Aquifer Case titled Pediatrics 02: Infant female well-child visits (2, 6, and 9 months).
Apply information from the Aquifer Case Study to answer the following questions:

Discuss the history that you would take on this child in preparation for the well-child visit. Include questions regarding her growth and development that are appropriate for her age.
Describe the developmental tool to be used for Asia, its reliability and validity and how Asia scored developmentally on this tool. Is she developmentally appropriate for her age?
What immunizations will Asia be given at this visit; what is the patient education and follow-up?

Pediatrics 02: Infant female well-child visits (2, 6, and 9
User: Daniela Fernandez
Date: July 27, 2021 11:56AM

Learning Objectives

Interpret standard growth charts to determine appropriate growth patterns in infants
Summarize nutritional requirements for appropriate growth for infants at ages 2, 6, and 9 months, including caloric
requirements, differences between formula and breast milk, and how and when to add solid foods to the diet
Compare and contrast developmental surveillance and developmental screening at well child visits
Distinguish normal developmental milestones at 2, 4, 6, 9 and 12 months of age
Integrate anticipatory guidance and parental education on topics such as behavior, development, nutrition, safety and
immunizations during well child visits
Create a differential diagnosis for asymptomatic abdominal mass in a child Propose a workup for an infant with an abdominal
List the components of a pediatrics health care maintenance office visit.
Describe expected weight changes in healthy infants in the first two weeks of life.
Describe how to properly obtain and record measurements of growth.
Explain how to elicit the Moro reflex and its value in the neurologic assessment of infants.
Describe common facial rashes of early infancy.
List normal primitive reflexes of infancy.
List conditions associated with abnormal red reflex in infants.
List normal developmental milestone at 9 and 12 months of age.


Components of a Well-child Visit

Interval History

If this is the first visit, obtain a detailed birth history.
Ask if there have been any illnesses or problems since the previous visit.
Using the available medical records, review any visit notes, hospitalizations, lab results, and radiology reports since the last
visit. Ask about persistence or resolution of any previously identified medical issues.
Ask if there are any new concerns today.


Developmental surveillance is recommended at every well-child visit when a validated developmental screening tool is not
Developmental surveillance may include eliciting parental concerns about development, reviewing a developmental history
if available, direct observation of the child and identification of risk factors for developmental delays.
The American Academy of Pediatrics (AAP) recommends developmental screening with a validated tool at the 9-month, 18-
month, and 30-month visits.
One of several validated developmental screening tools may be used (e.g., the Parents’ Evaluation of —-
Developmental Status [PEDS], or Ages and Stages Questionnaire [ASQ].
Specific screening for autism spectrum disorder is recommended at the 18-month and 24-month visits.


Growth is best assessed using a standard growth chart and analyzing the growth trends for weight, height and head
circumference (in younger children) over time.

Diet History

Inquire about feeding practices: breastmilk or formula feeding (in infants

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