respond to questions. Speaks eloquently can draw pictures |
Can skip, jump, and draw simple shapes of a human being.
Can hold a pen or pencil using thumb and fingers. Feed with milk, water, and balanced diet foods. Can feed what the adults are feeding on. |
Brushing off teeth. | Read bedtime stories.
Interact with the child. Encourage socializing with adults and children. Don’t leave a child unsupervised. Encourage talk. Ensure discipline. Praise when in good behavior. Ensure safe environments. |
Dtap
IPV MMR Seasonal influenza. |
| Middle Childhood-5 and 6 Year Visits | Able to tie shoes
Can count up to 10, a-z Dresses up by themselves Can make defined shapes. Fluent speech. |
Can jump, hop, skip, run without struggle.
Avoid too much sugar and junk foods. Feed in balanced diet. Give calcium, iron, itamin D, fruits, vegetables, milk, etc. |
Brushing of teeth.
Check for weak teeth. Encourage dentist check-ups. |
Safety belt while traveling
Monitor habits, interactions. Encourage socializing. Teach children safety measures, eg, while crossing the streets. Teach child fun activities, eg., swimming, riding a bike. Teach a child about protecting their private parts from other people. |
Dtap
IPV MMR Seasonal influenza. |
| Middle Childhood-7 and 8 Year Visits | Socializes with others freely.
Interacts with family, forms healthy relationships with other child and adults |
Balanced diet, eat fruits, vegetable minerals, and vitamin-rich foods, avoid sugar and junk, give milk. | Brush teeth, avoid sugary foods. | Use of safety belts
Spend time with a child. Listen to their school experiences. Ensure discipline. Teach the child about rules. Follow up on school work. Teach safe practices Monitor interactions with other people and pets. |
Seasonal influenza |
| Middle Childhood-9 and 10 Year Visits | Socializes with others freely.
Interacts with family form healthy relationships with other children and adults. Makes personal decisions. Displays levels of self-confidence. |
A balanced diet, eat fruits, vegetable minerals, and vitamin-rich foods, avoid sugar and junk, give milk. | Brush teeth, avoid sugary foods. | Use of safety belts
Spend time with the child. Listen to their school experiences. Ensure discipline. Teach the child about rules. Follow up on school work. Teach safe practices Monitor interactions with other people and pets. Monitor the use of electronics. Set rules and consequences. Follow up on homework |
Seasonal influenza |
| Early Adolescence-11 to 14 Year Visits | Socializes with others freely.
Interacts with family form healthy relationships with other children and adults. Makes personal decisions. Displays levels of self-confidence. Shows self-regulation |
A balanced diet, eat fruits, vegetable minerals, and vitamin-rich foods, avoid sugar and junk, give milk. Ensure the child is physically active. | Brush teeth, avoid sugary foods. | Use of safety belts
Spend time with the child. Listen to their school experiences. Ensure discipline. Teach a child about rules. Follow up on school work. Teach safe practices Teach about drugs Teach about adolescence Monitor internet usage. Monitor the use of electronics. Teach about responsibility. Follow up on schoolwork and assignment. Monitor social behavior and interaction. |
Menactra
HPV |
| Middle Adolescence-15 to 17 Year Visits | Socializes with others freely.
Interacts with family, forms healthy relationships with other peers and adults. Makes personal decisions. Displays levels of self-confidence. Shows self-regulation Practices a healthy lifestyle. Shows compassion/empathy. |
A balanced diet, eat fruits, vegetable minerals, and vitamin-rich foods, avoid sugar and junk, give milk. Ensure the child is physically active. | Brushes teeth, dentist checkups | Use of safety belts
Spend time with the child. Listen to their school experiences. Ensure discipline. Teach a child about rules. Follow up on school work. Teach safe practices Teach about drugs Teach about adolescence Monitor internet usage. Monitor the use of electronics. Teach about responsibility. Follow up on schoolwork and assignment. Monitor social behavior and interaction. Teach about sexuality Teach about physical features and changes associated with adolescence. Teach about love relationships. |
Seasonal influenza |
| Late Adolescence-18 to 21 Year Visits | others freely.
Interacts with family, forms healthy relationships with other peers and adults. Makes personal decisions. Displays levels of self-confidence. Shows self-regulation Practices a healthy lifestyle. Shows compassion/empathy. |
A balanced diet, eat fruits, vegetable minerals, and vitamin-rich foods, avoid sugar and junk, give milk. Ensure the child is physically active. | Brushes teeth, dentist checkups, use of food supplements if need be. | Use of safety belts
Spend time with the child. Listen to their school experiences. Ensure discipline. Teach the child about rules. Follow up on school work. Teach safe practices Teach about drugs Teach about adolescence Monitor internet usage. Monitor the use of electronics. Teach about responsibility. Follow up on schoolwork and assignment. Monitor social behavior and interaction. Teach about sexuality Teach about physical features and changes associated with adolescence. Teach about love relationships. Discuss STIs and pregnancies Teach on safe driving. Teach on drugs and drug addiction. |
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
Chatterjee, A. (2013). Vaccinophobia and Vaccine Controversies of the 21st Century. New York, NY: Springer New York
Friebert, S. E., Levetown, M., & Carter, B. S. (2011). Palliative care for infants, children, and adolescents: A practical handbook. Baltimore: Johns Hopkins University Press.
Grove, IL: American Academy of Pediatrics.
Hagan, J., Shaw, J. & Duncan, P. (2017). Bright futures: guidelines for health supervision of infants, children, and adolescents: a pocket guide. Elk