Child Care

The parents’ guide for
newborns through pre-school
! "
Baby’s Name ____________________________________
Date of Birth ____________________________________
Weight _________________________________________
Length _________________________________________
2 week measurements: _____________________________

2 month measurements: ____________________________
12 month measurements: ___________________________
- 2 -
NOTES
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
- 3 -
TABLE OF CONTENTS
Normal Newborn Characteristics .......................................................................5
Appearance ..................................................................................................5
General Care of Your Newborn .........................................................................6
Breastfeeding ............................................................................................... 9-11
Bottle Feeding ..................................................................................................12
Burping.............................................................................................................13
Elimination .......................................................................................................13
Behavior/Response...........................................................................................14
Temperature .....................................................................................................15
Car Seat Safety .................................................................................................15
Taking Baby Out ..............................................................................................15
Immunization Guide.........................................................................................16
Safety ...............................................................................................................17
When Your Child Has A Fever ........................................................................18
Colds ................................................................................................................19
Vomiting ..........................................................................................................20
Diarrhea...................................................................................................... 21-24
Constipation In Infancy ....................................................................................25
Colic .................................................................................................................26
Dry Skin/Eczema .............................................................................................27
Earaches ...........................................................................................................27
Dosage Charts ..................................................................................................28
Well Child Care at 2 weeks ..............................................................................29
Well Child Care at 2 months ............................................................................31
Well Child Care at 12 months ..........................................................................42
Well Child Care at 2 years ...............................................................................51
Well Child Care at 2 1/2 years .........................................................................55
- 4 -
Notes ................................................................................................................70
BABY CARE
(Normal Newborn Characteristics)
APPEARANCE
HEAD
Sometimes misshapen (bones are not fused together at birth, so you will notice
ridges).
BREATHING
Babies breathe irregularly at a rate of 30 – 60 breaths per minute. Breathing
should be easy and quiet.
COLOR
Hands and feet may be bluish (it sometimes takes several days for circulation to
adapt to the changes at birth). Your baby is okay if lips and inside of mouth
remain pink, and breathing is not labored.
REFLEXES
Normal reflexes in your baby include: rooting, sucking, grasping, and the
startle reflex.
FIVE SENSES
Your baby can see, hear, feel, smell, and taste. You should dim the lights for the
first few days to allow your baby to adjust to the light.
HICCUPS, YAWNING, SNEEZING, ETC.
Hiccups, yawning, sneezing, burping, passing gas, mild coughing, and crying
are all normal behaviors for babies. Sneezing helps them clear their nose.
Hiccups are muscle spasms of the diaphragm and are harmless. Offer the baby a
pacifier or burp the baby if baby becomes frustrated.
BIRTH MARKS
About 50% or so of babies have birthmarks. The most common are light red
patches on the skin, known generally as “salmon patches” on the upper eyelids,
between the eyebrows or center of the forehead (sometimes known as an “angel’s
kiss”), and the nape of the neck (where they are often called a “stork bite”) which
may well be unnoticeable as baby grows because it is hidden by his/her hair.
- 5 -
GENERAL CARE OF YOUR NEWBORN
SPONGE BATH
Sponge bathe your baby until the umbilical cord has dropped off and the navel
has healed.
1. Establish a routine (pick a time of day that you are least likely to be
disturbed or interrupted).
2. Choose a room free of drafts with temperature slightly higher than usual.
3. Gather all supplies: basin of warm water, change of clothing, wash cloth
and towel, mild soap, comb or baby brush, diaper, cotton tipped
applicators, cotton balls, alcohol or other cleanser as indicated by your
doctor for cord care, and petroleum jelly for circumcision.
4. Cleanse eyes first, Use plain water and one cotton ball per eye. (If
washcloth is used, use one corner per eye.)
5. Cleanse external ear with moist cotton tipped applicator. Clean only what
you can see. (Do not insert anything into the ear. Mucus or dried blood
will come out on its own.)
6. Cleanse face with clear water – no soap.
7. Bathe baby with mild soap and water, starting at neck and working down.
Be sure to get in folds and creases, especially behind the ears.
8. Pat dry. Be sure to dry in folds and creases.
9. Shampoo hair with baby in football hold. Dry and comb hair.
10. Apply appropriate cleanser to cord. Apply petroleum jelly to
circumcision if needed.
11. Dress infant.
SWADDLING
Bundling your baby snugly in a blanket gives the baby a sense of security and
can help when baby becomes fussy or little hands need to be restrained at feeding
time.
DRESSING
Dress your baby according to the temperature. On cold days your baby will
need a snug knit hat.
- 6 -
CORD CARE
The navel should be cleansed with a cotton ball moistened with alcohol twice
daily, unless specified otherwise by your doctor. The area should be kept dry and
exposed to air as much as possible. When the cord drops off (usually 10 to 20
days), there will be a small amount of drainage for a few days. Continue to use the
alcohol on the navel until it is completely healed.
DIAPERING
Diapers should be changed frequently to prevent diaper rash. Use unscented
baby wipes or a soft wet bath cloth or wet white paper towel to clean your baby’s
bottom at each diaper change.
DIAPER RASH
If your baby develops a rash, you may use a zinc oxide ointment or petroleum
jelly prior to diapering. Also, exposing your baby’s bottom to air is helpful in
clearing rashes. If the rash persists, call your pediatrician.
PENIS/CIRCUMCISION
Apply petroleum jelly (Vaseline) at each diaper change until healed (about 7
days). Then keep penis clean by washing with mild soap and water. Rinse well.
UNCIRCUMCISED PENIS
Keep penis clean. Do not attempt to push foreskin back unless instructed by
your physician.
GENITAL CARE
GIRLS:
Girl babies are sometimes swollen and red due to hormones that they receive
from their mothers. Gently clean bottom from front to back with plain water. You
may also notice a white or pink discharge in the diaper area. This is normal, and
again due to hormone changes.
Boy and girl babies sometimes have “brick colored” urine or residue on diaper.
This can be a normal finding in the newborn period.
SKIN
Avoid lotions, powders, and oils on your baby’s skin for the first few weeks.
Your baby’s skin may be dry and peeling at first. You may use a small amount of
Moisturel, Lubriderm, or Aveeno lotion on excessively dry skin.
Your baby’s nails are often attached to the skin so you should wait until they
separate before trying to cut with baby scissors. Use an Emory board or nail file to
smooth nails until they separate.
- 7 -
It is normal to see the fontanel (“soft spot” on your baby’s head where bones
have not closed) beat with your baby’s heartbeat. When bathing your baby, do not
be afraid to clean this area as you clean the rest of the head. Report if you notice
the fontanel bulging or sunken.
JAUNDICE
Most jaundice (a yellow tint to baby’s skin) in the newborn is a normal event
and is not considered serious. In most cases it will disappear after a few days,
often without any special treatment.
If your baby is breastfed, increase the frequency of feedings if possible. You
can also do “sun baths”: undress the infant as much as possible without
endangering temperature stability to allow skin exposure through the window to
outside light. This will help reduce the jaundice. Do this for 30 minutes at least
three times per day. Call if the skin becomes increasingly yellow, or the white of
the eyes become yellow.
If treatment of jaundice is necessary, your pediatrician may order a special
blanket or frequent blood tests. Please take the baby for all lab tests ordered and
use the blanket as directed.
- 8 -
BREASTFEEDING
BASIC CARE OF BREAST
1. Wash your hands, or use the disposable hand wipes, before each feeding.
2. Wash your nipples once a day with warm water. Do not use any soap on
the nipple area as this dries the skin and removes natural oils that help
protect the skin. You may apply an ointment such as Lanolin after
feeding if nipples are sore.
3. Do not wash the nipples before or after a feeding; keep your nipples
exposed to the air as much as possible by leaving the flaps down on your
nursing bra at intervals.
4. A properly fitting nursing bra is recommended to provide support for
your breasts during lactation. If you do not have a nursing bra, leave your
bra off for at least one hour after breastfeeding to air your nipples.
POSITIONS FOR BREASTFEEDING

You will need to be comfortable with your back and arm supported in all
positions. Using pillows will help.
1. Classic Cradling Position: lay the baby in the arm nearest the breast, on
his/her side facing the breast. (Not on his/her back with his/her head turned)
Pillows under the arm that is holding the baby will help support the weight
of the baby and prevent a backache for the mother.
2. Football Hold: put pillows from the mother’s lap out to her side. Lay the
baby on the arm nearest the breast and his/her head in her hand and his/her
body beside her (as a football player carries a ball at his side). He/She will
be tucked up under her arm with her hand positioning his/her head.
3. Sitting Football Hold: the baby can be “seated” at mother’s side facing the
breast, with pillows to support him/her. This hold may keep a sleepy
newborn awake longer and/or help an infant to feed in an upright position.
4. Lying down: either with baby beside the mother (lying on his/her side
facing her) or across the mother’s chest, if that is comfortable.
GENERAL INFORMATION ON BREASTFEEDING

Breast babies are usually fed on demand. This can be as frequently as every 2 to
3 hours, at first. The more milk your baby demands, the more you will produce to
satisfy him/her.
It is desirable to nurse the infant from both breasts at each feeding for maximum
stimulation of your milk supply.
- 9 -
Latch on: Get as much of your nipple and areola into the baby’s mouth as
possible. (If the baby has trouble getting the tongue cupped under the breast and
“biting” the nipple, firmly pull down on the baby’s chin after he/she begins
sucking.)
It is best to start on the breast which the baby finished with at the last feeding.
The baby gets most of the milk from the first breast during the first 5 minutes of
nursing, since he/she is hungrier at this time. Even though he/she nurses longer on
the second breast, he/she will not take as much milk; therefore, alternating breasts
will provide equal stimulation for both breasts. An easy way to remember is to
attach a safety pin to your bra strap on the side baby finished with. That is the side
to start with at the next feeding.
When it is time to stop nursing, break the suction by putting your finger between
the baby’s jaws. Allow the baby to nurse until content whenever possible rather
than timing feedings.
It is recommended that you try to burp the baby after each breast feed.
If you have difficulty keeping the baby awake for the entire feeding, try
unwrapping the blankets, removing the baby’s shirt, and/or changing the baby’s
diaper between breasts.
Your baby will be getting colostrum at first. This is thick, and the baby will
have to suck hard to get it. Colostrum is low in fat and very high in protein, and
contains the antibodies needed to protect your baby in this early newborn period.
You will find that you become very thirsty. Drink 8 – 10 glasses of fluid each
day: water, juice, milk, soup, etc.
Expect some abdominal cramping while breastfeeding. Your breastfeeding is
helping your uterus to return to its normal size and to help you lose the weight you
gained during pregnancy. This cramping and leaking of milk is an indication that
the “let down hormone” is working, and your true milk is coming in.
- 10 -
FOODS WHICH SHOULD BE AVOIDED IN EXCESS
1. Beverages: Tea, coffee, carbonated drinks, alcoholic beverages.
2. Vegetables: Green vegetables such as cabbage, broccoli, mustard greens,
turnip greens, etc. Gassy beans such as pork and beans, navy beans, lima
beans, etc.
3. Chocolate: Candy and chocolate milk.
4. Nuts
5. Spicy Foods: Mexican, Italian, Chinese.
Your body needs proper nutrition for your baby. To get a balanced diet while
you are breastfeeding, you should try to eat some foods from each of the following
food groups every day:
1. Lean meat, fish, and poultry.
2. Milk and dairy products.
3. Vegetables and fruits.
4. Breads and cereals.
Remember to take your prenatal vitamins as long as you are breastfeeding!
- 11 -
BOTTLE FEEDING
In the hospital, bottle feeding babies are fed every 3-5 hours. If your baby cries
less than 3 hours after a feeding, he/she may be wet or uncomfortable.
SUGGESTIONS:
Check diaper
Loving attention
Offer a pacifier
WARNINGS:
If your baby takes too much formula, he/she could spit up excessively, develop
diarrhea, or become bloated and uncomfortable.
AMOUNT TO FEED
This will vary. When your baby is 3 weeks old, he/she will probably be taking 2
½ to 4 ounces every feeding. As your baby grows, his/her demand will be greater.
The formula your baby receives is decided by your baby’s doctor. Many babies
make faces and spit as they learn to eat from a bottle. Be assured that this is
normal and not a sign that your baby doesn’t like the taste of the formula. It is
helpful to put the nipple completely in the baby’s mouth and to avoid tickling or
teasing motions.
If a baby has excess mucus (possibly due to rapid vaginal delivery or a
Cesarean delivery), the baby may gag at the first few feedings. Although this
requires more time and attention, it is not a cause for alarm.
Formula can be purchased in three forms: concentrated liquid, powder, and
Ready to Feed. Mixing formula with water provides fluoride that is not present in
Ready to Feed. Fluoride will help to prevent tooth decay. You may choose the
type of formula which best suits your needs. Ready to Feed is most expensive,
concentrated liquid mixes most easily, and powder is convenient when you are
away from home with no means to keep your bottles cool. The following are some
options for bottle preparation:
1. Assume that your baby will take six 4 ounce bottles in a 24 hour period. At
one time each day, pour 2 ounces of concentrated liquid formula into each of six
bottles. Cover each bottle with a nipple and/or lid and place them all in the
refrigerator. Be sure to refrigerate any formula left in the can. When it is time for
a feeding, remove one bottle from the refrigerator and add 2 ounces of warm
water. This will properly dilute the formula, but also warms it up sufficiently for
the feeding.
2. When using powdered formula, you may make up each bottle on an
individual basis or mix enough formula to make up your bottles for a 24 hour
period. Prepared bottles should be refrigerated.
- 12 -
When using Ready To Feed formula, you may pour the desired amount into your
bottles for a 24 hour period and store in the refrigerator. Or, you may make up
each bottle as needed, storing the leftover formula in the refrigerator.
Choose whatever option is most convenient for you.
BURPING
Burping helps remove air swallowed during feeding or during crying from the
baby’s stomach. Once or twice during a feeding and after a feeding hold your
baby upright against your shoulder or face down across your lap. You may also
hold your baby upright on your lap, supporting the head and chest with your
hands. Then gently pat or rub your baby’s back for a minute. Babies do not
always need to burp, so don’t insist if your baby doesn’t burp readily.
ELIMINATION
URINE PATTERN
Babies should have a minimum of 6 to 8 diapers in a 24 hour period. Breast-fed
babies may have fewer prior to your milk coming in. If there is no urine output in
12 hours, call the office.
BOWEL MOVEMENTS
“BMs” begin as meconium (tar-like and sticky) and progress through several
stages of brown, green, and yellow. Breast-fed babies will have frequent loose,
yellow BMs. It will not be unusual to find a BM at each feeding. Bottle fed
babies will have fewer, more firm BMs. If your baby seems to be having trouble
having BMs, or if they are small and formed like firm clay balls, your baby could
be constipated. If your baby does not have a BM in 48 hours, you need to call
during routine office hours.
- 13 -
BEHAVIOR/RESPONSE
SLEEP
Your baby will sleep 10-20 hours out of 24. Your baby goes through about
seven different asleep/awake cycles each day and will begin to form a more
individual sleep pattern as he/she becomes older.
Be sure to place your baby in his/her crib when drowsy, but still awake so
he/she may learn self quieting techniques that enable him/her to fall asleep on
his/her own when he/she awakens during the night. Your baby should sleep on
his/her back on a firm mattress.
AWAKE
If your baby is awake more during the night, attempt to reverse this cycle by
keeping the baby awake more during the day. Your baby should have tummy time
when he/she is awake during the day.
CRYING
Babies cry to let you know that they are hungry, cold, tired, or uncomfortable.
When parents respond quickly, babies soon learn to expect this response. This
communication is satisfying and an important part of early parent-infant
relationships. By 2 or 3 weeks of age, most babies begin a new, different type of
crying – fussy crying. This crying tends to be in the evening. It typically lasts
about 2 hours and continues no matter what you do.
- 14 -
TEMPERATURE
The normal temperature range is 97.6° to 99.6° degrees under the baby’s arm
(axillary). To take your baby’s temperature, make sure the armpit is dry and the
infant does not have clothing between his/her arm and chest. Carefully place the
tip of the thermometer high up into the armpit. If your baby’s temperature is
abnormal, check your environment to see if the room is too warm or too cold or
the baby is overdressed or underdressed.
Babies do not deal well with excesses of temperature in their environment.
They cannot shiver to stay warm or sweat to stay cool. If they get too hot or too
cold, they cannot survive. Therefore, it is up to you to make sure the environment
is of a moderate temperature. In the hospital, newborns should be wrapped in a
clean, dry blanket, and then covered with one or two blankets tucked under their
mattress. A hat may be placed on their head to prevent heat loss through the head.
CAR SEAT SAFETY
Mississippi state law does require that your infant be placed in an approved
car seat while riding in a vehicle. We ask that you please comply with this law.
TAKING BABY OUT
Short walks or car rides are fine. Avoid large crowds, i.e., church, shopping
centers, etc., until at least 2 months of age. Always avoid anyone who is sick.
- 15 -
IMMUNIZATION GUIDE
Your baby will receive a series of vaccinations against illness during childhood.
These are usually given during well-child checkups. If your baby has a cold or
significant illness when it’s time for a vaccination, it may be delayed until your
child is healthy.
Standard Immunization Schedule
Birth to 2 months: Hepatitis B
1 to 4 months: Hepatitis B
2 months: DTaP; Hib; Polio (IPV);
Pneumococcal (PCV); Rotavirus
4 months: DTaP; Hib; Polio (IPV);
Pneumococcal (PCV); Rotavirus
6 months: DTaP; Hib; Pneumococcal (PCV);

Rotavirus
6 to 18 months: Hepatitis B; Polio (IPV)
12 to 15 months: Hib; MMR; Pneumococcal (PCV);

Varicella
12 to 23 months: Hepatitis A
4 to 6 years: DTaP; Polio (IPV); MMR; Varicella
DISCLAIMER:
This Standard Immunization Schedule is subject to change per the guidelines furnished by the
Centers for Disease Control and/or the American Academy of Pediatrics.
- 16 -
SAFETY
Remember, an ounce of prevention is worth a pound of cure:
1. Never leave baby alone on changing table, sofa or bed.
2. Read the label each time you give baby medicine.
3. Don’t put pillows, large or floppy toys, or loose plastic sheeting in crib.
4. Infants should sleep on back on a firm mattress in their own crib to
decrease SIDS/crib death.
5. Use only flame-resistant clothing and bedding.
6. Install safety gates correctly.
7. Never leave baby alone in the tub – ignore phone calls and doorbells
8. Keep all medicines, pills, etc. secure and out of baby’s reach.
9. Test water with elbow prior to bathing to prevent scalding baby.
10. All windows should have window guards.
11. Never leave baby unattended in car.
12. Plastic bags should be stored well out of baby’s reach.
13. Always secure baby in an approved car seat.
14. Test formula temperature on your wrist before feeding baby.
15. Lock up cleaners, insecticides, and poisonous substances.
16. Use proper safety belts in high chair.
17. Keep small sharp objects out of baby’s reach and off the floor.
18. Never leave children alone with small children or pets.
19. Clean up spills immediately to prevent falls.
20. Keep all plants out of baby’s reach.
21. Cap or cover unused electrical outlets and secure electrical wires.
- 17 -
WHEN YOUR CHILD HAS A FEVER
Fever is a normal response to infection and is the body’s way of fighting the
infection. A fever is defined by a temperature greater than 100.5°. Seldom is
fever alone an emergency. It is more important to pay attention to the way your
child is acting and to how sick your child looks than to how high the fever is.
If your infant is less than 3 months old and has a temperature of more than
100.5° rectally, you should notify our office early in the day so we can be sure
your infant is seen. Fever in this age group is reason for concern and is the
exception to the rule of fever in older infants and children.
If your infant or child is uncomfortable, overly sleepy, or irritable, give
acetaminophen as directed on the bottle. The purpose of treating fever with
acetaminophen is to make your child more comfortable. If your child is happy
playing and is not uncomfortable despite the fever, there is no need to give the
medication. Do not give Tylenol to an infant younger than 2 months of age unless
instructed to do so by your pediatrician.
OFFER PLENTY OF FLUIDS
Do not bundle your child because this prevents the child’s body from giving off
heat. Use only a light blanket at bedtime and summer pajamas.
If your child’s temperature is above 102° and/or your child is uncomfortable
after giving acetaminophen, sponge bathe him/her in a lukewarm tub bath for 20
minutes and as often as necessary. You do not want your child to shiver. This
will cause the body to further increase its temperature. If shivering occurs, raise
the temperature of the water or stop the sponge bath.
During the sponge bath, rub your child’s skin with a washcloth to open the
capillaries, allowing them to give off heat. Dry your child in the same way with a
towel following the sponge bath.
PLEASE CONTACT OUR OFFICE IF:
the temperature is approaching 105° (immediately)
the fever lasts more than 24 hours without any other symptoms
the fever lasts more than 72 hours
- 18 -
COLDS
A cold or upper respiratory infection is a viral infection of the nose and throat.
The cold viruses are spread from one person to another by hand contact, coughing,
and sneezing – not by cold air or drafts. Since there are up to 200 cold viruses,
most healthy children get at least six colds each year; children attending out-of-
home care or children with siblings in school are likely to have more frequent
infections.
Any fever usually lasts less than three days, and most nose and throat symptoms
are gone by one week. A cough and cold may last 2-3 weeks. The main things to
watch for are secondary bacterial infections such as ear infections, yellow drainage
from the eyes, thick pus from the nose (often indicating sinus infection), or
difficulty breathing.
Not much can be done to affect how long a cold lasts. However, we can relieve
many of the symptoms. Keep in mind that the treatment for a runny nose is quite
different from the treatment for a stuffy nose.
TREATMENT FOR A RUNNY NOSE WITH CLEAR DISCHARGE
The best treatment is clearing the nose for a day or two. Sniffing and swallowing
the secretions are probably better than blowing because blowing the nose can force
the infection into the ears or sinuses. For younger babies, use a soft rubber suction
bulb to remove the secretions gently.
TREATMENT FOR A DRY OR STUFFY NOSE
Warm water nose drops and suctioning – Most stuffy noses are blocked by dry
mucous. Blowing the nose or suction alone cannot remove most dry secretions.
You may make saline nose drops, by mixing ¼ teaspoon of table salt in 8 ounces
of water. Make up a fresh solution every few days and keep it in a clean bottle.
Use a clean dropper to insert drops. Water can also be dripped or splashed in using
a wet cotton ball. Saline nasal drops can be purchased at your pharmacy (Ayr,
Little Noses, Ocean Spray or generic brands for example).
For the younger child who cannot blow his/her nose: Place 3 drops of saline
drops into each nostril. After 1 minute, use a soft rubber suction bulb to suck out
the softened mucous gently. To remove secretions from the back of the nose, you
will need to seal off both nasal openings completely with the tip of the suction
bulb and your fingers.
For the older child who can blow his/her nose: Use three drops as necessary
in each nostril while your child is lying on a bed with his head hanging over the
side. Wait one minute for the water to soften and loosen the dried mucous. Then
have your child blow his/her nose. This can be repeated several times in a row for
complete clearing of the nasal passages.
Errors in using warm water nose drops: The main errors are not putting in
enough water, not waiting long enough for secretions to loosen up, and not
repeating the procedure until the breathing is easy.
- 19 -
VOMITING
Most vomiting is caused by a viral infection of the stomach or eating something
that disagrees with your child. Often, the viral type is associated with diarrhea.
The vomiting usually stops in 6 – 24 hours. Dietary changes usually speed
recovery.
HOME CARE FOR VOMITING
Clear fluids for 8 hours. Offer child clear fluids (not milk) in small amounts
until 8 hours have passed without vomiting. For infants, we recommend one of
the electrolyte solutions such as Pedialyte.
Start with 1 teaspoon to 1 tablespoon, depending on age, every 10 minutes.
Double the amount each hour. If your child vomits using this treatment, rest the
stomach completely for one hour and then start over with smaller amounts. The
one-swallow-at-a-time approach rarely fails.
BLAND FOODS AFTER EIGHT HOURS WITHOUT VOMITING
After 8 hours without vomiting, your child can gradually return to a normal diet.
For older children, start with foods such as saltine crackers, white bread, bland
soups (for example, chicken with stars) rice, and mashed potatoes.
For babies, start with foods such as applesauce, strained bananas, and rice
cereal.
DIET FOR BREAST-FED BABIES
The key to treatment is providing breast milk in smaller amounts than usual. If
your baby has only vomited once or twice, continue breastfeeding but nurse on
only one side each time for 10 minutes. After 8 hours have passed since your baby
last vomited, return to both sides.
If vomiting occurs three or more times, put your baby on an oral electrolyte
solution. As soon as 4 hours elapse without vomiting, return to nursing, but again
with smaller amounts than usual for 8 hours.
COMMON MISTAKES IN TREATMENT OF VOMITING
A common error is to give as much clear fluid as your child wants rather than
gradually increasing the amount. This almost always leads to continued vomiting.
Also advancing to solids too soon can aggravate the vomiting.
DIARRHEA
- 20 -
DIAGNOSTIC FINDINGS
Diarrhea is the sudden increase in the frequency and looseness of bowel
movements. Mild diarrhea is the passage of a few loose or mushy stools.
Moderate diarrhea gives many watery stools. The best indicator of the severity of
the diarrhea is its frequency.
The main complication of diarrhea is dehydration from excessive loss of body
fluids. Symptoms are a dry mouth, the absence of tears, and reduction in urine
production (for example, none in 8 hours), and a darker, concentrated urine. It’s
dehydration you need to worry about, not the presence of diarrhea.
CAUSE
Diarrhea is usually caused by a viral infection of the intestines (gastroenteritis).
Occasionally it is caused by bacteria or parasites. Diarrhea can be due to excessive
fruit juice or to a food allergy. If only one or two loose stools are passed, the
cause was probably something your child ate.
EXPECTED COURSE
Diarrhea usually lasts from several days to a week, regardless of the treatment.
The main goal of therapy is to prevent dehydration by giving enough oral fluids to
keep up with the fluids lost in diarrhea. Don’t expect a quick return to solid stools.
Since one loose stool can mean nothing, don’t start dietary changes until there
have been at least two.
HOME CARE (DIET)
Dietary changes are the mainstay of home treatment for diarrhea. The optimal
diet depends on your child’s age and the severity of the diarrhea. Go directly to the
part that pertains to your child.
Diet for Diarrhea (Watery or Frequent Stools) in Children Less Than 1 Year
Old – Clear fluids (oral electrolyte solutions, such as Pedialyte) for 12 to 24
hours. Have your baby take an oral electrolyte solution for the first 12 to 24 hours.
These are available without a prescription in most pharmacies and supermarkets.
Until you obtain this special solution, half-strength Gatorade or another sports
drink will do. Give your baby as much of the liquid as he/she wants. Diarrhea
makes children thirsty and your job is to prevent dehydration.
Soy Formula – After being on clear fluids for 6 to 24 hours your baby will be
hungry, so begin his/her regular formula. If the diarrhea is severe, begin a soy
formula. Change to soy formula later if the diarrhea doesn’t improve after 3 days
on regular formula. There is often less diarrhea with soy formula than with cow’s
milk formulas because they don’t contain milk sugar (lactose). Plan on keeping
your baby on soy formula until the diarrhea is gone for 3 days. If your baby is
already on a hypoallergenic formula this should be used in place of soy formula.
Solids: The foods most easily absorbed are composed of starch. If your baby
wants solids, offer applesauce, strained bananas, strained carrots, mashed potatoes,
and rice cereal with water.
- 21 -
Diet for Moderate Diarrhea (Watery or Frequent Stools) in Children 1 to 2
Years Old – Babies 1 to 2 years old don’t need formula or milk of any kind for
the first week. During this week water or Powerade/Gatorade (at ½ strength) can
be used for fluids (avoid fruit juice). Gradually phase in the following special
solids:
Day 1: Clear fluids, Pedialyte  Freezer Pops and Popsicles. If your toddler is
hungry, add some foods from the day 2 list.
Day 2: Saltine crackers, toast with honey, rice, mashed potatoes, carrots,
applesauce, bland soups, or other high-fiber foods.
Day3: Lean meats, soft-boiled eggs, noodles, soft cooked fruits and vegetables,
and active culture yogurt.
Day 6: Regular diet but no milk products.
Day 8: Milk and milk products can gradually be added.
Note: Avoid cheeses which contain 80% of the lactose found in milk, until day 8.
By contrast, the lactose in active culture yogurt will be digested by the
Lactobacillus organisms.
Diet for Mild or Moderate Diarrhea in Children Over 2 Years Old –
For the child who is toilet trained for bowel movements, the approach to diarrhea
is the same as what any adult would do; namely eat a regular diet with a few
simple changes.
• Increase the intake of foods containing starch since these are easily absorbed
during diarrhea. Examples are breads, crackers, rice, mashed potatoes, and
noodles.
Increase the intake of water or clear fluids (those you can see through).
Reduce or eliminate the intake of milk and milk products
(Exception: active culture yogurt is fine).
• Avoid raw fruits and vegetable, beans, spices, and any other foods that cause
loose BMs.
• Resume normal diet 1 day after the diarrhea is gone, which is usually in 3 or 4
days.
Diet for Breastfeeding Babies with Diarrhea – No matter how it looks, the
stool of the breast-fed infant must be considered normal unless it contains mucus
or blood. In fact, breast-fed babies can normally pass some green stools or stools
- 22 -
with a watery ring. Frequency of movements is also not much help. During the
first 2 or 3 months of life, the breast-fed baby may normally have one stool after
each feeding. The presence of something in the mother’s diet that causes rapid
passage should always be considered in these babies (for example, coffee, cola, or
herbal tea). Diarrhea can be diagnosed if your baby’s stools abruptly increase in
number.
If your breast-fed baby has diarrhea, treatment is straightforward.
Breastfeeding should never be discontinued because of mild to moderate diarrhea.
The only treatment necessary is to offer extra fluids (such as Pedialyte) between
breast feedings. Breastfeeding may have to be temporarily discontinued if your
baby requires intravenous fluids for severe diarrhea and dehydration. Pump your
breasts to maintain milk flow until you can breastfeed again (usually within 12
hours).
HOME CARE (OTHER ASPECTS)
Common Mistakes: Using boiled skim milk or any concentrated solution can
cause serious complications for babies with diarrhea because they contain too
much salt. Kool-Aid and soda pop should not be used as the only foods because
they contain little or no salt and too much sugar. Use only the fluids mentioned.
Clear fluids alone should only be used for 6 to 24 hours because the body needs
more calories than they can provide. Likewise, a diluted formula should not be
used for more than 24 hours. A myth is that the intestine should be “put to rest”.
Restricting fluids can cause dehydration. Keep in mind that there is not an
effective, safe drug for diarrhea and that extra water and diet therapy work best.
Prevention: Diarrhea is contagious. Hand washing after diaper changing or
using the toilet is crucial for keeping everyone in the family from getting diarrhea.
Diaper Rash From Diarrhea: The skin near your baby’s anus can become
“burned” from the diarrhea stools. Wash it off after each BM and then protect it
with a thick layer of petroleum jelly or other ointment. This protection is
especially needed during the night and during naps. Changing the diaper quickly
after BMs also helps. Pampers Rash Care diapers and wipes are also helpful to
prevent and treat severe diaper rash.
Overflow Diarrhea in a Child Not Toilet Trained: For children in diapers,
diarrhea can be a mess. Place a cotton washcloth inside the diaper to trap some of
the more watery stools. Use disposable diapers, super-absorbent, to cut down on
cleanup time. Use the ones with snug leg bands or cover the others with a pair of
plastic pants. Wash your child under running water in the bathtub. Someday
he/she will be toilet trained.
Call Our Office Immediately if:

• Your child does not urinate in more than 12 hours.
• Crying produces no tears.
- 23 -
• The mouth becomes dry rather than moist.
• Any blood appears in the diarrhea.
• Severe abdominal cramps occur.
• The diarrhea becomes severe (such as a bowel movement every hour for more
than 8 hours).
• The diarrhea is watery and your child vomits the clear fluids three or more
times.
• Your child becomes dizzy with standing.
Note: If your child has vomited more than once, treatment of the vomiting has
priority over the treatment of diarrhea until your child has gone 8 hours without
vomiting.
During Regular Hours If:
• Mucus or pus appears in the stools.
• The diarrhea causes loss of bowel control.
• A fever (over 100.5°) has been present for more than 72 hours.
• Severe diaper rash persists for more than 72 hours (an antiyeast ointment may
be necessary to aid healing of the rash).
• The diarrhea does not improve after 48 hours on the special diet.
• Mild diarrhea lasts more than 1 week.
• You have other concerns or questions.
CONSTIPATION IN INFANCY
- 24 -
WHAT IS CONSTIPATION?
It is quite normal for infants to grunt, push, strain, or become flushed in the face
when trying to have a bowel movement (BM).
It is also normal for infants to go 3 to 4 days without having a bowel movement,
as long as the stool is soft (consistency of toothpaste).
Newborns’ stomachs have a small holding capacity which enlarges throughout
infancy. This enables infants to tolerate an increase in the amount of food they
consume.
Newborns also have very active rhythmic contractions of the intestines
(peristalsis) that move stool. This rapid peristaltic activity slows down throughout
infancy and therefore, infants have BMs less frequently.
WHEN SHOULD I TREAT THE CONSTIPATION?
In infancy, going 4 or more days without a BM is worthy of dietary treatment.
Constipation often responds to dietary changes.
HOW DO I TREAT CONSTIPATION IN MY INFANT?
Step 1: Add up to, 1 teaspoon of Dark Karo Syrup per ounce of formula.
Step 2: If the step above does not work, you may offer your baby 1 to 2 ounces of
baby apple juice, prune juice or pear juice.
Step 3: Call the physicians’ office during regular business hours.
If your infant has begun on solid foods, be sure to add strained apricots, plums,
prunes, pears, spinach, or oatmeal cereal to his/her diet twice a day.
Be sure to give each step adequate time to work and be careful not to overuse
the suppositories.
If these measures do not seem to be helping, please call us during regular office
hours for an appointment.
COLIC
- 25 -
CAUSE
Normally infants do some crying during the first months of life. When babies
cry without being hungry, overheated, or in pain, we call it “colic”. About 10% of
babies have colic. Although no one is certain what causes colic, these babies seem
to want to be cuddled or to go to sleep. Colic is not the result of bad parenting, so
don’t blame yourself.
EXPECTED COURSE
This fussy crying is harmless to your baby. The hard crying spontaneously starts
to improve at 2 months and is gone by 3 months.
COPING WITH COLIC
1. Cuddle and rock your baby whenever he/she cries. Consider using the
following:
• Cuddling your baby in a rocking chair
• Rocking your child in a cradle
• Placing your child in a baby carrier or sling
• A windup swing or a vibrating chair
• A stroller ride outdoors or indoors
• Anything else you think may be helpful (for example, a pacifier, a warm
bath, or massage)
2. Try these feeding strategies:

• Don’t feed your baby every time he/she cries. Being hungry is only one
of the reasons babies cry. It takes about 2 hours for the stomach to empty,
so wait that long between feedings or you may cause cramps from the
bloating.
3. Get rest and help for yourself. Although the crying can be reduced, what’s
left must be endured and shared. Avoid fatigue and exhaustion. Get at least
one nap each day in case the night goes badly. Caring for a colicky baby is a
two-person job.
4. You may use Mylicon drops, which can be purchased at most drug stores or
supermarkets. The dosage is 0.3 to 0.6 ml with feedings.
- 26 -
DRY SKIN/ECZEMA
In both conditions, the skin is deficient in lubricating oil. Dryness in the
winter, excessive swimming or bathing and excessive sweating often make these
conditions worse. Soaps should be avoided as much as possible since they wash
off the natural oils that lubricate the skin. If soap must be used, use a moisturizing
soap such as Dove, Aveeno, Caress, or soap free cleanser such as Cetaphil Lotion
cleanser.
Aveeno Lotion or cream, Alpha Keri, Moisturel, Curel, Eucerin or other
lubricating skin cream may be applied to the skin three times a day, especially
after bathing. Cortaid may also help. Benadryl may be used to reduce itching.
Keeping the child’s fingernails trimmed is also important. Your child will need to
be checked if his/her skin has not improved within 5 – 7 days or if the rash appears
to be infected.
EARACHES
Earaches are very common during the first 1 – 2 years of life, and then
decrease in frequency as the child gets older. Earaches may be due to infections
behind the ear drum (middle ear infections) from pressure of non-infected fluid
behind the ear drum (serious otitis), pain from the outer ear canal (swimmer’s ear)
or referred pain from the tonsils, temporo-mandibular joint or pharyngeal
structure.
Not all earaches are due to ear infections and because treatment depends on
assessment of the cause and severity of the condition, it is recommended that your
child be examined when he/she has an earache.
- 27 -
TYLENOL/MOTRIN
DOSAGE CHART
Tylenol Infants Suspension Soft Chews Chewable
Acetaminophen Acetaminophen Liquid Chewable Tablets Tablets
160mg/5ml 160mg/5ml 80mg each 160mg each
Dose Syringe Teaspoon (TSP) Tablet Tablet

WEIGHT AGE (Use only syringe provided)
(Use only the dropper
provided)
6-11 lbs 0-3 mos 1.25mL
12-17 lbs 4-11 mos 2.5mL 1/2 (TSP)
18-23 lbs 12-23 mos 3.75mL 3/4 (TSP)
24-35 lbs 2-3 yrs 5mL 1 (TSP) 2
36-47 lbs 4-5 yrs 1 1/2 (TSP) 3
48-59 lbs 6-8 yrs 2 (TSP) 4 2
60-71 lbs 9-10 yrs 2 1/2 (TSP) 5 2 1/2
72-95 lbs 11 yrs 3 (TSP) 6 3
96 lbs & over 12 yrs 4
Children's Ages 6 mos-23 mos Ages 2-11 Ages 2-11 Ages 6-11 Ages 6-11
Motrin Infants' Motrin Children's' Motrin Children's Motrin Junior Strength Motrin Junior Strength Motrin
IBUPROFEN Concentrated Drops Suspension Chewable Tablets Chewable Tablets Caplets
50mg/1.25 mL 100mg/5mL 50 mg 100 mg 100 mg
Dose Dropperful Teaspoon (TSP) Tablet Tablet Caplet
WEIGHT AGE (Use only the dropper provided)
Under 6 mos
12-17 lbs 6-11 mos 1= (1.25 mL) … … … …
18-23 lbs 12-23 mos 1-1/2=(1.875 mL) … … … …
24-35 lbs 2-3 yrs … 1 (TSP) 2 tablets … …
36-47 lbs 4-5 yrs … 1-1/2 (TSP) 3 tablets … …
48-59 lbs 6-8 yrs … 2 (TSP) 4 tablets 2 tablets 2 tablets
60-71 lbs 9-10 yrs … 2 1/2 (TSP) 5 tablets 2 1/2 tablets 2 1/2 tablets
72-95 lbs 11yrs … 3 (TSP) 6 tablets 3 tablets 2 1/2 tablets
One Dose Lasts 6-8 Hours
- 28 -
WELL CHILD CARE AT 2 WEEKS
FEEDING
Your baby is growing! At this age, a baby only needs breast milk or infant
formula. Breast-fed babies should usually feed about 10 minutes at each breast
during each feeding. Breast-fed babies may want to nurse as often as every 2
hours. Most babies take 2 to 3 ounces of formula every 2 to 3 hours now. Babies
usually wake up at night to feed. This is normal. If your baby wants to feed more
often, try a pacifier. Your baby may need to suck but not feed. It is important to
hold your baby during feeding. This is a good time to talk to your baby. Hold the
bottle and do not prop it up.
DEVELOPMENT
Babies are learning to use their eyes and ears. Smiling faces and gentle, pleasant
voices are interesting for babies at this age.
Many mothers find that the baby brings a lot of new work. Help from fathers,
friends, and relatives is often very important at this time.
Babies usually sleep 16 or more hours a day. Healthy babies should be placed in
bed on their backs. Sleeping on the back reduces the risk of sudden infant death
syndrome (SIDS).
Most babies will strain to pass bowel movements. As long as the bowel
movement is soft, there is no need to worry. Ask your doctor about bowel
movements that are hard (constipation). Babies usually wet the diaper at least 6
times each day.
Call your healthcare provider if you feel depressed or overwhelmed. Having a
new baby is a major life change and hormonal changes may lead to postpartum
depression.
- 29 -
SAFETY TIPS
CHOKING AND SUFFOCATION
• If you use a crib for your baby, be sure to pick a safe location. It should not be
too near a heater. Make sure the sides are always completely up. Use a crib
with slats not more than 2 and 3/8 inches apart. Crib slats more than 2 and 3/8
inches apart can lead to injury.
• Place your baby in bed on his back.
FALLS
• Never leave the baby alone except in a crib.

• Keep mesh netting of playpens in the upright position.
CAR SAFETY
• Car seats are the safest way for babies to travel in cars and are required by
law. Place Infant car seats in a back seat with the infant facing backwards.
• Never leave your baby alone in a car or unsupervised with young brothers,
sisters, or pets.
SMOKING
• Infants who live in a house where someone smokes have more respiratory
infections. Their symptoms are also more severe and last longer than those of
children who live in a smoke-free home.
• If you smoke, set a quit date and stop. Set a good example for your child. If
you cannot quit, do NOT smoke in the house or near children.
IMMUNIZATIONS
Immunizations protect your child against several serious, life-threatening
diseases. Between birth and 2 weeks of age, your child should have a hepatitis B
shot.
Call your child'
s healthcare provider if:
• Your baby develops a fever.

• Your child is very irritable and you cannot calm him.
NEXT VISIT
Your baby' s next appointment will usually be at the age of 2 months. At this
time your child will get a set of immunizations. Bring your child'
s shot card to all
visits.
- 30 -
WELL CHILD CARE AT 2 MONTHS
FEEDING
At this age, your baby needs only breast milk or infant formula to grow healthy
and strong. At this age most babies take about 4 to 5 ounces of formula every 3 to
4 hours.
Even if you only give your baby breast milk, it is a good idea to sometimes feed
your baby with pumped milk that you put in a bottle. Then your baby will learn
another way to drink milk and other people can enjoy feeding your baby. Always
hold your baby during feeding time. Then your baby learns that you are there to
meet his needs. This is an important and special time. It is not time to start cereal
or baby foods yet. Cereal can be started at 4 to 6 months of age.
DEVELOPMENT
Babies start to lift their heads briefly. They reach for things with their hands.
They enjoy smiling faces and sometimes smile in return. Cooing sounds are in
response to people speaking gentle, soothing words.
The American Academy of Pediatrics recommends NO TV or screen time at all
under the age of 2 years.
SLEEP
Many babies wake up every 3 to 4 hours, while others sleep for longer periods
during the night. Every baby is different. Feeding your baby a lot just before
bedtime doesn' t have much to do with how long your baby will sleep. Place your
baby in the crib when he's drowsy but still awake. Do not put your baby in bed
with a bottle. Ask your healthcare provider for ideas about ways to keep your baby
alert and awake during the day and sound asleep at night.
READING
Your newborn will enjoy just hearing your voice. You can read aloud your
favorite mystery or spy novel while feeding or cuddling with the baby. The time
you spend reading to your infant is far more important than the book itself.
SAFETY TIPS
Never leave your child alone, except in a crib.
• Use a crib with slats not more than 2 and 3/8 inches apart.
• Place your baby in bed on his back.
• Use a mattress that fits the crib snugly.
• Keep plastic bags, balloons, and baby powder out of reach.
- 31 -
FIRES AND BURNS
• Never eat, drink, or carry anything hot near the baby or while you are holding
the baby.
• Turn your water heater down to 120°F (50°C).
• Install smoke detectors.
• Keep a fire extinguisher in or near the kitchen.
FALLS
• Never step away when the baby is on a high place, such as on a changing
table.
• Keep the crib sides up.
CAR SAFETY
• Never leave a child alone in a car.
• Use an approved infant car safety seat and follow the instructions for proper
use.
• Parents should always wear seat belts.
SMOKING
• Infants who live in a house where someone smokes have more respiratory
IMMUNIZATIONS
At the 2-month visit, your baby should have a:
• DTaP (diphtheria, acellular pertussis, tetanus) shot
• Hib (Haemophilus influenza type B) shot
• Hepatitis B shot
• Polio shot
• Pneumococcal (PCV13) shot
• Rotavirus oral vaccine.
Some of these vaccines are mixed together in the same shot, so your baby will
usually not have to have 5 separate shots.
Your baby may run a fever and be irritable for about 2 days after getting shots.
Your baby may also have some soreness, redness, and swelling where the shots
were given.
- 32 -
You may give acetaminophen drops in the appropriate dose to treat the fever and
irritability. For swelling or soreness put a wet, warm washcloth on the area of the
shots as often and as long as needed for comfort.
Call your child'

• Your child has a rash or any reaction other than fever and mild irritability.
• You are concerned about the fever.
NEXT VISIT
Your baby's next routine visit should be at the age of 4 months. At this time
your child will get the next set of immunizations. Bring your child's shot card to
all visits.
FEEDING
Your baby should still be taking breast milk or infant formula. Most babies now
take about 6 to 7 ounces every 4 to 5 hours. You can start juice at the age of 4 to 6
months but should limit it to a few ounces each day.
If you give your baby breast milk, it is a good idea to sometimes feed your baby
with pumped milk that you put in a bottle. Then your baby will learn another way
to drink milk and other people can enjoy feeding your baby.
Some babies are now ready to start cereal. A baby is ready for cereal when he is
able to hold his head up enough to eat from a spoon. Use a spoon to feed your
baby cereal, not a bottle or an infant feeder. Sitting up while eating helps your
baby learn good eating habits. When you start cereal, start with rice cereal mixed
with breast milk or formula. You may want to start with a thin mix of cereal and
then thicken it gradually.
Babies will respond gleefully when they see a bottle, but don' t give your baby a
bottle just to quiet him when he really isn't hungry. Babies who spend too much
time with a bottle in their mouth start to use the bottle as a security object, which
makes weaning more difficult. They are also more likely to have ear infections and
tooth decay problems. Find another security object like a stuffed animal or a
blanket.
DEVELOPMENT
Babies are starting to roll over from stomach to back. Your baby' s voice may
become louder. He may squeal when happy or cry when he wants food or to be
held. In both cases, gentle, soothing voices are the best way to calm your baby.
Babies at this age enjoy toys that make noise when shaken.
It is normal for babies to cry. At this age you can'
t spoil a baby. Meeting your
baby' s needs quickly is still a good idea.
- 33 -
SLEEP
Many babies are sleeping through the night by 4 months of age and will also nap
4 to 6 hours during the daytime. If your baby'
s sleeping patterns are different than
this you may want to ask your doctor for ideas about ways to keep your baby alert
and awake during the day and sound asleep at night. Remember to place your baby
in bed on her back.
READING
As the baby gets older, read to her every day. Choose books that are durable
(cloth or board books). Pick books with bright colors and large simple pictures.
TEETHING
Your baby may begin teething. While getting teeth, your baby may drool and
chew a lot. A teething ring may be useful.
SAFETY TIPS
• Remove hanging mobiles or toys before the baby can reach them.
• Keep cords, ropes, or strings away from your baby, especially near the crib.
Ropes and strings around the baby' s neck can choke him.
• Keep plastic bags and balloons out of reach.
• Use only unbreakable toys without sharp edges or small parts that can come
loose.
FIRES AND BURNS
• Never eat, drink, or carry anything hot near the baby or while you are holding
the baby.
• Turn down your water heater to 120°F (50°C).
• Check your smoke detectors to make sure they work.
• Check formula temperature carefully. Formula should be warm or cool to the
touch.
FALLS
• Never leave the baby alone on a high place.

• Keep crib and playpen sides up.
• Do not put your baby in a walker.
- 34 -
CAR SAFETY
• Use an approved infant car seat correctly in the back seat.

• Never leave your baby alone in a car.
• Wear your safety belt.
SMOKING
• Children who live in a house where someone smokes have more respiratory
IMMUNIZATIONS

• Hib (Haemophilus influenza type B) shot
• Polio shot
Some babies also receive a hepatitis B shot at this age.
Some of these vaccines come mixed together in the same shot, so your baby will
not have to have 4 or 5 separate shots.
Your baby may run a fever and be irritable for about 2 days after the shots. Your
baby may also have some soreness, redness, and swelling where the shots were
given.
You may give acetaminophen drops in the appropriate dose to treat the fever and
irritability. For swelling or soreness, put a wet, warm washcloth on the area of the
shots as often and as long as needed for comfort.
Call your child'

• Your child has a rash or any reaction other than fever and mild irritability.
• Your child has a fever that lasts more than 36 hours.
- 35 -
NEXT VISIT
Your baby's next routine visit should be at the age of 6 months. At this time
your child will get the next set of immunizations. Bring your child's shot card to
all visits.

FEEDING
Your baby should continue to have breast milk or infant formula until he is 1
year old. Your baby may soon be ready for a cup although it will be messy at first.
Try giving a cup sometimes to see if your baby likes it. Don' t put your baby to bed
with a bottle. Your baby will see the bottle as a security object and this will make
it hard to wean your child from the bottle. Leaving a bottle with your baby,
especially at night, will lead to tooth decay and may cause ear infections.
Make cereal with formula or breast milk only. Use a spoon to feed your baby
cereal, not a bottle or an infant feeder. Sitting up while eating helps your baby
learn good eating habits.
If you haven'
t started your baby on baby foods (other than cereal), you can start
now. Start with fruits and vegetables. Start one new food at a time for a few days
to make sure your baby digests it well. Do not start meats until your baby is 7 to 8
months old. Do not give foods that require chewing. Don' t start eggs until age 12
months. Give the baby formula, or breast-feed your baby before giving baby food
at meals.
DEVELOPMENT
At this age babies are usually rolling over and beginning to sit by themselves.
Babies squeal, babble, laugh, and often cry very loudly. They may be afraid of
people they do not know. Meet your baby' s needs quickly and be patient with your
baby. If you feel overwhelmed, ask people you trust for help, or talk with your
healthcare provider.
SLEEP
6-month-olds may not want to be put in bed. A favorite blanket or stuffed
animal may make bedtime easier. Do not put a bottle in the bed with your baby.
Develop a bedtime routine like playing a game, singing a lullaby, turning the lights
out, and giving a goodnight kiss. Make the routine the same every night. Be calm
and consistent with your baby at bedtime. If your baby is not sleeping through the
night, ask your doctor for further information about preventing sleep problems.
And remember, do not put a bottle in the bed with your baby.
- 36 -
READING
Books help parent and child grow closer. One way to help your child learn to
love reading is to show that you enjoy reading. Pick books with bright colors and
large simple pictures. Reading the same books over and over will help your baby
to recognize and name familiar objects.
TEETHING
Teeth come in almost constantly from 6 months to 2 years of age. While getting
teeth, your baby may drool and chew a lot. It may help to massage your baby's
swollen gums with your finger for 2 minutes. A teething ring may be useful.
SAFETY TIPS
• Cords, ropes, or strings around the baby'

s neck can choke him. Keep cords
away from the crib.
• Keep all small, hard objects out of reach.
loose.
• Avoid foods on which a child might choke (such as candy, hot dogs, peanuts,
popcorn).
FIRES AND BURNS
• Check your smoke detector to make sure it is working.

• Check food temperatures carefully, especially if foods have been heated in a
microwave oven.
• Keep hot foods and liquids out of reach.
• Put plastic covers on unused electrical outlets.
• Throw away cracked or frayed old electrical cords.
• Turn the water heater down to 120°F (50°C).
FALLS
• Keep crib and playpen sides up.

• Do not use walkers.
• Install safety gates to guard stairways.
• Lock doors to dangerous areas like the basement or garage.
- 37 -
• Check drawers, tall furniture, and lamps to make sure they can'
t fall over
easily.
POISONING
• Keep all medicines, vitamins, cleaning fluids, and other chemicals locked
away. Dispose of them safely.
• Put safety latches on cabinets.
• Keep the poison center number on all phones.
SMOKING
IMMUNIZATIONS

• Hepatitis B shot
• Polio shot
Some children also receive an Hib (Haemophilus influenza type B) shot.
Some vaccines come mixed together in the same shot, so your baby will probably
not have to have 5 separate shots.
baby may also have some soreness, redness, and swelling in the area where the
shots were given.
You may give acetaminophen drops in the appropriate dose to treat fever and
irritability. For swelling or soreness, put a wet, warm washcloth on the area of the
shots as often and as long as needed to provide comfort.
Call your child'
• Your child has a rash or any reaction to the shots other than fever and mild
irritability.
- 38 -
NEXT VISIT
Your baby' s next routine visit should be at the age of 9 months. Bring your child'
s
shot card to all visits.

FEEDING
Your baby should continue to have breast milk or infant formula until he is 1
year old. Most babies now take 6 to 8 ounces of formula 4 times a day. Encourage
your child to drink formula and juice from a cup now. This is a good time to begin
weaning from the bottle. Do not let your baby keep the bottle between meal times.
You can begin adding meat to your child'
s diet.
DEVELOPMENT
Babies are starting to pull themselves up to stand. They love to bang things
together to make sounds. Soon, they may start to say "dada" and "mama." At this
age, babies learn what "no" means. Say "no" calmly and firmly and either take
away the item that your child should not be playing with or remove him from the
situation. Comfort your baby by using a soothing voice and being gentle with him.
Give your baby a choice of toys. Talk to him about the toy he chooses and what
he is doing with the toy. Peek-a-boo is a favorite game.
9-month-olds have a lot of energy and it requires a lot of energy to take care of
them. Make sure you get enough rest. Ask friends and family for help so you can
take a break and rest. If you are rested, you will be better able to take care of your
child.
SLEEP
A regular bedtime hour and routine are important. Babies enjoy looking at
picture books. You may want to read one regularly with your child. A favorite
blanket or stuffed animal may help your baby feel secure at bedtime. Never put
your baby in bed with a bottle. Put your baby to bed awake, but drowsy. If your
baby wakes up a lot at night, ask your doctor or nurse for advice.
- 39 -
SHOES
Shoes protect your child'
s feet, but are not necessary when your child is learning
to walk inside. When your child finally needs shoes, choose a flexible sole tennis
shoe or moccasin.
READING
Your child will enjoy feeling the rough and smooth textures found in "touching"
books and listening to the sounds of nonsense verse and nursery rhymes. You' ll be
surprised at how quickly she will learn to join in the rhymes and songs. It is
important to set rules about television watching.
DENTAL CARE
By now, many children have 2 or more teeth. After meals and before bedtime,
try to wash off the teeth with a clean cloth. Don' t worry too much about getting
every last bit off the teeth. Try to make this a fun time for your baby.
SAFETY TIPS
Child-proof the home. Remove or pad furniture with sharp corners. Keep sharp
objects out of reach.
• Avoid foods on which a child might choke (such as candy, hot dogs, popcorn,
peanuts).
• Cut food into small pieces.
• Store toys in a chest without a dropping lid.
FIRES AND BURNS
• Check your smoke detector to make sure it is working.

• Put plastic covers in unused electrical outlets.
• Keep hot appliances and cords out of reach.
• Keep all electrical appliances out of the bathroom.
• Don'
t cook when your child is at your feet.
• Use the back burners on the stove with the pan handles out of reach.
FALLS
• Make sure windows are closed or have screens that cannot be pushed out.
• Don'
t underestimate your child'
s ability to climb.
- 40 -
CAR SAFETY
If your child reaches 20 pounds and is still riding in an infant seat, it is time for
a new car seat. Some car seats can convert from a backward-facing infant seat to
a forward-facing toddler seat. Carefully follow the manufacturer' s instructions
when installing new or converting old car seats for your child.
WATER SAFETY
• Never leave an infant or toddler in a bathtub alone -- NEVER.

• Continuously supervise your baby around any water, including toilets and
buckets. Infants can drown in a bucket that has water in it. Empty all water
and store buckets turned over.
POISONING
• Put safety latches on cabinets.
SMOKING
IMMUNIZATIONS
At the 9-month visit, your child may not receive shots. Children over 6 months
of age should receive an annual flu shot.
NEXT VISIT
Your baby' s next routine visit should be at the age of 12 months. Bring your
child'
s shot card to all visits.
- 41 -
NUTRITION
When your child is 1 year old, you can start using whole milk. If you are ready
to wean your child from breast-feeding, wean him to whole milk. Toddlers need
the calories of whole milk (not low-fat or skim) until they are 2 years old. Some
children have harder bowel movements at first with whole milk. This is also the
time to wean completely off the bottle and switch to the cup.
Table foods that are cut up into very small pieces are best now. Baby food is
usually not needed at this age. It is important for your toddler to eat foods from
many food groups (fruits, vegetables, grains, and dairy products). Most one year
olds have 1 or 2 snacks each day. Cheese, fruit, and vegetables are all good snacks.
Serve milk at all meals. Your child will not grow as fast during the second year of
life. Your toddler may eat less. Trust his appetite.
DEVELOPMENT
Every child is different. Some have learned to walk before their first birthday.
Most 1-year-olds use and know the meaning of words like "mama" and "dada."
Pointing to things and saying the word helps them learn more words. Speak in a
conversational voice with your child and give them lots of encouragement to use
their voice. Smile and praise your child when he learns new things. Allow your
child to touch things while you name them. Children enjoy knowing that you are
pleased that they are learning.
As children learn to walk they will want to explore new places. Watch your
child closely.
SHOES
Shoes protect your child'
s feet, but are not necessary when your child is learning
to walk inside. When your child finally needs shoes, choose shoes with a flexible
sole.
READING
Read to your child every day. Children who have books read to them learn more
quickly. Choose books with interesting pictures and colors.
DENTAL CARE
• After meals and before bedtime, clean your baby' s teeth with a clean cloth.
Don't worry too much about getting every last bit off the teeth.
- 42 -
SAFETY TIPS
• Avoid foods on which a child might choke easily (candy, hot dogs, popcorn,
peanuts).
• Cut food into small pieces, about half the width of a pencil.
FIRES AND BURNS
• Check your smoke detector. Replace the batteries if necessary.

• Put plastic covers in unused electrical outlets.
• Keep all electrical appliances out of the bathroom.
• Don'
t cook with your child at your feet.
FALLS
• Don'
s ability to climb.
CAR SAFETY
• Never leave your child alone in the car.

• Use an approved toddler car seat correctly and wear your seat belt.
WATER SAFETY

• Continuously watch your child around any water, including toilets and
buckets. Keep lids to toilets down, never leave water in an unattended bucket,
and store buckets upside down.
POISONING
• Install safety latches on cabinets.
- 43 -
SMOKING
IMMUNIZATIONS
At the 12-month visit, your child may receive shots.
Children over 6 months of age should receive an annual flu shot. Your child
may run a fever and be irritable for about 2 days and may also have soreness,
redness, and swelling in the area where the shots were given.
You may give your child acetaminophen drops in the appropriate dose to help to
treat fever and irritability. For swelling or soreness, put a wet, warm washcloth on
the area of the shots as often and as long as needed for comfort.
Call your child'
irritability.
A small number of children get a rash and fever 7 to 14 days after the measles-
mumps-rubella (MMR) or the varicella vaccines. The rash is usually on the main
body area and lasts 2 to 3 days. Call your healthcare provider within 24 hours if
the rash lasts more than 3 days or gets itchy. Call your child'
s provider
immediately if the rash changes to purple spots.
NEXT VISIT
Your child' s next visit should be at the age of 15 months. Bring your child'
s shot
card to all visits.
- 44 -
NUTRITION
Your child should be learning to feed himself. He will use his fingers and maybe
start using a spoon. This will be messy. Make sure you cut food into small pieces
so that your child won't choke. Children need healthy snacks like cheese, fruit, and
vegetables. Do not use food as a reward.
By now, most toddlers should be using a cup only. If your child is still using a
bottle, it will soon start to cause problems with his teeth and might cause ear
infections. A child at this age will be sad to give up a bottle, so try to replace it
with another treasured item - perhaps a teddy bear or blanket. Never let a baby
take a bottle to bed.
DEVELOPMENT
Toddlers are very curious and want to be the boss. This is normal. If they are
safe, this is a time to let your child explore new things. As long as you are there to
protect your child, let him satisfy his curiosity. Stuffed animals, toys for pounding,
pots, pans, measuring cups, empty boxes, and Nerf balls are some examples of
toys your child may enjoy.
Toddlers may want to imitate what you are doing. Sweeping, dusting, or
washing play dishes can be fun for children.
BEHAVIOR CONTROL
Toddlers start to have temper tantrums at about this age. Trying to reason with
or punish your child may actually make the tantrum last longer. It is best to make
sure your toddler is in a safe place and then ignore the tantrum. You can best
ignore by not looking directly at him and not speaking to him or about him to
others when he can hear what you are saying.
READING
Reading to your child should be a part of every day. Children that have books
read to them learn more quickly. Choose books with interesting pictures and
colors. Children at this age may ask to read the same book over and over. This
repetition is a natural part of learning.
- 45 -
DENTAL CARE
After meals and before bedtime, clean your toddler'
s teeth.
SAFETY TIPS
Keep plastic bags, balloons, and small hard objects out of reach.
loose.
• Cut foods into small pieces. Avoid foods on which a child might choke
(popcorn, peanuts, hot dogs, chewing gum).
FIRES AND BURNS
• Keep lighters and matches out of reach.

• Don'
t let your child play near the stove.
• Turn the water heater down to 120°F (49°C).
CAR SAFETY

PEDESTRIAN SAFETY
• Hold onto your child when you are around traffic.

• Supervise outside play areas.
WATER SAFETY

buckets. Keep lids of toilets down. Never leave water in an unattended bucket.
Store buckets upside down.
POISONING
• Keep all medicines, vitamins, cleaning fluids, and other chemicals. locked
away.
• Put the poison center number on all phones.
• Buy medicines in containers with safety caps.
• Do not store poisons in drink bottles, glasses, or jars.
- 46 -
SMOKING
IMMUNIZATIONS
At the 15-month visit, your child may receive shots.
Children over 6 months of age should receive an annual flu shot. Your child
may run a fever and be irritable for about 1 day and may have soreness, redness,
and swelling in the area where the shots were given. You may give acetaminophen
drops in the appropriate dose to treat fever and irritability. For swelling or
soreness, put a wet, warm washcloth on the area of the shots as often and as long
as needed to provide comfort.
Call your child'
irritability.
A small number of children get a rash and fever 7 to 14 days after the measles-
mumps-rubella (MMR) or the varicella vaccines. The rash is usually on the main
body area and lasts 2 to 3 days. Call your healthcare provider within 24 hours if
the rash lasts more than 3 days or gets itchy. Call your child'
s provider
immediately if the rash changes to purple spots.
NEXT VISIT
Your child' s next visit should be at the age of 18 months. Bring your child'
s shot
card to all visits.
- 47 -
NUTRITION
Family meals are important for your baby. Let him eat with you. This helps him
learn that eating is a time to be together and talk with others. Don'
t make mealtime
a battle. Let your baby feed himself. Your child should use a spoon and drink from
a cup now.
DEVELOPMENT
Children at this age should be learning many new words. You can help your
child'
s vocabulary grow by showing and naming lots of things. Children have
many different feelings and behaviors such as pleasure, anger, joy, curiosity,
warmth, and assertiveness. It is important at this age to praise your child for doing
things that you like.
TOILET TRAINING
At 18 months, most toddlers are not yet showing signs that they are ready for
toilet training. When toddlers report to parents that they have wet or soiled their
diaper, they are starting to be aware that they prefer dryness. This is a good sign
and you should praise your child. Toddlers are naturally curious about the use of
the bathroom by other people. Let them watch you or other family members use
the toilet. It is important not to put too many demands on a child or shame the
child during toilet training.
BEHAVIOR CONTROL
Toddlers sometimes seem out of control, or too stubborn or demanding. At this
age, children often say "NO". To help children learn about rules:
• Divert and substitute. If a child is playing with something you don' t want him
to have, replace it with another object or toy that he enjoys. This approach
avoids a fight and does not place children in a situation where they' ll say "no."
• Teach and lead. Have as few rules as necessary and enforce them. Make rules
for the child'
s safety. If a rule is broken, after a short, clear, and gentle
explanation, immediately find a place for your child to sit alone for 1 minute.
It is very important that a "time-out" comes right after a rule is broken.
• Make consequences as logical as possible. For example, if you don' t stay in
your car seat, the car doesn'
t go. If you throw your food, you don'
t get any
more and may be hungry.
• Be consistent with discipline. Don' t make threats that you cannot carry out. If
you say you're going to do it, do it.
- 48 -
• Be warm and positive. Children like to please their parents. Give lots of praise
and be enthusiastic. When children misbehave, stay calm and say "We can' t
do that. The rule is ________." Then repeat the rule.
READING
Toddlers have short attention spans, so stories should always be short, simple,
and have lots of pictures. The best choices are large-format books that develop one
main character through action and activity. Make sure the books have happy,
clear-cut endings.
DENTAL CARE
After meals and before bedtime, clean your toddler'
s teeth with a clean cloth or
very soft toothbrush.
SAFETY TIPS
Child-proof the home. Go through every room in your house and remove
anything that is valuable, dangerous, or messy. Preventive child-proofing will stop
many possible discipline problems. Don' t expect a child not to get into things just
because you say no.
• Keep plastic bags, balloons, and small hard objects out of reach.
• Cut foods into small pieces.
FIRES AND BURNS

• Don'
t cook with your child at your feet.
• Keep hot foods and liquids out of reach.
• Keep matches and lighters out of reach.
FALLS
• Make sure that drawers, furniture, and lamps cannot be tipped over. Do not
place furniture (on which children may climb) near windows or on balconies.
• Install window guards on windows above the first floor (unless this is against
your local fire codes.)
• Don'
s ability to climb.
- 49 -
CAR SAFETY

PEDESTRIAN SAFETY
• Hold onto your child when you are near traffic.

• Provide a play area where balls and riding toys cannot roll into the street.
WATER SAFETY

buckets. Keep the lids of toilets down. Never leave water in an unattended
bucket and store buckets upside down.
POISONING
away.
• Buy medicines in containers with safety caps.
• Do not store poisons in drink bottles, glasses, or jars.
SMOKING
IMMUNIZATIONS
At the 18-month visit, your baby may receive shots.
Children over 6 months of age should receive an annual flu shot.
baby may also have some soreness, redness, and swelling in the area where the
shots were given.
You may give your child acetaminophen drops in the appropriate dose to treat
fever and irritability. For swelling or soreness, put a wet, warm washcloth on the
area of the shots as often and as long as needed for comfort.
Call your child'
- 50 -
irritability.
NEXT VISIT
Your child' s next visit should be at the age of 2 years. Bring your child'
s shot
card to all visits.
WELL CHILD CARE AT 2 YEARS

NUTRITION
Family meals are important for your child. They teach your child that eating is a
time to be together and talk with others. Letting your child eat with you makes her
feel like part of the family. Let your child feed herself. Your toddler will get better
at using the spoon, with fewer and fewer spills. It is good to let your child help
choose what foods to eat. Be sure to give her only healthy foods to choose from.
For many children, this is the time to switch from whole milk to 2% milk.
It is very important for your child to be completely off a bottle. Ask your doctor
for help if she is still using one.
DEVELOPMENT
Spend time teaching your child how to play. Encourage imaginative play and
sharing of toys, but don'
t be surprised that 2-year-olds usually do not want to share
toys with anyone else.
Mild stuttering is common at this age. It usually goes away on its own by the age
of 4 years. Do not hurry your child'
s speech. Ask your doctor about your child' s
speech if you are worried.
TOILET TRAINING
Some children at this age are showing signs that they are ready for toilet training.
When your child starts reporting wet or soiled diapers to you, this is a sign that
your child prefers to be dry. Praise your child for telling you. Toddlers are
naturally curious about other people using the bathroom. If your child seems
curious, let him go to the bathroom with you. Buy a potty chair and leave it in a
room in which your child usually plays. It is important not to put too many
demands on the child or shame the child about toilet training. When your child
does use the toilet, let him know how proud you are.
- 51 -
BEHAVIOR CONTROL
At this age, children often say "no" or refuse to do what you want them to do. This
normal phase of development involves testing the rules that parents make. Parents
need to be consistent in following through with reasonable rules. Your rules
should not be too strict or too lenient. Enforce the rules fairly every time. Be
gentle but firm with your child even when the child wants to break a rule. Many
parents find this age difficult, so ask your doctor for advice on managing behavior.
Here are some good methods for helping children learn about rules:
Divert and substitute. If a child is playing with something you don' t want him to
have, replace it with another object or toy that he enjoys. This approach avoids a
fight and does not place children in a situation where they' ll say "no."
Teach and lead. Have as few rules as necessary and enforce them. These rules
should be rules important for the child' s safety. If a rule is broken, after a short,
clear, and gentle explanation, immediately find a place for your child to sit alone
for 2 minutes. It is very important that a "time-out" comes immediately after a rule
is broken.
Make consequences as logical as possible. Remember that encouragement and

praise are more likely to motivate a young child than threats and fear. Do not
threaten a consequence that you do not carry out. If you say there is a consequence
for misbehavior and the child misbehaves, carry through with the consequence
gently, but firmly.
Be consistent with discipline. Don'

t make threats that you cannot carry out. If you
say you'
re going to do it, do it.
Be warm and positive. Children like to please their parents. Give lots of praise and
be enthusiastic. When children misbehave, stay calm and say "We can' t do that.
The rule is ________." Then repeat the rule.
READING AND ELECTRONIC MEDIA
Children learn reading skills while watching you read. They start to figure out that
printed symbols have certain meanings. Young children love to participate directly
with you and the book. They like to open flaps, ask questions, and make
- 52 -
comments. It is important to set rules about television watching. Limit total TV
time to no more than 1 hour per day.
DENTAL CARE
Brushing teeth regularly after meals is important. Think up a game and make
brushing fun.
Make an appointment for your child to see the dentist.
SAFETY TIPS
Child-proof the home. Go through every room in your house and remove anything
that is either valuable, dangerous, or messy. Preventive child-proofing will stop
because you say no.
FIRES AND BURNS
Practice a fire escape plan.
Check smoke detectors. Replace the batteries if necessary.
Check food temperatures carefully. They should not be too hot.
Keep hot appliances and cords out of reach.
Keep electrical appliances out of the bathroom.
Keep matches and lighters out of reach.
Don'
t allow your child to use the stove, microwave, hot curlers, or iron.
Turn your water heater down to 120°F (50°C).
FALLS
Teach your child not to climb on furniture or cabinets. Do not place furniture (on
which children may climb) near windows or on balconies.
Install window guards on windows above the first floor (unless this is against your
local fire codes.)
- 53 -
Lock doors to dangerous areas like the basement.
CAR SAFETY
Use an approved toddler car seat correctly.
Sometimes toddlers may not want to be placed in car seats. Gently but consistently
put your child into the car seat every time you ride in the car.
Give the child a toy to play with once in the seat.
Parents wear seat belts.
Never leave your child alone in a car.
PEDESTRIAN SAFETY
Hold onto your child when you are near traffic.
Provide a play area where balls and riding toys cannot roll into the street.
WATER SAFETY
Continuously watch your child around any water.
POISONING
Keep all medicines, vitamins, cleaning fluids, and other chemicals locked away.
Put poison center number on all phones.
Buy medicines in containers with safety caps.
Do not store poisons in drink bottles, glasses, or jars.
SMOKING
Children who live in a house where someone smokes have more respiratory
If you smoke, set a quit date and stop. Set a good example for your child. If you
cannot quit, do NOT smoke in the house or near children.
- 54 -
Teach your child that even though smoking is unhealthy, he should be civil and
polite when he is around people who smoke.
IMMUNIZATIONS
Routine infant vaccinations are usually completed before this age. However some
children may need to catch up on recommended shots at this visit. Children over 6
months of age should receive an annual flu shot. Ask your doctor if you have any
questions about whether your child needs any vaccines.
NEXT VISIT
A once-a-year check-up is recommended. Before starting school your child will

need more vaccinations. Bring your child'
s shot card to all visits.
WELL CHILD CARE AT 2 1/2 YEARS
NUTRITION
Family meals are important for your child. Letting your child eat with you makes
her feel like part of the family. Let your child feed herself. It is good to let your
child help choose what foods to eat. Be sure to give her only nutritious foods to
choose from. Lower fat content in milk and other dairy products is often a good
idea. Ask your healthcare provider about 2% or skim milk.
It is very important for your child to be completely off a bottle. Ask your
healthcare provider for help if she is still using one.
DEVELOPMENT
Two-and-a-half year olds often have lots of energy and curiosity; yet they often
lack social and language skills to know the limits of appropriate behavior. As such,
this is a time when parents and child alike need lots of support. A parent needs lots
of energy, patience and interest in teaching her child.
TOILET TRAINING
Some children show signs that they are ready for toilet training. When your child
starts reporting wet or soiled diapers to you, this is a sign that your child prefers to
- 55 -
be dry. Praise your child for telling you. Toddlers are naturally curious about other
people using the bathroom. If your child seems curious, let him go to the bathroom
with you. Buy a potty chair and leave it in a room in which your child usually
plays. It is important not to put too many demands on the child or shame the child
about toilet training. When your child does use the toilet, let him know how proud
you are.
BEHAVIOR CONTROL
Testing the rules and limits is common. Parents need to be consistent in following
through with reasonable rules. Rules should not be too strict or too lenient.
Enforce the rules fairly every time. Be gentle but firm with your child even when
the child wants to break a rule. Many parents find this age difficult, so ask your
healthcare provider for advice on managing behavior.
Here are some good methods to help children learn rules and keep them safe:
Divert and substitute. If a child is playing with something you don' t want him to
have, replace it with another object or toy that he enjoys. This approach avoids a
fight and does not place children in a situation where they' ll say "no."
is broken.
Make consequences as logical as possible. For example, if you don' t stay in your
car seat, the car doesn'
t get any more and
may be hungry.
Be consistent with discipline. Don'

t make threats that you cannot carry out. If you
say you'
re going to do it, do it.
Spend time teaching your child how to play. Encourage imaginative play and
sharing of toys, but don'
t be surprised that 2-and-one-half year-olds usually do not
want to share toys with anyone else.
Mild stuttering is common at this age. It usually goes away on its own by the age
of 4 years. Do not hurry your child's speech. Ask your healthcare provider about
your child's speech if you are worried.
- 56 -
It is important to set rules about television watching. Limit total TV time to 1 hour
per day. Watch television shows with your child. Ask your child questions about
what the characters were doing and how they were feeling. Children should not be
allowed to watch shows with violence or sexual behaviors. Find other activities
you can do with your child. Reading, hobbies, and physical activities are good
alternatives to TV.
SAFETY TIPS
because you say no.
FIRES AND BURNS
Check food temperatures carefully. They should not be too hot.
Keep hot appliances and cords out of reach.
Keep electrical appliances out of the bathroom.
Don'
t allow your child to use the stove, microwave, hot curlers, or iron.
Turn your water heater down to 120 F (50 C).
FALLS
Teach your child not to climb on furniture or cabinets. Do not place furniture (on
which children may climb) near windows or on balconies.
Install window guards on windows above the first floor (unless this is against your
local fire codes.)
Lock doors to dangerous areas like the basement.
- 57 -
CAR SAFETY
Use an approved toddler car seat correctly.
Sometimes toddlers may not want to be placed in car seats. Gently but consistently
put your child into the car seat every time you ride in the car.
Give the child a toy to play with once in the seat.
Parents wear seat belts.
PEDESTRIAN SAFETY
Hold onto your child when you are near traffic.
Provide a play area where balls and riding toys cannot roll into the street.
WATER SAFETY
Continuously watch your child around any water.
POISONING
Put poison center number on all phones.
Do not store poisons in drink bottles, glasses, or jars.
SMOKING
- 58 -
IMMUNIZATIONS
Routine infant vaccinations are usually completed before this age. However some
children may need to catch up on recommended shots at this visit. Children over 6
months of age should receive an annual flu shot. At age four, your child will need
additional vaccinations. Ask your healthcare provider if you have any questions
about whether your child needs any vaccines.
NEXT VISIT
A three-year old check-up is recommended. Bring your child'

s shot card to all
visits.
NUTRITION
Mealtime should be a pleasant time for the family. Your child should be feeding
himself completely on his own now. Buy and serve healthy foods and limit junk
foods. Your child will still have a daily snack. Choose and eat healthy snacks such
as cheese, fruit, or yogurt. If you are having problems at mealtime, ask your
healthcare provider for advice.
DEVELOPMENT
Children at this age often want to do things by themselves; this is normal. Patience
and encouragement will help 3-year-olds develop new skills and build self-
confidence. Many children still require diapers during the day or night. Avoid
putting too many demands on the child or shaming him about wearing diapers. Let
your child know how proud and happy you are as toilet training progresses.
BEHAVIOR CONTROL
For behaviors that you would like to encourage in your child, try to "catch your
child being good." That is, tell your child how proud you are when he does what
- 59 -
you want him to do. Be positive and enthusiastic when your child does things to
please you.
Here are some good methods for helping children learn about rules: Divert and
substitute. If a child is playing with something you don' t want him to have, replace
it with another object or toy that the child enjoys. This approach avoids a fight and
does not place children in a situation where they' ll say "no."
is broken.
Make consequences as logical as possible. For example, if you don' t stay in your
car seat, the car doesn'
t get any more and
may be hungry.
Be consistent with discipline. Remember that encouragement and praise are more
likely to motivate a young child than threats and fear. Do not threaten a
consequence that you do not carry out. If you say there is a consequence for
misbehavior and the child misbehaves, carry through with the consequence gently,
but firmly.
Children learn reading skills while watching you read. They start to figure out that
printed symbols have certain meanings. Young children love to participate directly
with you and the book. They like to open flaps, ask questions, and make
comments. It is important to set rules about television watching. Limit total TV
time to no more than 1 hour per day.
DENTAL CARE
Brushing teeth regularly after meals is important. Think up a game and make
brushing fun.
SAFETY TIPS
- 60 -
because you say no.
FIRES AND BURNS
FALLS
Do not allow your child to climb on ladders, chairs, or cabinets.
Make sure windows are closed or have screens that cannot be pushed out.
CAR SAFETY
Everyone in a car must always wear seat belts or be in an appropriate booster seat
or car seat.
PEDESTRIAN AND TRICYCLE SAFETY
Hold onto your child'

s hand when you are near traffic.
Practice crossing the street. Make sure your child stays right with you.
Do not allow riding of a tricycle or other riding toys on driveways or near traffic.
All family members should use a bicycle helmet, even when riding a tricycle.
WATER SAFETY
Watch your child constantly when he is around any water.
- 61 -
POISONING
Put the poison center number on all phones.
Do not put poisons into drink bottles, glasses, or jars.
STRANGERS
Teach your child the first and last names of family members.
Teach your child never to go anywhere with a stranger.
SMOKING
IMMUNIZATIONS
Routine vaccinations are usually completed before this age. Before starting
kindergarten your child will need vaccinations. Children should receive an annual
flu shot. Ask your doctor if you have any questions about whether your child
needs any vaccines.
NEXT VISIT
A once-a-year check-up is recommended.
NUTRITION
- 62 -
Your child should always be a part of the family at mealtime. This should be a
pleasant time for the family to be together and share stories and experiences. Give
small portions of food to your child. If he is still hungry, let him have seconds.
Selecting foods from all food groups (meat, dairy, grains, fruits, and vegetables) is
a good way to provide a balanced diet. Choose and eat healthy snacks such as
cheese, fruit, or yogurt.
DEVELOPMENT
At this age children usually become more cooperative in their play with other
children. They are curious and imaginative.
Allow privacy while your child is changing clothes or using the bathroom. When
your child starts wanting privacy on his own, let him know that you think this is
good.
BEHAVIOR CONTROL
Breaking rules occasionally occurs at this age. Making children stand in a corner
by themselves for 4 minutes is usually an effective punishment. If you have
questions about behavior, ask your doctor.
It is important to set rules about television watching. Limit total TV time to no

more than 1 hour per day. Children should not be allowed to watch shows with
violence or sexual behaviors. Watch TV with your child and discuss the shows.
Find other activities you can do with your child. Reading, hobbies, and physical
activities are good alternatives to TV.
DENTAL CARE
Brushing teeth regularly after meals and before bedtime is important. Think of a
way to make it fun.
If your child sucks his thumb, ask your doctor or dentist for advice on how to help
him stop.
SAFETY TIPS
- 63 -
Keep your child away from knives, power tools, or mowers.
FIRES AND BURNS
Check smoke detectors and replace the batteries as needed.
Keep a fire extinguisher in or near the kitchen.
Teach your child to never play with matches or lighters.
Teach your child emergency phone numbers and to leave the house if fire breaks
out.
CAR SAFETY
Everyone in a car must always wear seat belts or be in an appropriate booster seat
or car seat.
PEDESTRIAN AND BICYCLE SAFETY
Teach your child to never ride a tricycle or bicycle in the street.
All family members should use a bicycle helmet, even when riding a tricycle.
It is much too early to expect a child to look both ways before crossing the street.
Supervise all street crossing.
POISONING
Teach your child to never take medicines without supervision and not to eat
unknown substances.
Put the poison center number on all phones.
- 64 -
STRANGERS
Teach your child the first and last names of family members.
Teach your child to never go anywhere with a stranger.
SMOKING
IMMUNIZATIONS
Your child will probably receive shots such as:
DTaP (diphtheria, acellular pertussis, tetanus) shot
Measles, mumps, rubella (MMR)
Chickenpox (varicella)
Polio vaccine.
Children over 6 months of age should receive an annual flu shot. After a shot your
child may run a fever and become irritable for about 1 day. Your child may also
have some soreness, redness, and swelling where a shot was given.
For fever, give your child an appropriate dose of acetaminophen. For swelling or
soreness, put a wet, warm washcloth on the area of the shot as often and as long as
needed for comfort.
Call your child'

s healthcare provider immediately if:
Your child has a fever over 105 F (40.5 C).
- 65 -
Your child has a severe allergic reaction beginning within 2 hours of the
shot (for example, hives, wheezing or noisy breathing, swelling of the
mouth or throat).
Your child has any other unusual reaction.
NEXT VISIT
A once-a-year check-up is recommended. Be sure to check your child' s shot

records before starting school to make sure he or she has all the required
vaccinations. Children should receive an annual flu shot.

NUTRITION
Your child may enjoy helping to choose and prepare the family meals with
supervision. Children watch what their parents eat, so set a good example. This
will help teach good food habits. Mealtime should be a pleasant time for the
family. Avoid junk foods and soda pop.
DEVELOPMENT
Children at this age are imaginative, get along well with friends their own age,
and have lots of energy. Be sure to praise children lavishly when they share things
with each other.
Some children still wet the bed at night. If your child wets the bed regularly, ask
your doctor about ways to help your child.
Five-year-olds usually are able to dress and undress themselves, understand rules
in a game, and brush their own teeth. For behaviors that you would like to
encourage in your child, try to catch your child being good. That is, tell your child
how proud you are when he does things that help you or others.
BEHAVIOR CONTROL
You need to punish your child for dangerous or hurtful behaviors. Also teach
your child to apologize. Sending a child to a quiet, boring corner without anything
to do for 5 minutes should follow.
- 66 -
It is important to set rules about television watching. Limit electronic media
(TV, DVDs, or computer) time to 1 or 2 hours per day of high quality children' s
programming. Participate with your child and discuss the content with them. Do
not allow children to watch shows with violence or sexual behaviors. Find other
activities besides watching TV that you can do with your child. Reading, hobbies,
and physical activities are good choices.
Do not allow your child to have a TV in their room. It increases their risk for
obesity and high blood pressure.
- 67 -
DENTAL CARE
• Brushing teeth regularly after meals and before bedtime is important. Think
up a game and make brushing fun.
• Make an appointment for your child to see the dentist.
SAFETY TIPS
Accidents are the number-one cause of serious injury and death in children. Keep
your child away from knives, power tools, or mowers.
FIRES AND BURNS
• Practice a fire escape plan.

• Check smoke detectors and replace the batteries as needed.
• Teach your child to never play with matches or lighters.
• Teach your child emergency phone numbers and to leave the house if fire
breaks out.
FALLS
• Never allow your child to climb on chairs, ladders, or cabinets.

• Do not allow your child to play on stairways.
CAR SAFETY
• Everyone in a car should always wear seat belts or be in an appropriate

booster seat or car seat.
• Don'
t buy motorized vehicles for your child.
PEDESTRIAN AND BICYCLE SAFETY
• Always supervise street crossing. Your child may start to look in both
directions but don'
t depend on her ability to cross a street alone.
• All family members should use a bicycle helmet, even when riding a tricycle.
• Do not allow your child to ride a bicycle near traffic.
• Don'
t buy a bicycle that is too big for your child.
WATER SAFETY
• ALWAYS watch your child around swimming pools.
- 68 -
• Consider enrolling your child in swimming lessons.
POISONING
• Teach your child to take medicines only with supervision.

• Teach your child to never eat unknown pills or substances.
STRANGERS
• Discuss safety outside the home with your child.

• Teach your child her address and phone number and how to contact you at
work.
• Teach your child never to go anywhere with a stranger.
SMOKING
• Teach your child that even though smoking is unhealthy, he should be civil
and polite when he is around people who smoke.
IMMUNIZATIONS
If he has not already gotten them, your child may receive shots.
Children over 6 months of age should receive an annual flu shot. After a shot
your child may run a fever and become irritable for about 2 days. Your child may
also have some soreness, redness, and swelling in the area where a shot was given.
For fever, give your child an appropriate dose of acetaminophen. For swelling or
soreness put a wet, warm washcloth on the area of the shot as often and as long as
needed for comfort.
Call your child's healthcare provider immediately if:
• Your child has a fever over 105°F (40.5°C).
• Your child has a severe allergic reaction beginning within 2 hours of the shot
(for example, hives, wheezing or noisy breathing, swelling of the mouth or
throat).
• Your child has any other unusual reaction.
NEXT VISIT
A check-up is recommended when your child is 6 years old.
- 69 -
- 70 -
NOTES
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
- 71 -
Emergency Phone Numbers
Emergency: 911
Poison Control: 1-800-222-1222
Local Hospitals with 24 hr Emergency Rooms:
Forrest General Hospital: 601-288-2100
Marion General Hospital: 601-740-2152
Pearl River County Hospital: 601-240-3528
Perry County General Hospital: 601-788-6316
South Central Regional Medical Center: 601-426-4100
Stone County Hospital: 601-928-6628 or 601-928-6629
Wesley Medical Center: 601-296-3600
The information in this booklet has been compiled by the providers

of the Children’s Clinic and the Pediatric Clinic. The information
contained in this booklet is for informational purposes only and is
not intended to be a substitute for consultation with your medical
provider. You should contact your physician's office if you have
any medical questions.
This booklet is provided by your healthcare provider.
- 72 -
Revised 3310-IRIS
3/4/13

Child Care

Uploaded by

Copyright:

Available Formats

You might also like

Child Care

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Child Care

Uploaded by

Copyright:

Available Formats

The parents’ guide for

newborns through pre-school

Date of Birth ____________________________________

2 week measurements: _____________________________

POSITIONS FOR BREASTFEEDING

GENERAL INFORMATION ON BREASTFEEDING

Standard Immunization Schedule

Birth to 2 months: Hepatitis B

6 months: DTaP; Hib; Pneumococcal (PCV);

6 to 18 months: Hepatitis B; Polio (IPV)

12 to 15 months: Hib; MMR; Pneumococcal (PCV);

4 to 6 years: DTaP; Polio (IPV); MMR; Varicella

Call Our Office Immediately if:

2. Try these feeding strategies:

Dose Syringe Teaspoon (TSP) Tablet Tablet

• Never leave the baby alone except in a crib.

• Your baby develops a fever.

Call your child'

• Never leave the baby alone on a high place.

• Use an approved infant car seat correctly in the back seat.

• DTaP (diphtheria, acellular pertussis, tetanus) shot

Some babies also receive a hepatitis B shot at this age.

Call your child'

WELL CHILD CARE AT 6 MONTHS

• Cords, ropes, or strings around the baby'

• Check your smoke detector to make sure it is working.

• Keep crib and playpen sides up.

• DTaP (diphtheria, acellular pertussis, tetanus) shot

WELL CHILD CARE AT 9 MONTHS

• Check your smoke detector to make sure it is working.

• Never leave an infant or toddler in a bathtub alone -- NEVER.

• Check your smoke detector. Replace the batteries if necessary.

• Never leave your child alone in the car.

• Never leave an infant or toddler in a bathtub alone -- NEVER.

At the 12-month visit, your child may receive shots.

• Keep lighters and matches out of reach.

• Never leave your child alone in the car.

• Hold onto your child when you are around traffic.

• Never leave an infant or toddler in a bathtub alone -- NEVER.

• Keep hot appliances and cords out of reach.

• Never leave your child alone in the car.

• Hold onto your child when you are near traffic.

• Never leave an infant or toddler in a bathtub alone -- NEVER.

WELL CHILD CARE AT 2 YEARS

Make consequences as logical as possible. Remember that encouragement and

Be consistent with discipline. Don'

READING AND ELECTRONIC MEDIA

Make an appointment for your child to see the dentist.

FIRES AND BURNS

Practice a fire escape plan.

Check smoke detectors. Replace the batteries if necessary.

Check food temperatures carefully. They should not be too hot.

Keep hot appliances and cords out of reach.

Keep electrical appliances out of the bathroom.

Keep matches and lighters out of reach.

Turn your water heater down to 120°F (50°C).

Use an approved toddler car seat correctly.