Contents
Checkups,
Tests, and
Immunizations
Growth and
Development
Keeping Track
of Your Child's
Health
3. Growth and Development
When my son didn't walk on his own by the time he was 18 months old, I began to worry. But the doctor told us that each child develops at his or her own pace. Sure enough, in another couple of months, we were having trouble keeping up with him!
—Adam K.
Measurements
Your child's doctor or nurse 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. Keep track of the child's growth in the Growth Record. These measurements will help you and your doctor know whether your child is growing properly.
Milestones
Children 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 does not do many of these things at the ages given or if you have questions about his or her development, talk with your child's doctor or nurses.
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 up to standing.
1 Year
- Waves bye-bye, says mama or dada.
- Walks when holding on, picks up objects with thumb and first finger.
18 Months
- Says three words other than mama or dada, scribbles.
- Walks alone, feeds self using spoon.
2 Years
- Puts two words together, refers to self by name.
- Runs well, walks up stairs without help.
3 Years
- Knows age, helps button clothing, washes and dries hands.
- Throws ball overhand, rides tricycle.
4 Years
- Knows first and last name, tells a story, counts four 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 important for his or her health. Follow the nutrition guidelines below.
Guidelines for a Healthy Diet
Birth to 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 dark skinned, who do not get regular exposure to sunlight may need to receive Vitamin D supplements.
- Begin suitable solid foods at 4 to 6 months of age. Most experts recommend iron-enriched 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 1 week before adding each new cereal, vegetable, or other food.
- Use iron-rich foods, such as grains, iron-enriched cereals, and meats.
- Do not give honey to infants during the first 12 months of life.
- Do not limit fat during the first 2 years of life.
Two Years and Older:
- Provide a variety of foods, including plenty of fruit, 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.
Physical Activity
Your child needs regular physical activity through play and sports to stay fit. Good physical activity 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. Adults and children should try to get at least 30 minutes of physical activity most days of the week.
- Encourage your child to participate in physical activities, including sports.
- Encourage involvement in activities that can be enjoyed into adulthood (for example, walking, running, swimming, basketball, tennis, golf, dancing, and bicycle riding).
- 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 to the playground, park, gym, or swimming pool instead.
- Physical activity should be fun. Don't make winning the only goal.
- Many communities and schools offer exercise or sports programs—find out what is available for your child.
Dental and 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 younger than 2 years, less than .7 ppm for children older than 2 years), your child may need fluoride drops or tablets. Ask your child's doctor or your 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.
- Use dental floss to 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: don't use tobacco products yourself.
- If a permanent tooth is knocked out, rinse it gently and put it back into the socket or in a glass of cold milk or water. Take your child and the tooth to a dentist immediately.
