Health Promotion, Anticipatory Guidance, and Injury Prevention
Health promotion items combine the well-child schedule, immunizations, age-linked anticipatory guidance, and injury prevention counseling. The exam wants the specific recommendation tied to the age, not general safety advice.
Well-child care
- Newborn weight check within 3–5 days; frequent visits in the first months.
- Screenings: lead at 12 and 24 months (or per risk), hemoglobin at 12 months, vision at 3–5 years, hearing, developmental surveillance at every visit, autism screening at 18 and 24 months, adolescent depression screening.
Anticipatory guidance by age
- 0–6 months: back to sleep, no honey, no water, expect night waking.
- 6–12 months: childproofing, finger foods, stranger anxiety is normal.
- 12–24 months: whole milk 16–24 oz/day, no juice before 12 months, language burst.
- Preschool: screen time limited to 1 hour/day of high-quality programming, helmet, dental home.
- School age: bike helmets, sports safety, body safety, secure firearm storage.
- Adolescent: confidentiality, substance use, driving, sexual health, mental health.
Injury prevention
- Car seats: rear-facing until age 2 or until the seat's height/weight limit; then forward-facing with harness; booster until 4'9" (57 in) and 8–12 years.
- Safe sleep: alone, on the back, in a crib with a firm mattress, no bumpers.
- Water: touch supervision for toddlers; four-sided pool fencing.
- Poison: 1-800-222-1222 in the US; medications stored locked.
- Firearms: locked, unloaded, ammunition stored separately.
Worked example
A 15-month-old, 12 kg, is riding forward-facing. Correct guidance: he should remain rear-facing until 2 years or the seat's limit. Keep him rear-facing, harness snug at armpit level, no bulky coat under the harness, and no aftermarket inserts.
Traps
- Honey before 12 months (botulism).
- Whole milk before 12 months.
- Forward-facing “because he's tall.”
- Generic “keep safe” counseling with no specific behavior.