WELL BREASTFED INFANT CARE

 
Date Age  SUBJECTIVE
DEVELOPMENTAL TASKS S=SOCIAL FM=FINE MOTOR L=LANGUAGE M=GROSS MOTOR B=BREAST FEEDING
EXAM

a=NORMAL X = ABNORMAL

Date 1

week

See Assessment Handouts FM Quality of Suck M Root/ sucking reflex B Latch-on and positioning/ Mother-led vs. Child-led feeding GEN.AP  LATCH-ON & POSITIONING  HEENT 
LUNGS  C.V. SKIN ABD NEURO  EXT  GEN. 
Date 2-4

week

Nursing Frequency___
On demand______
# of Stools______
# of Voids_______
Breast/Nipple _______
S Cuddles FM Follow to Midline/Equal movements/ Responds to Sound/Moro M Primitive Step/ Palmar Grasp/Neck/Elbow Flexor Tone B Actively feeds> 10 minutes GEN.AP  LATCH-ON & POSITIONING  HEENT 
LUNGS  C.V. SKIN ABD NEURO  EXT  GEN. 
Date  6-8 Week S- S –Smiles FM Palmar Grasp Fades L Listens to Bell M Lifts Head B Baby opens mouth wide /Begins to position self GEN.AP  HEENT  LUNGS  C.V.
SKIN ABD NEURO  EXT  GEN. 
Date 3-4

M

S- S -Smiles Spontaneously /Hands Together/Follows 180 L   Squeals FM Laughs Babbles M Rolls Over, Head Steady, Sits w/ help B Efficiently nursing baby/Latches on Easily GEN.AP  HEENT  LUNGS  C.V.
SKIN ABD NEURO  EXT  GEN. 
Date 5-6 M S- S -Smiles at Mirror FM Grasps rattle/ Reaches for object L Coos M Prone Holds chest up/Sits B Signs of weaning/ solids readiness/Nurses sitting up/ Latch-on effortless GEN.AP  HEENT  LUNGS  C.V.
SKIN ABD NEURO  EXT  GEN. 

   

Date  9-10M S- S Bye bye/ Feeds self crackers/Peek-a-boo/ FM Pincer Grasp/Raking Grasp/Transfers bjectsd/Looks for Hidden Objects LMama Dada nonspecific/Turnse to Voice/Imitates Speeck Sounds M Stands holding on/ Bears some WT. B Crawls over to nurse/Comfort Nurses GEN.AP  HEENT  LUNGS  C.V.
SKIN ABD NEURO  EXT  GEN. 
Date 1

Year

S- S- Kiss/Interactive Games/Pat a Cake FM Bangs 2 Cubes L Mama Dada Specific M Walks with help/Stands alone Seconds B Uses words for nursing/Laughs with joy when offered breast GEN.AP  HEENT  LUNGS  C.V.
SKIN ABD NEURO  EXT  GEN. 

 
Date Age  ASSESSMENT BF=Breastfeeding EBF=exclusive MBF=mixed W=weaned PW=premature WC=well child
ANTICIPATORY GUIDANCE
SA=SAFETY SX=SYMPTOMATIC BF/FD=BREASTFEEDING Rx FL=FEELING
PLAN

INSTRUCTIONS/PROCEDURES/
RECOMMENDATIONS

Date 1

Week

A- SA Car Seats, Cosleeping, Back to Sleep, breastfeeding BF/ FD Burping, Hindmilk, Growth Spurts Avoid Bottle/ Pacifiers, Signs of Early Hunger and Satiation SX Stooling, Avoid Crying, Sleepy Baby FL Parents/ Sibling Nursing Frequency INCREASE LENGTH or PUMPING TO INCREASE SUPPLY BREAST COMPRESSION

NIPPLE CARE/SKIN-TO-SKIN CONTACT/CORD CARE /CIRC CARE/ F/U 1 week/ Rest and limit visitors


Date 2

Week

A- SA Bedding, Bathing, BF /FD NO Propping, Cluster Feeding GROWTH SPURTS, CHANGING DYNAMICSOF BF SX Colic, Nasal Hygiene, Thermometer/Fever, Skin Care FL SLEEP, ROUTINE-NO SCHEDULE NURSE ON DEMAND/Practice Nursing in Lying Position

EXCLUSIVE BF for 6 mo

After 3-4TH week PUMP for STORAGE F/U 2 mo & PRN 

Date  6-8

Week

A- SA FALLING (ROLLING OVER) CAR SEATS /Fire Retardant Clothing Small Objects Out of Reach BF/ FD Growth Spurts, BF Baby Leaner Cluster Feeding, Milk Supply maintenance, Feeding Efficiency/Breast Fullness SX Tylenol, Thermometer Use, Stooling Slows FL SLEEP, Oral Hygiene COMVAX #1 ____ DaPT #1 ____ IPV #1____ Prevnar___

EXCLUSIVE BF for 6 mo

F/U 4 mo & PRN

Date 3-4

M

A- SA Stairway Gaits, Avoid Walkers/Jumpers BF /FD SIGNS BABY READY FOR SOLIDS Shorter Nursing/ Easily Distracted Nursing Strikes SX DIARRHEA FL Behavior Expectations, Baby-sitters COMVAX #2 ___ DaPT #2___ IPV #2 ___ Prevnar___

CONTINUE EXCLUSIVE BF F/U 6 mo & PRN  


Date 5-6 M A- SA CRAWLING-ELECTRIC OUTLETS/Floor Heaters, Poisons BF /FD CHOKING, Pica, Spoon, NURSING FREQUENCY, Changing Composition of Milk/MUTUAL/Natural WEANING, Intro. Cup/Avoid Bottles, With Solids Milk Supply Becomes Supplementary SX DENTAL CARE/TEETHING URI-Review Ibuprofen, Ipecac FL Stimulation/ Consistency DaPT #3___ Prevnar___

COMMENDATION for EXCLUSIVE BF RECOMMEND CONTINUATION for a MINIMUM of 1 YEAR/ F/U 9 mo (FIRST TIME BF MOMS) ) & PRN12-13 mo (SECOND TIME MOMS) & PRN

   

Date  9-12M A- SA Ambulation Hazards BF /FD Finger Foods WEANING and TRIPLE NIPPLES SX Dental Hygiene OM, Shoes FL Exploration Strangers Discipline, Temper Separation Anxiety CONTINUE BF

F/U 12-13 mo & PRN 

Date 1

Year

A-  SA Climbing Window, Stairs BF/ FD Decreasing Appetite, Eating Habits Nursing Manners/Setting Limits/Tandem Nursing/Nursing Frequency Commonly Increases with Illness/Teething. SX Vomiting, Review FL Independence Testing, Consistent Limits MMR#1___ VARICELLA___ COMVAX #3___ PPD___ LEAD___ Prevnar_____

Congratulations AAP GUIDELINES MET WHO/UNICEF Recommendations > 2 YEARS F/U 15-18 mo & PRN COMFORT NURSING Encouraged