ANTICIPATORY GUIDANCE: SUGGESTED TOPICS AT EACH VISIT

Age Injury Prevention Feeding/Nutrition Daily Care/Activity Developmental/ Behavioral Medical

Issues
Prenatal Safe baby furniture; car Breast-feeding vs. bottle- Infant should sleep in Maternal health issues; social Family health history.
safety seat use, starting feeding. Breast-feed until supine position. supports; siblings. Childcare Circumcision. What to
with ride home from the first birthday or use iron- plans. Encourage participation expect at delivery.
hospital. Safety alarms: fortified formula. If of the father or other supportive Schedule of health
smoke, heat, carbon committed to bottle- family member in labor, supervision visits and
monoxide detectors; fire feeding, discuss family delivery and hospital stay. immunizations.
extinguisher; water history of milk How pediatrician will be
thermostats set < 120 F. allergy/intolerance and notified at time of birth.
formula choice.
Availability of WIC.
Initial and
date Initials:__________ Initials:__________ Initials: ________ Initials:____________ Initials:__________
below
categories Date: _____________ Date: _____________ Date: ___________ Date: _______________ Date: _____________
discussed.
Newborn Review the topics above. Norms and common Crying, sleeping, Normal reflexes (startle); Immunizations. Care of
Emphasize: never leave problems with breast- stooling patterns; individuality of infant; umbilical cord and
infant unattended; use car feeding and bottle-feeding. sleeping position and importance of close interaction circumcision; jaundice;
safety seat placed in environment; bathing and responding to infant’s how to take baby’s
middle of rear seat; and skin care; hiccups, needs will not spoil infant. temperature; when and
microwave safety (do not sneezing, “wet burps”. how to call the doctor;
use to heat bottles); crib Postpartum adjustment; change jaundice, fever, vomiting,
safety, siblings, pets. in parent and family diarrhea, decreased
relationships; sibling reactions; feeding, review schedule
visitors. of health supervision
visits.
Initial and
date Initials:__________ Initials:__________ Initials: ________ Initials:____________ Initials:__________
below
categories Date: _____________ Date: _____________ Date: ___________ Date: _______________ Date: _____________
discussed.
 ANTICIPATORY GUIDANCE: SUGGESTED TOPICS AT EACH VISIT

Age Injury Prevention Feeding/Nutrition Daily Care/Activity Developmental/ Behavioral Medical

Issues
2-4 Review the topics listed Issues with breast vs. Sleep patterns; suggest Emphasize: infant’s abilities; Immunizations.
Weeks for newborn. Bath safety; bottle-feeding. naps for mother and enjoy holding, cuddling, talking Reinforce when to call
sun exposure/protection. that parents share to baby (cannot spoil infant). doctor.
feedings when
possible; crying and Parents’ time for themselves;
“colic”, bladder and baby sitters, spending time with
bowel habits; sleeping siblings; plans for substitute
position. care if mother works outside
home.
Initial and
date Initials:__________ Initials:__________ Initials: ________ Initials:____________ Initials:__________
below
categories Date: _____________ Date: _____________ Date: ___________ Date: _______________ Date: _____________
discussed.
2 Review the topics listed Review the topics listed Sleep, crying and Review the topics listed for 2-4 Immunizations. URI
Months for 2-4 weeks old. for 2-4 weeks old. bowel patterns. weeks old. management; bulb
Emphasize: use car Waiting to introduce solid Play with infant. Childcare syringe, saline nose
restraints, protect from foods at 4 to 6 months; arrangements and support; signs drops.
falls and rolling; do not Vitamin D, iron; no honey; of maternal depression.
leave unattended on bed no corn syrup.
or table; caution about
hot liquids, burns; advise
against infant walkers;
smoke-free home and car;
gun safety.

Initial and
date Initials:__________ Initials:__________ Initials: ______ Initials:____________ Initials:_______
below
categories Date: _____________ Date: _____________ Date: __________ Date: _______________ Date: __________
discussed.
 ANTICIPATORY GUIDANCE: SUGGESTED TOPICS AT EACH VISIT
Age Injury Prevention
4 Review the topics listed
Months for 2 months old.
Emphasize: keep small
objects out of reach; safe
toys; microwave safety
(do not use to heat
bottles).
Initial and
date Initials:__________
below
categories Date: _____________
discussed.
6 “Child-proofing” house in
Months preparation for mobility,
Poison
Control Center number;
car safety seat; stair gates;
window-guards;
highchair safety, bathtub
safety; electrical cords
and outlets; burn risks.
Discourage use of infant
walkers. Microwave
safety. Bicycle seat safety
and bicycle helmets. CPR
course.
Initial and
date Initials:__________
below
categories Date: _____________
discussed.
Feeding/Nutrition Daily Care/Activity Developmental/ Behavioral Medical
Issues
Introducing solid foods one at a Sleep; night Review the topics listed for 2 Immunizations.
time; iron-fortified cereal, fruits, awakening; months old. Management of mild
vegetables and formula; avoid teething/drooling. Talk to baby; respond to gastroenteritis. Expect
honey or corn syrup until 12 Elimination. vocalizations; consider about six upper
months. investigating persistent “colic”. respiratory tract
Parent and family functions; infections per year;
childcare arrangements and most will not need
support. Sibling rivalry. Free antibiotics.
time for parents. Unnecessary antibiotics
may be harmful.
Initials:__________ Initials: ______ Initials:____________ Initials:_______
Date: _____________ Date: __________ Date: _______________ Date: __________
Start feeding solids if not yet Resistance to sleep; Review topics listed for 4 Immunizations.
done, including iron-fortified suggest favorite toy or months old. First dental visit.
cereal. Norms regarding caloric possession Separation and stranger anxiety.
needs (volumes); introducing (transitional objects); Talk and read to infant
finger foods (7 to 9 months). soft flexible shoes.
Introducing juice in cup; no Teething and /dental
more than 8 oz per day; care.
discourage milk or juice as
pacifier or bottle to bed; breast-
feeding or iron-fortified formula
until first birthday, discuss when
to introduce cow’s milk (end of
first year, if possible). Fluoride
supplementation in areas without
fluoridated water.
Initials:__________ Initials: ______ Initials:____________ Initials:_______
Date: _____________ Date: __________ Date: _______________ Date: __________
 ANTICIPATORY GUIDANCE: SUGGESTED TOPICS AT EACH VISIT
Age Injury Prevention
9 Review the topics listed
Months for 6 months old.
Emphasize: car safety
seat height and weight
requirements. Avoid
choking risks (peanuts,
hot dogs, hard candy).
Infants should eat seated
and be observed by an
adult, never crawl or walk
with food in mouth.
Burns.
Initial and
date below Initials:__________
categories
discussed. Date: _____________
12 Review the topics listed
Months for 9 months old.
Car safety seat height and
weight requirements.
Reinforce;
Poison Control
Center number, tap water
at maximum of 120 F.
Window; kitchen, stairs,
water and car safety,
fences, gates, and latches;
burn risks. Never leave
alone in bathtub.
Initial and
date below Initials:__________
categories
discussed. Date: _____________
Feeding/Nutrition
Finger and table foods; self-
feeding; cup and spoon practice.
Breast milk or iron-fortified
formula until first birthday,
begin to wean from bottle;
anticipate decreased food intake;
introducing cow’s milk. Regular
mealtime; offer soft table foods.
Initials:__________
Date: _____________
Table foods, weaning from
bottle; decreased food intake;
introducing cow’s milk. Do not
force feed. Transition from baby
food to all table foods.
Initials:__________
Date: _____________
Daily Care/Activity Developmental/ Behavioral Medical
Issues
Sleep; night Separation and stranger anxiety; Immunizations. Assess
awakening favorites vocalization, communication, TB risk factors; PPD
toy or possession; imitation; social games; now or at 12 months if
shoes; dental care. anticipate autonomy issues of indicated. (should be
Regular bedtime toddler period; discipline; limit read in 48 to 72
routine. setting, consistency, distraction. hours).
Parent and family functioning;
childcare arrangements and
support.
Initials: _______ Initials: ___________ Initials: ______
Date: ___________ Date: _______________ Date: __________
Review the topics Review the topics listed for 9 Immunizations.
listed for 9 months months old. Lead screening.
old. Speech development; talk to Dental visits.
Discuss pros and cons baby; discuss autonomy, limit Expect about six upper
of child sleeping in setting, discipline; praise respiratory tract
parent’s bed. desired behavior (positive infections per year;
reinforcement). Prohibitions: most will not need
few but firm. Cuddle, talk, and antibiotics.
sing with child; read books, Unnecessary
point out objects. In most cases, antibiotics may be
defer toilet training. harmful.
Initials: _______ Initials: ___________ Initials: ______
Date: ___________ Date: _______________ Date: __________
 ANTICIPATORY GUIDANCE: SUGGESTED TOPICS AT EACH VISIT

Age Injury Prevention Feeding/Nutrition Daily Care/Activity Developmental/ Behavioral Medical

Issues
15 Review the topics listed Self-feeding, eats meals with Review the topics Review indicators of toilet Immunizations.
Months for 12 months old. Avoid family; phase out bottle use; listed for 12 months training readiness; do not
play with plastic bags or advise against bottle in bed. old. Encourage hiding expect toddler to toilet train
balloons. Avoid hot Three regular meals with adult games and until past 18 months of age.
stoves heaters, iron; do supervision. Toddler sits still to representational play. Discipline; temper tantrums;
not hold child while eat and empties mouth before Give more “yes” than remove from temptation;
holding hot liquids. leaving table to play. Continue “no” messages; state consistency between parents;
Protect toddler from fluoride supplementation, if “no” clearly; distract time-out, substitution; avoid
sunburn (hat, clothing indicated. and redirect infant. reinforcing tantrum behavior;
and sunscreen). praise good behavior; read
Continuous supervision books together; talk and sing.
when in or near water. Limit amount of TV. Drive
Gun safety. autonomy.
Initial and
date below Initials:__________ Initials:__________ Initials: _____ Initials:____________ Initials: ______
categories
discussed. Date: _____________ Date: _____________ Date: _________ Date: _______________ Date: __________
18 Review the topics listed Wean from bottles; good use of Sleep; short ritual Review the topics listed for 15 Immunizations.
Months for 15 months old. spoon and cup in self-feeding. before regular months old.
Emphasize: supervised Balanced diet. bedtime; night fears, Discipline; need for autonomy
play near street, in night awakening; self- and independence;
driveway, yard; comforting behaviors; “rapprochement” – transient
pedestrian and thumb-sucking return to clinging behavior; may
playground safety; masturbation, favorite show toilet training readiness at
dangers of climbing; toy or possession. 18 to 24 months; play games;
never leave unattended in praise, show affection; read
car or in house; avoid simple stories to child regularly.
play with plastic bags and Parallel versus interactive play.
balloons. Durable toys Clear statement of rules; natural
with out small parts. consequences; “time-out”.
Initial and
date below Initials:__________ Initials:__________ Initials: _________ Initials:____________ Initials: ___________
categories
discussed. Date: _____________ Date: _____________ Date: _____________ Date: _______________ Date: ________
 ANTICIPATORY GUIDANCE: SUGGESTED TOPICS AT EACH VISIT
Age Injury Prevention Feeding/Nutrition
24 Review the topics listed Discontinue bottle-feeding (if
Months for 18 months old. not yet done). Decrease fat
content of milk. Offer a
balanced diet; allow child to
determine how much to eat.
Discourage non-nutritious
snacks; encourage social/family
aspects of meals. Continue
appropriate fluoride
supplementation in areas without
fluoridated water.
Initial and
date below Initials:__________ Initials:__________
categories
discussed. Date: _____________ Date: _____________
Daily Care/Activity Developmental/ Behavioral Medical
Issues
Sleep; discuss a move Autonomy; do not hurry; set Immunizations.
to a regular bed; consistent limits; present Lead screening.
reassure that day choices between acceptable Dental visits.
napping varies. alternatives. Positive outcomes
Regular bedtime for desirable behavior. “Time-
routine. Use of out”. Toilet learning: does child
toothbrush and oral show interest and readiness,
hygiene. understand expectations?
Encourage child to use the toilet
with positive reinforcement.
Read to the child; limit
television. Curiosity about body
parts; provide for play and peer
contacts; imaginary friends.
Initials: _________ Initials:____________ Initials: ___________
Date: _____________ Date: _______________ Date: ________
 ANTICIPATORY GUIDANCE: SUGGESTED TOPICS AT EACH VISIT

Age Injury Prevention Feeding/Nutrition Daily Care/Activity Developmental/ Behavioral Issues Medical
3 years Review the topics listed for 24 Balanced diet, avoidance Sleep: regular Age-appropriate discipline. Toilet Immunizations.
months old. of junk foods. Encourage bedtime and routine; training support. Nursery school, day- Dental visits.
Emphasize: car safety seats; street self-feeding with utensils; napping variability. care, baby sitters; encourage out-of-
and water safety; animals and pets; allow child to say when home experiences, peer interactions.
teach full name, emergency full. Continue appropriate Allow to explore, show initiative and
number and address. Behavior fluoride supplementation, communicate; talk about activities with
toward strangers. Avoid nuts, hard in areas with out child; reserve time alone with child;
candy, chewing gum. Helmet for fluoridated water. show affection. Limit television
bicycle and in-line skating. Gun Adequate calcium intake. viewing; watch children’s programs
safety. with child. Masturbation; satisfy
curiosity about babies, sex difference.
Give proper names for genitalia and
answer questions honestly.
Initial and
date Initials:__________ Initials:__________ Initials: ________ Initials:_____________ Initials: ______
below
categories Date: _____________ Date: _____________ Date: ___________ Date: _______________ Date:________
discussed.
4 Review the topics listed for 3 years Balanced diet; avoid Calm bedtime ritual. Toilet training status; nocturnal Immunizations.
Years old. excess fat, sodium, sugar. enuresis. Discipline; provide Dental visits.
Emphasize: bicycle and pedestrian Social aspects of meals. interactions with other children.
safety including bicycle helmets; Supervise; praise desired behavior;
water safety; car seat, booster or reprimand in private; have clear limits
seat belt; refusal of food or rides and consequences; “time-out”. Assign
from strangers; electrical tools, chores; limit television viewing.
fire-arms, matches and poisons; Sexual curiosity; masturbation.
know emergency number and Nursery school, day-care; issues
address; home fire safety drills. around school, readiness assessment.
Hazards of animals. Internet Family functioning.
safety.
Initial and
date Initials:__________ Initials:__________ Initials: ________ Initials:________________ Initials: ______
below
categories Date: _____________ Date: _____________ Date: ___________ Date: ___________________ Date: _______
discussed.
 ANTICIPATORY GUIDANCE: SUGGESTED TOPICS AT EACH VISIT

Age Injury Prevention Feeding/Nutrition Daily Care/Activity Developmental/ Behavioral Issues Medical
5 Review the topics listed for 4 years Balanced diet; discourage Sleeping in own School readiness = plays well with Immunizations.
Years old. junk food. bed. Regular other children, normal development, Dental visits.
Hazards of tools and guns. physical activity. endures half-day separation from
Avoidance of drugs, alcohol, and home. Promote interactions with other
tobacco. Inhalation abuse. Internet children. Assign chores. Praise
safety liberally. Discipline. Sexual curiosity,
masturbation. Discuss sexuality if
interest is shown. Family functioning.
Initial and
date Initials:__________ Initials:__________ Initials: ________ Initials:________________ Initials: ______
below
categories Date: _____________ Date: _____________ Date: ___________ Date: ___________________ Date:________
discussed.
6 Review the topics listed for 5 years Balanced diet. Fluoride, Brush teeth. Praise child’s positive activities. Immunizations.
Years old. vitamin, iron, calcium, if Encourage self-responsibility.
Use of seatbelts. Skating safety. indicated. Avoid excessive Encourage reading. Limit television
Learning to swim. Street safety. fat, salt and sugar. viewing. Establish chores.
Gun safety. Avoidance of drugs
alcohol and tobacco. Inhalation
abuse. Internet safety.
Initial and
date Initials:__________ Initials:__________ Initials: _____ Initials:____________ Initials:______
below
categories Date: _____________ Date: _____________ Date: _________ Date: _______________ Date: _______
discussed..
8 Review the topics listed for 6 years Balanced diet. Avoid junk Exercise regularly. Balance rules; consequences for not Immunizations.
Years old. food, maintain appropriate Brush teeth. following them. Act as role model; Dental visits.
Sports safety (helmets, protective weight; encourage social Adequate sleep; provide allowance; spend time with
gear). Gun safety. Avoidance of aspects of mealtime. school and academic child; show interest in school; praise,
drugs, alcohol, and tobacco. Supplement fluoride, iron, activities; peer encourage, show affection; limit
Inhalation abuse. Internet safety. calcium and vitamins as interactions, family television viewing. Library card.
indicated. interactions.
Initial and
date Initials:________________ Initials:__________ Initials: ________ Initials:____________ Initials:______
below
categories Date: ___________________ Date: _____________ Date: ___________ Date: _______________ Date: _______
discussed.
 ANTICIPATORY GUIDANCE: SUGGESTED TOPICS AT EACH VISIT

Age Injury Prevention Feeding/Nutrition Daily Care/Activity Developmental/ Behavioral Issues Medical
10-11 Emphasize: sports safety (helmets, Balanced diet. Avoid junk Exercise regularly; Balance rules, consequences for not Immunizations.
Years protective gear). Gun safety. food, maintain appropriate Brush teeth. following them. Act as a role model; Dental visits.
Internet safety. Avoidance of weight; encourage social Adequate sleep; provide allowance; spend time with
drugs, alcohol, and tobacco; aspects of mealtime. school and academic child; show interest in school; praise,
inhalation abuse. Supervise Supplement fluoride, iron, activities, peer encourage independence, show
potentially hazardous activities. calcium and vitamins as interactions, family affection; limit television viewing.
Risk taking behavior. indicated. interactions. Library card. Discuss confidentiality
and right to privacy. Social
interactions: peers, hobbies, social
skills. Sex education at home, school;
discuss pubertal changes. Academic
activities. Family communications:
methods of conflict resolution, limit-
setting, sense of responsibility.
Encourage age appropriate decision-
making.
Initial and
date Initials:__________ Initials:__________ Initials: _______ Initials:___________________ Initials:______
below
categories Date: _____________ Date: _____________ Date: ___________ Date: _______________________ Date: _______
discussed.
12-13 Review the topics listed for 10-11 Avoid junk food, maintain Exercise regularly; Discuss rapid physical growth and Immunizations.
Years years old. appropriate weight; Brush teeth. sexual development, body image. Dental visits.
Avoidance of drugs, alcohol and encourage social aspects Adequate sleep; Establish rules. Communicate with
tobacco; Hazards of drinking and of mealtime. school and academic child; respect privacy, allow decision-
driving. Inhalation abuse. activities, weekend making. Promote independence and
jobs, peer and self-esteem. Encourage sexual
family interactions. abstinence; if sexually active, discuss
contraception, sexually transmitted
disease prevention, including HIV.
Initial and
date Initials:__________ Initials:__________ Initials: ________ Initials:_________________ Initials:______
below
categories Date: _____________ Date: _____________ Date: ___________ Date: ____________________ Date: _______
discussed.
 ANTICIPATORY GUIDANCE: SUGGESTED TOPICS AT EACH VISIT

Age Injury Prevention Feeding/Nutrition Daily Care/Activity Developmental/ Behavioral Issues Medical
14-15 Review the topics listed for Review the topics Review the topics Review the topics listed for 12-13 Immunizations.
Years 12-13 years old. listed for 12-13 years listed for 12-13 years years old. Dental visits.
Emphasize: risk-taking old. old. Encourage age appropriate peer
behaviors; encourage activities. Sexuality; sexually
responsibility for health and transmitted disease; HIV. Resist
health behavior choices. harmful peer pressure.
Hazards of drinking and
driving. Tobacco, alcohol,
drug use. Inhalation abuse.
Supervision of hazardous
activities. Internet safety.

Initial and
date Initials:__________
below
categories Date: _____________
discussed.
16-17 Car safety. Hazards of
Years drinking and driving.
Avoidance of tobacco, alcohol,
drug use. Inhalation abuse.
Avoidance of violence. Gun
safety. Internet safety.
Initials:_________ Initials: ________ Initials:_________________ Initials:______
Date: ____________ Date: ___________ Date: ____________________ Date: __________
Balanced diet. Exercise. Adequate Plans for college/vocational training. Immunizations.
sleep. Peer pressure. Sexuality, sexually Dental visits.
transmitted disease; HIV;
contraception. Communication.
Privacy.

Initial and
date Initials:_______________ Initials:_________ Initials: ___________ Initials:___________________ Initials: ________
below
categories Date: __________________ Date: ____________ Date: __________ Date: _______________________ Date: _________
discussed.
 ANTICIPATORY GUIDANCE: SUGGESTED TOPICS AT EACH VISIT
Age Injury Prevention
18-19 Review the topics listed for
Years 16-17 years old.
Avoidance of drugs, alcohol,
and tobacco. Hazards of
drinking and driving.
Inhalation abuse. CPR
training. Internet safety.
Initial and
date below Initials:__________
categories
discussed. Date: _____________
20-21 Review the topics listed for
Years 18-19 years old.
Initial and
date below Initials:_______________
categories
discussed. Date: __________________
Feeding/Nutrition Daily Care/Activity Developmental/ Behavioral Issues Medical
Balanced diet, Dental care. School Family and peer communication; Immunizations.
maintaining and academic expect periods of estrangement; Dental visits.
appropriate weight. activities, sports, respect privacy; encourage
hobbies, jobs; regular independence; serve as a role model;
physical exercise; peer sexuality and support to say no;
and family contraception and prevention of
interactions. sexually transmitted disease, including
HIV.
Initials:________ Initials: ________ Initials:____________ Initials:_______
Date: ____________ Date: ___________ Date: _______________ Date: __________
Balanced diet Dental care. Exercise Plans for future employment. Immunizations.
Sexuality; support to say no. Dental visits.
Initials:_________ Initials: ________ Initials:_____________ Initials:_______
Date: ____________ Date: ___________ Date: _______________ Date: _________