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Regular Checkups

Checkups allow your doctor to review your child's growth and development, perform tests, or give shots. To help your doctor get a full picture of your child's health, bring this booklet with you to each visit and keep the forms in the Keeping Track of Your Child's Health section up to date.

Checkups also are a good time for parents to ask questions. Make a list of your questions and concerns and bring it with you. The doctor will have answers to many questions about your child, such as whether your child is eating too much or too little, whether he or she seems uncoordinated, or what to do if your child isn't sleeping well.

Some authorities recommend checkups at ages 2-4 weeks; 2, 4, 6, 9, 12, 15, and 18 months; and 2, 3, 4, 5, 6, 8, 10, 12, 14, 16, and 18 years.

Some children may need to be seen more often, others less.

Newborn Screening

Required newborn screening tests vary depending on which State you live in. With new scientific discoveries, State newborn screening programs are growing rapidly. A few States screen for more than 30 disorders.

Some common tests check for phenylketonuria (PKU), thyroid disease, and sickle cell disease. If you are pregnant, check with your doctor or local health department about tests required by your State.

Immunizations

Immunizations (shots) protect your child from many serious diseases. Below is a list of immunizations and when most children should receive them. Some children, for example those with chronic illnesses or those in certain areas of the country, may need to follow a different schedule. Your child's doctor can help you decide which immunizations your child needs and when. Be sure to talk with the doctor or nurse about possible reactions and what you should do if your child has one.

• Hepatitis B: At birth, 1-4 months, and 6-18 months.
• Diphtheria, Tetanus, Pertussis: At 2 months, 4 months, 6 months, 15-18 months, and 4-6 years.
• Tetanus-Diphtheria: At 11-12 years.
• Haemophilus Influenzae Type B: At 2 months, 4 months, 6 months, and 12-15 months. Depending on the type of vaccine your doctor uses, the 6-month dose may not be needed.
• Inactivated Poliovirus: At 2 months, 4 months, 6-18 months, and 4-6 years.
• Measles, Mumps, Rubella: At 12-15 months and 4-6 years. Children who have not previously received the second dose should receive it by 11-12 years.
• Chickenpox (Varicella): At 12-18 months if your child lacks a reliable history of chickenpox.
• Pneumococcal disease (PCV vaccine): At 2 months, 4 months, 6 months, and 12-15 months.
• Pneumococcal disease (PPV vaccine): Recommended in addition to PCV for certain high-risk groups. Ask your doctor.
• Hepatitis A: For children in selected areas or in certain high risk groups. At 2 years or older, two doses at least 6 months apart. Ask your doctor.
• Influenza: Yearly for children 6 months or older with risk factors such as asthma, cardiac disease, sickle cell disease, HIV, and diabetes; and household members of persons in groups at high risk. Government experts recently recommended that all children aged 6 to 23 months receive annual influenza vaccine starting in the fall of 2004. Immunization schedules for influenza may change. For the latest information, check with your doctor or go to: www.cdc.gov/flu/.

Measurements

Your child's doctor or nurse will measure your child's height and weight regularly. Your child's head size will also be measured during the first 2 years of life. Keep track of the child's growth in the Growth Record. These measurements will help you and your doctor know whether your child is growing properly.

Milestones

Children develop at different rates. This table shows the ages by which most young children develop certain abilities. It is normal for a child to do some of these things later than the ages noted here. If your child does not do many of these things at the ages given or if you have questions about his or her development, talk with your child's doctor or nurses.

2 Months

• Smiles, coos.
• Watches a person, follows with eyes.

4 Months

• Laughs out loud.
• Lifts head and chest when on stomach, grasps objects.

6 Months

• Babbles, turns to sound.
• Rolls over, supports head well when sitting.

9 Months

• Responds to name, plays peek-a-boo.
• Sits alone, crawls, pulls up to standing.

1 Year

• Waves bye-bye, says mama or dada.
• Walks when holding on, picks up objects with thumb and first finger.

18 Months

• Says three words other than mama or dada, scribbles.
• Walks alone, feeds self using spoon.

2 Years

• Puts two words together, refers to self by name.
• Runs well, walks up stairs without help.

3 Years

• Knows age, helps button clothing, washes and dries hands.
• Throws ball overhand, rides tricycle.

4 Years

• Knows first and last name, tells a story, counts four objects.
• Balances on one foot, uses children's scissors.

5 Years

• Names 4 colors, counts 10 objects.
• Hops on one foot, dresses self.

Nutrition

What your child eats is important for his or her health. Follow the nutrition guidelines below.

Guidelines for a Healthy Diet

Birth to 2 Years Old:

• Breast milk is the best single food for infants from birth to 6 months of age. It provides good nutrition and protects against infection. Breast-feeding should be continued for at least the first year, if possible. If breast-feeding is not possible or not desired, iron-enriched formula (not cow's milk) should be used during the first 12 months of life. Whole cow's milk can be used to replace formula or breast milk after 12 months of age.
• Breast-fed babies, particularly if dark skinned, who do not get regular exposure to sunlight may need to receive Vitamin D supplements.
• Begin suitable solid foods at 4 to 6 months of age. Most experts recommend iron-enriched infant rice cereal as the first food.
• Start new foods one at a time to make it easier to identify problem foods. For example, wait 1 week before adding each new cereal, vegetable, or other food.
• Use iron-rich foods, such as grains, iron-enriched cereals, and meats.
• Do not give honey or corn syrup to infants during their first year.
• Do not limit fat during the first 2 years of life.