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2 WEEK CHECK-UP

GROWTH

  • Most babies have regained their birth weight.
  • Average weight gain is ½-1 oz. per day.
  • Average height increase is 1 inch per month.

DEVELOPMENT

  • Baby lifts head while on stomach.
  • Looks at faces.
  • Quiets in response to voices.
  • Startles to some noises, yet has capability to sleep through major household noises.
  • Alert only about 20% of day.

NUTRITION

  • Baby should be either breast-feeding or taking a formula.
  • It is not necessary to give extra water.
  • Solid foods are not necessary until at least 4 months of age.
  • It is not necessary to boil tap water or sterilize bottles. If you have well water we recommend that you boil water for the first four months.
  • If breast-feeding exclusively and mom is planning on returning to work, you may want to introduce a bottle around 4-5 weeks of age using pumped breast milk. Baby may take bottle better from someone other than mom. - Exclusively breast fed babies require extra vitamin D. This is available through daily supplementation with Tri-Vi-Sol, an over the counter vitamin supplementation.

SLEEPING

  • Most babies will sleep between 10 and 18 hours per day, but will often wake every two to three hours. We recommend putting your infant to bed while drowsy instead of fully asleep. This way the infant learns to go to sleep on his own, instead of depending on nursing or rocking to go to sleep. This may also help your baby learn to sleep through the night.
  • The Academy of Pediatrics has recently issued new guidelines to reduce the risk of crib death (SIDS). This includes recommendations that babies sleep on their backs next to the parents’ bed the first six months of life, and the use of pacifiers at nighttime and naps as soon as breastfeeding is well established (by 1 month), or just after birth in formula fed babies. -Because of this sleep position, babies will sometimes develop a flattening to the back of their heads. It helps to have the baby spend some wakeful time on their stomachs (only if they enjoy this position, it’s not that crucial) and also to alternate sleep position in the crib (one day the head should be at the top of the crib, and the next at the bottom).

CRYING/FUSSING

  • All babies will have periods of crying and fussiness. These periods are usually in the evenings. The amount of crying tends to increase over the first 6-8 weeks of life and then begins to decline. If you think that your baby is crying excessively or is inconsolable, please call for advice or make an appointment.

SIGNS & SYMPTOMS OF ILLNESS

  • Any temperature greater than 100 degrees rectally.
  • Sleeping through several expected feeding times.
  • Vomiting after several feeds.
  • Decreased urination.
  • Inconsolable or excessive crying

RECTAL TEMPERATURE TAKING

  • Rectal temperatures are the most accurate way to measure fevers. Use a rectal thermometer and lubricate end of thermometer with Vaseline. Put baby on stomach and place on your lap. Use one hand to open buttocks; use the other hand to insert thermometer about 1 inch and hold for 2-3 minutes.

TOYS

  • Babies prefer to look at objects with dark and light patterns and moving objects.

NEXT DEVELOPMENTAL MILESTONE

  • Baby will probably begin to smile and coo by six weeks of age.

VACCINATIONS

  • Over the next two years your baby will be receiving numerous injections to protect against many dangerous diseases. We follow the national vaccine guidelines recommended by the Centers for Disease Control and the American Academy of Pediatrics, and have copies of the vaccine information statements at the office. These guidelines, along with a wealth of information concerning these vaccines, are also available online at www.cdc.gov/nip. We strongly recommend that you visit this web site before the next check-up.
  • We also recommend parents receive certain vaccines to further protect their babies. This includes a flu vaccine in the fall, and a DPT booster to protect against pertussis. Both of these vaccines are available for parents in our office. Please call to schedule an appointment.

CHADIS- Child Health & Development Interactive System

  • Our practice is pleased to announce that we are expanding our use of CHADIS, an interactive online system developed by Johns Hopkins University pediatric specialists, which screens for developmental, social, emotional and behavioral problems.
  • This system allows the child's caregivers to provide more in-depth observations of their child to the child's health care providers through the use of confidential online questionnaires. Done prior to the office visit, the information you provide will help in the early identification and treatment of these important issues.
  • The use of pre-visit questionnaires like CHADIS is supported by the American Academy of Pediatrics.

We are currently using the CHADIS system for all check-up visits and all behavior visits. For this tool to be successful, we need your help by completing these brief questionnaires a few days prior to your office visit. Please follow these instructions:

  1. Go online to http://www.chadis.com and register your child.
  2. The "invitation code" for our office is our phone number 3018692292. Create your password.
  3. For checkups, when asked visit type, choose "well child/checkup visit." You will see the age appropriate tests for your child. Select "begin" and complete all the questionnaires listed. It is normal for some of the questions to seem too mature for your child.

Your provider will discuss the results at the check-up or behavioral visit. We appreciate your participation as it helps us provide your child with the best care possible.

Next check-up is at 2 months of age.


2 MONTH CHECK-UP

GROWTH

  • Average weight gain is about 5-7 oz. per week.
  • Average height increase is about 1 inch per month.

DEVELOPMENT

  • Able to hold head more erect.
  • Smiles and coos.
  • Eyes will follow an object from side to side.
  • Calms down when spoken to.

NUTRITION

  • Breast milk or formula is all that is needed. The early introduction of solid foods does not usually help babies sleep through the night. "Spitting up" is very common and is generally more of a nuisance than a real problem.
  • Exclusively breast fed babies require extra vitamin D. This is available through daily supplementation with Tri-Vi-Sol, or other brands, as an over the counter vitamin supplementation.

SLEEP

  • Babies sleep schedules often becomes more established. Some babies will be sleeping through the night and others will be waking up still every 3-4 hours. We recommend putting your infant to bed while drowsy instead of fully asleep. This way the infant learns to go to sleep on his own, instead of depending on nursing or rocking to go to sleep. This may also help your baby learn to sleep through the night.
  • We recommend that babies sleep on their backs the first six months to reduce the risk of crib death (SIDS). Because of this sleep position, babies will sometimes develop a flattening to the back of their heads. It helps to have the baby spend some wakeful time on their stomachs (only if they enjoy this position, it’s not that crucial) and also to alternate sleep position in the crib (one day the head should be at the top of the crib, and the next at the bottom).

TOYS

  • Babies prefer mirrors, bright rattles, soft cuddlies and musical toys. Their favorite "toy" however, is PARENTS!

NEXT DEVELOPMENTAL MILESTONE

  • Your baby may start to reach for objects and begin to vocalize more. Some babies will begin to roll by 4 months of age.

CHADIS- Child Health & Development Interactive System

  • Our practice is pleased to announce that we are expanding our use of CHADIS, an interactive online system developed by Johns Hopkins University pediatric specialists, which screens for developmental, social, emotional and behavioral problems.
  • This system allows the child's caregivers to provide more in-depth observations of their child to the child's health care providers through the use of confidential online questionnaires. Done prior to the office visit, the information you provide will help in the early identification and treatment of these important issues.
  • The use of pre-visit questionnaires like CHADIS is supported by the American Academy of Pediatrics.

We are currently using the CHADIS system for all check-up visits and all behavior visits. For this tool to be successful, we need your help by completing these brief questionnaires a few days prior to your office visit. Please follow these instructions:

  1. Go online to http://www.chadis.com and register your child.
  2. The "invitation code" for our office is our phone number 3018692292. Create your password.
  3. For checkups, when asked visit type, choose "well child/checkup visit." You will see the age appropriate tests for your child. Select "begin" and complete all the questionnaires listed. It is normal for some of the questions to seem too mature for your child.

Your provider will discuss the results at the check-up or behavioral visit. We appreciate your participation as it helps us provide your child with the best care possible.

Next check-up is at 4 months of age.


4 MONTH CHECK-UP

GROWTH

  • May have almost doubled birth weight.
  • Still gains about ½-1 oz. every day.
  • Height increases about 1 inch per month.

DEVELOPMENT

  • Holds head steady when upright.
  • May start to roll over.
  • Laughs out loud and squeals.
  • Looks at hands.
  • Reaches for and grasps toys.

NUTRITION

  • Continue with breast-feeding or formula with iron until baby is 1 year old.
  • The American Academy of Pediatrics recommends that breastfeeding mothers wait until their baby is around six months of age before starting their babies on solid foods.
  • If you are feeding your baby with formula you may start solid foods at 4 months of age. Cereal is usually the first solid food offered. Feed with a baby spoon while infant is upright in an infant seat or high chair. Start with 1-2 tsp. once a day and gradually increase volume. After about 2-4 weeks, start introducing vegetables and fruits. There is no specific order to starting foods, just be sure to wait 2-3 days in between each new food, watching for signs of food allergies (rashes, diarrhea, upset stomachs). Most babies do not have any food allergies. A varied diet is a healthy diet. We would recommend that you offer the baby a variety of all types of foods, including a variety of grains. Also, juice may be given now but is not necessary.
  • Babies under age one should not eat raw honey because of the risk of poisoning from the botulism toxin.

DROOLING

  • You will probably observe that your baby is drooling more and that everything goes into the mouth. Many people think that this is teething. The average age for the first tooth to appear is 6-9 months. Babies are very oral at this age and mouthing objects is their way of exploring and learning about the world by the taste, shape, texture and smell of objects.

TOYS

  • Babies are more fun to play with now. Put your baby on his stomach and place him on the floor (while awake). Parents can get down on the floor and play too. Put bright objects such as rattles, spoons, balls, blocks, squeaky toys, or plastic containers where he can see and reach for them.

NEXT DEVELOPMENTAL MILESTONE

  • Baby may start to sit upright with or without support at 6 months of age.

CHADIS- Child Health & Development Interactive System

  • Our practice is pleased to announce that we are expanding our use of CHADIS, an interactive online system developed by Johns Hopkins University pediatric specialists, which screens for developmental, social, emotional and behavioral problems.
  • This system allows the child's caregivers to provide more in-depth observations of their child to the child's health care providers through the use of confidential online questionnaires. Done prior to the office visit, the information you provide will help in the early identification and treatment of these important issues.
  • The use of pre-visit questionnaires like CHADIS is supported by the American Academy of Pediatrics.

We are currently using the CHADIS system for all check-up visits and all behavior visits. For this tool to be successful, we need your help by completing these brief questionnaires a few days prior to your office visit. Please follow these instructions:

  1. Go online to http://www.chadis.com and register your child.
  2. The "invitation code" for our office is our phone number 3018692292. Create your password.
  3. For checkups, when asked visit type, choose "well child/checkup visit." You will see the age appropriate tests for your child. Select "begin" and complete all the questionnaires listed. It is normal for some of the questions to seem too mature for your child.

Your provider will discuss the results at the check-up or behavioral visit. We appreciate your participation as it helps us provide your child with the best care possible.

Next check-up is at 6 months.


6 MONTH CHECK-UP

GROWTH

  • Weight gain slows down to about ½ oz. per day.
  • Usually has doubled birth weight.
  • Height increases about ½ inch per month.

DEVELOPMENT

  • Rolls both ways.
  • May be able to sit alone or with support.
  • Should be able to bear weight on legs.
  • Laughs and babbles; may be able to say "dada."
  • Transfers objects from hand to hand.

NUTRITION

  • Continue feeding infant with breast milk or formula with iron. If you have been exclusively breast feeding your baby you should refer back to the 4 month sheet for guidelines on starting solids. Continue to advance solids (see 4 month sheet)- introduce one new food at a time, waiting 2-3 days in between new foods. You may introduce one serving per day of dairy, such as yogurt. Many 6-7 month olds are up to 2-3 meals a day and down to 4 bottles. We will discuss finger foods at the 9 month visit.
  • Babies under age one should not eat raw honey because of the risk of poisoning from the botulism toxin.
  • Introduce baby to a cup with a lid within the next month or two. May start with water or juice in cup, but gradually try to give some formula or breast milk in the cup so that baby will take milk in the cup when the bottle or breast is weaned.
  • Parents should ensure that their infants have fluoride in their diet. Formula should be made with tap water which contains fluoride. Breast fed infants can use concentrated frozen juices diluted with tap water (4-8 ounces per day). If child drinks well water, they usually need a fluoride supplement.

PACIFIER

  • If your baby is using a pacifier, this is a great time to stop. Babies now have less need to suck, which makes stopping easier. Recent studies also suggest an increased rate of ear infections for babies who use a pacifier between 6 and 24 months of age.

TEETHING

  • The average age to begin developing teeth is about 6-9 months. Many normal infants will not develop teeth until later. Teething may cause some crankiness and discomfort. If an infant develops fever over 101 degrees, green runny nose, diarrhea, or other symptoms, it is best not to blame these symptoms upon teething. If you are concerned about the symptoms, please call for medical advice. Firm objects such as chilled (not frozen) teething rings, will help alleviate some of the discomfort. Use of topical anesthetics (Orajel) is discouraged- it is expensive and effects are very temporary. Begin brushing teeth with a baby toothbrush (no toothpaste) as soon as teeth have erupted.
  • Babies may need a fluoride supplementation if they are on well water, bottled water, or exclusively breast-fed.

TOYS

  • Toys that can be manipulated are favorites- examples are busy boxes, stacking cups, blocks, household objects (pots and pans), bath toys, squeaky toys, and mirrors.

NEXT DEVELOPMENTAL MILESTONE

  • Baby will probably begin to crawl and pull to stand by 9 months of age.

CHADIS- Child Health & Development Interactive System

  • Our practice is pleased to announce that we are expanding our use of CHADIS, an interactive online system developed by Johns Hopkins University pediatric specialists, which screens for developmental, social, emotional and behavioral problems.
  • This system allows the child's caregivers to provide more in-depth observations of their child to the child's health care providers through the use of confidential online questionnaires. Done prior to the office visit, the information you provide will help in the early identification and treatment of these important issues.
  • The use of pre-visit questionnaires like CHADIS is supported by the American Academy of Pediatrics.

We are currently using the CHADIS system for all check-up visits and all behavior visits. For this tool to be successful, we need your help by completing these brief questionnaires a few days prior to your office visit. Please follow these instructions:

  1. Go online to http://www.chadis.com and register your child.
  2. The "invitation code" for our office is our phone number 3018692292. Create your password.
  3. For checkups, when asked visit type, choose "well child/checkup visit." You will see the age appropriate tests for your child. Select "begin" and complete all the questionnaires listed. It is normal for some of the questions to seem too mature for your child.

Your provider will discuss the results at the check-up or behavioral visit. We appreciate your participation as it helps us provide your child with the best care possible.

Next check-up is at 9 months.


9 MONTH CHECK-UP

GROWTH

  • Weight increases by about 1/2 oz. per day.
  • Height increases about 1/2 inch per month.

DEVELOPMENT

  • Sits alone.
  • Crawls and pulls to standing position.
  • Begins pincer grasp (picks up objects with thumb and index finger).
  • Uncovers toys hidden by cloth.
  • Says "mama" or "dada."
  • Responds to name.

NUTRITlON

  • Continue with breast milk or formula with iron, until 1 year of age. Begin to give table foods.  Allow baby to feed self with finger foods and continue to encourage use of the cup. Examples of finger foods are cooked vegetables, soft fruits, chicken, ground meat, luncheon meats, pasta, toast, and baked potatoes. This is an excellent time to introduce foods containing whole grains. You may give one serving per day of dairy foods, including yogurt and cheese.
  • Do not give foods that are known to cause choking such as popcorn, hard candy, nuts, raisins, hot dogs, and grapes.
  • Some kids have trouble drinking milk from sippy cups with a spill proof lid. You may have to either disable the spill proofing mechanism or use a regular sippy cup for milk.


STRANGER ANXIETY

  • You may notice an increase in shyness and clinginess to parents when strangers are present. This is very normal and will probably get worse before improving, around 2 years of age.

TOYS

  • Babies like to play peek-a-boo, pat-a-cake and waving bye-bye with parents. Favorite toys are interesting toys such as measuring cups, stacked, blocks, and containers for " in and out" play. Try to incorporate reading to baby on a daily basis. They like cardboard and cloth books.

NEXT DEVELOPMENTAL MILESTONE

  • Your infant will probably be cruising around furniture or walking by 1 year of age.

CHADIS- Child Health & Development Interactive System

  • Our practice is pleased to announce that we are expanding our use of CHADIS, an interactive online system developed by Johns Hopkins University pediatric specialists, which screens for developmental, social, emotional and behavioral problems.
  • This system allows the child's caregivers to provide more in-depth observations of their child to the child's health care providers through the use of confidential online questionnaires. Done prior to the office visit, the information you provide will help in the early identification and treatment of these important issues.
  • The use of pre-visit questionnaires like CHADIS is supported by the American Academy of Pediatrics.

We are currently using the CHADIS system for all check-up visits and all behavior visits. For this tool to be successful, we need your help by completing these brief questionnaires a few days prior to your office visit. Please follow these instructions:

  1. Go online to http://www.chadis.com and register your child.
  2. The "invitation code" for our office is our phone number 3018692292. Create your password.
  3. For checkups, when asked visit type, choose "well child/checkup visit." You will see the age appropriate tests for your child. Select "begin" and complete all the questionnaires listed. It is normal for some of the questions to seem too mature for your child.

Your provider will discuss the results at the check-up or behavioral visit. We appreciate your participation as it helps us provide your child with the best care possible.

Next check-up is at one year of age.


12 MONTH CHECK-UP

GROWTH

  • Most babies have tripled their birth weight.

DEVELOPMENT

  • Usually cruises around furniture or walks alone.
  • May say "mama" and "dada" specifically, plus one other word.
  • Feeds self finger foods with pincer grasp (thumb and finger grasp).
  • Follows simple directions.

NUTRITION

  • You should switch from formula to whole milk now. Please keep on whole milk until 2 years of age, because todlers need fat in their diet for proper growth. It is important to wean baby from the bottle within the next 1-2 months. We encourage this to help prevent tooth decay and because it is much easier to wean off the bottle now, instead of 6 months from now when it has become a habit. Total daily intake of milk may decrease after weaning. Toddlers need only 12-16 oz. a day of milk. Eating several servings of cheese or yogurt would be a suitable alternative.
  • Toddlers may have most any kind of food now, except for the foods that may cause choking (nuts, hard candy, popcorn, hot dogs, grapes). Baby cereal is still a good source of iron. Encourage the use of the cup, fork, and spoon. Some kids have trouble drinking milk from sippy cups with a spill proof lid. You may have to either disable the spill proofing mechanism or use a regular sippy cup for milk. We recommend a daily multivitamin, to ensure adequate Vitamin D for your child.

INDEPENDENCE

  • Children at this age are developing a sense of independence. They want to do more for themselves and they seem to resist everything that you want them to do. Try not to get into a power struggle over everything. Allow a reasonable amount of freedom within a safe environment - "baby proof"' their environment.

SLEEP

  • Some children may start to refuse their morning naps in the next several months. This can be an awkward stage. You may try an early lunch followed by an early afternoon nap.

TOYS/ACTIVITIES

  • Pull toys, blocks for stacking and building, toy telephones, soft toys and balls are favorites. Toddlers love to imitate adult chores such as dusting, wiping dishes, and sweeping the floor. Toddlers may play beside other children, but they don't really know how to play with other children at this age.

CHADIS- Child Health & Development Interactive System

  • Our practice is pleased to announce that we are expanding our use of CHADIS, an interactive online system developed by Johns Hopkins University pediatric specialists, which screens for developmental, social, emotional and behavioral problems.
  • This system allows the child's caregivers to provide more in-depth observations of their child to the child's health care providers through the use of confidential online questionnaires. Done prior to the office visit, the information you provide will help in the early identification and treatment of these important issues.
  • The use of pre-visit questionnaires like CHADIS is supported by the American Academy of Pediatrics.

We are currently using the CHADIS system for all check-up visits and all behavior visits. For this tool to be successful, we need your help by completing these brief questionnaires a few days prior to your office visit. Please follow these instructions:

  1. Go online to http://www.chadis.com and register your child.
  2. The "invitation code" for our office is our phone number 3018692292. Create your password.
  3. For checkups, when asked visit type, choose "well child/checkup visit." You will see the age appropriate tests for your child. Select "begin" and complete all the questionnaires listed. It is normal for some of the questions to seem too mature for your child.

Your provider will discuss the results at the check-up or behavioral visit. We appreciate your participation as it helps us provide your child with the best care possible.

Next check-up is at 15 months.

Contact Us

Pediatric & Adolescent Care, P.A.

(301) 869-2292
903 Russell Avenue, Suite 301 Gaithersburg, MD 20879