This clinical content conforms to AAFP criteria for CME.
Well-child care for newborns and infants (birth to 12 months) allows clinicians to identify any abnormalities in growth and development, administer vaccinations, and provide anticipatory guidance. History should focus on feeding, stooling, and sleeping. Trends in infant growth over time should be observed. Infants require a comprehensive physical examination to assess for normal development. Caregivers should be counseled on vaccination practices and their importance for disease prevention with adherence to standard schedules. Vaccine hesitancy should be addressed. Clinicians should review or perform routine newborn screenings for critical congenital heart disease, genetic conditions, hearing, hyperbilirubinemia, and neonatal opioid withdrawal syndrome. The birthing person should be screened for perinatal mood disorders through the infant’s first 6 months of life. Families should be screened for social determinants of health and offered community resources to help with identified areas of need. Caregivers should be educated on infant nutrition, including breastfeeding and introduction of solid foods. Many infants may benefit from vitamin D and iron supplementation. Safety should be discussed with caregivers, including rear-facing car seats, water safety, and avoiding infant walkers. Caregivers should be counseled on normal infant sleep patterns and safe sleep.
Case 1. JR is a 6-month-old infant brought to your office by his parents. They are concerned that he is not sitting by himself like his older sister did at this age. On review of his records, you see that his last visit was 4 months ago, and he is behind on recommended vaccinations.
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