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Pediatric Health Maintenance 12 Months quick look
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This chart rates treatment options according to general effectiveness, ease of use,
side effects and safety.
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Check coordination and muscle strength, language, and social skills
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Not available
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Toddler should sit without support, crawl and pull himself/herself up to standing, possibly walk alone. He/she should point with index finger and say words for mother, father, and at least one other word. He/she should feed self and use a cup. He/she should play socially (with others) and look for hidden objects.
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Full physical exam
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Not available
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Physician compares height to a growth chart to see if growth is normal. Physician should also check eyes for lazy eye (strabismus).
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Full physical exam
With lazy eye (strabismus) the eye will not follow or track an object as it moves from side to side.
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Blood tests
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Excellent
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Complete blood count, blood lead level if at risk for lead poisoning, and tuberculin testing (if these tests were not done at the 9-month visit). Children at risk for lead poisoning include those in older homes or those with siblings (brother or sister) who have had lead poisoning. These blood tests can be done at the 9 month, 1 year, or 15 month follow-up visits. Children at risk for anemia are those who are exclusively breast-fed, drinking a low iron formula, or have a distaste for iron-rich foods. Iron supplements will be prescribed if anemia is becoming a problem.
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Blood tests
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Possible immunizations include: DTaP booster, HIB booster, VAR, MMR, PCV booster, IPV booster, Hepatitis A (first dose)
(DTaP=Diphtheria/Tetanus/Pertussis, HIB=Hemophila Influenza B; Varicella (chicken pox), MMR=Measles/Mumps/Rubella, PVC=Pneumoccal pneumonia, IPV=Inactivated Polio, Hepatitis A)
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Excellent
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These vaccines should only be given if the child is over 12 months of age at the time of the visit. DTaP (diptheria/tetanus/pertussis) booster is only given at the 12 month visit if it has been at least 6 months since the third DTaP dose in the series.
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Possible immunizations include: DTaP booster, HIB booster, VAR, MMR, PCV booster, IPV booster, Hepatitis A (first dose)
The recommended age ranges for administering these vaccines are: - VAR (Varicella-Chicken Pox) 12-18 months,
- MMR (Measles/Mumps/Rubella) 12-15 months,
- HIB (Hemophilus Influenza Type B) 12-15 months,
- PCV (Pneumococcal Pneumonia) 12-15 months,
- DTaP (Diphtheria/Tetanus/Pertussis) 15-18 months.
Hepatitis A vaccination #1 (of a two part series) is now recommended for all children, with the first vaccination between 12 and 18 months.
The decision about when to give these vaccines depends on several factors including whether previous doses have been given on schedule, whether the particular vaccine is available at the time of the visit, cost, and preference of the parents. The most common side effects from these vaccines are pain at the area of the injection and fever. MMR causes fever in about 5% of children. The fever can be very high, and can trigger seizures in children who tend to seize with high fevers. The fever starts 7-12 days after the vaccine and can last 1-2 days. Sometimes children can also get a rash from MMR. Severe reactions are rare and most of these are due to allergic reactions. DTaP can rarely cause a nerve problem called brachial neuritis. MMR can rarely cause a problem with low blood counts and a serious brain problem called encephalopathy. These rare reactions occur once in every 2 million vaccinations. Physicians must give parents vaccine information statements to inform them of the risks of any vaccine. These statements are available at: http://www.immunize.org/vis/). The only babies who should not get one of these vaccines are those who have had a severe reaction or who are allergic to an ingredient in the vaccine. (See vaccine information statement at http://www.immunize.org/vis/).
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Influenza Vaccine
(flu shot)
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Good
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Children over 6 months of age should get the flu shot every year. The best time to get the shot is from October to mid-November.
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Influenza Vaccine
If a child has never had a flu shot he/she will need two doses (about a month apart) the first year the vaccine is given. After the first year only one dose is needed per year. The major side effects are pain at the injection site and fever. There have been rare severe side effects reported involving the nervous system. The only children who should not get a flu shot are those with a severe allergic reaction to eggs.
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Discuss nutrition, health and sleep habits, behavior, and safety issues
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Not available
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The toddler's diet should mostly consist of 3 table meals plus 2-3 snacks. He/she can be weaned to milk rather than breast milk or formula. Teeth should be cleaned daily. Limit-setting is important. Information about water/tub safety and supervised outdoor play should be discussed/stressed.
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Discuss nutrition, health and sleep habits, behavior, and safety issues
Toilet training should be delayed until at least age 2. Fluoride supplements are recommended if the drinking water contains less than 0.3 ppm
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