Read Online Pediatric Primary Care by Beth Richardson - Free Book Online
Authors: Beth Richardson
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sleep in own cribs to decrease smothering or injury. Babies should sleep on their back in cribs to decrease incidence of sudden infant death syndrome (SIDS).
V. GROWTH AND DEVELOPMENT
A. Growth.
1. Should regain birth weight by 2 weeks. Should gain 0.5-1 oz/day or approximately 2 lbs/month for next 5 months.
2. Infant grows, on average, 1 in./month for first 6 months.
3. Head circumference increases 0.5 cm/month in first year.
B. Development.
1. Moves all 4 extremities, keep hands fisted, and has flexed posture.
2. Has startle response to noises.
3. May have a smile. May begin to look for “who is talking.”
4. May have “fussy” time of 1-2 hours/day, often in evening.
5. Should have some supervised, “tummy” play time (15-20 minutes/session).
6. Ask about behavior after feedings to determine any colic or reflux.
VI. SOCIAL DEVELOPMENT
A. Babies have specific sounds/cries for specific needs. They will fuss/cry 1-2 hours/day. Providing for infant's needs should stop the crying. Crying gradually decreases by 3 months of age.
B. Infant needs holding; touching; feeding; dry, clean diaper; warm, yet comfortable environment.
C. Discourage taking baby to public places or visiting relatives since infant has not been immunized. Sick adults should stay away from infant.
D. Encourage mother to rest when baby rests/sleeps. Determine if night times are “awake times for the pair” and the mother is not getting her sleep.
VII. IMMUNIZATIONS (SEE APPENDIX A )
A. If mother is HBsAg-, infant may not have received first hepatitis B vaccine in newborn nursery and will need to get it today or before 2 months of age. If infant received hepatitis B immunization in the nursery, he/she will need to get four hepatitis B immunizations.
B. Infant should not have fever or fussiness from the immunization.
C. Discuss importance of getting immunizations. Many parents are concerned about risks. One in eight parents in the United States refused at least one recommended vaccine for their child.
VIII. SAFETY/ANTICIPATORY GUIDANCE
A. Sleep position “back to sleep.”
1. Not safe for baby to sleep in adult bed.
2. Discuss room temperature (comfortable), amount of clothing to put on baby (not to overdress infant).
3. No pillows/toys in the crib that could potentially smother child.
4. Federal motor vehicle safety tested and approved car seat: installed properly in backseat, facing backward in automobile. Contact local hospital, fire department, or local March of Dimes for car seat rental programs.
B. No smoking around infant.
C. Reassure parents they cannot spoil infant at this age.
D. Discuss sibling jealousy and possible regression of toddler. Encourage parent to spend “special time” with older sibling.
E. Discuss pet safety: Do not leave infant unattended near pet.
F. Discuss toys.
G. Discuss what to look for when choosing babysitter or daycare (e.g., handwashing, number of children, sick policy, feeding techniques).
H. One-piece pacifiers only, discuss appropriate use of pacifiers. Should not pin them on a string to baby's clothing, wash with soap and water if they fall out of the baby's mouth, do not lick or moisten it prior to giving to baby.
I. May give 1 oz of sterile water in 24 hours if stools are very hard. No corn syrup (Karo) for constipation.
J. No solids.
K. Remind parents of when and how to call healthcare provider. Review call-in phone policy and explain hours that are best to call office.
1. Breathing difficulties.
2. Seizures.
3. Irritability.
4. Poor feeding, vomiting.
5. No urine in 12 hours, black or decreased bowel movements.
6. Reddened, draining umbilical site.
7. Jaundice.
8. Rash or pustules not present on discharge.
9. Concerns.
BIBLIOGRAPHY
Car Safety Seats: A Guide For Families 2010. American Academy of Pediatrics Healthy Children website:
V. GROWTH AND DEVELOPMENT
A. Growth.
1. Should regain birth weight by 2 weeks. Should gain 0.5-1 oz/day or approximately 2 lbs/month for next 5 months.
2. Infant grows, on average, 1 in./month for first 6 months.
3. Head circumference increases 0.5 cm/month in first year.
B. Development.
1. Moves all 4 extremities, keep hands fisted, and has flexed posture.
2. Has startle response to noises.
3. May have a smile. May begin to look for “who is talking.”
4. May have “fussy” time of 1-2 hours/day, often in evening.
5. Should have some supervised, “tummy” play time (15-20 minutes/session).
6. Ask about behavior after feedings to determine any colic or reflux.
VI. SOCIAL DEVELOPMENT
A. Babies have specific sounds/cries for specific needs. They will fuss/cry 1-2 hours/day. Providing for infant's needs should stop the crying. Crying gradually decreases by 3 months of age.
B. Infant needs holding; touching; feeding; dry, clean diaper; warm, yet comfortable environment.
C. Discourage taking baby to public places or visiting relatives since infant has not been immunized. Sick adults should stay away from infant.
D. Encourage mother to rest when baby rests/sleeps. Determine if night times are “awake times for the pair” and the mother is not getting her sleep.
VII. IMMUNIZATIONS (SEE APPENDIX A )
A. If mother is HBsAg-, infant may not have received first hepatitis B vaccine in newborn nursery and will need to get it today or before 2 months of age. If infant received hepatitis B immunization in the nursery, he/she will need to get four hepatitis B immunizations.
B. Infant should not have fever or fussiness from the immunization.
C. Discuss importance of getting immunizations. Many parents are concerned about risks. One in eight parents in the United States refused at least one recommended vaccine for their child.
VIII. SAFETY/ANTICIPATORY GUIDANCE
A. Sleep position “back to sleep.”
1. Not safe for baby to sleep in adult bed.
2. Discuss room temperature (comfortable), amount of clothing to put on baby (not to overdress infant).
3. No pillows/toys in the crib that could potentially smother child.
4. Federal motor vehicle safety tested and approved car seat: installed properly in backseat, facing backward in automobile. Contact local hospital, fire department, or local March of Dimes for car seat rental programs.
B. No smoking around infant.
C. Reassure parents they cannot spoil infant at this age.
D. Discuss sibling jealousy and possible regression of toddler. Encourage parent to spend “special time” with older sibling.
E. Discuss pet safety: Do not leave infant unattended near pet.
F. Discuss toys.
G. Discuss what to look for when choosing babysitter or daycare (e.g., handwashing, number of children, sick policy, feeding techniques).
H. One-piece pacifiers only, discuss appropriate use of pacifiers. Should not pin them on a string to baby's clothing, wash with soap and water if they fall out of the baby's mouth, do not lick or moisten it prior to giving to baby.
I. May give 1 oz of sterile water in 24 hours if stools are very hard. No corn syrup (Karo) for constipation.
J. No solids.
K. Remind parents of when and how to call healthcare provider. Review call-in phone policy and explain hours that are best to call office.
1. Breathing difficulties.
2. Seizures.
3. Irritability.
4. Poor feeding, vomiting.
5. No urine in 12 hours, black or decreased bowel movements.
6. Reddened, draining umbilical site.
7. Jaundice.
8. Rash or pustules not present on discharge.
9. Concerns.
BIBLIOGRAPHY
Car Safety Seats: A Guide For Families 2010. American Academy of Pediatrics Healthy Children website:
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