Well Child

Overview

Well child visits include:

• vaccines

• growth/FTT

• Abuse/neglect

• Safety

• development

Growth / Failure to thrive

Growth, order of importance

• Head circumference: most important

• Height

• Weight: can lose weight in exchange for height

Failure to Thrive

Kids fall off growth chart and stay off:

• first lose weight, then fall of height curve, then fall of circumference curve

Can be organic (baby) or nonorganic (parents) causes:

• Organic: genetic syndrome (CF), heart diseases, GI disorders (pyloric stenosis, GERD)

• Nonorganic: Formula, Feeds (amount), Frequency (how often)

Abuse/Neglect

• Any injury in infant

• Suspicious injuries, especially shape, location (feet, buttocks, cigarrete shaped)

• Big injuries: subdural, femur fractures (kids are squishy and bounce. They don't fall that far becase not tall)

• FTT

Safety

• smoking cessation

• seat belts, car seats

• gun safety (get guns out of home)

• Drowning/pool

• trampolines: don't have them

Development

Gross Motor	Gross Motor	Fine Motor	Language
2	Lift head		Noise
4	Lift body (roll over)		Noise
6	Lift body and stay (sit)		Noise
1 yr	Walk		1 word
2 yr	Steps		2 words
3 yr	Tricycle	Circle	3 words
4 yr	Hop	Cross	4 words
5 yr	Skip	Triangle	5 words