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Child Health Guide
Print out this form and fill it in
Important Information
Child's Name:____________________________________________
Date of Birth:___________________________________________
Parent/Guardian Name(s):_________________________________
_________________________________________________________
Home Telephone:__________________________________________
Work Telephone(s):_______________________________________
_________________________________________________________
Address:_________________________________________________
_________________________________________________________
Important Health Problems/Allergies:_____________________
_________________________________________________________
Health Care Provider Name(s) and Phone Number(s):________
_________________________________________________________
_________________________________________________________
Health Insurance Number(s):______________________________
_________________________________________________________
_________________________________________________________
Poison Control Center Phone Number:______________________
_________________________________________________________
A Message About Your Child's Health
Preventive care is as important for your child's health as
treatment is when he or she is sick This care includes immunizations,
tests, and health guidance. Your child receives preventive care from the
doctor or other health care provider at check-up visits and at other
times. Proper preventive care helps keep your child healthy.
As a parent, you should know what preventive care your child needs.
Work with your child's doctor or other health care provider to assure
that he or she gets proper care.
The Child Health Guide has information on needed preventive care
and on good health habits. Use it as a permanent record to help you keep
track of your child's health and care through the years. This guide can
help your child get a healthy start on life.
M. Joycelyn Elders, M.D.
Surgeon General
U.S. Public Health Service
How to Use The Child Health Guide
Each page of the Child Health Guide covers an important health care
topic.
- Read each page carefully and ask your child's doctor or other
health care provider to answer any questions that you may have.
- The Preventive Care Timeline in the center of this booklet gives an
overview of care your child may need at each age.
- Use the records throughout the Child Health Guide to keep track of
the immunizations (shots), tests, exams, and other types of health
care that your child gets. Use these records to remind you when
your child needs to be seen next.
- Take the Child Health Guide home and keep it in a safe place. Check
it often to make sure that your child is getting the preventive
care that he or she needs. Keep the Child Health Guide up-to-date.
- Bring the Child Health Guide every time your child goes to a doctor
or other health care provider--such as a nurse, nurse practitioner,
or physician assistant.
Table of Contents
Check-Up Visits
Immunizations
Tests and Exams
- Growth
- Blood Pressure
- Anemia
- Lead
- Vision and Hearing
- Additional Tests
- Test and Exam Record
Preventive Care Timeline
Health Guidance
- Development
- Nutrition
- Dental/Oral Health
- Physical Activity
- Smoking
- Safety
- A Special Message About SIDS
- Child Abuse
- As Your Child Grows Up
- For More Information
- Visit and Illness Record
- Put Prevention Into Practice
Check-Up Visits
Your child's doctor or other health care provider may want to see
your child for check-up visits even when shots or test are not due. Some
authorities recommend check-up visits at the following 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. Your child's doctor or other health cam provider will
discuss with you increasing or decreasing the number of these visits to
meet the individual needs of your child.
My Child's Check-Up Schedule:
(Record age and/or date)
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
Immunizations
Your child needs immunizations. Immunizations (shots) protect your
child from many serious diseases. Below is a list of immunizations and
the ages when your child should receive them. Immunizations should be
given at the recommended ages--even if your child has a cold or minor
illness at the time. Ask your health care provider about when your child
should receive these important shots. Ask also if your child needs
additional immunizations.
* Polio (OPV): At 2 months, 4 months, 6 months, and 4-6 years.
* Diphtheria-Tetanus-Pertussis (DTP, DTP): At 2 months, 4 months, 6
months, 15 months, and 4-6 years. Tetanus-Diphtheria (Td) at 14-16
years.
* Measles-Mumps Rubella (MMR) At 12-15 months and EITHER 4-6 years OR
11-12 years.
* Haemophilus influenzae type b (Hib): At 2 months, 4 months, 6
months, and 12-15 months; OR 2 months, 4 months, and 12-15 months,
depending on the vaccine type.
* Hepatitis B (HBV): At birth, 1-2 months and 6-18 months; OR 1-2
months, 4 months, and 618 months.
* Chickenpox (VZV): At 12-18 months.
Immunization Record
Use this chart or an official immunization card to keep track of
your child's immunizations. Significant reactions should be recorded and
reported to your Health care provider immediately.
Growth Record
Your child's doctor or other health care provider 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. These measurements will help
you and your health care provider know if your child is growing
properly. Use this record or the growth charts on pages 10-13 to keep
track of your child's growth. If you need help using these charts, ask
your doctor or other health care provider.
Birth
Date______ Weight_____ Height_____ Head Size_____
Growth Record
Date/Age_____ Weight_____ Height_____
High Blood Pressure
Your child should have blood pressure measurements regularly,
starting at around 3 years of age. High blood pressure in children needs
medical attention. It may be a sign of underlying disease and, if not
treated, may lead to serious illness.
Check with your child's doctor or health care provider about blood
pressure measurements.
Anemia
Your child should be tested for anemia ("low blood") when he or she
is still a baby (usually around the first birthday) and also may need
anemia tests as he or she gets older. Anemia may cause your child to
grow slowly, tire easily, and get infections more often. Anemia in
children is usually caused by too little iron in the diet. Your child
needs to eat iron-rich foods such as meats, green leafy, vegetables, and
iron-fortified cereals.
Check with your child's doctor or health care provider about anemia
testing.
Lead
Lead can harm your child, slowing physical and mental growth and
damaging many parts of the body. The most common way children get lead
poisoning is by being around old house paint that is chipping or
peeling. Some authorities recommend lead tests at 1 and 2 years of age.
Use a (X) to mark "yes" answers to the questions below. Any "yes"
answers may mean that your child needs lead tests earlier and more often
than other children.
HAS YOUR CHILD:
- Lived in or regularly visited a house with peeling or chipped paint
built before 1960? (This could include a day care center,
preschool, the home of a babysitter, etc.)
- Lived in or regularly visited a house built before 1960 with
recent, ongoing, or planned renovation or remodeling?
- Had a brother or sister, housemate, or playmate with lead
poisoning?
- Lived with an adult whose job or hobby involves exposure to lead
(such as refinishing furniture, making pottery or stained glass, or
working in any of the industries listed in the next question)?
- Lived near a lead smelter, battery plant, car repair shop, glass or
pipe factory, or other industry likely to release lead?
Vision and Hearing
Your child's vision should be tested before starting school, at
about 3 or 4 years of age. Your child may also need vision tests as he
or she grows. Some authorities recommend hearing testing beginning at 3
to 4 years of age.
If at any age your child has any of the vision or hearing warning
signs listed below, be sure to talk with your doctor or other health
care provider.
Vision Warning Signs
- Eyes turning inward (crossing) or outward
- Squinting
- Headaches
- Not doing as well in school work as before
- Blurred or double vision
Hearing Warning Signs
- Poor response to noise or voice
- Slow language and speech development
- Abnormal sounding speech
SPECIAL WARNING: Listening to very loud music, especially with
earphones, can permanently damage your child's hearing.
Additional Tests
Your child may need other tests to prevent health problems. Check
this list with your child's doctor or other health care provider.
Newborn Screening (for PKU, thyroid and other inherited/metabolic
diseases)--If your child did not receive this blood test before coming
home from the hospital, or received it before 24 hours of age. Some
states require a repeat test during the first month of life.
Sickle Cell or Thalassemia Test--If your child has an
African-American, Mediterranean, Asian, or Middle Eastern family
background.
Tuberculosis (TB) Skin Test--If your child has had close contact
with a person having TB, lives in an area where TB is more common than
average (such as a Native American reservation, a homeless shelter, or
an institution), or has recently moved from Asia, Africa, Central
America, South America, the Caribbean, or the Pacific Islands.
Cholesterol Test--If your child has a parent with high cholesterol
or a parent or grandparent with heart disease before age 55.
Urinalysis Test--If your child is less than 5 years of age,
particularly if your child has had a bladder or kidney infection.
Child Preventive Care Timeline
Check-up visits are important for your child's health. Some
authorities recommend these visits at the following 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. Your child's doctor or other health care provider will discuss
with you the individual needs of your child. At check-up visits, your
child may receive a physical examination.
Development
Children grow and 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 fails to do many of these at the ages given, or you
have questions about his or her development, talk with your child's
doctor or other health care provider.
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 sew up to standing
1 YEAR
- Waves bye-bye, says mama or dada
- Walks when holding on, picks up small objects with thumb and first
finger
18 MONTHS
- Says 3 words other than mama or dada, scribbles
- Walks alone, feeds self using spoon
2 YEARS
- Puts 2 words together, refers to self by name
- Runs well, walks up stairs by self
3 YEARS
- Knows age, helps in buttoning clothing, washes and dries hands
- Throws ball overhand, rides tricycle
4 YEARS
- Knows first and last name, tells a story, counts 4 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 very important for his or her health.
Follow the nutrition guidelines below.
Guidelines for a Healthy Diet
0-2 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 darkskinned, who do not get
regular exposure to sunlight may need to receive Vitamin D
supplements.
* Begin suitable solid foods at 4-6 months of age. Most experts
recommend ironenriched 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 one week before adding each new cereal,
vegetable, or other food.
* Use iron-rich foods, such as meats, ironenriched cereals, and other
grains.
* Do not give honey to infants during the first 6-12 months of life.
* Do not limit fat during the first 2 years of life.
2 YEARS AND OLDER:
* Provide a variety of foods, including plenty of fruits, vegetables,
and whole grains.
* Use salt (sodium) and sugars in moderation.
* Encourage a diet low in fat, saturated fat, and cholesterol.
* Help your child maintain a healthy weight by providing proper foods
and encouraging regular exercise.
Dental/Oral Health
Your child needs regular dental care starting at an early age. Talk
with your dentist to schedule the first visit. Good oral health requires
good daily care. Follow these guidelines.
FOR BABIES:
* If most of your child's nutrition comes from breast feeding, or if
you live in an area with too little fluoride in the drinking water
(less than .3 ppm for children less than 2 years old, less than .7
ppm for children over 2 years old), your child may need fluoride
drops or tablets. Ask your health care provider or local water
department about the amount of fluoride in your water and note it
here:______ ppm.
* Don't use a baby bottle as a pacifier or put your child to sleep
with a baby bottle. This can cause tooth decay and ear infections.
* Keep your infant's teeth and gums clean by wiping with a moist
cloth after feeding.
* When multiple teeth appear, begin gently brushing your infant's
teeth using a soft toothbrush and a very small (pea-sized) amount
of toothpaste with fluoride.
FOR OLDER CHILDREN:
* Talk with your dentist about dental sealants. They can help prevent
cavities in permanent teeth.
* Using dental floss can help prevent gum disease. Talk with your
dentist about when to start.
* Do not permit your child to smoke or chew tobacco. Set a good
example and don't smoke yourself.
* If a permanent tooth is knocked out, rinse it gently and put it
back into the socket or into a glass of cold milk or water. See a
dentist immediately.
Physical Activity
Your child needs regular physical activity through play and sports
to stay fit. Good exercise habits learned early can help your child
become an active and healthy adult. Adults who are physically active are
less likely to be overweight or to have heart disease, high blood
pressure, and other diseases. Set a good example for your child--get
regular physical exercise yourself.
Physical Activity Tips for Children
* Encourage your child to walk or ride a bicycle to school and to
visit friends.
* Plan physical activities with family or friends; exercise is more
fun with others.
* Limit the time your child spends watching TV to less than 2 hours
per day. Encourage going out to a playground, park, gym, or
swimming pool instead.
* Encourage your child to be actively involved in sports, rather than
only being an observer.
* Find out about exercise or sports programs at your child's school
and in your community.
* Encourage children with disabilities to participate in physical
activities as much as possible.
* Exercise should be fun. Don't make winning the only goal.
Smoking
Smoking is very harmful to your health (causing lung cancer, heart
disease, and other serious illnesses) and to your child's health. If you
smoke, your child is more likely to get infections of the ears, sinuses,
and lungs. Smoking in the home may also cause lung cancer in family
members who do not smoke.
Do not permit your child to smoke. Set a good example and don't
smoke yourself. If you do smoke, talk with your doctor or other health
care provider about getting help with quitting.
Quit Date: I will stop smoking on: (fill in) ____________
_________________________________________________________
The three reasons that I should stop smoking are: (fill in)
1._______________________________________________________
2._______________________________________________________
3._______________________________________________________
Safety
More children die from injuries than any other cause. The good news
is that most injuries can be prevented by following simple safety
guidelines. Talk with your doctor or other health care provider about
ways to protect your child from injuries. Fill out this safety
checklist.
Safety Guidelines Checklist
Read the list below and check off (û) each guideline that your
family already follows. Work on those you don't.
FOR ALL AGES:
* Use smoke detectors in your home. Change the batteries every year
and check to see that they work once a month.
* Keeping a gun in your home can be dangerous. If you do, make sure
that the gun and ammunition are locked up separately and kept out
of reach.
* Never drive after drinking alcohol.
* Teach your child traffic safety. Children under 9 years of age need
supervision when crossing streets.
* Learn basic life-saving skills (CPR).
* Keep a bottle of ipecac at home to treat poisoning. Talk with a
doctor or the local Poison Control Center before using it. Post the
Poison Control Center number near your telephone and write it in
the space provided on the inside front cover.
INFANTS AND YOUNG CHILDREN:
* Use a car safety seat at all times until your child weighs at least
40 pounds. When possible, secure it in the center of the back seat.
* Keep medicines, cleaning solutions, and other dangerous substances
in childproof containers, locked up and out of reach.
* Use safety gates across stairways (top and bottom) and guards on
windows above the first floor.
* Keep hot water heater temperatures below 120° F.
* Keep unused electrical outlets covered with plastic guards.
* Baby walkers can be dangerous. Children using them should be
closely supervised. Access should be blocked to stairways and to
objects that can fall (such as lamps) or cause burns (such as
stoves).
* Keep objects and foods that can cause choking away from your child,
such as coins, balloons, small toy parts, hot dogs (unmashed),
peanuts, and hard candies.
* Use fences that go all the way around pools and keep gates to pools
locked.
A SPECIAL MESSAGE ABOUT SIDS
Sudden Infant Death Syndrome (SIDS) is the leading cause of death
for infants. Some authorities believe that placing sleeping infants on
the side or back, instead of the stomach, decreases the risk of SIDS.
FOR OLDER CHILDREN:
* Use car safety belts at all times. Use with a booster seat if your
child weighs less than 70 lbs. The lap belt should be snug and low
on the hips. The shoulder belt should cross the chest, not the
face, neck, or stomach. If it does not fit properly, tuck it behind
the shoulders instead.
* Make sure your child uses a safety helmet while riding on a bicycle
or motorcycle.
* Make sure your child uses protective equipment (such as mouth
guards, pads, sports goggles, and helmets) when playing contact
sports, rollerskating, or skateboarding.
* Don't let your child use alcohol or illegal drugs. Many driving-,
sports-, and violence-related injuries are caused by the use of
alcohol or drugs.
* Read all instructions for safe handling of household tools, such as
saws and lawn mowers. Teach your child to use these tools safely.
* Don't allow your child to ride on or drive heavy farm equipment,
such as tractors, without special training.
* Teach your child to deal with anger and conflict without using
violence. Set a good example for your child.
Child Abuse
Child abuse is a hidden, serious problem. It can happen in any
family. The scars, both physical and emotional, can last for a lifetime.
Because children can't protect themselves, we must protect them.
Ways to Prevent Child Abuse
* Teach your child not to let anyone touch his or her private parts.
* Tell your child to say "No" and run away from sexual touches.
* Take any reports by your child of physical or sexual abuse
seriously. Report any abuse to your local or state child protection
agency. Local Hotline:______________________________________
* If you feel angry and out of control, leave the room, take a walk,
take deep breaths, or count to 100. Don't drink alcohol or take
drugs. These can make your anger harder to control.
* If you are afraid you might harm your child, get help now! Call
someone and ask for help. Talk with a friend or relative, other
parents, or your health care professional. Take time for yourself.
Share child care between parents, trade baby-sitting with friends,
or use day care.
As Your Child Grows Up
As your child grows up, he or she will have to begin dealing with
many important health issues not included in the Child Health Guide.
Some examples of these issues are:
* Alcohol
* Drugs
* Tobacco
* Sexuality
* AIDS
* Birth Control
Talk to your child's doctor or other health care provider about
these important issues even while your child is still young. You may
also get assistance from authorities listed on the next two pages.
Start early to teach your child to make responsible choices--not
mistakes that can have a lifelong effect. Take the time to "be there for
your child--listening, advising, and supporting. The rewards will be
well worth the effort.
For More Information
If you would like more information about how to help your child
stay healthy, talk with your child's doctor or other heath care
provider. You can also get information by calling your local health
department (look in the phone book) or the authorities listed below,
many of which have toll-free numbers.
AIDS
* CDC National AIDS Hotline
(800) 342-AIDS
Alcohol and Drugs
* National Clearinghouse for Alcohol and Drug Information
(800) 729-6686
Child Abuse
* National Child Abuse Hotline
(800) 422-4453
Counseling/Crisis Intervention
* National Youth Crisis Hotline
(800) HIT-HOME
Food and Drug Safety
* Food and Drug Administration, Office of Consumer Affairs
(301) 443-3170
General Child Health Information
* American Academy of Family Physicians
(800) 274-2237
* American Academy of Pediatrics
(800) 433-9016
Immunizations
* General Information: Centers for Disease Control and Prevention
(404) 332-4553
* Vaccine Adverse Event Reporting System
(800) 822-7967
Maternal and Child Health
* National Maternal and Child Health Clearinghouse
(703) 821-8955 ext. 254
Safety and Injury Prevention
* Consumer Product Safety Commission
(800) 638-CPSC
* National Highway Traffic Safety Administration Auto Safety Hotline
(800) 424-9393
* The Children's Safety Network
(703) 524-7802
Sexually Transmitted Diseases
* CDC National STD Hotline
(800) 227-8922
Health Care Visit and Illness Record
Use this chart to keep track of your child's visits to doctors or
other health care providers. Also use this chart to keep track of your
child's illnesses (such as chicken pox, measles, or mumps) and injuries
(such as broken bones). A record of childhood illnesses and injuries
will be useful even when your child is an adult.
Health Care Visit and Illness Record
Date:_____ illness/Reason:_____
Treatment/ for Visit:_________________________________________________________
Medication:____________________________________________________
Put Prevention Into Practice
"Put Prevention Into Practice" is a national initiative of the U.S.
Department of Health and Human Services' Public Health Service in
partnership with public and private health care organizations.*
The goal of "Put Prevention Into Practice" is to preserve the
health of all Americans by improving the preventive care they receive.
You can help to put prevention into practice by working with your
health care providers to make sure you get all the preventive care you
need.
You can also do your part by following the health advice in this
Personal Health Guide. Take charge of your health and live a longer and
healthier life!
* Neither the Public Health Service nor the U.S. Department of Health
and Human Services endorses any particular product, service or
organization.
For more information about the Put Prevention Into Practice
campaign, write:
Put Prevention Into Practice
National Health Information Center
P.O. Box 1133
Washington, DC 20013-1133
For sale by the U.S. Government Printing Office
Superintendent of Documents, Mail Stop: SSOP,
Washington, DC 20402-9328
Information provided by the NIH.
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