Pediatrics Rotation Exam Course

Pediatric (EOR): Anticipatory Guidance

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
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
Pediatric (EOR): Neurology/Developmental (Pearls) (Prev Lesson)
(Next Lesson) Pediatric (EOR): Down Syndrome
Back to Pediatrics Rotation Exam Course

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