POCKET GUIDE - Bright Futures - American Academy of Pediatrics

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Infancy 14 Bright FUTURES by 1 monTh Interview Questions for Parents of all infants ■ how often are you feeding your baby during the day? During the night? ■ how do you know if your baby is hungry? how do you know if your baby has had enough food? ■ have there been times when she seemed to be growing very fast and seemed to want to eat all the time? What did you do? ■ how easily does your baby burp during or after a feeding? ■ how many wet diapers and stools does your baby have each day? ■ What is the longest time your baby has slept? ■ Are you giving your baby any supplements, herbs, or vitamins? for Parents of breastfed infants ■ Are you breastfeeding exclusively? if not, what else are you feeding your baby? ■ how often do you feed your baby? how long do you feed him each time? ■ Are you breastfeeding more often or for longer periods? ■ how can you tell if your baby is satisfied at the breast? ■ Are you planning to return to work or school? if so, are you pumping your breast milk? how do you store it? how long do you keep it? for Parents of formula-fed infants ■ Do you ever prop a bottle to feed your baby or put her to bed with a bottle? ■ What formula do you use? is the formula iron-fortified? ■ how often does your baby feed? how much does she take at a feeding? ■ how long does it take to feed your baby? ■ have you given your baby anything other than infant formula? ■ What concerns do you have about infant formula (cost, preparation, nutrient content)? ■ Are you worried about having enough money to buy infant formula?
Screening and Assessment ■ if possible, observe the mother breastfeeding or either parent bottle-feeding the infant. Assess how comfortable the parent seems with feeding the infant, eye contact between the parent and the infant, the parent’s interaction with the infant, the parent’s and the infant’s responses to distractions in the environment, and the infant’s ability to suck. ■ For breastfed and partially breastfed infants, determine whether the infant is receiving vitamin D supplementation. Anticipatory Guidance discuss with Parents of all infants ■ Their infant’s increasing appetite during growth spurts, between ages 6 and 8 weeks. ■ Forgoing foods other than breast milk or infant formula until their infant is developmentally ready (at about age 4–6 months, when the sucking reflex changes to allow coordinated swallowing and the infant is sitting with support and has good head and neck control). ■ helping their infant focus on feeding by rocking, patting, stroking, or swaddling the infant or feeding in a room with fewer distractions (lights, noise). ■ indications of colic (crying inconsolably for several hours and passing a lot of gas). (if the mother is breastfeeding, recommend short, frequent feedings.) discuss with Parents of breastfed infants ■ Their infant is getting enough milk if there are 6 to 8 wet diapers and 3 or 4 stools in 24 hours and the infant is gaining weight as expected. ■ When appropriate, introducing a bottle by someone other than the mother when their infant is neither extremely hungry nor full and allowing the infant to explore the bottle’s nipple and put it in his mouth. discuss with Parents of formula-fed infants ■ Feeding their infant on average 24 to 27 oz of formula, but the infant may consume 20 to 31 oz of formula in 24 hours. (infant needs to feed every 3–4 hours.) 15 Bright FUTURES Infancy
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