Guidelines For Health Supervision Of Infants, Children . - Bright Futures
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THE BRIGHT FUTURES PROJECT The mission of Bright Futures is to promote and improve the health, education, and well-being of children, adolescents, families, and communities. Bright Futures is a national child health promotion and disease prevention initiative launched in 1990 with the support of the Maternal and Child Health Bureau, Health Resources and Services Administration, and the Medicaid Bureau, Health Care Financing Administration. Bright Futures is dedicated to developing educational materials for health and education professionals and for families and to the implementation of the Bright Futures content, philosophy, and materials. BRIGHT FUTURES MATERIALS The content of the Bright Futures Encounter Forms for Families is based on Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Second Edition. Other Bright Futures materials include: Available Bright Futures Pocket Guide Bright Futures Anticipatory Guidance Cards Bright Futures Activity Book Bright Futures in Practice: Nutrition Bright Futures in Practice: Oral Health Bright Futures Oral Health Quick Reference Cards Bright Notes Newsletter Forthcoming Bright Futures in Practice: Physical Activity Bright Futures in Practice: Mental Health Bright Futures for Families Materials Bright Futures for Children with Special Health Care Needs For more information about the Bright Futures project and publications contact: Bright Futures Project National Center for Education in Maternal and Child Health 2000 15th Street, North, Suite 701, Arlington, VA 22201-2617 phone (703) 524-7802, fax (703) 524-9335 e-mail: brightfutures@ncemch.org Web site: www.brightfutures.org These encounter forms have been published by the National Center for Education in Maternal and Child Health, Arlington, VA, 2000, under its cooperative agreement (MCU-119301) with the Maternal and Child Health Bureau, Health Resources and Services Administration, Public Health Service, U.S. Department of Health and Human Services. The line drawings by Michael David Brown are from Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents. The encounter forms are made possible through an educational grant from Pfizer Pediatric Health. NATIONAL CENTER FOR EDUCATION
HOW TO USE THE ENCOUNTER FORMS FOR FAMILIES The Bright Futures family and professional encounter forms are meant to be used together. A family form should be handed to the family when they come in for a health supervision visit, and they should be encouraged to review it before the visit begins. Bright Futures for Families Encounter Forms can be used By parents, children, adolescents, other family members, and caregivers. To provide families and professionals with a shared framework for health promotion and health supervision that fosters partnership. To engage health professionals in discussion, share information, ask questions, and raise issues and concerns. To be prepared for and informed about what will happen in today’s visit and the next health supervision visit. To bring home specific age-appropriate health promotion messages and tasks to accomplish. To become more active participants in the health supervision process. Share information about the child’s weight and height for the parent’s records. 5 Year Visit Date: Space has been left for practice setting information. Name Age Weight Height Bright Futures AT TODAY’S VISIT You and your doctor will have an opportunity to talk about your child’s growth and development. Your doctor will ask for an update on your child’s health. Your child will have a physical examination. Your child’s vision, hearing, and blood pressure will be checked. AT TODAY’S VISIT What to expect of the physical exam, screenings, and immunizations. You will be asked about your child’s possible exposure to lead and your family’s history of heart disease. Your child may have a test for tuberculosis. Your child may receive one or more immunizations: DTP; polio; MMR. Ask your doctor about them. You and your child will have an opportunity to ask questions. THINGS YOU AND YOUR CHILD MAY WANT TO DISCUSS DURING THIS VISIT What you think about going to school. What you like to do for fun. Preparing your child for school and meeting the teachers. Arrangements for before-school and after-school care. Changes in your family since your last visit. Some things your child can do now that he couldn’t do at the last visit. Any other topics you may want to discuss. THINGS YOU MAY WANT TO DISCUSS DURING THIS VISIT Developmentally appropriate. Star symbols for the child. Bulleted points for the parent. Space to note other topics. These points correspond to the “Questions for Parent” and “Questions for Child” on the professional forms. NOTES: Working Together to Keep Your Child Healthy and Happy Working Together to Keep Children Healthy and Happy
HOW TO USE THE ENCOUNTER FORMS FOR FAMILIES Family graphic indicates that the form is for use by the parent/caregiver and child. 5 Year Visit Date: Name THINGS TO KEEP IN MIND BETWEEN NOW AND THE NEXT VISIT THINGS TO KEEP IN MIND BETWEEN NOW Bright Futures AND THE NEXT VISIT Talk with your child about how to be safe (near strangers, on the playground, crossing streets, in the school bus or car). Limit TV. Provide healthy food choices for meals and snacks. Information about the child’s current and next developmental phase. Tasks to accomplish. Talk with your dentist about dental sealants for your child. These points correspond to the highlighted “Anticipatory Guidance” topics on the professional forms. HOW Teach your child family rules, respect for authority, and right from wrong. Play with your child and show him affection. Expect your child to start being curious about sex, and answer his questions using correct terms. Participate as a family in school or community activities. Prepare your child for school, tour the school together, and meet the teachers. TO PREPARE FOR THE NEXT VISIT Share what you’ve learned at today’s visit with other family members and caregivers. HOW TO PREPARE NEXT VISIT FOR THE Information, concerns, and observations to share. Things to keep track of. Questions to prepare. Forms to complete. Helping the family to be prepared for a visit promotes partnership. Keep track of illnesses and injuries, including visits to other health facilities and the emergency room. Note changes in your child’s eating, sleeping, and social behaviors. Fill out and bring in school health forms for the doctor to complete. Prepare your child to discuss issues, concerns, and achievements with the doctor. Help your child learn about the health visit process. Share ideas with the doctor about community resources that you have found useful. Keep a list of topics you would like to discuss at your next visit. WHAT TO EXPECT AT THE NEXT VISIT Your child will have a physical examination. Your child’s vision, hearing, and blood pressure will be checked. You will be asked about your child’s exposure to lead and your family’s history of heart disease. Your child may have a test for tuberculosis. Your child may receive one or more immunizations. WHAT TO EXPECT NEXT VISIT AT THE Components of the physical exam, screenings, and immunizations. NATIONAL CENTER FOR EDUCATION IN MATERNAL AND CHILD HEALTH
Initial Visit Date: Name Expected due date Bright Futures AT TODAY’S VISIT You and your health professional will have an opportunity to talk about how your pregnancy is going. Your health professional will ask you questions about your pregnancy and the preparations you’ve made for the new baby. You will have an opportunity to ask questions. THINGS YOU MAY WANT TO DISCUSS DURING THIS VISIT Excitement, nervousness about being a new mother/parent. Preparations you’ve made at home. Your physical and emotional well-being. Preparing your other children for the new baby. Questions about breastfeeding and bottlefeeding. Questions about circumcision. Plans for returning to work or school. Child care arrangements. Concerns about food or supplies for the new baby. Any other topics you may want to discuss. NOTES: Working Together to Keep Your Child Healthy and Happy
Date: Initial Visit Name THINGS TO KEEP IN MIND BETWEEN NOW AND THE Bright Futures NEXT VISIT Install a rear-facing infant safety seat in the back seat of your car, following the vehicle owner’s manual and manufacturer’s instructions. Never place your baby’s safety seat in the front seat of a vehicle with a passenger seat air bag. The back seat is the safest place for children of any age to ride. Turn down hot-water heater temperature to 120º or lower. Make sure your crib is safe (slats no more than 2 3/8 inches apart). Put your baby to sleep on his back or side (back is preferred). Avoid the use of soft bedding (quilts, pillows, blankets) or soft toys. Maintain a smoke-free environment. Install smoke alarms in your home. Do not smoke or use drugs or alcohol. Keep your prenatal appointments. Attend childbirth and infant CPR classes. Expect changes in family relationships. Prepare your other children for the arrival of the new baby. Anticipate that you may feel tired sometimes or have the “baby blues” after your baby is born. Ask friends and family to help out when you need it. HOW TO PREPARE FOR THE NEXT VISIT Be prepared to talk about family members’ reactions to the new baby. Be aware of your own physical and emotional well-being and discuss any concerns you may have with the health professional. Bring in questions or concerns about breastfeeding or bottlefeeding. Have questions ready about safety issues regarding safety seats, cribs, and your home environment. Keep a list of topics you would like to discuss at your next visit. WHAT TO EXPECT AT THE NEXT VISIT Your baby will have a physical exam. Your baby’s hearing will be tested and he will have a blood test. Your baby may receive an immunization. NATIONAL CENTER FOR EDUCATION IN MATERNAL AND CHILD HEALTH
Newborn Visit Date: Name DOB Weight Length Bright Futures AT TODAY’S VISIT You and your health professional will have an opportunity to talk about how things are going with your new baby. Your baby will have a physical examination. Your baby’s hearing will be tested. Your baby will have a blood test. Your baby may receive an immunization for hepatitis. Ask your health professional about it. You will have an opportunity to ask questions. THINGS YOU MAY WANT TO DISCUSS DURING THIS VISIT How you are feeling after your delivery. Questions you may have about feeding your baby. Caring for yourself: getting plenty of rest, eating healthy foods. (If breastfeeding, ask questions about drinking plenty of fluids, relieving breast engorgement or tenderness, caring for nipples.) Your arrangements at home for the new baby. Who to turn to when you have questions about your baby’s care. Any other topics you may want to discuss. NOTES:
Newborn Visit Date: Name THINGS TO KEEP IN MIND BETWEEN NOW AND THE Bright Futures NEXT VISIT Install a rear-facing infant safety seat in the back seat of your car, following the vehicle owner’s manual and manufacturer’s instructions. The back seat is the safest place for children of any age to ride. Never place your baby’s safety seat in the front seat of a vehicle with a passenger seat air bag. Make sure your crib is safe (slats no more than 2 3/8 inches apart). Put your baby to sleep on her back or side (back is preferred). Avoid the use of soft bedding (quilts, pillows, blankets) or soft toys. If breastfeeding: Hold your baby and get her to latch on properly. Feed on demand 8–12 times a day until she seems content. Expect 6–8 wet diapers daily. If bottlefeeding: Use iron-fortified, review formula preparation and feeding techniques. Hold baby in semisitting position. Do not use microwave to heat formula. Learn cord, circumcision, skin, and nail care and signs of illness. Try to comfort your baby by holding, cuddling, or rocking her. Rest while your baby is sleeping; realize there may be times when you feel tired, overwhelmed, or “blue”. HOW TO PREPARE FOR THE NEXT VISIT Keep track of illnesses and injuries, including visits to other health facilities and the emergency room. Prepare and bring in questions and observations about your baby’s sleeping and eating behaviors. Note changes in your own feelings and well-being. Keep a list of topics you would like to discuss at your next visit. WHAT TO EXPECT AT THE NEXT VISIT Your baby will have a physical examination. Your baby‘s hearing may be checked. Your baby may have a blood test. Your baby may receive an immunization. NOTES:
1 Week Visit Date: Name Age Weight Length Bright Futures AT TODAY’S VISIT You and your health professional will have an opportunity to talk about your baby’s growth and development. Your health professional will ask for an update on your baby’s health. Your baby will have a physical examination. Your baby’s hearing may be checked if not tested earlier. Your baby may have a blood test. Your baby may receive an immunization for hepatitis. Ask your health professional about it. You will have an opportunity to ask questions. THINGS YOU MAY WANT TO DISCUSS DURING THIS VISIT Your baby’s personality. Your baby’s fussy periods; how to comfort your baby. Questions or concerns about breastfeeding or bottlefeeding. How to deal with feeling tired or blue. Getting enough rest and time for yourself. Any other topics you may want to discuss. NOTES: Working Together to Keep Your Child Healthy and Happy
1 Week Visit Date: Name THINGS TO KEEP IN MIND BETWEEN NOW Bright Futures AND THE NEXT VISIT Use a rear-facing infant safety seat in the back seat of your car. Put your baby to sleep on his back or side (back is preferred). Avoid the use of soft bedding (quilts, pillows, blankets) or soft toys. Learn signs of illness: fever; seizure; skin rash; unusual irritability or lethargy; failure to eat; vomiting; diarrhea; dehydration; jaundice (yellowing of eyes and skin); apnea (long pauses in breathing). Never, never shake your baby. Keep your home and car nonsmoking zones. Do not put your baby to bed with a bottle or prop it in his mouth. Do not warm bottles in the microwave. Try to console your baby when he cries; crying may peak at 6 weeks of age. Hold, cuddle, and rock your baby; talk and sing to him. Encourage your partner to help care for the baby. Accept support from friends and family; learn about parent support groups. Schedule a postpartum checkup. HOW TO PREPARE FOR THE NEXT VISIT Keep track of illnesses and injuries, including visits to other health facilities and the emergency room. Prepare and bring in questions and observations about your baby’s sleeping and eating behaviors. Be prepared to share information about safety in your home and neighborhoood. Complete and bring in any questionnaires or forms given to you by the health professional. Keep a list of topics you would like to discuss at your next visit. WHAT TO EXPECT AT THE NEXT VISIT Your baby will have a physical examination. Your baby’s hearing may be checked if not tested earlier. Your baby may receive an immunization. NOTES: NATIONAL CENTER FOR EDUCATION IN MATERNAL AND CHILD HEALTH
1 Month Visit Date: Name Age Weight Length Bright Futures AT TODAY’S VISIT You and your health professional will have an opportunity to talk about your baby’s growth and development. Your health professional will ask for an update on your baby’s health. Your baby will have a physical examination. Your baby’s hearing may be checked if not tested before. Your baby may receive an immunization for hepatitis. Ask your health professional about it. You will have an opportunity to ask questions. THINGS YOU MAY WANT TO DISCUSS DURING THIS VISIT Your baby’s personality. Your baby’s fussy periods; how to comfort your baby. Your baby’s sleeping habits. Questions or concerns about breastfeeding or bottlefeeding. Dealing with being tired or feeling blue. Plans to return to work or school. Changes in your family since your last visit. Some things your baby can do now that she couldn’t do at the last visit. Any other topics you may want to discuss. NOTES: Working Together to Keep Your Child Healthy and Happy
1 Month Visit Date: Name THINGS TO KEEP IN MIND BETWEEN NOW AND THE Bright Futures NEXT VISIT Put your baby to sleep on her back or side (back is preferred); avoid the use of soft bedding. Test bath water temperature with your wrist to make sure it’s not too hot. Do not drink hot liquids or smoke cigarettes while holding your baby. Keep you home and car smokefree. Be sure your baby is gaining weight. Keep small and sharp objects and plastic bags out of reach. Delay giving solid foods until your baby is 4–6 months old. Do not put cereal in her bottle. Do not put your baby to bed with a bottle or prop it in her mouth. Try to console your baby when she cries; crying may peak at 6 weeks of age. Wash your hands frequently, especially after diaper changes and before feeding the baby. Have your postpartum checkup; discuss family planning with your partner and the health professional. Think about child care arrangements and how they will meet your baby’s and your family’s needs. HOW TO PREPARE FOR THE NEXT VISIT Share what you’ve learned at today’s visit with other family members and caregivers. Keep track of illnesses and injuries, including visits to other health facilities and the emergency room. Note changes in your baby’s eating and sleeping behaviors. Complete and bring in any questionnaires or forms given to you by the health professional. Talk with family members and your baby’s other caregivers about issues they might want you to raise with the health professional. Keep a list of topics you would like to discuss at your next visit. WHAT TO EXPECT AT THE NEXT VISIT Your baby will have a physical examination. Your baby’s hearing may be checked if not tested earlier. Your baby may receive one or more immunizations. NOTES: NATIONAL CENTER FOR EDUCATION IN MATERNAL AND CHILD HEALTH
2 Month Visit Date: Name Age Weight Length Bright Futures AT TODAY’S VISIT You and your health professional will have an opportunity to talk about your baby’s growth and development. Your health professional will ask for an update on your baby’s health. Your baby will have a physical examination. Your baby’s hearing may be checked if not tested earlier. Your baby may receive one or more immunizations: hepatitis; DTaP; Hib; polio. Ask your health professional about them. You will have an opportunity to ask questions. THINGS YOU MAY WANT TO DISCUSS DURING THIS VISIT Your baby’s sleeping habits and schedule. Observations about your baby’s vision and hearing. Making time to go out without your baby. Spending time with other parents and babies. Changes in your family since your last visit. Questions or concerns about breastfeeding or bottlefeeding. How your other children have adjusted to the baby. Some things your baby can do now that he couldn’t do at the last visit. Any other topics you may want to discuss. NOTES: Working Together to Keep Your Child Healthy and Happy
2 Month Visit Date: Name THINGS TO KEEP IN MIND BETWEEN NOW AND THE Bright Futures NEXT VISIT Put your baby to sleep on his back or side (back is preferred); avoid the use of soft bedding. Keep small and sharp objects and plastic bags out of reach. Delay giving solid foods until 4–6 months old. Do not put cereal in your baby’s bottle. Do not put your baby to bed with a bottle or prop it in his mouth. Wash your hands often, especially after diapering and before feeding your baby. Learn your baby’s temperament. Hold, cuddle, and rock your baby; talk and sing to him. Always keep one hand on your baby and do not leave him alone in the bathtub or on high places. Consider attending parent support groups or parenting classes. Take time for yourself and time with your partner. HOW TO PREPARE FOR THE NEXT VISIT Take some time to think about ways to make your next visit with the doctor even better. Keep track of illnesses and injuries, including visits to other health facilities and the emergency room. Note changes in your baby’s eating and sleeping behaviors. Bring in the Individualized Family Service Plan if your baby has special needs. Update your baby’s health and immunization records. Be prepared to discuss your baby’s possible exposure to lead, tuberculosis, violence, or other hazards. Keep a list of topics you would like to discuss at your next visit. WHAT TO EXPECT AT THE NEXT VISIT Your baby will have a physical examination. Your baby may receive one or more immunizations. NOTES: NATIONAL CENTER FOR EDUCATION IN MATERNAL AND CHILD HEALTH
4 Month Visit Date: Name Age Weight Length Bright Futures AT TODAY’S VISIT You and your health professional will have an opportunity to talk about your baby’s growth and development. Your health professional will ask for an update on your baby’s health. Your baby will have a physical examination. Your baby’s hearing may be checked if not tested earlier. Your baby may receive one or more immunizations: hepatitis; DTaP; Hib; polio. Ask your health profressional about them. You will have an opportunity to ask questions. THINGS YOU MAY WANT TO DISCUSS DURING THIS VISIT How your family is getting along. Getting the help you need with the baby. How to tell what your baby wants and needs. Your baby’s sleeping habits. Plans to return to work or school, and child care arrangements. Finding time for you and your partner to go out without your baby; choosing responsible babysitters Changes in your family since your last visit. Some things your baby can do now that she couldn’t do at the last visit. Any other topics you may want to discuss. NOTES:
4 Month Visit Date: Name THINGS TO KEEP IN MIND BETWEEN NOW AND THE Bright Futures NEXT VISIT Childproof your home. Keep medicines, cleaning aids, small or sharp objects, plastic bags, balloons, sockets, cords, and guns out of your baby’s reach. Keep the number of your local poison control center handy. Obtain a bottle of ipecac syrup but use it only at the direction of the poison control center or your health professional. Do not use baby walkers. Always keep one hand on your baby and do not leave her alone in the bathtub or on high places. Introduce solid foods gradually (one per week). Start with iron-fortified baby cereal, then pureed foods (fruits or vegetables, then meats). Do not put your baby to bed with a bottle or prop it in her mouth. Establish a bedtime routine, and put your baby to bed while she’s awake. Encourage your partner and other children to help out with the baby. HOW TO PREPARE FOR THE NEXT VISIT Share what you’ve learned at today’s visit with other family members and caregivers. Keep track of illnesses and injuries, including visits to other health facilities and the emergency room. Be prepared to share information about your baby’s possible allergies to food or medication. Talk with family members and your baby’s other caregivers about issues they might want you to raise with the health professional. Keep a list of topics you would like to discuss at your next visit. WHAT TO EXPECT AT THE NEXT VISIT Your baby will have a physical examination. Your baby may receive one or more immunizations. NOTES: NATIONAL CENTER FOR EDUCATION IN MATERNAL AND CHILD HEALTH
6 Month Visit Date: Name Age Weight Length Bright Futures AT TODAY’S VISIT You and your health professional will have an opportunity to talk about your baby’s growth and development. Your health professional will ask for an update on your baby’s health. Your baby will have a physical examination. Your baby may receive one or more immunizations: hepatitis; DTaP; Hib; polio. Ask your health professional about them. You will have an opportunity to ask questions. THINGS YOU MAY WANT TO DISCUSS DURING THIS VISIT Your baby’s daily activities. Questions about breastfeeding or bottlefeeding. Foods your baby is eating and any reactions to them. Concerns about your baby’s hearing or vision. Balancing the roles of partner and parent. Child care arrangements. Some things your baby can do now that he couldn’t do at the last visit. Any other topics you may want to discuss. NOTES:
6 Month Visit Date: Name THINGS TO KEEP IN MIND BETWEEN NOW AND THE Bright Futures NEXT VISIT If you are using an infant-only safety seat, switch to a rear-facing convertible safety seat when your baby weighs 20 to 30 pounds. Childproof your home. Keep small and sharp objects, plastic bags, hot liquids, poisons, medications, outlets, cords, and guns out of reach. Always keep one hand on your baby and do not leave him alone in the bathtub or on high places. Do not give your baby foods that could cause choking, such as peanuts, popcorn, hot dogs, carrot or celery sticks, whole grapes, raisins, whole beans, hard cand. or large bites of food. Do not use a baby walker. Ask your dentist about infant fluoride supplements. Provide opportunities for safe exploration and play games with your baby (pat-a-cake, peekaboo). Keep your baby’s environment smokefree. HOW TO PREPARE FOR THE NEXT VISIT Take some time to think about ways to make your next visit even better. Keep track of illnesses and injuries, including visits to other health facilities and the emergency room. Note changes in your baby’s eating and sleeping behaviors. Think about your own well-being and be prepared to discuss any concerns. Be prepared to provide information about changes in your family (births, deaths, marriages, divorces, losses of income, moves). Keep a list of topics you would like to discuss at your next visit. WHAT TO EXPECT AT THE NEXT VISIT Your baby will have a physical examination. You may be asked about your baby’s possible exposure to lead, and your baby may be tested for lead. Your baby may have a blood test. Your baby may receive one or more immunizations. NOTES: NATIONAL CENTER FOR EDUCATION IN MATERNAL AND CHILD HEALTH
9 Month Visit Date: Name Age Weight Length Bright Futures AT TODAY’S VISIT You and your health professional will have an opportunity to talk about your baby’s growth and development. Your health professional will ask for an update on your baby’s health. Your baby will have a physical examination. You may be asked about your baby’s possible exposure to lead, and your baby may be tested for lead. Your baby may have a blood test. Your baby may receive one or more immunizations: hepatitis; polio. Ask your health professional about them. You will have an opportunity to ask questions. THINGS YOU MAY WANT TO DISCUSS DURING THIS VISIT Your baby’s eating and sleeping habits. Childproofing your home and checking for hazards. Your baby’s increasing independence. Keeping up with your baby. Finding time for yourself. Changes in your family since your last visit. Some things your baby can do now that she couldn’t do at the last visit. Any other topics you may want to discuss. NOTES:
9 Month Visit Date: Name THINGS TO KEEP IN MIND BETWEEN NOW AND THE Bright Futures NEXT VISIT If you are using an infant-only safety seat, switch to a rear-facing convertible safety seat when your baby weighs 20 to 30 pounds. Do not use a baby walker. Do not give your baby foods that could cause choking, such as peanuts, popcorn, hot dogs, carrot or celery sticks, whole grapes, raisins, whole beans, hard candy, tough meat or large bites of food. Supervise your baby while she is eating. Brush your baby’s teeth with a soft toothbrush and water only. Talk, read, and sing to your baby. Play games with your baby (pat-a-cake, peekaboo); provide safe toys. Encourage your partner and your other children help out with the baby. Join play groups and parent support groups. HOW TO PREPARE FOR THE NEXT VISIT Share what you’ve learned at today’s visit with other family members and caregivers. Keep track of illnesses and injuries, including visits to other health facilities and the emergency room. Prepare and bring in questions about your baby’s development (eating, temperament, activity level, thumb sucking or use of p
The mission of Bright Futures is to promote and improve the health, education, and well-being of children, adolescents, families, and communities. . The content of the Bright Futures Encounter Forms for Familiesis based on Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Second Edition. Other Bright .
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