Childhood Development
Your child may receive any one or a combination of the following immunizations at their preventive care visit that are recommended by the ACIP and American Academy of Pediatrics. Some of the vaccines are listed below along with other important information.
Hepatitis B Vaccine(HBV) – Hepatitis B
Inactivated Polio Vaccine(IPV) – Polio
Strep Pneumonia meningitis vaccine(Prevnar) – Pneumococcal Disease
DtaP – Diphtheria Tetanus Acellular Pertussis Vaccine
Hib Vaccine – Haemophilus Influenzae
MMR Vaccine – Measles Mumps Rubella
Chickenpox Vaccine – Varicella
Gardasil – Human Papilloma Virus (vaccine for girls).
- Well-Baby check-ups should be scheduled at 2 weeks, 2 months, 4 months, 6months, 9 months, 12 months, 18 months and 2 years. Thereafter, well-child preventative visits are recommended annually.
- Beginning at 2 months of age, immunizations are evaluated at each well-child appointment.
- Please bring your child’s immunization record to each well-child appointment so it can be updated as needed.
* Allergy shots are available during regular office hours Monday through Friday.
* Keep in mind that patients are required to stay in the clinic for 30 minutes following each injection.
- Occasionally, the doctor will need a lab test to verify the best course of treatment for your child.
- In the event that you visit the clinic in order to drop off a specimen or to have a specimen collected, a minimum office call will be charged.
- You will be notified of any lab results which are not within normal limits.
- Some specimens are sent to an outside lab. You will receive a bill from the lab for work. done by them.
- If you feel your child has a medical problem that cannot wait until regular office hours, please call (360) 748-6693 to speak with our answering service.
- Our providers are on call 24 hours a day.
- Thank you for choosing Chehalis Children’s Clinic for your child’s care!
* Remember to visit our Facebook page!
We look forward to your visit with us!
Childhood Preventative Visits
2 WEEK VISIT
PKU #2 Test
Accident Prevention:
Car Seats are required, appropriate for child’s weight.
Smoke Detectors are recommended in the home.
Hot Water heater settings should not exceed 120 – 130°F.
Watch For:
Rolling/Falls from beds or sofa by being too close to edge.
Avoid small objects. (Choking)
Avoid string/bags. (Strangling)
No direct sun, child will sunburn easily.
Feeding:
Average 4-5 ounces of formula when feeding.
Breast feeding usually every 2-3 hours.
Nurse or drink about 6 times every 24 hours.
Solids not necessary until 4-6 months.
Development:
Child will stare.
Child should begin to track moving objects.
Should begin to lift their heads.
Child will have “Moro suck reflex”.
Suggested Stimulation:
Bright objects are fascinating!
Mobiles are fun but keep out of reach.
Sing / Read / Talk
Common Concerns:
Skin Rashes – May have pimply rash on the face which usually clears without treatment.
It may last for 4-6 months.
“Cradle Cap” is due to oily skin, not food. Soap & Water will help.
Notes:
Fussiness peaks at about 6 weeks; be patient!
Babies cannot be spoiled!
No need to sterilize water or bottles.
Should have own bed.
Avoid bottle propping.
Colds are possible – know how to use a rectal thermometer and nasal bulb.
Next Appointment: 2 Months
BE SURE TO SCHEDULE YOUR NEXT WELL APPOINTMENT!
2 MONTH VISIT
Immunizations:
- DTaP #1
- IPOL #1
- Hib #1
- Hep. B #2
- Prevnair #1
- Rotavirus #1
Possible side effects of immunizations include fever, fussiness, loss of appetite, sleepiness, redness or
swelling at the injection site.
Acetaminophen drops can be given every 4 hours if needed for fever, dose depends on weight.
Accident Prevention:
- Car seat as required.
- Keep small objects out of reach of child.
- No direct sun, child will burn easily.
- Child should always be on back to sleep.
Feeding:
- Nurse or drink 5-6 times per day.
- Solids are not necessary until 4-6 months.
- Never give a bottle in bed.
Development:
- Will begin to babble & Coo.
- Will start to smile.
- Will begin to thrash arms and legs.
- Child will lift head and look at objects.
- May begin to grasp.
Stimulation:
- Move them around to different scenes and positions.
- Can provide rattles.
- Can provide child swing with supervision.
- Mobiles can be provided out of reach.
- Read / Sing / Talk to your child.
Common Concerns:
- Colic – Usually over by 3-4 months. Rocking or bundling may help.
- Rolling – May start anytime. Do not leave baby alone on a couch, table or bed.
Notes:
- Each baby has individual personality & development.
Next Appointment: 4 Months
BE SURE TO SCHEDULE YOUR NEXT WELL APPOINTMENT!
4 MONTH VISIT
Immunizations:
- DTaP #2
- Hib #2
- IPOL #2
- Prevnair #2
- Rotavirus #2
Side effects may vary; they may be the same, less or more than with the first shot.
Occasionally a fever and irritability may occur after immunizations.
Acetaminophen drops can be given every 4 hours if needed for fever, dose depends on weight.
Accident Prevention:
- Car seats are required, appropriate for child’s weight.
- Avoid small toys or small objects that can be swallowed.
- Avoid hot drinks.
- Starting to roll, take appropriate safety measures on sofa’s or open beds.
- Gate on stairs.
- Keep mobiles out of reach of child.
Feeding:
- Nurse or drink 3-4 times per day.
- No bottles in bed.
- If food is started:
- Feed rice cereal
- Begin with small amounts
- Add one new food at a time, allow for several days between
- Start with yellow or green vegetables
- No regular milk
Development:
- Will begin laughing.
- Will start to rollover.
- Will begin to hold objects.
- Will try to place everything into their mouth.
- Will imitate sounds.
Stimulation:
- Tactile toys.
- Speak normally.
- Music.
Common Concerns:
- Sleeping – most sleep through the night and 2 naps.
- Good time to introduce the playpen.
- Drooling – Glands are producing saliva and the baby doesn’t know how to swallow it.
- Funny bowel movements – when solid food is given the consistency and color will change.
- Teething pain – rubbing the gum with a clean finger or ice in a washcloth may help.
Tylenol elixir may help if inconsolable.
Notes:
- Shoes are not needed for walking at any age. They are for warmth, protection and fashion only.
Next Appointment: 6 Months
BE SURE TO SCHEDULE YOUR NEXT WELL APPOINTMENT!
6 MONTH VISIT
Immunizations:
- DTaP #3
- Hib #3
- IPOL #3
- Hep B #2
- Rotavirus #3
- Prevnair #3
Occasionally a fever and irritability may occur after immunizations.
Acetaminophen drops can be given every 4 hours if needed for fever, dose depends on weight.
Accident Prevention:
- Car seats are required, appropriate for child’s weight.
- Stairs should have gates.
- Avoid small objects that can be swallowed an cause choking.
- Avoid hot drinks.
- Childproof Your Home!
- If you can’t watch the baby, use a secure playpen or crib.
Feeding:
- Keep baby on breast milk or formula and introduce a sip cup.
- Gradually introduce cereal, fruit, and vegetables.
- Homemade foods need no sugar.
- No regular milk until 1 year of age.
- Fluoride supplements if not on fluoridated water from your city.
Development:
- Sits briefly
- Babbles
- Stranger anxiety
- Oral exploration
- “Teething”
- Tries to help with feeding
Stimulation:
- Exploration with supervision.
- Playpen is O.K.
- Walkers are not recommended.
- Noisy toys.
- Stacking toys.
Discipline:
- “NO!” Harsh discipline is not safe, nor desirable at this age.
Common Concerns:
- Sleep – Many will sleep through the night but will wake up early. Still needs naps.
- Biting – Part of child’s exploration, but let the baby know that this is unacceptable.
Next Appointment: 9 Months
BE SURE TO SCHEDULE YOUR NEXT WELL APPOINTMENT!
9 MONTH VISIT
No Immunizations Scheduled.
Accident Prevention:
- Car seat as required.
- Water heater should be set less than 120 – 130°F.
- Avoid hot drinks.
- Block electrical sockets, keep electrical cords out of reach.
- Be aware of potential falls due to increased mobility.
- Baby proof all household access to medicines, cleansers, poisons, etc.
- Avoid mini-blind cords in home.
Feeding:
- Child is beginning to eat some table food.
- Snacks are commonly needed.Use fruit, pureed vegetables as tolerated. Avoid sugars and processed foods.
Do not give nuts, chunky vegetables, grapes, apple chunks or hot dogs – foods they can choke on. - No regular milk until 1 year of age.
Development:
- Child is beginning to sit without support.
- Child will crawl or creep.
- Beginning to babble.(“Mama”, “Dada”)
- Continues to have stranger anxiety.
- May wake at night.
- Plays peek-a-boo.
Discipline:
- Distraction in place of discipline works better.
Diet:
- Soft table foods
- Baby foods O.K.
- Finger foods
- Introduce sip cup if not done
Common Concerns:
- Sleep – Most will sleep about 12 hours at night and naps during the day.
Next Appointment: 12 Months
BE SURE TO SCHEDULE YOUR NEXT WELL APPOINTMENT!
12 MONTH VISIT
Hemocrit: Blood test for anemia
Lead exposure testing
Immunizations:
- MMR #1
- DTaP #4
- Hib
- HepA #1
- Varicella #1
May get rash and/or fever 7-14 days after the MMR immunization. Acetaminophen can be given as directed.
Accident Prevention:
- Car seat as required.
- Burns/Scalding from hot water.
- Stairs should have gates.
- Supervise child in all water environments.
- Be aware of all potential objects child may choke on including small toys and peanuts.
- Avoid mini-blind cords.
Diet:
- Soft table foods
- Uses sip or regular cup
- Child enjoys self-feeding
- Child can have milk (2-3 cups daily)
Feeding:
- Child should be drinking from a cup and eating table foods with fingers or grabbing for spoon.
- Avoid chunky or crunchy foods that are easily aspirated or cause choking.
- May have a decrease in appetite.
- Eliminate the bottle, move towards using the sip cup or regular cup.
- A pint of milk a day is adequate, 16-32 oz/day, no more than 32 oz/day.
- Parents should start to brush child’s teeth
Development:
- Is walking with support or crawling very fast.
- Is using their thumb and first finger grasp.(pincer grasp)
- Should be using at least 2-4 words.
- Demonstrates permanence in objects, will “hide and find” objects.
- Plays social games.
Discipline:
- Distraction instead of discipline.
- Consistency with instructions.
- Consistent reinforcement for good & bad behavior.
Common Concerns:
- Sleep – child will sleep about 12 hours at night and at least 1 nap during the day.
Next Appointment: 18 Months
BE SURE TO SCHEDULE YOUR NEXT WELL APPOINTMENT!
18 MONTH VISIT
Immunizations:
- MMR #2
- Varicella #2
- Hep A #1 or #2
Accident Prevention:
- Car seat as required.
- Stair safety with gates continues.
- Pan handles to back of stove for safety.
- Electrical cords out of reach.
- Keep away from plastic bags & balloons.
- Supervise bathing.
- Sunscreen precautions.
- Lock away any poisons – childproof your home!
Feeding:
- Self feeds, but spills.
- Decrease in appetite.
- Encourage balanced meal but don’t force.
- Brush child’s teeth.
Development:
- Drinks from cup alone.
- Points to what he/she wants.
- Uses 8 – 10 words.
- Walks well, will begin to climb.
- Has tantrums if things go wrong.
- Imitates & mimics things or others.
- Will begin to removes clothes like shoes and socks.
- Scribbles.
- Names pictures.
- Will begin climbing equipment at playground.
Discipline:
- Praise appropriate behavior.
- Ignore tantrums if possible.
- Distraction over discipline.
- “Time-out” chair may be effective. Use 1 minute per year of age rule.
Common Concerns:
- Will sleep all night and naps during the day.
- Potty-training can wait until older.
Next Appointment: 2 Years
BE SURE TO SCHEDULE YOUR NEXT WELL APPOINTMENT!
Note: Next immunizations before kindergarten – DTaP #5, IPV #4, MMR #2, Varicella #2
2 YEAR VISIT
Accident Prevention:
- Car seat as required.
- Sunscreen in summer.
- Never leave alone in bathtub or swimming areas.
- This is a peak age for poisonings! Child-proof cabinets!
- Supervise child around streets and traffic.
Feeding:
- Child may limit diet to favorite foods, encourage as wide a variety as possible.
- Limit refined sugars in juices and foods, replace with whole foods and fruits.
Common Concerns:
- Sleep. Life is too exciting. Use a routine to prepare for bedtime. Naps are good.
- Keep potty chair in bathroom. Wait until child is interested, most are trained by age 3.
Development:
- Runs. And runs, everywhere!
- Climbs up and down stairs well.
- Removes clothing easily.
- Helps to brush their teeth.
- Can toss and kick sports balls.
- Will turn pages of books.
- Will parallel play with others.
- Will try to sing, and use 2-3 word sentences.
- Will treat a doll or stuffed animal as if it were alive.
Discipline:
- Avoid direct choices. Give options.
- Be flexible with clothing and food choices.
- Be firm with rules and consistent.
- Have reasonable expectations for age appropriate behavior.
Next Appointment: Annually thereafter
BE SURE TO SCHEDULE YOUR NEXT WELL APPOINTMENT!
3 YEAR VISIT
Accident Prevention:
- Car seat as required.
- Sunscreen in summer.
- Never leave alone in bathtub or swimming areas.
- Put decals on large glass doors.
Feeding:
- Child’s appetite improves.
- Likes to eat & run.
- Time for first visit to the dentist.
Common Concerns:
- Sleep – Need quiet time or rest period in the afternoon. May develop night fears.
- Potty Training – Daytime trained but nighttime wetting may continue for a year or two.
Development:
- Can open doors, and unscrew lids on jars.
- Can color and begins to draw.
- Dresses self.
- Can catch a bounced ball and runs easily.
- Gives First and Last name.
- Can ride a tricycle.
- Enjoys other children the same age.
- Washes & dries hands, may even obsess with hand washing.
Discipline:
- Consistent reinforcement for good behaviors and bad behaviors.
- Time-out for misbehavior.
Next Appointment: Annually
BE SURE TO SCHEDULE YOUR NEXT WELL APPOINTMENT!
- * Regular office hours are 9:00 a.m. to approximately 5:00 p.m. Monday through Friday, except holidays.
* We will begin answering phones at 8:00 a.m. for appointments.
* Extended office hours are Saturday and Sunday 10:00 a.m. to 1:00 p.m. for urgent care appointments
* We ask that you make appointments in advance so that we can provide time for every patient. If you need to cancel your appointment, please make sure to call to cancel as soon as possible. If you do not cancel or keep your appointment two times or more, you may be dismissed from the clinic care. Please be aware that a missed appointment could have been utilized for someone else.
Welcome! Please take a look at our Patient Forms page where New Patient Forms are located and can be downloaded or printed for you to bring to your first appointment. You may also send them to us at contact@ccckids370
*Yes. Please call the office prior to your appointment to verify that we contract with your insurance company.
* When you have insurance, please provide us with your group and subscriber numbers at each visit.