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Prevention Guidelines for Infants and Toddlers

Here are the screening tests and immunizations for infants from birth to age 2. Although you and your health care provider may decide that a different schedule is best for your baby, this plan can guide your discussion.

Screening

Who needs it

How often

APGAR (a test to determine how well an infant tolerated the birthing process and is adapting to his or her new environment)

All newborns

One minute and five minutes after birth

Congenital hypothyroidism

All newborns

2 to 4 days of age

Hearing loss

All newborns

Before leaving hospital or at 1 month of age

Elevated lead levels

All year-old infants* and children age 2 who are at average or increased risk

Yearly

Iron-deficiency anemia

All infants between 6 and 12 months* and children ages 1 to 5 years who are at average or increased risk

Yearly

Newborn screenings (some states require 29 or more tests for infections and disorders)

All newborns

Before leaving hospital

Phenylketonuria

All newborns

Before leaving hospital

Prevention of dental caries

Children ages 6 months to 5 years whose primary water source is deficient in fluoride

At routine exams; first dental visit recommended at one year of age

Sickle cell disease

Newborns

Birth to 2 months of age

Visual impairments

Children younger than 5 years

At well-child/routine exams

Immunization

Who needs it

How often

Hepatitis B vaccine (monovalent)

All infants

At birth, between 1 and 4 months, and a final dose at 6 to 18 months

Diphtheria

All infants

At 2 months, 4 months, 6 months, and a fourth dose six months after third dose

Tetanus toxoids

All infants

At 2 months, 4 months, 6 months, and a fourth dose six months after third dose

Acellular pertussis

All infants

At 2 months, 4 months, 6 months, and a fourth dose six months after third dose

Haemophilus influenzae type b conjugate

All infants

At 2 months and 4 months

Inactivated poliovirus

All infants

At 2 months, 4 months, 6 to 18 months, and a booster at 4 to 6 years)

Pneumococcal (conjugate)

All infants

At 2 months, 4 months, 6 months, and at 12 to 15 months

Measles, mumps, rubella (MMR)

All infants

First dose between 12 and 15 months, and the second dose at ages 4 to 6 years, or before starting kindergarten

Chickenpox (varicella)

Those infants who have not contracted chickenpox

Between 12 and 15 months, and the second dose at ages 4 to 6 years

Flu (seasonal); trivalent inactivated influenza

All infants

At 6 months, and then annually during flu season

Hepatitis A

All infants

At ages 12 to 23 months, with a second dose at least six months after the first dose

Rotavirus

All infants

At 2 months, 4 months, and 6 months (must be started before 14 weeks, 6 days of age)

* Screening guidelines from the American Academy of Pediatrics

All other screening guidelines from the U.S. Preventive Services Task Force

Immunization schedule from the Centers for Disease Control and Prevention (CDC)

Online Resources

American Academy of Pediatrics  http://aappolicy.aappublications.org/cgi/content/full/pediatrics;111/2/436
American Academy of Pediatrics  http://aappolicy.aappublications.org/cgi/content/full/pediatrics;116/4/1036#sec8
Agency for Healthcare Research and Quality  http://www.ahrq.gov/clinic/3rduspstf/dentalchild/dentchrs.htm
Agency for Healthcare Research and Quality  http://www.ahrq.gov/clinic/3rduspstf/visionscr/vischrs.htm
Agency for Healthcare Research and Quality  http://www.ahrq.gov/clinic/pocketgd09/pocketgd09.pdf
Agency for Healthcare Research and Quality  http://www.ahrq.gov/clinic/tfchildcat.htm#heartvasc
Agency for Healthcare Research and Quality  http://www.ahrq.gov/clinic/uspstf/uspslead.htm
Agency for Healthcare Research and Quality  http://www.ahrq.gov/clinic/uspstf06/ironsc/ironrs.htm#summary1
Agency for Healthcare Research and Quality  http://www.ahrq.gov/clinic/uspstf08/conhypo/conhyprs.htm
Agency for Healthcare Research and Quality  http://www.ahrq.gov/clinic/uspstf08/newbornhear/newbhearrs.htm
Agency for Healthcare Research and Quality  http://www.ahrq.gov/clinic/uspstf09/depression/chdeprrs.htm
Agency for Healthcare Research and Quality  http://www.ahrq.gov/clinic/uspstf10/childobes/chobesrs.htm
CDC  http://www.cdc.gov/ncbddd/dd/hi3.htm#screening
CDC  http://www.cdc.gov/vaccines/pubs/vis/default.htm#hepa
CDC  http://www.cdc.gov/vaccines/recs/schedules/downloads/child/2010/10_0-6yrs-schedule-pr.pdf
CDC  http://www.cdc.gov/vaccines/vpd-vac/polio/in-short-both.htm#who
CDC  http://www.cdc.gov/vaccines/vpd-vac/rotavirus/default.htm
American Association for Clinical Chemistry  http://www.labtestsonline.org/understanding/wellness/a_newborn_1.html
March of Dimes  http://www.marchofdimes.com/298_834.asp
March of Dimes  http://www.marchofdimes.com/professionals/24279_15455.asp
MedLine Plus encyclopedia  http://www.nlm.nih.gov/medlineplus/ency/article/003402.htm

© 2000-2011 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.