Ages | Injury Prevention | Violence Prevention | Nutritional Counseling | Fostering Optimal Development |
Birth and/or 3−5 days | Crib safety Hot water heaters <120° F Car safety seats Smoke detectors Back to sleep Crib safety |
Assess bonding and attachment Identify family strife, lack of support, pathology Educate parents on nurturing |
Exclusive breastfeeding encouraged (should breastfeed every 2-3 hours) Formula as a second-best option (every 3-4 hours) |
Discuss parenting skills Refer for parenting education |
2 weeks or 1 month | Falls Back to sleep Tummy time when awake: 5-10 min 2-3 times per day |
Discuss sibling rivalry Assess if guns in the home |
Assess breastfeeding and offer encouragement, problem-solving Should be back to birth weight at 2-weeks |
Recognize and manage postpartum blues Child care options |
2 months | Burns/hot liquids Back to sleep |
Reassess firearm safety | After 3 they do not need to eat during the night | Parent getting enough rest and managing returning to work |
4 months | Infant walkers Choking/suffocation Back to sleep |
Reassess | Introduction of solid foods |
Discuss central to peripheral motor development Praise good behavior |
6 months | Burns/hot surfaces Place on back to sleep, but once infant can roll no need to worry about rolling to tummy. |
Reassess | Start water and baby food | Consistent limit-setting versus“spoiling” an infant Praise good behavior |
9 months | Water safety Home safety review Ingestions/poisoning |
Assess parents’ ideas on discipline and “spoiling” | Avoiding juice Begin to encourage practice with cup drinking No honey until 1 yo |
Assisting infants to sleep through the night if not accomplished Praise good behavior |
12 months | Firearm hazards Auto-pedestrian safety |
Discuss timeout versus corporal punishment Avoiding media violence Review firearm safety |
Introduction of whole cow’s milk (and constipation with change discussed) Assess anemia, discuss iron-rich foods |
Safe exploration Proper shoes Praise good behavior |
15 months | Review and reassess topics | Encourage nonviolent punishments (timeout or natural consequences) | Discuss decline in eating with slower growth Assess food choices and variety |
Fostering independence Reinforce good behavior Ignore annoying but not unsafe behaviors |
18 months | Review and reassess topics Rear-facing seat until 2 y/o |
Limit punishment to high yield (not spilled milk!) Parents consistent in discipline |
Discuss food choices, portions, “finicky” feeders | Preparation for toilet training Reinforce good behavior |
2 years | Falls—play equipment Forward-facing car seat |
Assess and discuss any aggressive behaviors in the child |
Assess body proportions and recommend low-fat milk Assess family cholesterol and atherosclerosis risk |
Toilet training and resistance |
3 years | Review and reassess topics | Review, especially avoiding media violence |
Discuss optimal eating and the food pyramid Healthy snacks |
Read to the child Socializing with other children Head Start if possible |
4 years | Booster seat versus seat belts Bike helmet |
Healthy snacks | Read to child Head Start or pre-K options |
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5 years | Bicycle safety Water/pool safety |
Developing consistent, clearly defined family rules and consequences Avoiding media violence |
Assess for anemia Discuss iron-rich foods |
Reinforcing school topics Read to child Library card Chores begun at home |
6 years | Fire safety | Reinforce consistent discipline Encourage nonviolent strategies Assess domestic violence Avoiding media violence |
Assess content, offer specific suggestions | Reinforcing school topics After-school programs Responsibility given for chores (and enforced) |
7–10 years | Sports safety Firearm hazard Lap and shoulder safety belt in back seat (8-12 y/o) |
Reinforcement Assess domestic violence Assess discipline techniques Avoiding media violence Walking away from fights (either victim or spectator) |
Assess content, offer specific suggestions | Reviewing homework and reinforcing school topics After-school programs Introduce smoking and substance abuse prevention (concrete) |
11–13 years | Review and reassess Child can start sitting in the front seat at 13 y/o |
Discuss strategies to avoid interpersonal conflicts Avoiding media violence Avoiding fights and walking away Discuss conflict resolution techniques |
Junk food versus healthy eating |
Reviewing homework and reinforcing school topics Smoking and substance abuse prevention (begin abstraction) Discuss and encourage abstinence; possibly discuss condoms and contraceptive options Avoiding violence Offer availability |
14–16 years | Motor vehicle safety Avoiding riding with substance abuser |
Establish new family rules related to curfews, school, and household responsibilities |
Junk food versus healthy eating |
Review school work Begin career discussions and college preparation (PSAT) Review substance abuse, sexuality, and violence regularly Discuss condoms, contraception options, including emergency contraception Discuss sexually transmitted diseases, HIV Providing no questions−asked ride home from at-risk situations |
17–21 years | Review and reassess | Establish new rules related to driving, dating, and substance abuse | Heart-healthy diet for life | Continuation of above topics Off to college or employment New roles within the family |