Parents are often the best source of developmental information to help the pediatrician make an evaluation of the child’s development. Keep accurate records of development. Be sure and discuss your observations with your child’s pediatrician. If you have questions, ask them.
Standardized developmental charts show the physical stages of growth and development for the infants and children. These can show where your child is in developing gross and fine motor, visual, language, and cognitive skills, and also to measure height, weight, and head circumference.
How your child reaches a growth stage is as individual as fingerprints. At each age a child is expected to master certain tasks — in other words reaching a “developmental milestone.”
Remember that there is a wide range of development. A child, for example, who is large for height, weight and/or head circumference might be slow to roll back and forth; for this child, then, it would not be considered a developmental delay. A toddler might walk anywhere from nine months of age to 2 years of age and still be considered developmentally normal. Caution should be used in comparing one child’s development to another, especially siblings. What might be normal for one is not necessarily normal for the other.
Choose a doctor for your child before birth so that he/she will be accessible immediately following. When looking for a doctor, get recommendations from those you trust and respect. Consider the location of the office. You want to be sure it is as convenient as possible for regular visits. Interview, if you can, potential doctors. During this time, feel out the fit of your personality and needs with the personality and services the doctor provides. You want to feel comfortable with this person. Check the doctor’s credentials and any discipline actions taken against him/her.
A good doctor for you and your child is someone with whom you feel comfortable enough to ask any question. Always ask what new things you can expect at your child’s upcoming age; always ask what you can do to optimize your child’s brain development at each age.
It’s the best way of keeping your baby healthy. A medical provider can pick up health problems early, before even symptoms of real trouble. And your baby’s immunizations will be kept up to date.
- Child younger than 6 months is higher than 100 F.
- Child has fever and cannot be consoled.
- Child has fever and has trouble waking from sleep.
- Child has fever and cries when you touch or move him/her.
- Child older than 6 months has fever greater than 100 F more than two days.
- Child older than 6 months has fever equal to or higher than 102 F.
- Child has fever and is drowsy.
- Child has fever and is breathing heavily.
- Child has fever and has pains.
- Child has fever and a stiff neck, cannot bend head forward and is sensitive to bright lights.
- Child has recurring, unexplained fevers.
- Child is throwing up.
- Child has diarrhea or is constipated.
- Child is inconsolable.
- Child has unexplained marks, bumps or bruises on body.
- You have diet/eating concerns about your child.
- Other concerns about your child’s health and development.
What is community pediatrics?
The American Academy of Pediatrics (AAP) has issued a policy statement for pediatricians addressing the critical importance of the community in children’s health care. Rising levels of intentional and unintentional injuries, substance abuse and dependency, behavioral and developmental disorders, maladaptive family behaviors, sexually transmitted diseases, unplanned pregnancies, and high infant mortality rates in certain communities have not been addressed adequately by the traditional medical practice model alone. Children’s health must be addressed within a context of biology, family and community. A community pediatric health-based perspective can intervene early in the life cycle to prevent later problems and promote healthy child development.
The AAP defines community pediatrics as:
- A perspective that enlarges the doctor’s focus from one child to all children in the community.
- A recognition that family, educational, social, cultural, spiritual, economic, environmental and political forces significantly affect children’s health and functioning.
- A synthesis of clinical practice and public health principles directed toward providing health care to a child and promoting the health of all children within the context of family, school and community.
- A commitment to collaboration with other professionals, agencies and parents to optimize accessibility, appropriateness and quality of services, and to advocate for those in need.
- An integral part of the professional role and duty of the pediatrician.
What is needed to promote community pediatric health based strategies?
Two fundamental issues must be addressed in developing interventions based on social and behavioral research. These include (1) the need to address generic social and behavioral determinants of health, and (2) the need to intervene at multiple sources of health influence. In addition, following are recommendations to guide pediatricians in addressing the needs of children and families in a community context:
- Focus. Focus on social and behavioral determinants of disease, injury and disability at the national and local levels to be informed of the health and social risks for children, and identifying ways to enhance or modify services and programs so community-based strategies are developed.
- Interventions that tackle multiple levels of influence and multiple risk factors must make the best use of resources at each level.
- Multiple Approaches. Use multiple approaches to promote health such as education, social support, laws, incentives, behavior change programs; identifying and coordinating existing services to ensure children get a strong start by providing, for example, appropriate early education, immunization, injury prevention, nutrition and opportunities for physical activity.
- Multiple approaches address multiple levels of influence simultaneously – individuals, families, communities and organizations.
- A social ecological model provides a structure for intervention at multiple levels of influence – individual, interpersonal, institutional, community and policy levels.
- Health behavior changes need to be supported not only at the individual level, but both at the school based and community-based level for sustained change. Change is influenced by interacting factors.
- Partnerships. A partnership with community members offers the best chance to collaborate with others interested in the health and well being of the community’s children.
- Strive to provide a medical home for every child in the community. The pediatric primary care clinic or office may be an opportune setting in which to link child health services to other community-based programs.
- There is a role for child health supervisors in settings such as child care centers and schools.
- Bring community and school resources to bear on children’s problems.
- Involve those sectors of society that have not traditionally been associated with health promotion efforts, including law, business, education, social services and the media.
- Build relationships with communities, and develop interventions that derive from the communities’ assessment of their needs and priorities.
- The long view. Opportunities for community pediatric health-based services do not end at childhood; evidence indicates that intervention efforts with adolescents and adults can be successful if these efforts address major developmental tasks at each stage and address major sources of health risk at multiple levels.
- Many risk factors observed in adults can be detected in childhood.
- Risk behaviors are closely linked to social and economic conditions such as economic inequality, social norms and other forces and interventions needed to address and reduce risks across large population segments.
- There is compelling evidence that the physical, cognitive and emotional health of infants can be improved with comprehensive, community-based, high quality services that address basic needs of children and families.
- Adolescents can enjoy healthier life styles if greater attention is paid to the social and environmental context (family, school, work settings) in which youth live and learn. Poor health habits can be avoided and developmental risk averted.
- Behavioral and social interventions can directly impact physiological functioning.
- Educate and mentor. Act as an educator and role model to residents and medical students in community settings, using resources from the AAP on community-based practice.
- AAP chapters and members should provide leadership for furthering the understanding of community pediatrics, and participation in community-based practice models.
- AAP chapters should provide leadership, support and recognition for pediatricians involved in advocacy efforts at local, state and national levels to ensure access to care by all children, and to foster integration of community activities as an integral part of the professional role and duty of the pediatrician.
Best Practices for community pediatric health promotion?
- Best practices for a comprehensive community-based pediatric health strategy must not just emphasize services but stress a more comprehensive policy and program package, one that includes economic and financial support as well as services aimed at preventing problems. Efforts to improve the health of communities can benefit from public policies that promote healthful environments.
- A consistent theme across health promotion research calls for interventions and research conducted in partnerships with communities — that is, research efforts are conducted by communities rather than on communities, and interventions not strictly message-driven but guided by the voice of the community.
- Community partnerships influence community priorities toward healthy outcomes.
- Community participation and buy-in enhance the sustainability of interventions.
Sources: American Academy of Pediatrics Committee on Community Health Services (1999). The pediatrician’s role in community practice. Pediatrics, 103(6), 1304-1306.
Promoting health: Intervention strategies from social and behavioral research (2000). Institute of Medicine, Washington, D.C.: National Academy Press.
- What can I do to create a safe environment for my baby’s brain development?
- Be sure to see the doctor for all scheduled appointments.
- Make sure your baby gets immunizations on time.
- Put your baby on his/her back to sleep.
- Avoid placing soft, fluffy bedding such as pillows, blankets/comforters, sheepskins or toys in your baby’s crib that can interfere with your baby’s breathing.
- Be sure the slats on your baby’s crib are no more than 2 3/8 inches apart.
- Protect your child from stairs once he/she begins crawling.
- Avoid scalding (burning with water) your baby by setting the temperature of your hot water heater to 120 degrees Fahrenheit. Always check the temperature of water you are going to place your baby in with a thermometer or with your elbow.
- Never leave your baby alone in or near water (e.g., bathtub, swimming pools, pet water dishes, buckets, etc.). A baby can drown in even one inch of water.
- Use appropriate car seats. It’s the law, too.
- Block/cover electrical outlets.
- Put yourself at your baby’s height to test for safety of his/her environment. Remove anything harmful, including kitchen chemicals, electrical cords, and furniture with sharp edges.
- Remove any objects and toys from your baby’s environment that he/she can swallow. Anything that can fit into a toilet tissue roll is a potential choking hazard.
- Never shake your baby, so that his/her head is rattled.
For additional information and resources please visit:
Good nutrition is necessary for brain growth and development. The nutritional food plate can help you select the best foods for you before your baby is born and help guide the foods to feed your baby after his/her birth. To see the nutritional food plate you can visit: http://www.choosemyplate.gov/
Your baby’s birth weight and brain size depend on the quality of the mother’s nutrition during pregnancy. For more information on breastfeeding your infant please visit:
Typically, children are thought of as overweight 20% or more above normal weight for that age but the makeup of each child’s build and body is unique. Please talk to your child’s doctor about any concerns.
Establishing and modeling healthy and nutritious eating habits now will help your baby make healthy and nutritious eating choices as he/she gets older.
Every family must decide whether a baby boy should be circumcised. Circumcision is a procedure performed by a doctor after birth and before leaving the hospital. The procedure involves removing the foreskin covering the end of the penis. The decision of circumcision is really a personal choice based on parental preference. Consider the following when deciding:
Pros of the Procedure
- During your child’s first year, the occurrence of urinary tract infections is reduced.
- There is no chance for the surgical procedure between ages 3-5.
- No chance of cancer of the penis
- Prevents phimosis, a condition that keeps the foreskin from folding back.
Cons of the Procedure
- Chance of infection.
- Complications connected to foreskin infections.
- Pain the child will feel.
The procedure is usually performed after birth and before leaving the hospital. The penis should heal after 5-10 days. Once the redness has gone away, the area is healed. Until then follow three guidelines:
- Dab the penis with Vaseline each time you change a diaper. Be sure to completely remove the old Vaseline application before applying more. This will ensure bacteria and infection does not invade the area.
- Do not submerge the penis in water until completely healed. Instead, give your son a sponge bath.
- Call your child’s doctor if you see redness more than 10 days, if there is swelling or there are sores. A yellow discharge from the penis is normal.
Nutrition is the process in which the body takes in the food necessary for health and growth. Providing children with nutritious meals is very important to help stimulate their health and growth. For more information about nutrition and other topics related to child nutrition please visit any of the websites below:
Food-borne illness is transmitted by microscopic pathogens such as a virus, bacteria or parasite. When a person eats food affected by a pathogen, the person becomes infected.
Food-borne infections occur from a pathogen growing inside a human body. The time between consumption of the pathogen and symptom onset can be days or weeks because the pathogen needs time mature.
Food-borne intoxications occur when a pathogen has had time to mature in the food product. Symptom onset is usually quick and easily attributed to the contaminated food.
Follow proper food safety practices to ensure foods you prepare and consume are pathogen free.
University of Florida Extension / Institute of Food and Agricultural Sciences, edis.ifas.ufl.edu
Allergies and asthma can easily be confused. They share some symptoms: wheezing, coughing, lack of energy. Allergies are part of a body’s normal response system to a perceived harmful substance; asthma blocks of airways. Making normal breathing difficult. Allergies can be linked to such triggers as pollens, animals and foods; asthma is the result of extreme physical exertion.
Allergies can be treated through pills, shots and lifestyle changes. Treatment will vary according to each individual case. Severity, frequency and regularity will be considered when prescribing treatment.
Asthma is treated with inhalants to widen the passages to the lungs. Children with asthma may be especially susceptible to high concentrations of air pollution and smog. Consult your doctor.
Mealtime is more than eating. Babies learn skills then. For instance:
- Oral skills: Rather than spooning food in, gently touch the spoon to your baby’s lips and let him or her come for it.
- Jaw skills: Add soft table food when your baby starts munching at 9-10 months and when the baby starts chewing at 12-14 months.
- Sensory skills: Allow your baby to get messy. Experiencing foods through sight, taste, touch, smell and sound promotes pleasant and nurturing mealtimes.
- Hand-to-mouth skills: Allow babies to explore toys and food with their hands and mouths.
- Healthy eating skills: Repeated exposure is key to learning to enjoy a variety of foods.
Reintroduce something even if the child didn’t like it the first time. For more information please visit: www.aap.org
Listed below are average height and weight measurements. If your child’s measurements differ greatly from these, talk with your pediatrician about anything you should do.
|1 month||8-11 lbs.||20-23 in.|
|7 months||15-20 lbs.||25-28 in.|
|12 months||19-25 lbs.||28-31 in.|
|2 years||24-30 lbs.||32-36 in.|
|3 years||28-34 lbs.||36-39 in.|
|4 years||32-39 lbs.||38-42 in.|
|5 years||36-44 lbs.||41-44 in.|
Some doctors think that one cause of “Sudden Infant Death Syndrome” (SIDS) may be infant botulism (food poisoning). A number of public health officials now believe there may be many unrecognized cases of this disease each year, and honey has been implicated as a cause in a few. Symptoms vary from mild to severe, but there have been no cases found in children over 26 weeks old. The Infectious Disease Section and Microbial Diseases Laboratory of the California Department of Health has provided evidence that botulism spores in the infant intestinal tract can produce the growing stage of the bacterium, Clostridium botulinum. This in turn manufactures a highly toxic poison. So far, this research indicates no reason why the disease is produced only in infants under 7 months old.
Botulism spores are found everywhere in nature. They are not harmful themselves, but in the absence of oxygen (anaerobic conditions), the spores germinate and the resultant bacteria produce a powerful poison. That’s why all canned vegetables are heated prior to packing.
Raw agricultural crops, however, are never heated. And many foods, even if heated or processed, once exposed to the air would be susceptible to re-infestation by botulism spores. Research suggests an unknown risk factor in feeding raw agricultural products, including honey, to infants under a year. Although honey has been blamed as a source of spores in a few infant botulism cases, some medical officials are not convinced about its role in the disease. Dr. Roger Feldman of the Federal Center for Disease Control says data are not yet strong enough for the CDC to issue a warning about honey. But he says parents should be aware of the findings so they can decide for themselves. Perhaps there are other foods involved, and honey may be no risk at all. We just don’t know.
Honey is highly nutritious. No other disease besides infant botulism has been linked to honey. The risk of this disease appears small.
University of Florida Extension / Institute of Food and Agricultural Sciences, edis.ifas.ufl.edu.
Because Floridians are used to warm weather, extra precautions should be taken when traveling to cold climates. Dress your child in one more layer than you think you should. Children’s small bodies lose heat more quickly and are not as well insulated as adults; as a result, children are at greater risk for hypothermia and frostbite.
If your child is numb, shivering or confused in cold climates, get him/her to a warm place and wrap in blankets. Do not expose your child to direct sources of heat such as fire or a heater. Call for help to be sure your child is properly cared for.
The hot and humid weather in Florida can contribute to the onset of dehydration, heat exhaustion, heat cramps and heat stroke. Small children can be at greater risk for these occurrences because their small bodies cannot fully regulate the body’s cooling system.
To prevent heat-related emergencies, be sure to keep your child hydrated; provide a lot of water for him/her to drink. When your child is playing in hot and humid weather, limit playtime to short intervals and interrupt every so often for water breaks. Dress your child in non-restricting lightweight clothes.
Watch for these signs to tell you your child needs attention:
- high temperature.
- flushed complexion.
- feeling dizzy.
- feeling sick.
- feeling overtired.
- muscle cramps.
If you notice any of these signs in your child, get him/her to a cool place. Provide water for your child to drink and time for his/her body to recuperate in a cool space.
If your child seems confused, is not sweating or has a temperature above 103 degrees, call 9-1-1 immediately. These are signs of heat stroke and can be deadly. In this case submerge your child in cool water, but do not provide drinking water.
Never leave your child unattended in a hot car this can lead to heat stroke and ultimately death in a very short period of time.
In the first three of years of life, a baby’s brain can be injured much more easily than an adult’s brain. One way of hurting a young child’s brain is by shaking the baby. This can happen when caregivers or parents are frustrated or angry. Even if you have had a bad day either at home or at work and the baby is getting on your nerves,
NEVER, NEVER SHAKE YOUR BABY
This may lead to such severe brain damage that the baby dies. Even if the child survives, he/she can suffer from blindness and /or mental retardation.
- Set your baby in a safe and secure place.
- Leave the room.
- Take deep breaths-count-calm down.
- Once you have regained control, reconnect with your baby.
Make sure that anyone caring for your baby also understands and practices this concept.
Sudden Infant Death Syndrome refers to a baby’s death without any apparent cause. It is not clear what exactly causes SIDS, but there are three things you can do to protect your child:
- Do not expose your baby to second-hand smoke.
- Put your baby to sleep on his/her back. Babies should be put to sleep on their backs until they can turn themselves over. www.nichd.nih.gov/ , Click on the Back to Sleep campaign logo.
- Keep pillows, comforters and stuffed toys out of your child’s sleeping area. These items can lead to suffocation.
Smoking while pregnant lowers the amount of oxygen available to the baby. Moreover, the chemicals in nicotine pass into your baby’s bloodstream. All this can retard your baby’s growth and development. It’s also linked to a greater likelihood of premature birth, low birth weight, infant death, and health problems after birth.
Smoking after birth continues to present great risks to your child’s health. It exposes your child to second-hand smoke and provides an unhealthy model for your child. Exposure to second hand-smoke increases your child’s chances of ear infections, asthma and SIDS (Sudden Infant Death Syndrome). In the long run it contributes to lung cancer, heart disease and cataracts.
If you are a smoker, it is in the best interest of your child to quit.
Be sure anyone who does smoke, smokes outside. You want to be sure that the air in your home is healthy for your child to breathe.
Babies do not need vitamins unless he/she was not carried to full term or there are other medical problems; your child’s doctor will prescribe if necessary. Consult your pediatrician at any time if you are concerned about your child’s nutrient intake.
- for severe difficulty breathing, gasping for air and or choking on something.
- for a convulsion.
- for severe injuries, including deep or extensive cuts.
- for serious reactions.
- for a permanent tooth that has been knocked out.
- for a child underwater more than a couple seconds.
- for burns larger than the child’s fist.
- for exposure to smoke or toxic fumes.
- For head injuries.
- For loss of consciousness.
Call the Poison Control Center if you have a suspicion your child has ingested any harmful substance: 1-800-222-1222