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Anticipatory guidance is the name we use to label the group of advices that as pediatricians we are to give parents and patients in every well visit. Yes, well visits are not supposed to be only getting to an office to get shots, weight and height. There are lots of other things that should be happening at every visit. As the newborn becomes an infant, then a child, then a teenager, these advices change for every child’s and teen’s needs.
I had a friend once asking me in a very interesting tone of “You talk about those things?” Like she had never heard of a doctor talking about behavior, sleep, feeding or safety. Yes, your doctor should always at least ask if you have questions regarding of all of these topics! All we want is to educate everyone regarding what is considered the safest way to take care of your kids. And, although many of these things can sound obvious to some, many, in fact, do not know a lot of important information. That is why we at least try to touch bases in every point–and expand on those that are not familiar to you. We know that not everyone knows everything–or even thinks about some of these issues–we don’t expect you to do it as it is our job to provide you with the information!
For newborn babies, we have some advice that can be a lifesaver: baby should always sleep on their back. This is to avoid sudden death. No pillows, no stuffed animals, not even bumpers in that crib. Nothing should be there. This applies until baby is at least 1 year of life, and the sleep on their back applies until baby turns on their own. Fever–which by definition is a temperature of 100.4 Fahrenheit degrees or above–means that newborn baby–until the age of 1 month and 30 days–needs to be evaluated in an emergency room. Also the American Academy of Pediatrics recommends vitamin D for all babies– breastfeeding ones or formula feeding babies–one dropper full a day–400 international units. No, neither breast milk nor formula alone can supply the required vitamin D for a healthy level.
As the baby grows, some safety things to go over: car seat should be rear facing–until the age of 2! And a 5-point harness until your child is 4 years AND 40 pounds (my boy was 5 years old before he hit that 40 pounds mark, so the booster seat for him did not happen until much later.) The recommended safest time to change from a booster to a seat belt only is NOT based on age but rather on height: that magic number is 4 feet 9 inches. Many states have laws that only go for the years of age but the fact is that a normal 8-year-old can be quite shorter than the average, and that is why it is better to go by height standards.
It is another recommendation to try to avoid screen time (tv, computers, electronic tablets, phones, etc.) for the first 2 years of life. After that, to limit it to no more than 2 hours a day. One of the reasons behind this is to promote more physical activity–even if doing a puzzle or playing with toys, you move more than sitting in front of a screen. Going outside whenever safe and possible is ideal. Riding a bicycle–always use a helmet. Going to the park–discuss stranger safety and the importance of supervision of an adult. Using sunscreen when we are going to be exposed to the sun for prolonged periods of time.
Dr. Gomez is a board certified Pediatrician, who knew from an early age that she wanted to be a “doctor for children and teenagers”. She and her husband moved to Arizona in 2006, shortly after marrying, and then began her pediatric residency program in 2007 at St. Joseph’s Hospital and Medical Center in Phoenix. She took over Pediatrics of Queen Creek upon finishing her residency in 2010. At her graduation she was given the 2010 The Walt Vikram Award, granted to the graduate that had demonstrated the most exemplary compassion in the care of newborns. She has worked with community programs to teach and educate the public on several health topics. She has a special interest in educating parents about healthy eating, breastfeeding and helping those families dealing with asthma. Dr. Gomez is a mother of 2: a very funny and active boy and a loud and happy daughter. They enjoy traveling and their special Friday movie nights at home.
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