Birth - Ideally, the first time I like to see my patients is when they are born in the hospital.
This
paragraph posted on 8/11/2009 - There has been an increase in babies dying of asphyxiation.
According to
the journal "Pediatrics", a number of parents are having new babes sleep in bed with the parents. And unfortunately,
a parent may roll over on the babe in their sleep and suffocate the baby.
PLEASE do not have your baby sleep in
bed with you, on the couch with you, etc.
Have the new babe sleep in a bassinet next to your bed. Do not feed the
babe in bed. Feed the babe in a chair and then place him or her back in the bassinet.
Vaccinations
- Usually, your child would get the first hepitis B vaccination in the hospital
2 to 4 weeks of age -
Vaccinations - none for the babe, but (and you may not want
to hear this) it is now recommended that the new parents get the adult DPT shot. Why? (you cry) Briefly, pertussis (the "P"
of the DPT shot) has increased in incidence. The pertussis organism is hiding in the nasopharynx of adults.The new adult DPT
shot was made to correct this problem.Why should new parents get it. Because parents have given pertussis to their new babies.
Pertussis is Whooping cough.
Safety - Please do not leave your babe alone on an open surface. He/she
could roll off. Always have the babe protected in a car seat when riding in the car, facing backwards. Ensure all the babe's
clothing and bedding are flame retardant.
2 months of age -
Vaccinations
- DPT, Polio, Haemophilus Influenza Group B, Hepititis B, and Rototeq
Safety - The biggest hazard to kids under
one year is choking to death. "Small things go in small hands into small mouths causing big problems." Keep small
things off the floor and out of the crib. Also, it's time to start baby proofing the house. Put latches on the cabinets,
outlet covers on all the wall sockets, etc. Your munchkin will be crawling in a few months, and everything that is missed
will wind up in that little mouth.
4 months of age -
Vaccinations - DPT, Polio, Haemophilus
Influenza Group B, Pneumococcal Congugate (some insurance plans cover this, some do not, check with your plan) and Rototeq.
Safety - Again, choking is the big hazard. Don't allow anything smaller than a shoe on the floor.
6 months of age -
Vaccinations - DPT, Haemophilus Influenza Group B, Pneumococcal Congugate
and Rototeq
Developement - At this age, the kids can sit up on their own. This is the time to start reading to
them, several times daily. The earlier, and more frequently we read to our children, the better they do in school and in life.
9 months of age -
Vaccinations - Pneumococcal Congugate, Hepatitis B
Saftey
- Walkers make the kids more happy because they make the kids more mobile. Walkers are dangerous because they make the kids
more mobile. Avoid them. Ensure all medicine and dietary supplement bottles have kid proof caps. Ensure you have functioning
smoke detectors. And, of course, choking.
12 months of age -
Vaccinations - Haemophilus Influenza
Group B, Hepatitis A ( if available)
Safety - Now the fun begins. They are starting to walk now. this
means instead of crawling into danger, they will be running into danger. You have to be ahead of them physically and mentally.
You have to anticipate the trouble they will get into.
15 months of age -
Vaccinations
- MMR (measles, mumps, rubella), Chicken Pox
Development - Temper tantrums start now. It's best not
to respond to temper tantrums. If you do respond, you just gave the kid another button to push. Ignoring the tantrum and walking
away (as long as they don't have something dangerous like a carving knife) is the best way in the long run to suppress
temper tantrums.
18 months of age -
Vaccinations - DPT, Polio
Safety
- The kids have much better fine motor coordination now. They can start equipment. Like cars. It has happened. Please, if
there is power equipment around, and you are not, insure that the little one can not get to it.
Two years
of age -
Vaccinations - Pneumococcal vaccine, Hepatitis A (if available)
Obesity
- I start computing the child's body mass index at this well check. This begins the discussion of obesity in earnest.
I'll publish a separate page to the website on obesity later, but bottom line (backside line? sorry about that) is that
we are getting fat because of two reasons.
1. It takes fewer calories to live now than in the past.
2. Food is much cheaper than it was in the past.
We do not need to eat the food we easily can and want to.
Three years of age -
Vaccinations - None (currently)
Development
- At this age the little ones realize that they have genitalia, and they start playing with it.
Take a deep breath.
They need to know about their body. Later on you will tell them what it does. If you slap a kid's hand away from their
genitalia, they are going to think that they have a "bad" part on them. There is no such thing as a bad part on
a kid. Like most behaviors, if you ignore it, they will stop.
Most kids at this age can recite the ABCs. Our kids
grew up on the Sesame Street ABC tapes. They're great.
Four years of age -
Vaccinations - DPT, Polio. Please know that New Jersey State law says that these vaccinations must be given on or after
the fourth birthday. If it is given just one day prior to the fourth birthday, the State will require an additional shot after
the birthday. As an aside, please don't schedule you kid's well check on his or her birthday. I hate giving shots
on birthdays.
Five years of age -
Vaccinations - MMR, Chicken Pox
Development - I ask the kids if they know their address and telephone number. They will be going to Kindergarden soon, which
means they will be leaving home. They have to know how to get back. Being able to memorize arbitrary things like a phone numbers
and addresses says they are ready for school.
Six years of age -
Vaccinations - catch up second
Chicken Pox vaccine.
Development - Your munchkins are getting bigger, and expanding their, and
your, horizons. They are joining organizations which help grow their bodies and minds. Sports teams, Scouts, 4-H, etc.
I
urge parents to let their kids try several different organizations, and then settle on one or two. We did the Scouts when
ours were here. It's a lot of work, and a lot of fun. You'll probably wind up being one of the leaders, and you will
grow too. One of the really fun things we did with the Scouts was spend overnights in the museums in the Philadelphia area.
These are great learning experiences. You get locked in the institution overnight, and you have the run of the place. There
are trained instructors giving high quality teaching/play sessions. We slept over at the Camden Aquarium, the Philadelphia
Zoo, and The Museum of Natural History once,and the Franklyn Institute three times. They were all excellent experiences. The
only cautionary note, bring a really good air mattress!
Seven years of age -
Vaccinations -
catch up vaccinations
Eight years of age -
Nine yeas of age-
Vaccinations - Gardasil
vaccine for girls to protect against cervical cancer. There are three shots in this series over a six to twelve month period.
Ten years of age -
Eleven years of age -
Vaccinations - Adacel vaccine. This is the
new adult DPT shot. All individuals eleven and older need this vaccination. (That means the parents, too)
Menactra vaccine. This is a new vaccine to protect against
a vicious bacteria called neisseria Meningitidis.This one is a really bad actor. It is fortunately rare, but if it hits, the
fatality rate
can be high. The most at risk population is college freshman living in dormatories, and military recruits.
High
School students are at a slightly increased risk also. The State of New Jersey has now demanded that all sixth graders, after
they turn eleven years of age, get this vaccine. I usually give this shot at the eleven year well check. If your child's
school is yelling at you to get the shot now, come on in and we'll do it.
Twelve years
of age
Vaccinations -
Personal responsibility - Alcohol - Unfortunately,
nationwide stats note that as much as ten percent of sixth graders drink on a regular basis. Not every day, but weekly or
bi weekly. Now is the time to start discussing both alcohol and drug use, if you have not already.
Thirteen
years of age -
Development - The kids are now in Middle School. (We called it Junior High when
I was this age.)
The data to be learned is more extensive, and the concepts are more sophisticated. This is the
time when attention problems become apparent in some of the kids. I have an interest in Attention Deficit/Hyperactivity Disorder.
If your young adolescent's grades are falling off, please discuss it with me. And please don't blow off the kid's
bad grades because you might think he is just lazy. I hear that description repeatedly in adolescents who are actually trying
their hardest, but just lack the attention to understand the concepts and data.
Personal responsibility
- At this age I suggest that your child learn CPR. Some may have already had it in school, or in Scouts. Part of this suggestion
is purely selfish. If all the adolescents in Atlantic County knew CPR, my job, and that of my colleagues, would be a lot easier.
But the ability to help save someone's life is a good thing to have. And when you actually do it, the feeling is tremendous.
The Red Cross has courses. Give them a call.
