Anticipatory Guidance: Not Just for Patients
Posted by Brian T. MaurerComment

Maurer-125x188This article appears in the June issue of JAAPA.

A PA student accompanies me to see a 6-month-old for his well-child check. His mother looks up at both of us and smiles. I introduce the student and start the interview with an open-ended question: “How are things going with Bobby?”

“Just fine,” the mother says. “He rolls over both ways, and he can sit up now. He’s very vocal—talks all the time, don’t you Bobby?” As though on cue, the infant laughs from his mother’s lap.

“How are the feedings going?” I ask. “What does he eat over the course of the day?”

The mother launches a detailed litany of the boy’s daily intake: five breastfeedings interspersed with three feedings of beikost: cereal, pureed fruits, and vegetables. “I put him to breast once more before bed, and he sleeps through the night,” she beams.

“He’s certainly getting plenty of calories,” I say, demonstrating his robust percentile rankings on the growth chart. “Let’s look at him.”

I examine Bobby as he sits in his mother’s lap. He appears to be a healthy, cherubic infant—the classic Gerber baby.

“Bobby’s growth and development are right on target,” I say. “We ought to see him back in 3 months for his 9-month well-child check.”

“Meantime, remember that he’ll become a bit more mobile over the next month or two. If you haven’t already done so, now would be a good time to do a home safety survey and baby-proof your house.” Briefly, I discuss locks on cabinet doors, covers for electrical outlets, gates for stairs. “Questions? No? Good—the nurse will be in shortly to give him his shots.”

Read the rest of the article in JAAPA.

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