First Year

Routine Check-Ups

 

Well Child Visits:               What will be done?  At each visit there will be a history & physical, developmental exam plus:

 

1-2 weeks                                 Feeding evaluation and weight check.

2 months                                   Immunizations:             DTaP, HepB/Hib (Comvax), Polio (IPV), Prevnar

4 months                                   Immunizations:             DTaP, HepB/Hib (Comvax), Polio (IPV), Prevnar

6 months                                   Immunizations:             DTaP, Prevnar.   Fluoride drops to be started

9 months                                                                       Hemoglobin blood test (finger poke)

12 months                                 Immunizations:             HepB/Hib (Comvax), Polio (IPV), MMR, Varivax

Prevnar booster may be given at 12-15 months

TB Skin Test if indicated

15-18 months                            Immunizations:             DTaP, MMR

24 months                                 Immunizations:             Hep A

 

Immunizations:                        Research continues and recommendations for your child changes as new and safer immunizations are developed. 

We encourage you to visit these websites:   www.cispimmunize.org, www.immunize.org, or www.vaccine.chop.edu for more information.

Chicken Pox:                            Given at 12 months or older (Varivax).  If initiated at greater than 12 years, 2 shots are given.

Flu Vaccine:                             Recommended for all children 6-23 months old, especially for children with asthma or other chronic diseases.  It is given October-November on a yearly basis.

Fluoride/vitamins:                    Given at 6 months as a liquid drop and are continued throughout the first 14 years with dose increases at 3 & 6 years.  If taken regularly, fluoride can reduce cavities by 60% or more.  To inquire if your area has fluoridated water call Fresno City at 559-621-8600.  Poly Vi Sol vitamin drops without fluoride can be given before 6 months & is recommended for breast feeding infants.

Hepatitis A:                              Given at age 2 & over– a series of 2 shots given 6-18 months apart.

Hepatitis B:                              Everyone now needs a series of these important 3 shots, given anytime.  These are required for school.

Polio:                                       Injectible killed vaccine is now given at 2 & 4 months for safety reasons.  Oral live vaccine is no longer given.

Prevnar:                                   Pneumococcal vaccine given at 2, 4, 6, 12-15 months.

 

Infant Feeding

 

¨       Breast milk and formula should be the only food for first 4-6 months.

Feed on demand, whenever baby is hungry.  Scheduled feedings may begin by 2 months.

Extra water is not needed.

¨       Breast milk is recommended for the first year of life!

Formula fed infants should be fed formula with iron (Similac or Enfamil) until 12 months

Whole milk can be used after 12 months until age 2.

Low-fat milk (1-2%) can be given after age 2 to 3 years.  Non-fat by age 4-5.

Avoid evaporated or whole milk before age 1 as it may lead to mineral (iron) deficiencies and

stress the child’s system with salt and protein loads.

¨       Solid foods may be introduced at 4-6 months of age.  (Most babies can wait until 6 months)

 

Solid Foods: Suggested order of foods to introduce to your baby

 

0-4 months        Breast milk or iron fortified formula.  No baby food necessary.

4-6 months        Breast milk or formula.  May begin with rice cereal thinned with breast milk, formula or water once or twice a day; 2-3 teaspoons to start.  Avoid putting cereal in bottle… use baby spoon.  After 2-3 weeks begin vegetables (squash, carrots, peas, beans) followed by fruits (bananas, pears, or applesauce) and other cereals (oatmeal, barley).  Juices are unnecessary.  It is better for your baby to eat the fruit itself.

7-8 months        Introduce protein foods and meats.  Lean meats are best, especially poultry (chicken and turkey).  Other foods include egg yolk, plain yogurt, cottage cheese, tofu, and beans, other veggies, grains and fruits.

9-12 months      Concentrate on developing balanced meals from the four basic food groups; vegetables, fruits, grains, and animal products.  Increase amount of finger foods and soft table foods.  Drinking filtered water (not juice) is good in-between meals. 

Foods to avoid until 9-12 months because of potential allergies or reactions: fish, egg white, wheat, peanuts, citrus, and strawberries.

 

Tips to remember

¨       Try preparing your own baby foods, using a simple baby food grinder or blender.  Avoid seasonings.  Freeze in ice cube container for individual servings.

¨       Commercial Baby Food: 

Check the “use by” date on the container.

            Read labels carefully

            Refrigerate unused portion immediately.  Leftovers should be used in 1-2 days.

¨       Avoid heating milk or food in microwave, due to “hot spots”

¨       NO HONEY OR KARO SYRUP until after 1 year of age.

¨       If there is a family history of a specific food allergy, postpone its use until later.

¨       As your baby grows older, he needs less milk.  Encourage filtered water. 

¨       Wean baby off bottle by 12-18 months of age. 

¨       Falling asleep with a bottle of milk or juice in the mouth can be damaging to the teeth.

¨       Encourage cup drinking by 12-18 months!

 

Accidents

¨       Protect baby from common injuries.  Do not leave alone on a bed, changing table, or couch.

¨       Always have infant in back car seat, reverse facing, until 1 year of age & 20 lbs., when traveling.

¨       Keep hot water, coffee (beverages) out of reach. 

¨       If the skin is accidentally burned (minor injury), place it in cold water & cover with a clean wet cloth & apply Polysporin or Neosporin. If burn is severe, contact your doctor immediately.

¨       Don’t ever leave baby unattended in the bathtub for any reason!

¨       Learn CPR!  Call Valley Children’s Hospital or the American Heart Association for classes.

 

Suggested Books to Read

1.      Caring For Your Baby & Young Child by the American Academy of Pediatrics.  A comprehensive book on child medical care from behavior and nutrition to illness and treatment.  A must!

2.      Guide to your Child’s Nutrition.  American Academy of Pediatrics 1999

3.      New Guide to Breastfeeding. American Academy of Pediatrics

4.      The Nursing Mother’s Companion, 5th Edition.  Kathleen Huggins.

5.      Your Baby’s First Year.  American Academy of Pediatrics

6.      Touchpoints.  Berry Brazelton, MD.  Describes stages of a child’s life & how to deal with difficulties.

 

                                                                                                               

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