‘PedAnticipatoryGuidance
General safety recommendations for your child include using child restraints anytime in vehicle with transition from rear facing car seats to front facing car seat to booster seat as your child meets these specific recommendations. Wear helmets while riding tricycles/bicycles. Maintain functioning smoke detectors and be sure water heater is not set above 120 °F. Monitor child closely around any water including bathtubs and toilets. Keep infant away from high surfaces and be sure to have secure gates at stairways. Keep small objects away form infant as they can be a choking hazard. Please have your infant sleep on their backs on a firm mattress for first year of life without blankets or soft objects in crib. Protection against SIDS includes breastfeeding, pacifier use, and room sharing. Increased risk of SIDS is seen in exposure to tobacco use, alcohol, drugs, co-sleeping. Never bottle feed infant in bed, and infants should be weened to a cup by 12 months of age. Fluoride supplementation/varnish and dental visits are recommended at tooth eruption during teething. Breastfeeding, if able, is recommended for at least first 6 months of life, but ideally for first 12 months of life. 400 IU of Vitamin D supplementation for the first year of life is recommended in exclusively breastfed infants to prevent vitamin D deficiency and rickets. May consider initiation of solid (baby safe) foods at the age of 4 months. This should not be for nutrition but purely for the infants enjoyment and to get used to the texture of solid foods and the oral sensation. Avoid fatty/sugary foods. There is evidence that introduction of highly allergenic foods (peanuts, eggs, etc.) prior to 1 year old decreases likelihood of food allergies in childhood. Recommendations for juice are to avoid juice before 1 year of life, with maximum of 4 oz per day during years 1-3, and 4-6 oz per day as maximum from 4-6 years of age. I recommend that the child participate in at least 60 minutes of active fee play per day. Avoid screen time in ages <18 months as the benefit of hands on exploration is great. Between ages of 2-5 years old, limit screen time to 1 hour per day, as excessive screen time may be linked to sleep issues, obesity, and social-emotional delays.
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