ANTICIPATORY GUIDANCE
2 MONTHS
NEWBORN
• Care of umbilical cord; circumcision
• Breast engorgement; vaginal discharge
• Jaundice
• Crying, colic
• Sleeping
• Jitteriness
• Hiccups, sneezing, spitting up
• Fontanel; stools
• Pacifier; bathing and skin care
• Unwanted advice
• Postpartum adjustment
• Importance of close interaction
• Rest of mother; sibling reaction
• Change of parent and family
relationships
• Feeling of inadequacy, depression
• Individuality of infant
• Breast and bottle feeding
• Vitamin and fluoride supplement, if
indicated
• When to call the doctor
• Fever, vomiting, diarrhea
• Accident, prevention, crib safety
• Never leave alone with pets or young
siblings
• Be careful of hot water during bath
2-4 WEEKS
• Injury prevention
Never leave infant unattended
• Nutrition
Breast or formula feeding
• Sleep, crying
• Bladder and bowel habits, urinary
stream
• Emphasize infant’s abilities
• Hold, cuddle, enjoy, talk to baby
• Time to themselves for parents
• Avoid isolation
• Prepare for future immunizations
• Injury prevention
Do not lay infant on bed or table
unattended
Caution about hot liquids, cigarette
ashes
Advise against infant walker
• Nutrition
Introduction of solid foods at 4-6
months if indicated
Iron supplement in preterm infants
• Sleep
• Playing with baby; talking to and
cuddling baby
• Spending time with siblings
• Substitute care if mother works
12 MONTHS
• Injury prevention
Caution about hot liquids
Kitchen, stair, water and care safety
Fences, gates, latches
Moving machinery, mowers, backing
cars
• Good parenting practices
Speech development: talk to baby
Pick up, hold, cuddle, love
Discuss autonomy, limit setting,
discipline
Praise desired behavior
Prohibitions few but firm
• Nutrition
Table foods, bottle use
Decrease in food intake
Fluoride, if indicated
Phase of bottle use
• Advise against bottle in bed
• Child care
15 MONTHS
• Injury prevention
Locked doors, safety gates; poison-
proof home
 Danger of aspiration from nuts,
popcorn, chewing gum
Burns, scalds, electrical injuries
Supervision near water, danger of
plastic bags
• Play, talk, read and sing with baby
• Nutrition
Self-feeding; eats meals with family
Fluoride supplement, if necessary
• Review indications of toilet-training
readiness
• Discipline
• Remove from temptation
• Praise good behavior
• Consistency between parents
• Day care
16 MONTHS
• Injury prevention
Car restraints; protection against falls
Supervised play near street, in
driveway. Never leave unattended in
care or in house
Electrical injuries; water safety
• Good parenting practices
Read simple stories to child regularly
Play games; praise; show affection
• Nutrition
Wean from bottle
Fluoride supplement, if needed
• Sleep
Short ritual before regular bedtime
Night fear; night awakening
• May show toilet training readiness at
18-24 months
• Discipline
• Need for autonomy and independence
• Self-comforting behaviors
Thumb-sucking, masturbation
Favorite toy or possession
• Child care arrangement
24 MONTHS
• Injury prevention
Burn; falls; car; safety restraint
Toxic substance and disc battery
ingestion
Unsafe toys, plastic bags, balloons
Electrical injuries; drowning
Supervision when playing near street
• Good parenting practices
Read regularly; talk at meals
Provide for play and peer contacts
Watch children’s TV programs with
child
• Nutrition
Fluoride supplement if needed
Avoid struggles about eating
Discourage non-nutritious snacks
• Sleep
Discuss a move to regular bed
Reassure that day napping varies
• Toilet training
Does child show interest and readiness?
Does child understand expectations?
• Day care
• Curiosity about body parts
• Use of toothpaste
• Mild speech dysfluency may be normal
3 YEARS
• Injury prevention
Danger of running into street
Strange fogs; street safety
Water safety
• Good parenting practice
Talk about activities with child
Reserve time alone with child
Allow to explore, showing initiative, and
communicate
Encourage out-of-home experiences
Limit TV viewing; showing affection
Tolerate transient speech dysfluency
Satisfy curiosity about babies, sex
differences
• Nutrition
 Balanced diet, avoidance of junk foods
Fluoride supplement, if indicated
• Discipline
• Dental appointment
• Toilet training
• Nursery school, day care, baby sitters
• School readiness skills
4 YEARS
• Injury prevention
Electrical tools, firearms, matches,
poisons
Bike riding in street
Car seat restrains
Uninterrupted supervision near water
Refusal of food or riders from stranger
Strange dogs, street proofing
• Good parenting practices
Provide interaction with other children
Assign chores; help set and clean the
table
Take exploratory walks and trips
Limit TV viewing
Answer questions about sex at child’s
level
• Toilet Training
• Discipline
• Nursery school, day care and baby
sitting
5 YEARS
• Injury prevention
Electrical tools, firearms, marches,
poisons
Bicycle safety, water safety
Car seat belts
Home fire safety
Telephone numbers and address
Should not go with or accept anything
from strangers
• Good parenting practices
Promote interaction with other children
Assign chores
Demonstrates interest in kindergarten
• School readiness
Plays well with other children
Normal development
Endures half day separation from home
• Sex education
• Nutrition
• Dental care
• Discipline
6 YEARS
• Good health habits
Avoid junk foods; maintain appropriate
weight
Exercise regularly; learn to swim
Brush teeth at least 3 times a day
Bicycle safety; seat belts
Get adequate sleep; limit TV viewing
• Social interaction with family and peers
• Good parenting practices
Establish rules; acts as model
Provide allowance; spend time with
child
Show interest in school
Adult supervision when away
Praise, encourage, show affection
Hobbies, exercise
8 YEARS
• Good health habits
Balanced diet, avoid junk foods;
maintain appropriate weight, exercise
regularly
Practice bicycle and car safety
Get adequate sleep
• Social family interaction
• Good parenting practices
Establish fair rules; communicate with
child
Show interest in school
Provide allowance; be a role model
Praise and encourage child
Show affection; promote outside
activities
Obtain a library card for child
10 YEARS
• Good health habits
Balanced diet, avoid junk foods;
maintain appropriate weight, exercise
regularly
Practice bicycle and car safety
Dental care
Sex education at home/school
Seatbelts; TV and videogame limits
• Social interaction with peers; hobbies
• Academic activities
• Good parenting practices
Establish fair rules; supervise potentially
hazardous activities
Spend time with child; contribute self-
esteem
Praise and encourage child’s activities
Preparing girls for menarche

12 YEARS
• Good health habits
Balanced diet; appropriate weight
Physical activity, sports, hobbies
Dental care
Drug, tobacco and alcohol use
Rapid physical growth and sexual
development
Breast and testes examination
Seat belts; hitch hiking
• Sex education
• Social interaction with peers; hobbies
• Sports, hobbies, weekend jobs
• School
• Good parenting practices
Establish fair rules; supervise hazardous
activities
Spend time with child; communicate,
show affection
Respect privacy, allow decision making