PEDIA LECTURE | 100516

TABLE (10-2)
SOLITARY GAMES
Concern Related to Growth and Development
Separation Anxiety
-

Parents should reassure child that they are still there even if not physically
present, phone calls, transitional objects
Stranger Anxiety
- talk sofly; meet child at eye level maintain safe distance from infant, avoid
sudden intrusive gestures

Limit setting and discipline

-

Understand the childs exploratory behavior

Consideration
Fear or parents about spoiling
Alternative child care arrangements

Thumb sucking & Pacifier Use

-

Benefits of non-nutritive sucking

Better to use pacifier than fingers
Does not cause malocclusion unless done beyond 1 year old or if with
permanent teeth
Should not replace actual feeding or suckling
Dependency may cause social and speech problem

Dentition and Dental Care

-

Physiologic process and should not cause fever, diarrhea, and other serious
upset
Give frozen teething ring or ice cube wrapped in wash cloth
Analgesic for severe pain
Dental care (Figure 10-2)

Dentition begins at around 6 months with the 2 lower central incisor

(milk/temporary) deciduous teeth = 20 complete by around 2-3 years old

Formula for no. of teeth = age in months 6

-

Introduce infant to tooth cleaning by wiping with damp cloth when dentition
begins
First dental visit when dentition is complete should be a friendly visit only
Avoid propping bottle and giving fruit juice with bottle
Sheds off at 6-7 years old
Replaced by permanent teeth (32 complete set first last 3 rd molar wisdom
tooth)

Promoting Optimum Nutrition

Nutrition
-

Breastfeeding most desirable for the first 6 months

Weaning started 2nd half of first year iron fortified formula if not breastfeed
Whole cows milk only after 1 year of age
Expressed breast milk (ref 5 days / freezer 12 months)
Fluoride supplementation (PRN)
Daily vitamin B & D supplement/ multivitamin
Complementary feeding at 6 months (One at a time)

Selection and Introduction of Solid Foods

Cereals
-

Fruit juices from a cup not to exceed 4-5 oz. /day

(Avoid apple, pear, prune, sweet cherry, peach, grape high fructose &
sorbitol causing abdominal pain and diarrhea)
Fruits then Vegetables last meats

Dont give egg whites until 1 year old

Commercially prepared baby food

Sleep
-

Amount depends upon his need

Position on this side for safety (prevents aspiration and SIDS Sudden Infant
Death Syndrome)
Co Sleeping Dangerous

Health Supervision
-

Well baby check-up to monitor growth and development and give

immunization

Injury Prevention (Box 10-5)

Aspiration
-

Foreign materials in the respiratory tract combine with chemical suffocation

Toys, solid food items, buttons, pacifiers, baby powder
Emergency management to dislodge the item (Heimlich Maneuver)

Suffocation
-

Covering of the airway, pressure on the throat or exclusion of air by

entrapment
Crib hazards, blanket, mattress, crib slats
Sleeping with parents
Plastic bags
Cords and toys with siblings

Motor Vehicle Injuries

-

Riding on the lap of mother occupant motorcycle accidents

Use proper infant car seat, semi-received, rear facing at the back of the car
until 20 lbs or 1 year old
Air bags
Overheated inside car/carbon monoxide poisoning

Falls
-

By 3-5 months (roll-over)

Danger with changing tables, high chair, infant walkers, stairs
Slippery socks, shoes
Never place a child unattended on a raised surface with no side rails, safest
place is on the floor

Poisoning
-

Highest incidence at 2 years old due to improper storafe

Inhalation poisoning
PCC (Poison Control Center)

Burns
-

Scalding from hot bath water, microwave formula

Sunburn
Electrical outlets
Flame retarded sleepwear
Excessive heat in poorly ventilated cars

Drowning
-

Bathtub, toilet, swimming pools

Bodily damage
-

Sharp objects
Small objects into body orifices
Excessive noise from toys
Animal attacks