POCKET GUIDE - Bright Futures - American Academy of Pediatrics

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Early Childhood 34 Bright FUTURES 18 monThs Interview Questions ■ Are you breastfeeding your child? Are you giving him bottles? Milk in a cup? What kind of milk does he drink? how much? ■ how much fruit juice or how many sweetened drinks (fruit drinks, soft drinks) does your child drink? is the juice 100% fruit juice? When does he drink them? ■ Which foods does your child like to eat? Are there any foods he doesn’t like? ■ Describe your child’s mealtimes. Does he eat meals with the family? ■ Does he ask for food between meals and snacks? if so, how do you handle this? ■ Does your child throw tantrums over food? if so, how do you handle them? Screening and Assessment ■ screen the child for lead exposure. ■ evaluate the child’s progress in developing large motor skills. Children should be actively playing with a parent daily. Anticipatory Guidance discuss with Parents ■ offering their child food every 2 to 3 hours. (Children’s capacity to eat at any one time is limited.) ■ giving their child opportunities to develop eating skills (chewing, swallowing) by offering a variety of foods and eating at a family table. ■ Providing forks and spoons designed for children (smaller and easier to use than utensils designed for adults). ■ turning off the television during mealtimes. ■ Discouraging television viewing for children younger than age 2, and encouraging interactive activities (talking, playing, singing, and reading together). 2 years Interview Questions ■ has your child been weaned from the bottle? ■ What kind of milk does she drink? how much? ■ how much fruit juice or how many sweetened drinks (fruit drinks, soft drinks) does your child drink? is the juice 100% fruit juice? When does she drink them? ■ Which foods does your child like to eat? Are there any foods she doesn’t like?
■ Describe your child’s mealtimes. how often does she eat with the family? ■ Can your child shovel sand into a pail or pour water from a bucket? if she can, let her try to serve foods from a bowl or platter onto her plate. ■ Does she eat the same foods as the rest of the family? Screening and Assessment ■ screen the child for lead exposure. ■ Assess the child’s risk for familial hyperlipidemia. ■ evaluate the child’s progress in developing large motor skills. Anticipatory Guidance discuss with Parents ■ giving their child opportunities to develop eating skills (chewing, swallowing) by offering a variety of foods and eating at a family table. ■ Allowing their child to self-regulate food intake by serving himself from bowls and plates. (This is messy at first, but with practice this self-help skill can be mastered.) ■ handling their child’s food jags (wanting to eat only a particular food) by serving the favorite food along with other healthy foods. ■ turning off the television during mealtimes. ■ Limiting total entertainment media time (watching television, playing computer or video games) to no more than 1 to 2 hours of quality programming a day. ■ encouraging interactive activities (talking, playing, singing, and reading together). 3 To 4 years Interview Questions ■ What kind of milk does your child drink? how much? ■ how much fruit juice or how many sweetened drinks (fruit drinks, soft drinks) does your child drink? is the juice 100% fruit juice? When does he drink them? ■ Which foods does your child like to eat? Are there any foods he doesn’t like? ■ What concerns do you have about your child’s weight? ■ Describe what your child does during mealtimes. Does he serve himself foods? Does he eat meals with the family? ■ how often do you serve snacks? What types of foods do you serve? Screening and Assessment ■ screen the child for lead exposure. ■ obtain the child’s blood pressure. ■ Assess the child’s risk for familial hyperlipidemia. 35 Bright FUTURES Early Childhood
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