Well Child Visits

Congratulations! Your baby is finally here. 

Health Supervision

• Development: periods of being awake are good for socialization, motor skills, listening skills and interaction with you are part of the bonding process.

• What is your interaction with the baby? How do you feel? If you are feeling sad or blue, please talk to someone. A few days of the “baby blues” are normal, but should level out. Both parents can feel overwhelmed by the caring for this new human.

• If there are other children in the household, don’t forget to spend some one-on-one time with them.

Physical Exam

• Measure, plot the length, weight, head circumference. This will help us track your  baby’s growth and physical development.

• The complete physical exam will be performed by your child’s provider to assess characteristics of the newborn. Ask your provider what he/she is looking for or any concerns you have.

• Screenings: Review hearing results from the hospital, Newborn screen as needed. 

Immunizations

• Discussion of hepatitis B, if given in hospital and if not, can give at office visit.

• Discussion of the RSV immunization to prevent this respiratory illness. Talk to your healthcare provider.

Safety

• Use of car seat. Is it properly installed? Rear facing carseat in back seat only.

• Never leave the baby without supervision in the car, on the bed or anywhere near water.

• BACK TO SLEEP is the motto of all of the healthcare providers at St. Rose Pediatrics.

Feeding

• We recommend breast milk or formula (your choice) to provide the nourishment for your baby. We support breast feeding but also realize there are circumstances where formula is acceptable nourishment. 

• If breast feeding, most babies are fed on demand. Every 2-3 hours is usually sufficient with 5-10 minutes on both sides/sometimes only one side.  The best way to know if baby is getting sufficient amount is to (1) watch baby’s growth/weight and/or (2) if the baby has 6-8 diapers/day he or she is getting sufficient food. Watch for food intolerences in your diet that affects baby. Ask your healthcare provider if there are concerns.

• If bottle feeding or using formula, make sure you are mixing the formula correctly! Prepared formula can be offered as 2-3 ounces every 2-3  hours in the beginning with burping. Can offer more if still hungry.

• WIC and breast feeding specialists can be of help to you if needed. We can also help you navigate the feeding concerns.

• Never prop a bottle for your baby. Holding the baby during this special time gives you a great bonding opportunity.

Social

• Please do not smoke near the baby. If there is a smoker in the home, have him/her change shirts, wash hands prior to handling the baby after smoking.

• Never hit or shake the baby. If you feel yourself needing a break, it’s okay to lay the baby in a safe crib to avoid hurting the baby. Then call a trusted friend/family member for assistance or if you need help, call 911.

• Create an emergency-preparedness plan.

• Wash hands often and avoid crowds with baby. Baby’s immune system is not prepared for the influx of germs in our world.

NEXT VISIT IS AT 2 WEEKS.

We do a lot at this visit, including:

• Check your baby’s weight.
• Monitor for signs of jaundice.
• Check to see how your baby is feeding.
• Answer questions about your new baby.

Immunizations: 

• HepB#1 (if not given in hospital)

Tests/Screens/Assessments:

• Follow-up on Newborn Metabolic Screen done in hospital

Helpful Info: 

• Caring for Your Newborn

Health Supervision

• Development: periods of being awake are good for socialization, motor skills, listening skills and interaction with you are part of the bonding process.

• You should be developing a little bit of a schedule for you and your household. Don’t fret! Sleep when baby sleeps and eat well, drink water and enjoy this time the best you can.

• What is your interaction with the baby? How do you feel? If you are feeling sad or blue, please talk to someone. A few days of the “baby blues” are normal, but should not be continuing. Both parents can feel overwhelmed by the caring for this new human. Share these feelings with each other. We can refer you if needed for professional help.

• If there are other children in the household, don’t forget to spend some one-on-one time with them.

Physical Exam

• Measure, plot the length, weight, head circumference. This will help us track your baby’s growth and physical development.

• The complete physical exam will be performed by your child’s provider to assess characteristics of the newborn. Ask your provider what he/she is looking for or any concerns you have.

• Screenings: Newborn screen #2. Bring form from hospital.

Immunizations

• Discussion of hepatitis B, if given in hospital and if not, can give at office visit.

• Discussion of the RSV immunization to prevent this respiratory illness. Talk to your healthcare provider.

Safety

• Use of car seat. Is it properly installed? Rear facing carseat in back seat only.

• Never leave the baby without supervision in the car, on the bed or anywhere near water.

• BACK TO SLEEP is the motto of all of the healthcare providers at St. Rose Pediatrics.

Feeding

• We recommend breast milk or formula (your choice) to provide the nourishment for your baby. We support breast feeding but also realize there are circumstances where formula is acceptable nourishment. 

• If breast feeding, most babies are fed on demand. Every 2-3 hours is usually sufficient with 5-10 minutes on both sides/sometimes only one side.  The best way to know if baby is getting sufficient amount is to (1) watch baby’s growth/weight and/or (2) if the baby has 6-8 diapers/day he or she is getting sufficient food. Watch for food intolerances in your diet that affects baby. Ask your healthcare provider if there are concerns.

• If bottle feeding or using formula, make sure you are mixing the formula correctly! Prepared formula can be offered as 2-3 ounces every 2-3  hours in the beginning with burping. Can offer more if still hungry.

• Never prop a bottle for your baby. Holding the baby during this special time gives you a great bonding opportunity.

Social

• Please do not smoke near the baby. If there is a smoker in the home, have him/her change shirts, wash hands prior to handling the baby after smoking.

• Never hit or shake the baby. If you feel yourself needing a break, it’s okay to lay the baby in a safe crib to avoid hurting the baby. Then call a trusted friend/family member for assistance or if you need help, call 911.

• Create an emergency-preparedness plan.

• Wash hands often and avoid crowds with baby. Baby’s immune system is not prepared for the influx of germs in our world.

NEXT VISIT IS AT 1 MONTH

We do a lot at this visit, including:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Remind you to give your baby a daily supplement of 400 IU of vitamin D drops if you are breastfeeding.

Immunizations:  

• None

Tests/Screens/Assessments: 

• None

Helpful Info: 

• Back to Sleep, Tummy to Play

Health Supervision

• Development: periods of being awake are good for socialization, motor skills, listening skills and interaction with you are part of the bonding process.

• Social language: follows you with eyes, lots of hands to mouth for self-comforting, loves to be held. Will briefly look at objects.

• Gross motor skills: moves arms and legs together and individually. 

• Fine motor skills: will open hands briefly at rest

Physical Exam

• Measure, plot the length, weight, head circumference. This will help us track your baby’s growth and physical development.

• The complete physical exam will be performed by your child’s provider to assess characteristics of the newborn. Ask your provider what he/she is looking for or any concerns you have.

• Screenings: Maternal depression screening is given.

Immunizations

• No immunizations due at the 1 month visit. Can catch up Hepatitis B if desired.

• Discussion of the RSV immunization to prevent this respiratory illness. Talk to your healthcare provider.

Safety

• Use of car seat. Is it properly installed? Rear facing carseat in back seat only.

• Learn infant CPR/first aid. Know emergency numbers. Make your emergency plan.

• Never leave the baby without supervision in the car, on the bed or anywhere near water.

• BACK TO SLEEP is the motto of all of the healthcare providers at St. Rose Pediatrics.

• Safety in the home: pesticides used? Firearms or weapons secured? Alcohol or drugs used in the home?

• Please don’t smoke around the baby. Inhaling the carcinogens that escape through smoking can be harmful for a small baby’s developing lungs.

Feeding

• We recommend breast milk or formula (your choice) to provide the nourishment for your baby. We support breast feeding but also realize there are circumstances where formula is acceptable nourishment. 

• If breast feeding, most babies are fed on demand. Every 2-3 hours is usually sufficient with 5-10 minutes on both sides/sometimes only one side.  The best way to know if baby is getting sufficient amount is to (1) watch baby’s growth/weight and/or (2) if the baby has 6-8 diapers/day he or she is getting sufficient food. Watch for food intolerances in your diet that affects baby. Ask your healthcare provider if there are concerns.

• If bottle feeding or using formula, make sure you are mixing the formula correctly! Prepared formula can be offered as 2-3 ounces every 2-3  hours in the beginning with burping. Can offer more if still hungry.

• Never prop a bottle for your baby. Holding the baby during this special time gives you a great bonding opportunity.

Social

• Infant behavior and development: More periods of wakefulness. Great time to interact. If baby is fussy, consider pacifier. Don’t overfeed during times of fussiness. Soothing, calming motions can help.

• Never hit or shake the baby. If you feel yourself needing a break, it’s okay to lay the baby in a safe crib to avoid hurting the baby. Then call a trusted friend/family member for assistance or if you need help, call 911.

• Tummy time is important in the physical development of baby. 5-10 minutes a few times/day at first.

• Wash hands often and avoid crowds with baby. Baby’s immune system is not prepared for the influx of germs in our world.

NEXT VISIT IS AT 2 MONTHS.

Immunizations: 

• None

Tests/Screens/Assessments: 

• Post Partum Depression Assessment, TB Surveillance

Helpful Info: 

• Back to Sleep, Tummy to Play

Health Supervision

• Social language: smile responsively. Makes sounds to show upset or happiness like cooing sounds

• Gross motor skills: Lifts head to look around during tummy time. Keeps head steady in sitting position

• Fine motor skills: will open  and close hands and bring them together.

Physical Exam

• Measure, plot the length, weight, head circumference. This will help us track your baby’s growth and physical development.

• The complete physical exam will be performed by your child’s provider to assess characteristics of the newborn. Ask your provider what he/she is looking for or any concerns you have.

• Screenings: Maternal depression screening can be given during this visit,

Immunizations

• First set of immunizations are given during this visit: DTAP/IPV/HEP B; HIB, PCV and oral Rotavirus. Let your SRP explain the need and use of the immunizations.

• Discussion of the RSV immunization to prevent this respiratory illness. Talk to your healthcare provider.

Safety

• Use of car seat. Is it properly installed? Rear facing carseat in back seat only.

• Learn infant CPR/first aid. Know emergency numbers. Make your emergency plan.

• Never leave the baby without supervision in the car, on the bed or anywhere near water.

• BACK TO SLEEP is the motto of all of the healthcare providers at St. Rose Pediatrics.

• Keep home and car smoke-free.

Feeding

• Breast or bottle-formula only for first 4-6 months of life. Baby sill now start to let you know when he/she is hungry but sucking, rooting, putting hands to mouth and making noise to get your attention.

• Make sure to adequately clean and dry bottles/nipples.

• Never prop a bottle for your baby. Holding the baby during this special time gives you a great bonding opportunity.

• For breast feeding moms, continue pre-natal vitamins, good nutrition and increased water for good milk production.

Social 

• Continue to blend your family time including baby and any other siblings or family members.

• Take time as a couple. 

• Choose quality child care if needed. Discuss working outside the home and how you feel about leaving your baby with someone else.

• Tummy time is still very important. Baby may start reaching for toys during tummy time. Encourage this.

• Wash hands often and avoid crowds with baby. Baby’s immune system is not prepared for the influx of germs in our world.

NEXT VISIT IS AT 4 MONTHS.

We do a lot at this visit, including:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Provide your baby’s first set of immunizations. Immunizations are safe, effective and keep your child and our community healthy. During this visit, you will be able to discuss any questions you may have about immunizations.
• Screen for post-partum depression.

Immunizations: 

 (DTaP, HIB, IPV), Prevnar#1, Rotavirus#1, HepB#2

Tests/Screens/Assessments: 

• Post Partum Depression Assessment

Helpful Info: 

• Crying and Your Baby: How to Calm a Fussy or Colicky Baby

Health Supervision

• Social language: Laughs out loud. Looks to parent/caregiver when upset Makes many noises

• Gross motor skills: Supports self on elbows/wrists when on stomach, rolls from stomach to back

• Fine motor skills: Keeps hands open, grasps objects that he/she sees.

Physical Exam

• Measure, plot the length, weight, head circumference. This will help us track your baby’s growth and physical development.

• The complete physical exam will be performed by your child’s provider to assess characteristics of the newborn. Ask your provider what he/she is looking for or any concerns you have.

• Screenings: Maternal depression screening can be given during this visit,

• Oral health: Make sure to keep all toys, pacifiers clean. Clean new teeth twice a day with soft cloth or baby toothbrush but no toothpaste needed.

Immunizations

• Second  set of immunizations are given during this visit or 60 days from previous immunizaitons: DTAP/IPV/HEP B; HIB, PCV and oral Rotavirus. Let your SRP explain the need and use of the immunizations.

• Discussion of the RSV immunization to prevent this respiratory illness. Talk to your healthcare provider.

Safety

• Use of car seat. Is it properly installed? Rear facing carseat in back seat only.

• Keep small objects and plastic bags away from baby. Don’t cook while holding baby to avoid burns

• Never leave the baby without supervision in the car, on the bed, in the tub or anywhere near water.

• BACK TO SLEEP is the motto of all of the healthcare providers at St. Rose Pediatrics.

• Keep home and car smoke-free.

Feeding

• Breast or bottle-formula only for first 4-6 months of life. Baby sill now start to let you know when he/she is hungry but sucking, rooting, putting hands to mouth and making noise to get your attention.

• Breastfeeding babies should be getting a VITAMIN D supplement at 400 IU/day. Consider iron supplementation

• Never prop a bottle for your baby. Holding the baby during this special time gives you a great bonding opportunity.

• Don’t put baby in the crib with a bottle. This can start habits that can harm baby’s teeth once they begin to erupt.

• Can start simple solid foods after 4-6 months. Discuss this with your St. Rose Pediatrics provider.

Social 

• Continue to blend your family time including baby and any other siblings or family members.

• Take time as a couple. 

• Choose quality child care if needed. Discuss working outside the home and how you feel about leaving your baby with someone else.

• Tummy time is still very important. Baby may start reaching for toys during tummy time. Encourage this.

• Wash hands often and avoid crowds with baby. Baby’s immune system is not prepared for the influx of germs in our world.

• Travel: if baby will travel with you, make sure he/she is breastfeeding or has a bottle during take-off and landing due to changing cabin pressures and comfort for baby.

NEXT VISIT IS AT 6 MONTHS.

At this visit we will:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Provide your baby’s immunizations.
• Discuss when to start feeding your baby solid foods.
• Screen for post-partum depression.

Immunizations: 

•  (DTaP, HIB, IPV), Prevnar#2, Rotavirus#2

Tests/Screens/Assessments: 

• Post Partum Depression Assessment, Anemia Surveillance

Helpful Info: 

• Starting Solid Foods

Health Supervision

• Social language: Looks when name is called. Smiles at self in mirror/own reflection.

• Verbal language: babbles and makes sounds like “ga” “ma”, “da” and “ba”

• Gross motor skills: Rolls back to stomach, sits briefly without support

• Fine motor skills: Passes a toy from one hand to another, rakes in small objects with four fingers,

Physical Exam

• Measure, plot the length, weight, head circumference. This will help us track your baby’s growth and physical development.

• The complete physical exam will be performed by your child’s provider to assess characteristics of the newborn. Ask your provider what he/she is looking for or any concerns you have.

• Screenings: Maternal depression screening can be given during this visit,

• Oral health: Make sure to keep all toys, pacifiers clean. Clean new teeth twice a day with soft cloth or baby toothbrush and a very tiny dab of fluoride toothpaste

Immunizations

• Third set of immunizations are given during this visit or 60 days from previous immunizaitons: DTAP/IPV/HEP B; HIB, PCV and oral Rotavirus. Let your SRP explain the need and use of the immunizations.

• Discussion of the RSV immunization to prevent this respiratory illness. Talk to your healthcare provider.

Safety

• Use of car seat. Is it properly installed? Rear facing carseat in back seat only.

• Keep small objects and plastic bags away from baby. Don’t cook while holding baby to avoid burns

• Never leave the baby without supervision in the car, on the bed, in the tub or anywhere near water.

• BACK TO SLEEP is the motto of all of the healthcare providers at St. Rose Pediatrics.

• Keep home and car smoke-free.

• Time to do a full sweep of safety hazards as baby prepares to become mobile. 

• Walkers are not generally recommended; but baby will enjoy a padded area on the floor where he/she can explore

Feeding

• Continue breast or bottle feeding. Continue BF babies with vitamin D supplementation.

• Baby may be ready for solids: offer single ingredient foods one at a time. Iron-rich baby cereals and vegetables are the best starts for your baby’s diet. Try to give one a week in case there is reaction: rash, vomiting, diarrhea. There won’t be confusion as to what the food was that caused the reaction.

• Never prop a bottle for your baby. Holding the baby during this special time gives you a great bonding opportunity.

• Don’t put baby in the crib with a bottle. This can start habits that can harm baby’s teeth once they begin to erupt.

• Can start simple solid foods after 4-6 months. Discuss this with your St. Rose Pediatrics provider.

Social 

• Continue to blend your family time including baby and any other siblings or family members.

• Take time as a couple. 

• Use an upright high chair so baby can be part of the family. Include in meal time as a family.

• Baby will love singing, rhymes, interactive games like “itsy bitsy spider”

• Travel: if baby will travel with you, make sure he/she is breastfeeding or has a bottle during take-off and landing due to changing cabin pressures and comfort for baby.

NEXT VISIT IS AT 9 MONTHS.

At this visit we will:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Provide your baby’s immunizations.
• Discuss the introduction of fluoridated water to encourage the development of strong and healthy teeth. If you have city or rural water,  your water is fluoridated. If you have well water,  you should have your water tested for fluoride before offering it to your baby.
• Screen for post-partum depression.

Immunizations:  (DTaP, HIB, IPV), Prevnar#3, Rotavirus#3, Influenza vaccine (during flu season)

Tests/Screens/Assessments: 

• Post Partum Depression Assessment, TB Surveillance, Lead Surveillance, Oral  Health Surveillance, Fluoride Varish

Helpful Info: 

• Teething

Health Supervision

• Social language: Uses arms to ask to be lifted, looks for objects in “peek a boo”, turns to name

• Verbal language: babbles and makes sounds like “mama” “dada” and looks around for familiar items

• Gross motor skills: Sits well without support, pulls up on furniture, cruises, crawls

• Fine motor skills: Picks up foods with three fingers and a thumb, can drop items intentionally, bangs items

Physical Exam

• Measure, plot the length, weight, head circumference. This will help us track your baby’s growth and physical development.

• The complete physical exam will be performed by your child’s provider to assess characteristics of the newborn. Ask your provider what he/she is looking for or any concerns you have.

• Screenings: HEMOGLOBIN check to check for anemia. Discuss results with your healthcare provider.

• Oral health: Make sure to keep all toys, pacifiers clean. Clean new teeth twice a day with soft cloth or baby toothbrush and a very tiny dab of fluoride toothpaste. Daily cleaning of cups, utensils and bottles.

Immunizations

• No immunizations are due at this visit with exception of FLU immunization in fall.

• Discussion of the RSV immunization to prevent this respiratory illness. Talk to your health care provider.

Safety

• Use of car seat. Is it properly installed? Rear facing carseat in back seat only.

• Keep small objects and plastic bags away from baby. Don’t cook while holding baby to avoid burns

• Never leave the baby without supervision in the car, on the bed, in the tub or anywhere near water.

• BACK TO SLEEP is the motto of all of the healthcare providers at St. Rose Pediatrics. When baby starts to roll over, STOP SWADDLING to allow baby to move around freely 

• Keep home and car smoke-free. POISON CONTROL 1-800-222-1222. Keep handy!!

• Time to do a full sweep of safety hazards as baby prepares to become mobile. 

• Walkers are not generally recommended; but baby will enjoy a padded area on the floor where he/she can explore

Feeding

• Continue breast or bottle feeding. Solids and meals are priority. Baby is social and wishes to be included in mealtimes. Make sure foods are appropriate. Ask your healthcare provider for appropriate foods.

• Gradually increase table foods with a variety of textures.

• Encourage use of a “sippy cup” for water. Think about weaning baby and when you will feel comfortable.

• Never prop a bottle for your baby. Holding the baby during this special time gives you a great bonding opportunity.

• Don’t put baby in the crib with a bottle. This can start habits that can harm baby’s teeth once they begin to erupt.

Social 

• Continue to blend your family time including baby and any other siblings or family members.

• Baby loves to be social, has separation anxiety and “stranger danger”. Don’t force baby to go to people he/she is not comfortable with. Lots of play: talking, singing, rhymes, reading books. Respond to baby’s cues

• Use an upright high chair so baby can be part of the family. Include in meal time as a family.

• Baby will love singing, rhymes, interactive games like “itsy bitsy spider”

• Travel: if baby will travel with you, make sure he/she is breastfeeding or has a bottle during take-off and landing due to changing cabin pressures and comfort for baby.

NEXT VISIT IS AT 12 MONTHS.

At this visit we will:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Discuss your baby's upcoming dental care. Your baby should see a dentist at 1 year of age. You should be brushing your child's teeth with an infant toothbrush and a tiny smear of fluoride toothpaste. 

Immunizations: 

• HepB#3, Influenza vaccine (during flu season)

Tests/Screens/Assessments: 

• Ages and Stages Questionnaire, Oral Health Surveillance, Fluoride Varnish, Hemoglobin Test, Lead Test

Helpful Info: 

• Teething

Health Supervision

• Social language: Looks for hidden objects. Imitates gestures

• Verbal language: Uses “dada” and “mama” specifically, Knows at least one other word. Follows some simple directions.

• Gross motor skills: Sits well without support, may take first few independent steps.

• Fine motor skills: Drops objects in a cup or bowl (show him/her how first), Picks up objects with pincer grasp

Physical Exam

• Measure, plot the length, weight, head circumference. This will help us track your baby’s growth and physical development.

• The complete physical exam will be performed by your child’s provider to assess characteristics of the newborn. Ask your provider what he/she is looking for or any concerns you have.

• Screenings: At 12 months there are no screenings required. Can catch up Hemoglobin check if missed at 9 mos.

• Oral health: Make sure to keep all toys, pacifiers clean. Clean new teeth twice a day with baby toothbrush and a very tiny dab of fluoride toothpaste. Daily cleaning of cups, utensils and bottles.

• American Academy of Pediatrics recommends baby’s first dental visit around 1 year of age. 

Immunizations

• IMMUNIZATIONS: MMR, VAR, PSV, HEPATITIS A. Flu shot if in fall of year.  Your provider can explain and answer questions regarding the immunizations.

• Discussion of the RSV immunization to prevent this respiratory illness. Talk to your health care provider.

Safety

• Use of car seat. Is it properly installed? Rear facing carseat in back seat only.

• Keep small objects and plastic bags away from baby. Don’t cook while holding baby to avoid burns

• Never leave the baby without supervision. Swimming pool and water safety. Consider life saving water classes for baby.

• Use sunscreen, heat protection by keeping baby in shade. May need to increase water intake during hot months.

• Time to do a full sweep of safety hazards as baby prepares to become mobile. Consider stair cases and gates

• Monitor interactions with baby and any pets.  POISON CONTROL 1-800-222-1222

Feeding

• Continue breast or bottle feeding. Solids and meals are priority. Baby is social and wishes to be included in mealtimes. Make sure foods are appropriate. Ask your healthcare provider for appropriate foods.

• Baby will prefer to feed him/herself. Be sure foods are nutritious and not empty calories. 

• Encourage use of a “sippy cup” for water. Think about weaning baby and when you will feel comfortable.

• Never prop a bottle for your baby. Holding the baby during this special time gives you a great bonding opportunity.

• Don’t put baby in the crib with a bottle. This can start habits that can harm baby’s teeth once they begin to erupt.

Social 

• Continue to blend your family time including baby and any other siblings or family members.

• Establishing routines will bring the most calm to your household with baby. Bedtime routines can help him/her sleep better and avoid late night issues.

• Continue with naptime. Baby may only want one nap per day and sleep about 12 hours at night.

• Avoid using social media, computers, IPads for baby’s learning unless special circumstances. You are the best teacher!

• Travel: if baby will travel with you, make sure he/she is breastfeeding or has a bottle during take-off and landing due to changing cabin pressures and comfort for baby.

NEXT VISIT at 15 months

At this visit we will:

• Measure your baby’s weight, length, and head size and record on a growth curve.
• Provide your baby’s immunizations.
• Discuss dental health and apply fluoride varnish to your baby’s teeth.

Immunizations: 

• HepA#1, MMR#1, VAR#1, Influenza vaccine (during flu season)

Tests/Screens/Assessments: 

• TB Surveillance, Lead Surveillance, Oral Health Surveillance, Fluoride Varnish

Helpful Info: 

• Playing Is How Toddlers Learn

Health Supervision

• Social language: Imitates scribbling, points to things he/she wants, looks for objects out of sight

• Verbal language: Uses three words other than names; speaks in sounds and babbles; follows simple directions.

• Gross motor skills: Walks, squats to pick up objects, starts to run and will crawl up stairs.

• Fine motor skills: Makes marks with crayon, drops objects and puts back in containers. 

Physical Exam

• Measure, plot the length, weight, head circumference. This will help us track your baby’s growth and physical development.

• The complete physical exam will be performed by your child’s provider to assess characteristics of the newborn. Ask your provider what he/she is looking for or any concerns you have.

• Screenings: At 15 months there are no screenings required. Informal visual and hearing checks during exam

• Oral health: Make sure to keep all toys clean. Clean new teeth twice a day with baby toothbrush and a very tiny dab of fluoride toothpaste. Daily cleaning of cups, utensils and bottles.

• American Academy of Pediatrics recommends baby’s first dental visit around 1 year of age. 

Immunizations

• IMMUNIZATIONS:  DTAP, HIB,  Flu shot if in fall of year.  Your provider can explain and answer questions regarding the immunizations.

Safety

• Use of car seat. Is it properly installed? Rear facing carseat in back seat only. Check manufacturer’s suggestions for use of car seat.

• Smoke detectors, fire extinguishers, escape routes for upper floors of home in case of emergency.

• Never leave the baby without supervision. Swimming pool and water safety. Consider life saving water classes for baby.

• Use sunscreen, heat protection by keeping baby in shade. May need to increase water intake during hot months.

• Monitor interactions with baby and any pets.  POISON CONTROL 1-800-222-1222

Feeding

• Continue breast or bottle feeding. Solids and meals are priority. Baby is social and wishes to be included in mealtimes. Make sure foods are appropriate. Ask your healthcare provider for appropriate foods.

• Baby will prefer to feed him/herself. Be sure foods are nutritious and not empty calories. 

• Encourage use of a “sippy cup” for water. Think about weaning baby and when you will feel comfortable.

• Never prop a bottle for your baby. Holding the baby during this special time gives you a great bonding opportunity.

• Don’t put baby in the crib with a bottle. This can start habits that can harm baby’s teeth once they begin to erupt.

Social 

• If possible, give child to choose between two objects only. Keep information concrete. Use simple commands and words. Remain firm in  your voice when correcting. Try to remove child from volatile situations.

• Establishing routines will bring the most calm to your household with baby. Bedtime routines can help him/her sleep better and avoid late night issues.

• Continue with naptime. One nap per day is usual and sleep about 12 hours at night.

• Avoid using social media, computers, IPads for baby’s learning unless special circumstances. You are the best teacher! Encourage fun and interactive activities.

• If baby still is having a bottle at night, should be only water.

NEXT VISIT at 18 months

At this visit we will:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Provide your baby’s immunizations.

Immunizations: 

 (DTaP, HIB, IPV), Prevnar#4, Influenza vaccine (during flu season)

Tests/Screens/Assessments: 

• Anemia Surveillance, Fluoride Varnish

Helpful Info: 

• Choking Prevention and First Aid for Infants and Children

Health Supervision

• Social language: Helps dress, undress; points to pictures; knows animal sounds; learns body parts; uses words to ask for help. Use simple language.

• Verbal language: Names at least 5 familiar items/objects; will call the pet or know siblings' names.

• Gross motor skills: Walks up stairs, sits in small chair, carries toys while walking

• Fine motor skills: Scribbles, throws ball forward with good hand control

Physical Exam

• Measure, plot the length, weight, head circumference. This will help us track your baby’s growth and physical development. Ask your provider what he/she is looking for or any concerns you have.

• Screenings: At 18 months, child is screened for lead and autism through an MCHAT form you will complete. Informal visual and hearing checks during exam.

• Oral health: Continue to brush teeth twice a day with baby toothbrush and a very tiny dab of fluoride toothpaste. Daily cleaning of cups, utensils and bottles.

• American Academy of Pediatrics recommends baby’s first dental visit around 1 year of age. 

Immunizations

• IMMUNIZATIONS:  HEPATITIS B and FLU shot if in fall of year.  Your provider can explain and answer questions regarding the immunizations.

Safety

• Use of car seat. Is it properly installed? Rear facing carseat in back seat only. Check manufacturer’s suggestions for use of car seat.

• Smoke detectors, fire extinguishers, escape routes for upper floors of home in case of emergency.

• Never leave the baby without supervision. Swimming pool and water safety. Consider life saving water classes for baby.

• Use sunscreen, heat protection by keeping baby in shade. May need to increase water intake during hot months.

• Monitor interactions with baby and any pets.  POISON CONTROL 1-800-222-1222

Healthy Nutrition

• Offer variety of healthy foods/snacks. Include healthy vegetables, fruits and lean proteins.

• Provide 16-20 ounces of milk only with one large meal and several small meals/snacks/day

• Your child doesn’t need juice. If you choose to give juice, limit to 4 ounces/day with water mixed in

• Continue to offer new foods daily. Your toddler may need to be exposed to new foods a few times before he/she will eat it.

Social/Temperament/Behavior and Discipline 

• If possible, give child to choose between two objects only. Keep information concrete. Use simple commands and words. Remain firm in  your voice when correcting. Try to remove child from volatile situations.

• Establishing routines will bring the most calm to your household with baby. Bedtime routines can help him/her sleep better and avoid late night issues.

• Continue with naptime. One nap per day is usual and sleep about 12 hours at night.

• Avoid using social media, computers, IPads unless special circumstances. You are the best teacher! Encourage fun and interactive activities.

• Try to plan ahead for difficult situations. Be consistent with discipline

• Wait for child to be ready for toilet-training. If he/she is dry for periods of 2 hours, knows wet and dry, can pull pants up and down and can indicate having a bowel movement, toddler may be ready to toilet train. Don’t rush it.

NEXT VISIT at TWO YEARS

At this visit we will:

• Measure your child’s weight, length and head size and record on a growth curve.
• Provide your baby’s immunizations.
• Discuss dental health and apply fluoride varnish to your baby’s teeth.
• Discuss temper tantrums.
• Review your child’s development with you using the MCHAT (Autism screening tool) questionnaire.

Immunizations: 

• Influenza vaccine (during flu season)

Tests/Screens/Assessments: 

• Ages and Stages Questionnaire, MCHAT Questionnaire, TB Surveillance, Anemia Surveillance, Lead Surveillance, Oral Health Surveillance, Fluoride Varnish

Helpful Info: 

• Is Your Toddler Communicating With You?

Health Supervision

• Social language: Plays alongside other children (parallel play), gets undressed, uses a spoon

• Verbal language: Has about 50 words, follows commands, speaks in words that are 50% understandable by strangers, names body parts

• Gross motor skills: Kicks a ball, jumps off ground with 2 feet, runs with coordination, climbs ladder at playground

• Fine motor skills: Stacks objects, turns pages of book, can turn door hands, switches up and down, draws lines

Physical Exam

• Measure, plot the length, weight, head circumference. This will help us track toddler’s growth and physical development. Ask your provider what he/she is looking for or any concerns you have.

• Screenings: No formal screenings are done at 2 years. Informal visual and hearing checks during exam.

• Oral health: Continue to brush teeth twice a day with toothbrush and a very tiny dab of fluoride toothpaste. Daily cleaning of cups, utensils and bottles.

• American Academy of Pediatrics recommends dental visits every six months. 

Immunizations

• IMMUNIZATIONS:  FLU shot if in fall of year.  Can use this visit as catch-up if needed. Your provider can explain and answer questions regarding the immunizations.

Safety

• Use of car seat. Is it properly installed? Check manufacturer’s suggestions for use of car seat.

• Smoke detectors, fire extinguishers, escape routes for upper floors of home in case of emergency.

• Never leave toddler unattended. Supervision is very important due to toddler not knowing danger from safety.

• Use sunscreen, helmets if using riding toys.

• Teach child to wash hands and assist each time.

• Remove all weapons and firearms from the home. OR make sure they are very securely kept away from toddler

• POISON CONTROL 1-800-222-1222

Healthy Nutrition

• Offer variety of healthy foods/snacks. Include healthy vegetables, fruits and lean proteins.

• Provide 16-20 ounces of milk only with one large meal and several small meals/snacks/day

• Your child doesn’t need juice. If you choose to give juice, limit to 4 ounces/day with water mixed in

• Continue to offer new foods daily. Your toddler may need to be exposed to new foods a few times before he/she will eat it.

Social/Temperament/Behavior and Discipline 

• If possible, give child to choose between two objects only. Keep information concrete. Use simple commands and words. Remain firm in  your voice when correcting. Try to remove child from volatile situations.

• Praise good behabvior and accomplishments. Help child express feelings. Encourage free play

• Continue with naptime. One nap per day is usual and sleep about 12 hours at night.

• Avoid using social media, computers, IPads unless special circumstances. You are the best teacher! Encourage fun and interactive activities.

• Wait for child to be ready for toilet-training. If he/she is dry for periods of 2 hours, knows wet and dry, can pull pants up and down and can indicate having a bowel movement, toddler may be ready to toilet train. Don’t rush it.

NEXT VISIT at TWO and HALF  YEARS

At this visit we will:

• Measure your child’s weight, length, head size and body mass index and record on a growth curve.
• Most of our patients do not have immunizations due at this visit.  Your child may need immunizations if they are behind on their shots.
• Test for lead exposure with a finger prick in the office.
• Screen your baby for vision abnormalities with our ocular photoscreen device.
• Discuss dental health and apply fluoride varnish to your child's teeth.
• Discuss toilet training and time out.

Immunizations: 

• HepA#2, Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• TB Surveillance, Anemia Surveillance, Lead Surveillance, Dyslipidemia Surveillance, Oral Health Surveillance, Fluoride Varnish, Lead Test

Helpful Info: 

• Playground Safety

Health Supervision

• Social language and self help: potty training,  uses a fork, washes and dries hands, engages in imaginary play; three word sentences “Look at me”

• Verbal language: new words everyday; uses pronouns correctly

• Gross motor skills: Walks up stairs with alternating feet, runs with better balance

• Fine motor skills: Copies vertical lines, grasps pencils/crayons correctly, better hand/eye with catching a ball

Physical Exam

• Measure, plot the length, weight, head circumference. This will help us track toddler’s growth and physical development. Ask your provider what he/she is looking for or any concerns you have.

• Screenings: No formal screenings are done at 2 years. Informal visual and hearing checks during exam.

• Oral health: Continue to brush teeth twice a day with toothbrush and a very tiny dab of fluoride toothpaste. Daily cleaning of cups, utensils and bottles.

• American Academy of Pediatrics recommends dental visits every six months. 

Immunizations

• IMMUNIZATIONS:  FLU shot if in fall of year.  Can use this visit as catch-up if needed. Your provider can explain and answer questions regarding the immunizations.

Safety

• Use of car seat. Is it properly installed? Check manufacturer’s suggestions for use of car seat.

• Smoke detectors, fire extinguishers, escape routes for upper floors of home in case of emergency.

• Never leave toddler unattended. Supervision is very important due to toddler not knowing danger from safety.

• Use sunscreen, helmets if using riding toys.

• Teach child to wash hands and assist each time.

• Remove all weapons and firearms from the home. OR make sure they are very securely kept away from toddler

• POISON CONTROL 1-800-222-1222

Healthy Nutrition

• Offer variety of healthy foods/snacks. Include healthy vegetables, fruits and lean proteins.

• Provide 16-20 ounces of milk only with family meals and snacks daily. 

• Your child doesn’t need juice. If you choose to give juice, limit to 4 ounces/day with water mixed in

• Continue to offer new foods. Your toddler may need to be exposed to new foods a few times before he/she will eat it.

• Try to  avoid fast foods, fried foods and fatty foods to help develop good cholesterol/triglyceride levels.

Social/Temperament/Behavior and Discipline 

• If possible, give child to choose between two objects only. Keep information concrete. Use simple commands and words. Remain firm in  your voice when correcting. Try to remove child from volatile situations.

• Praise good behavior and accomplishments. Help child express feelings. Encourage free play

• Continue with naptime. One nap per day is usual and sleep about 12 hours at night.

• Avoid using social media, computers, IPads unless special circumstances. You are the best teacher! Encourage fun and interactive activities.

• Socialization with others: trips to the library, preschools, encourage independence, playdates

NEXT VISIT AT AGE 3

At this visit we will:

• Measure your child’s weight, length, head size and record on a growth curve
• Most of our patients do not have immunizations due at this visit.
• Evaluate your child’s development with the ASQ.  Please do the ASQ developmental screening 2-3 days prior to the visit, which is on our website.
• Discuss dental health  (if they have not yet seen a dentist, they should!)
• Discuss healthy meals/snacks, avoid food pouches and no or little juice

Immunizations: 

• Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• Ages & Stages Developmental Screening

Helpful Info: 

• Snacks for Toddlers

Health Supervision

• Social language and self-help: Mostly potty trained; can dress self and eats independently; uses imagination and understands cooperation and sharing, brushes teeth with help

• Verbal language: 3-4 word sentences with language that is understandable to strangers; will tell you a story from a book by looking at pictures and from memory; understands and uses words like “on”, “in” and “around”

• Gross motor skills: Pedals a tricycle, jumps forward with both feet, skips

• Fine motor skills: Draws a circle and can draw a person with a head and one other face part, by age 4 holds the pencil correctly

Physical Exam

• Measure, plot the length, weight, and blood pressure starting at age 3. This will help us track  your preschooler’s  growth and physical development. Ask your provider what he/she is looking for or any concerns you have.

• Screenings: No formal screenings are done at 3 or 4 years. Informal visual and hearing checks during exam.

• Oral health: Continue to brush teeth twice a day with toothbrush and a very tiny dab of fluoride toothpaste. Daily cleaning of cups, utensils and bottles. Should still be supervised during brushing teeth.

• American Academy of Pediatrics recommends dental visits every six months. 

Immunizations

• IMMUNIZATIONS: None at age 3 except flu shot in fall.  

• At age 4, preschool immunizations are given: DTAP/IPV, MMR and Varicella boosters. Be sure to ask for a shot record due to school needing it for enrollment. 

• Can use this visit as catch-up if needed. Your provider can explain and answer questions regarding the immunizations.

Safety

• Use of car seat. Is it properly installed? Check manufacturer’s suggestions for use of car seat for front facing.

• Smoke detectors, fire extinguishers, escape routes for upper floors of home in case of emergency.

• Make sure your preschooler is aware of “stranger danger”.  Supervise outside play.

• Use sunscreen, helmets if using riding toys. Be safe around pets, trampolines and swimming pools

• Remove all weapons and firearms from the home. OR make sure they are very securely kept away from toddler

• POISON CONTROL 1-800-222-1222

Healthy Nutrition and Physical Activity

• Offer variety of healthy foods/snacks. Include healthy vegetables, fruits and lean proteins.

• Provide 12-18 ounces of low-fat milk divided between meals and snacks. Water intake becomes more important.

• Your child doesn’t need juice. If you choose to give juice, limit to 4 ounces/day with water mixed in

• Engage in physical activity daily: 60 minutes is the minimum preschoolers need on a daily basis.

• Try to avoid fast foods, fried foods and fatty foods to help develop good cholesterol/triglyceride levels.

Social/Temperament/Behavior and Discipline 

• School readiness is important.

• Encourage play with safe toys for age. Interactive games with other kids and time at the park to engage in meeting new children.

• Learn about taking turns. Has a little more patience and understanding for waiting his/her turn.

• Praise good behavior and accomplishments. Help child express feelings. Encourage free play

• Some kids give up naptimes during these ages. A quiet time is still encouraged daily if possible.

• Avoid using social media, computers, IPads unless special circumstances. You are the best teacher! Encourage fun and interactive activities.

• Socialization with others: trips to the library, preschools, encourage independence, playdates

NEXT VISIT AT AGE 5 and 6

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Most of our patients do not have immunizations due at this visit.  Your child may need immunizations if they are behind on their shots or during flu season.
• Discuss dental health and apply fluoride varnish to your child's teeth.

Immunizations: 

• Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• TB Surveillance, Anemia Surveillance, Anemia Surveillance, Lead Surveillance, Oral Health Surveillance, Fluoride Varnish

Helpful Info: 

• Toilet Training

Health Supervision and Development

• Balances well on one foot. Hops, skips

• Can tie a knot, draw a person with 5-6 body parts

• Prints numbers and letters. Knows colors and how to spell his/her name.

• Good articulation/language skills

• Follows directions and can dress with minimal assistance.

Physical Exam

• Measure, plot the height, weight, BMI and blood pressure at each well visit. We will still want to monitor growth and physical development. Ask your provider what he/she is looking for or any concerns you have.

• Screenings: Vision screenings will begin yearly at age 5.  Because of increased media use, we find many kids who need additional evaluations from our visual acuity exam.

• Oral health: Continue to brush teeth twice a day including the tongue. Flossing teeth should be part of daily dental routines. Should still be supervised during brushing teeth.

• American Academy of Pediatrics recommends dental visits every six months. 

Immunizations

• IMMUNIZATIONS: There are no formal immunizations due if all are completed by this time. Catch up vaccines can be completed during these well visits.

• Flu shots in the fall are recommended for all children.

Safety

• Use of car seat. Check the manufacturers instructions and the Nevada Department of Public Safety website to review safety seats for kids in this age group.

• Smoke detectors, fire extinguishers, escape routes for upper floors of home in case of emergency.

• Avoid smoking around your school age child.

• Teach street safety: how and when to cross the streets. Looking for cars before proceeding into crosswalk

• Use sunscreen, helmets if using riding toys. Be safe around pets, trampolines and swimming pools

• Remove all weapons and firearms from the home. OR make sure they are very securely kept away from child.

• POISON CONTROL 1-800-222-1222

Healthy Nutrition and Physical Activity

• Offer variety of healthy foods/snacks. Include healthy vegetables, fruits and lean proteins.

• Help your child choose healthy foods. Offer family meals. Encourage breakfast eating. 

• Limit sugar intake

• Engage in physical activity daily: 60 minutes is the minimum children need on a daily basis.

• Try to avoid fast foods, fried foods and fatty foods to help develop good cholesterol/triglyceride levels.

Social/Temperament/Behavior and Discipline 

• School readiness is important. Adapting to school and schoolwork is an important development at this age.

• Mental health concerns need to be addressed as well as learning concerns. Ask your provider for assistance.

• Encourage play with safe toys for age. Interactive games with other kids and time at the park to engage in meeting new children.

• Praise good behavior and accomplishments. Help child express feelings. Encourage free play

• Sleep is very important: 7-10 hours per night depending on the child’s needs.

• Avoid using social media, computers, IPads unless special circumstances. You are the best teacher! Encourage fun and interactive activities.

• Organized sports and activities are a natural part of these kid’s days.

NEXT VISIT AT AGE 9 and 10

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Review your child’s speech and development.
• Discuss exercise and nutrition.
• Discuss kindergarten readiness.
• Discuss dental health and apply fluoride varnish to your child's teeth.

Immunizations: 

• MMR#2, Var#2, Quadracel (DTaP, IPV) (if not received at 4 years), Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• TB Surveillance, Anemia Surveillance, Lead Surveillance, Oral Health Surveillance, Fluoride Varnish

Health Supervision and Development

• Demonstrates social and emotional competence

• Knows parents’ names, address and phone numbers. Knows how to get home if parents not available.

• Forms caring, supportive relationships with family members and other adults

• Peers are becoming very important. Bullying starts/ parents need to be aware of the s/s of bullying

Physical Exam

• Measure, plot the height, weight, BMI and blood pressure at each well visit. We will still want to monitor growth and physical development. Ask your provider what he/she is looking for or any concerns you have.

• Screenings: Vision screenings will begin yearly at age 5.  Because of increased media use, we find many kids who need additional evaluations from our visual acuity exam.

• Oral health: Continue to brush teeth twice a day including the tongue. Flossing teeth should be part of daily dental routines. Should still be supervised during brushing teeth. Malocclusion and misalignment of teeth can mean visits to the orthodontist for braces/mouth apparatus. Wear mouth guards during sports/if needed.

• American Academy of Pediatrics recommends dental visits every six months. 

Immunizations

• IMMUNIZATIONS: There are no formal immunizations due if all are completed by this time. Catch up vaccines can be completed during these well visits.

• Flu shots in the fall are recommended for all children.

Safety

• Use of car seat. Check the manufacturers instructions and the Nevada Department of Public Safety website to review safety seats for kids in this age group.

• Smoke detectors, fire extinguishers, escape routes for upper floors of home in case of emergency.

• Avoid smoking around your school age child.

• Teach street safety: how and when to cross the streets. Looking for cars before proceeding into crosswalk

• Use sunscreen, helmets if using riding toys. Be safe around pets, trampolines and swimming pools

• Remove all weapons and firearms from the home. OR make sure they are very securely kept away from child.

• POISON CONTROL 1-800-222-1222

Healthy Nutrition and Physical Activity

• Offer variety of healthy foods/snacks. Include healthy vegetables, fruits and lean proteins.

• Help your child choose healthy foods. Offer family meals. Encourage breakfast eating. 

• Limit sugar intake

• Engage in physical activity daily: 60 minutes is the minimum children need on a daily basis.

• Try to avoid fast foods, fried foods and fatty foods to help develop good cholesterol/triglyceride levels.

Social/Temperament/Behavior and Discipline 

• Adapting to school and schoolwork is an important development at this age. Preferences for certain subjects becomes apparent.

• Mental health concerns need to be addressed as well as learning concerns. Ask your provider for assistance.

• Make sure to use parental controls on streaming websites, computers and keep them in family areas. Monitor computer/phone use daily.

• Praise good behavior and accomplishments. Help child express feelings. Encourage free play

• Sleep is very important: 7-10 hours per night depending on the child’s needs.

• Organized sports and activities are a natural part of these kid’s days.

At this visit we will:

• Measure your child’s weight, height and body mass index  and record on a growth curve.
• Review your child’s school performance and development.
• Discuss exercise and nutrition.
• Review safety issues.

Immunizations: 

• Flu vaccine (during flu season)

Tests/Screens/Assessments: 

 TB Surveillance, Anaemia Surveillance

Helpful Info: 

• Growing Up Healthy: Fat, Cholesterol, and More

Health Supervision and Development

• Demonstrates social and emotional competence including independent decision-making.

• Displays self-confidence.

• Knows parents’ names, address and phone numbers. Knows how to get home if parents not available.

• Forms caring, supportive relationships with family members and other adults

• Peers are becoming very important. Bullying starts/ parents need to be aware of the s/s of bullying

Physical Exam

• Measure, plot the height, weight, BMI and blood pressure at each well visit. We will still want to monitor growth and physical development. Ask your provider what he/she is looking for or any concerns you have.

• Screenings: Vision screenings will begin yearly at age 5.  Because of increased media use, we find many kids who need additional evaluations from our visual acuity exam.

• Checking the back of your school age child for scoliosis should be part of each well visit. Labs can be ordered if deemed necessary. Talk to your provider.

• Physical changes that will occur as your child matures should be discussed.  There are a lot of questions regarding sexuality and puberty. Honest answers from the parent are needed to help form healthy attitudes.

• Oral health: Continue to brush teeth twice a day including the tongue. Flossing teeth should be part of daily dental routines. Malocclusion and misalignment of teeth can mean visits to the orthodontist for braces/mouth apparatus. Wear mouth guards during sports/if needed.

• American Academy of Pediatrics recommends dental visits every six months. 

Immunizations

• IMMUNIZATIONS: There are no formal immunizations due if all are completed by this time. Catch up vaccines can be completed during these well visits.

• Flu shots in the fall are recommended for all children.

Safety

• Car safety, safety during sports activites, water safety, sun protection, knowing child’s friends and families

• Smoke detectors, fire extinguishers, escape routes for upper floors of home in case of emergency.

• Avoid smoking around your school age child.

• Be safe around pets, trampolines and swimming pools. Proper safety equipment.

• Remove all weapons and firearms from the home. OR make sure they are very securely kept away from child.

• POISON CONTROL 1-800-222-1222

Healthy Nutrition and Physical Activity

• Offer variety of healthy foods/snacks. Include healthy vegetables, fruits and lean proteins.

• Help your child choose healthy foods. Offer family meals. Encourage breakfast eating. 

• Limit sugar intake

• Engage in physical activity daily: 60 minutes is the minimum children need on a daily basis.

• Try to avoid fast foods, fried foods and fatty foods to help develop good cholesterol/triglyceride levels.

Social/Temperament/Behavior and Discipline 

• Adapting to school and schoolwork is an important development at this age. Preferences for certain subjects becomes apparent.

• Mental health concerns need to be addressed as well as learning concerns. Ask your provider for assistance.

• Make sure to use parental controls on streaming websites, computers and keep them in family areas. Monitor computer/phone use daily.

• Praise good behavior and accomplishments. Help child express feelings. Encourage free play

• Sleep is very important: 7-10 hours per night depending on the child’s needs.

• Organized sports and activities are a natural part of these kid’s days.

NEXT VISITS will be during AGES 11 through 14.

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Review your child’s school performance and development.
• Complete sports physical forms and discuss sport safety (if your child is participating in sports).
• Discuss exercise and nutrition.
• Review safety issues.

Immunizations: 

• Flu vaccine (during flu season)

Tests/Screens/Assessments: 

•  TB Surveillance, Anemia Surveillance, Lipid Profile testing (completed once between 9-11 years)

Helpful Info: 

• The Importance of Family Routines

Health Supervision and Development

• Forms caring and supportive relationships with family members, other adults and peers

• Engages in behaviors that optimize wellness and contribute to a healthy lifestyle.

• Demonstrates competence in physical, cognitive, emotional, social and moral areas of life.

• Exhibits compassion and empathy

• Shows some resilience when confronted with life stressors. Experiences grief and loss

Physical Exam

• Measure, plot the height, weight, BMI and blood pressure at each well visit. We will still want to monitor growth and physical development. Ask your provider what he/she is looking for or any concerns you have.

• Screenings: Yearly vision screenings with optometrist are recommended.  Because of increased media use, we find many kids who need additional evaluations from our visual acuity exam.

• Checking the back of your school age child for scoliosis should be part of each well visit. Labs can be ordered if deemed necessary. Talk to your provider.

• Physical changes that will occur as your child matures should be discussed.  There are a lot of questions regarding sexuality and puberty. Honest answers from the parent are needed to help form healthy attitudes.

• Oral health: Continue to brush teeth twice a day including the tongue. Flossing teeth should be part of daily dental routines. Malocclusion and misalignment of teeth can mean visits to the orthodontist for braces/mouth apparatus. Wear mouth guards during sports/if needed. Dental visits every 6 months.

• Acne, piercings, signs of self-harm or injury are all evaluated during these visits. 

Immunizations

• IMMUNIZATIONS: At age 11adolescents receive immunizations: TDAP, Meningitis A and HPV.

• Flu shots in the fall are recommended   all children.

Safety

• Car safety, safety during sports activities, water safety, sun protection, knowing child’s friends and families

• Smoke detectors, fire extinguishers, escape routes for upper floors of home in case of emergency.

• Avoid smoking around your school age child.

• Be safe around pets, trampolines and swimming pools. Proper safety equipment.

• Remove all weapons and firearms from the home. OR make sure they are very securely kept away from child.

• POISON CONTROL 1-800-222-1222

Healthy Nutrition and Physical Activity

• Offer variety of healthy foods/snacks. Include healthy vegetables, fruits and lean proteins.

• Help your child choose healthy foods. Offer family meals. Encourage breakfast eating. 

• Limit sugar intake. Drink water daily. Both of these can cause headaches and an unwell feeling.

• Engage in physical activity daily: 60 minutes is the minimum children need on a daily basis.

• Try to avoid fast foods, fried foods and fatty foods to help develop good cholesterol/triglyceride levels.

Social/Temperament/Behavior and Discipline 

• Adapting to school and schoolwork is an important development at this age. Preferences for certain subjects becomes apparent.

• Mental health concerns need to be addressed as well as learning concerns. Dealing with stress is new to this age group. We will provide a PHQ-9 form to complete during every well visit. This can give us an indication of any issues the adolescent is having so we may address them.

• Monitor computer/phone use daily. 

• Continue to praise good behavior and accomplishments. Help child with self-expression.

• Addressing sexual health: pregnancy, sexually transmitted infections, alcohol, cigarette smoking, street drugs during each well visit, as well as other times during the year, with honest answers are important.

• Sleep is very important: 7-10 hours per night depending on the child’s needs.

• Organized sports and activities are a natural part of these kid’s days.

At this visit we will:

• Measure your child’s weight, height, and body mass index and record on a growth curve.
• Provide your child’s immunizations.
• Screen your child for anemia and dysipidemia per AAP recommendations.
• Review your child’s school performance and development.
• Complete sports physical forms and discuss sport safety (if your child is participating in sports).
• Discuss exercise and nutrition.
• Discuss puberty changes to expect or that may be starting to occur.

Immunizations: 

• Tdap#1, MCV#1, ​HPV#1 (series of 2; 11-12 years)

Tests/Screens/Assessments: 

• TB Surveillance, Anemia Surveillance, Dyslipidemia Surveillance, Lipid Profile (completed once between 9-11 years)

Helpful Info: 

• Substance Abuse Prevention

Health Supervision and Development

• Forms caring and supportive relationships with family members, other adults and peers

• Engages in behaviors that optimize wellness and contribute to a healthy lifestyle.

• Demonstrates competence in physical, cognitive, emotional, social and moral areas of life.

• Exhibits compassion and empathy

• Shows some resilience when confronted with life stressors. Experiences grief and loss

Physical Exam

• Measure, plot the height, weight, BMI and blood pressure at each well visit. We will still want to monitor growth and physical development. Ask your provider what he/she is looking for or any concerns you have.

• Screenings: Yearly vision screenings with optometrist are recommended.  Because of increased media use, we find many kids who need additional evaluations from our visual acuity exam.

• Checking the back of your school age child for scoliosis should be part of each well visit. Labs can be ordered if deemed necessary. Talk to your provider.

• Physical changes that will occur as your child matures should be discussed.  There are a lot of questions regarding sexuality and puberty. Honest answers from the parent are needed to help form healthy attitudes.

• Oral health: Continue to brush teeth twice a day including the tongue. Flossing teeth should be part of daily dental routines. Malocclusion and misalignment of teeth can mean visits to the orthodontist for braces/mouth apparatus. Wear mouth guards during sports/if needed. Dental visits every 6 months.

• Acne, piercings, signs of self-harm or injury are all evaluated during these visits. 

Immunizations

• IMMUNIZATIONS: At age 16, teen will get the second Meningitis A and first Meningitis B. HPV #2 should be given prior to age 16; if not, the third HPV should be given at this age. The second Meningitis B should be given 6 months after the first. This concludes the immunizations given to children/teens per the AAP.

• Flu shots in the fall are recommended for all.

Safety

• Car safety, safety during sports activities, water safety, sun protection, knowing child’s friends and families

• Smoke detectors, fire extinguishers, escape routes for upper floors of home in case of emergency.

• Avoid smoking around your school age child.

• Be safe around pets, trampolines and swimming pools. Proper safety equipment.

• Remove all weapons and firearms from the home. OR make sure they are very securely kept away from child.

• POISON CONTROL 1-800-222-1222

Healthy Nutrition and Physical Activity

• Offer variety of healthy foods/snacks. Include healthy vegetables, fruits and lean proteins.

• Help your child choose healthy foods. Offer family meals. Encourage breakfast eating. 

• Limit sugar intake. Drink water daily. Both of these can cause headaches and an unwell feeling.

• Engage in physical activity daily: 60 minutes is the minimum children need on a daily basis.

• Try to avoid fast foods, fried foods and fatty foods to help develop good cholesterol/triglyceride levels.

Social/Temperament/Behavior and Discipline 

• Preparation for school or work beyond high school. Be open and allow your student to choose a path that best suits him/her.

• Mental health concerns need to be addressed as well as learning concerns. Dealing with stress is new to this age group. We will provide a PHQ-9 form to complete during every well visit. This can give us an indication of any issues the adolescent is having so we may address them.

• Monitor computer/phone use daily. 

• Offer guidance as requested by your teen. Communicate often with your teen and make sure they know your expectations.

• Addressing sexual health: pregnancy, sexually transmitted infections, alcohol, cigarette smoking, street drugs during each well visit, as well as other times during the year, with honest answers are important.

• Sleep is very important: 7-10 hours per night depending on the needs and availability.

• Organized sports and activities can still be a natural part of the teen’s days.

NEXT VISITS will be during AGES 18-21 and beyond

At this visit we will:

• Measure your child’s weight and length and record on a growth curve.
• Complete sports physical forms and discuss sport safety (if your child is participating in sports).
• Review your child’s school performance.
• Reinforce healthy choices and risk behavior avoidance.
• Perform any recommended yearly screening tests
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet.
• Complete driver's permit if your child is 15y 6mo old or older.
• Complete PA driver's permit. (If you do not do this at your well visit, your teen must be present and sign in the presence of the physician at another time)

Immunizations: 

• Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• TB Surveillance, Anemia Surveillance, Dyslipidemia Surveillance, Adolescent Depression Screening, Hemoglobin Test (females)

Helpful Info: 

• Teens, Behavior

Your child is now transitioning to adult life! They will still look to you for support and guidance, but will be more on their own when it comes to decision making. 

Your child is legally considered an adult.

Health Supervision and Development

• Welcome to being an adult! Your teen will still need guidance and caring with acceptance.

• Forms caring and supportive relationships with family members, other adults and peers

• Engages in behaviors that optimize wellness and contribute to a healthy lifestyle.

• Demonstrates competence in physical, cognitive, emotional, social and moral areas of life.

• Exhibits compassion and empathy

• Shows some resilience when confronted with life stressors. Experiences grief and loss

Physical Exam

• Measure, plot the height, weight, BMI and blood pressure at each well visit.

• Screenings: Yearly vision screenings with optometrist are recommended.  Because of increased media use, we find many kids who need additional evaluations from our visual acuity exam.

• Once there is no physical height changes for several years, scoliosis check of the back can be discontinued.

• There are a lot of questions regarding sexuality and puberty. Honest answers are needed to help form healthy attitudes and help the young adult make good choices.

• Oral health: Continue to brush teeth twice a day including the tongue. Flossing teeth should be part of daily dental routines. Wear mouth guards during sports/if needed. Dental visits every 6 months.

• Acne, piercings, signs of self-harm or injury are all evaluated during these visits. 

Immunizations

• IMMUNIZATIONS: Catch up on any and all immunizations that are needed and missing. 

• Flu shots in the fall are recommended for all.

Safety

• Safe sexual encounters are important to discuss along with risks, domestic violence, substances abuse.

• Teach safety and proper use of all firearms. Keep them out of reach of younger children.

• Learn how to manage conflict without physical confrontation. Avoid risky situations.

• POISON CONTROL 1-800-222-1222

Healthy Nutrition and Physical Activity

• Include a variety of healthy foods/snacks in daily diet.

• Limit sugar intake. Drink water daily. Limit caffeine and sports drinks.

• Energy drinks should be avoided at all costs. Tachycardia and other related symptoms can develop when using energy drinks.

• Engage in physical activity daily: 60 minutes is the minimum children need on a daily basis.

• Try to avoid fast foods, fried foods and fatty foods to help develop good cholesterol/triglyceride levels.

Social/Temperament/Behavior and Discipline 

• Preparation for school or work beyond high school. College-bound teens need extra guidance with many changes that will occur during the first year.

• Mental health concerns need to be addressed as well as learning concerns. Dealing with stress is new to this age group. We will provide a PHQ-9 form to complete during every well visit. This can give us an indication of any issues the adolescent is having so we may address them.

• Limit computer/phone use daily. 

• Offer guidance as requested by your teen. Communicate often with your teen and make sure they know your expectations.

• Addressing sexual health: pregnancy, sexually transmitted infections, alcohol, cigarette smoking, street drugs during each well visit, as well as other times during the year, with honest answers are important.

• Sleep is very important: 7-10 hours per night depending on the needs and availability.

• Organized sports and activities can still be a natural part of the lifestyle of your teen/young adult.

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Provide immunizations.
• Discuss transitions to life after high school—whether that be work, travel, vocational school or college.
• Discuss importance of responsible decision making and recognizing healthy -vs- unhealthy relationships.
• Complete college physical forms and any required college screening labs/tests.
• Perform any recommended yearly screening tests
• Reinforce healthy choices and risk behavior avoidance.

Immunizations: 

•  Flu vaccine (during flu season)
• MenB (optional, if not already taken - consists of initial shot and another 6 months later)

Tests/Screens/Assessments: 

• TB Surveillance, Anemia Surveillance, Dyslipidemia Surveillance, Adolescent Depression Screening, Urine Chlamydia Screen (females), Hemoglobin Test (females), Universal HIV Testing

Helpful Info: 

• Teens, Behavior