Health Promotion and Anticipatory Guidance
Domain 2 tests whether you can deliver age-specific health promotion and anticipatory guidance: immunizations, screening, nutrition, oral health, injury prevention, and family education. The focus is what to do at each visit and how to make guidance practical.
Core rules
- Use periodicity schedules and the current immunization schedule; mild illness, fever, or antibiotic use is not a reason to delay routine vaccines.
- Newborn: safe sleep (alone, back, crib), breastfeeding support, jaundice, car seat, no honey before 12 months.
- Infancy: tummy time, introduction of iron-rich solids around 6 months, fluoride assessment, lead risk screening.
- Early childhood: limit juice, whole milk after 12 months, dental home, rear-facing car seat until age 2 or seat limit, poisoning prevention.
- School age/adolescence: vision/hearing, obesity, mental health, substance use, sexual health, driving safety.
Worked example
At a 2-month visit, a term infant is growing well. Give DTaP, IPV, Hib, PCV, hepatitis B, and rotavirus per schedule. Anticipatory guidance: put infant to sleep on the back in a crib with no loose bedding; feed responsively; supervise tummy time; use a rear-facing car seat; call for fever, poor feeding, or breathing difficulty. Document refusal or questions without judgment.
Traps
Giving generic advice not matched to the visit, missing maternal depression or safety screening, and telling parents to delay vaccines for a mild cold. Also avoid recommending cow’s milk or honey too early, and do not forget dental and car-seat guidance.