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Child Health Guide

Print out this form and fill it in

Important Information

Child's Name:____________________________________________

Date of Birth:___________________________________________

Parent/Guardian Name(s):_________________________________


Home Telephone:__________________________________________

Work Telephone(s):_______________________________________




Important Health Problems/Allergies:_____________________


Health Care Provider Name(s) and Phone Number(s):________



Health Insurance Number(s):______________________________



Poison Control Center Phone Number:______________________


A Message About Your Child's Health

Preventive care is as important for your child's health as treatment is when he or she is sick This care includes immunizations, tests, and health guidance. Your child receives preventive care from the doctor or other health care provider at check-up visits and at other times. Proper preventive care helps keep your child healthy.

As a parent, you should know what preventive care your child needs. Work with your child's doctor or other health care provider to assure that he or she gets proper care.

The Child Health Guide has information on needed preventive care and on good health habits. Use it as a permanent record to help you keep track of your child's health and care through the years. This guide can help your child get a healthy start on life.

M. Joycelyn Elders, M.D.
Surgeon General
U.S. Public Health Service

How to Use The Child Health Guide

Each page of the Child Health Guide covers an important health care topic.

  • Read each page carefully and ask your child's doctor or other health care provider to answer any questions that you may have.

  • The Preventive Care Timeline in the center of this booklet gives an overview of care your child may need at each age.

  • Use the records throughout the Child Health Guide to keep track of the immunizations (shots), tests, exams, and other types of health care that your child gets. Use these records to remind you when your child needs to be seen next.

  • Take the Child Health Guide home and keep it in a safe place. Check it often to make sure that your child is getting the preventive care that he or she needs. Keep the Child Health Guide up-to-date.

  • Bring the Child Health Guide every time your child goes to a doctor or other health care provider--such as a nurse, nurse practitioner, or physician assistant.

Table of Contents

Check-Up Visits


  • Immunization Record

Tests and Exams

  • Growth
  • Blood Pressure
  • Anemia
  • Lead
  • Vision and Hearing
  • Additional Tests
  • Test and Exam Record

Preventive Care Timeline

Health Guidance

  • Development
  • Nutrition
  • Dental/Oral Health
  • Physical Activity
  • Smoking
  • Safety
  • A Special Message About SIDS
  • Child Abuse
  • As Your Child Grows Up
  • For More Information
  • Visit and Illness Record
  • Put Prevention Into Practice

Check-Up Visits

Your child's doctor or other health care provider may want to see your child for check-up visits even when shots or test are not due. Some authorities recommend check-up visits at the following ages: 2-4 weeks; 2, 4, 6, 9, 12, 15 and 18 months; and 2, 3, 4, 5, 6, 8, 10, 12, 14, 16 and 18 years. Your child's doctor or other health cam provider will discuss with you increasing or decreasing the number of these visits to meet the individual needs of your child.

My Child's Check-Up Schedule:
(Record age and/or date)









Your child needs immunizations. Immunizations (shots) protect your child from many serious diseases. Below is a list of immunizations and the ages when your child should receive them. Immunizations should be given at the recommended ages--even if your child has a cold or minor illness at the time. Ask your health care provider about when your child should receive these important shots. Ask also if your child needs additional immunizations.

* Polio (OPV): At 2 months, 4 months, 6 months, and 4-6 years.

* Diphtheria-Tetanus-Pertussis (DTP, DTP): At 2 months, 4 months, 6 months, 15 months, and 4-6 years. Tetanus-Diphtheria (Td) at 14-16 years.

* Measles-Mumps Rubella (MMR) At 12-15 months and EITHER 4-6 years OR 11-12 years.

* Haemophilus influenzae type b (Hib): At 2 months, 4 months, 6 months, and 12-15 months; OR 2 months, 4 months, and 12-15 months, depending on the vaccine type.

* Hepatitis B (HBV): At birth, 1-2 months and 6-18 months; OR 1-2 months, 4 months, and 618 months.

* Chickenpox (VZV): At 12-18 months.

Immunization Record

Use this chart or an official immunization card to keep track of your child's immunizations. Significant reactions should be recorded and reported to your Health care provider immediately.

Growth Record

Your child's doctor or other health care provider will measure your child's height and weight regularly. Your child's head size will also be measured during the first 2 years of life. These measurements will help you and your health care provider know if your child is growing properly. Use this record or the growth charts on pages 10-13 to keep track of your child's growth. If you need help using these charts, ask your doctor or other health care provider.


Date______    Weight_____    Height_____    Head Size_____  

Growth Record

Date/Age_____    Weight_____    Height_____   

High Blood Pressure

Your child should have blood pressure measurements regularly, starting at around 3 years of age. High blood pressure in children needs medical attention. It may be a sign of underlying disease and, if not treated, may lead to serious illness.

Check with your child's doctor or health care provider about blood pressure measurements.


Your child should be tested for anemia ("low blood") when he or she is still a baby (usually around the first birthday) and also may need anemia tests as he or she gets older. Anemia may cause your child to grow slowly, tire easily, and get infections more often. Anemia in children is usually caused by too little iron in the diet. Your child needs to eat iron-rich foods such as meats, green leafy, vegetables, and iron-fortified cereals.

Check with your child's doctor or health care provider about anemia testing.


Lead can harm your child, slowing physical and mental growth and damaging many parts of the body. The most common way children get lead poisoning is by being around old house paint that is chipping or peeling. Some authorities recommend lead tests at 1 and 2 years of age.

Use a (X) to mark "yes" answers to the questions below. Any "yes" answers may mean that your child needs lead tests earlier and more often than other children.


  • Lived in or regularly visited a house with peeling or chipped paint built before 1960? (This could include a day care center, preschool, the home of a babysitter, etc.)

  • Lived in or regularly visited a house built before 1960 with recent, ongoing, or planned renovation or remodeling?

  • Had a brother or sister, housemate, or playmate with lead poisoning?

  • Lived with an adult whose job or hobby involves exposure to lead (such as refinishing furniture, making pottery or stained glass, or working in any of the industries listed in the next question)?

  • Lived near a lead smelter, battery plant, car repair shop, glass or pipe factory, or other industry likely to release lead?

Vision and Hearing

Your child's vision should be tested before starting school, at about 3 or 4 years of age. Your child may also need vision tests as he or she grows. Some authorities recommend hearing testing beginning at 3 to 4 years of age.

If at any age your child has any of the vision or hearing warning signs listed below, be sure to talk with your doctor or other health care provider.

Vision Warning Signs

  • Eyes turning inward (crossing) or outward
  • Squinting
  • Headaches
  • Not doing as well in school work as before
  • Blurred or double vision

Hearing Warning Signs

  • Poor response to noise or voice
  • Slow language and speech development
  • Abnormal sounding speech

SPECIAL WARNING: Listening to very loud music, especially with earphones, can permanently damage your child's hearing.

Additional Tests

Your child may need other tests to prevent health problems. Check this list with your child's doctor or other health care provider.

Newborn Screening (for PKU, thyroid and other inherited/metabolic diseases)--If your child did not receive this blood test before coming home from the hospital, or received it before 24 hours of age. Some states require a repeat test during the first month of life.

Sickle Cell or Thalassemia Test--If your child has an African-American, Mediterranean, Asian, or Middle Eastern family background.

Tuberculosis (TB) Skin Test--If your child has had close contact with a person having TB, lives in an area where TB is more common than average (such as a Native American reservation, a homeless shelter, or an institution), or has recently moved from Asia, Africa, Central America, South America, the Caribbean, or the Pacific Islands.

Cholesterol Test--If your child has a parent with high cholesterol or a parent or grandparent with heart disease before age 55.

Urinalysis Test--If your child is less than 5 years of age, particularly if your child has had a bladder or kidney infection.

Child Preventive Care Timeline

Check-up visits are important for your child's health. Some authorities recommend these visits at the following ages: 2-4 weeks; 2, 4, 6, 9, 12, 15 and 18 months; and 2, 3, 4, 5, 6, 8, 10, 12, 14, 16 and 18 years. Your child's doctor or other health care provider will discuss with you the individual needs of your child. At check-up visits, your child may receive a physical examination.


Children grow and develop at different rates. This table shows the ages by which most young children develop certain abilities. It is normal for a child to do some of these things later than the ages noted here. If your child fails to do many of these at the ages given, or you have questions about his or her development, talk with your child's doctor or other health care provider.


  • Smiles, coos
  • Watches a person, follows with eyes


  • Laughs out loud
  • Lifts head and chest when on stomach, grasps objects


  • Babbles, turns to sound
  • Rolls over, supports head well when sitting


  • Responds to name, plays peek-a-boo
  • Sits alone, crawls, pulls sew up to standing


  • Waves bye-bye, says mama or dada
  • Walks when holding on, picks up small objects with thumb and first finger


  • Says 3 words other than mama or dada, scribbles
  • Walks alone, feeds self using spoon


  • Puts 2 words together, refers to self by name
  • Runs well, walks up stairs by self


  • Knows age, helps in buttoning clothing, washes and dries hands
  • Throws ball overhand, rides tricycle


  • Knows first and last name, tells a story, counts 4 objects
  • Balances on one foot, uses children's scissors


  • Names 4 colors, counts 10 objects
  • Hops on one foot, dresses self


What your child eats is very important for his or her health. Follow the nutrition guidelines below.

Guidelines for a Healthy Diet


* Breast milk is the best single food for infants from birth to 6 months of age. It provides good nutrition and protects against infection. Breast feeding should be continued for at least the first year, if possible.

* If breast feeding is not possible or not desired, iron-enriched formula (not cow's milk) should be used during the first 12 months of life. Whole cow's milk can be" used to replace formula or breast milk after 12 months of age.

* Breast-fed babies, particularly if darkskinned, who do not get regular exposure to sunlight may need to receive Vitamin D supplements.

* Begin suitable solid foods at 4-6 months of age. Most experts recommend ironenriched infant rice cereal as the first food.

* Start new foods one at a time to make it easier to identify problem foods. For example, wait one week before adding each new cereal, vegetable, or other food.

* Use iron-rich foods, such as meats, ironenriched cereals, and other grains.

* Do not give honey to infants during the first 6-12 months of life.

* Do not limit fat during the first 2 years of life.


* Provide a variety of foods, including plenty of fruits, vegetables, and whole grains.

* Use salt (sodium) and sugars in moderation.

* Encourage a diet low in fat, saturated fat, and cholesterol.

* Help your child maintain a healthy weight by providing proper foods and encouraging regular exercise.

Dental/Oral Health

Your child needs regular dental care starting at an early age. Talk with your dentist to schedule the first visit. Good oral health requires good daily care. Follow these guidelines.


* If most of your child's nutrition comes from breast feeding, or if you live in an area with too little fluoride in the drinking water (less than .3 ppm for children less than 2 years old, less than .7 ppm for children over 2 years old), your child may need fluoride drops or tablets. Ask your health care provider or local water department about the amount of fluoride in your water and note it here:______ ppm.

* Don't use a baby bottle as a pacifier or put your child to sleep with a baby bottle. This can cause tooth decay and ear infections.

* Keep your infant's teeth and gums clean by wiping with a moist cloth after feeding.

* When multiple teeth appear, begin gently brushing your infant's teeth using a soft toothbrush and a very small (pea-sized) amount of toothpaste with fluoride.


* Talk with your dentist about dental sealants. They can help prevent cavities in permanent teeth.

* Using dental floss can help prevent gum disease. Talk with your dentist about when to start.

* Do not permit your child to smoke or chew tobacco. Set a good example and don't smoke yourself.

* If a permanent tooth is knocked out, rinse it gently and put it back into the socket or into a glass of cold milk or water. See a dentist immediately.

Physical Activity

Your child needs regular physical activity through play and sports to stay fit. Good exercise habits learned early can help your child become an active and healthy adult. Adults who are physically active are less likely to be overweight or to have heart disease, high blood pressure, and other diseases. Set a good example for your child--get regular physical exercise yourself.

Physical Activity Tips for Children

* Encourage your child to walk or ride a bicycle to school and to visit friends.

* Plan physical activities with family or friends; exercise is more fun with others.

* Limit the time your child spends watching TV to less than 2 hours per day. Encourage going out to a playground, park, gym, or swimming pool instead.

* Encourage your child to be actively involved in sports, rather than only being an observer.

* Find out about exercise or sports programs at your child's school and in your community.

* Encourage children with disabilities to participate in physical activities as much as possible.

* Exercise should be fun. Don't make winning the only goal.


Smoking is very harmful to your health (causing lung cancer, heart disease, and other serious illnesses) and to your child's health. If you smoke, your child is more likely to get infections of the ears, sinuses, and lungs. Smoking in the home may also cause lung cancer in family members who do not smoke.

Do not permit your child to smoke. Set a good example and don't smoke yourself. If you do smoke, talk with your doctor or other health care provider about getting help with quitting.

Quit Date: I will stop smoking on: (fill in) ____________


The three reasons that I should stop smoking are: (fill in)





More children die from injuries than any other cause. The good news is that most injuries can be prevented by following simple safety guidelines. Talk with your doctor or other health care provider about ways to protect your child from injuries. Fill out this safety checklist.

Safety Guidelines Checklist

Read the list below and check off () each guideline that your family already follows. Work on those you don't.


* Use smoke detectors in your home. Change the batteries every year and check to see that they work once a month.

* Keeping a gun in your home can be dangerous. If you do, make sure that the gun and ammunition are locked up separately and kept out of reach.

* Never drive after drinking alcohol.

* Teach your child traffic safety. Children under 9 years of age need supervision when crossing streets.

* Learn basic life-saving skills (CPR).

* Keep a bottle of ipecac at home to treat poisoning. Talk with a doctor or the local Poison Control Center before using it. Post the Poison Control Center number near your telephone and write it in the space provided on the inside front cover.


* Use a car safety seat at all times until your child weighs at least 40 pounds. When possible, secure it in the center of the back seat.

* Keep medicines, cleaning solutions, and other dangerous substances in childproof containers, locked up and out of reach.

* Use safety gates across stairways (top and bottom) and guards on windows above the first floor.

* Keep hot water heater temperatures below 120 F.

* Keep unused electrical outlets covered with plastic guards.

* Baby walkers can be dangerous. Children using them should be closely supervised. Access should be blocked to stairways and to objects that can fall (such as lamps) or cause burns (such as stoves).

* Keep objects and foods that can cause choking away from your child, such as coins, balloons, small toy parts, hot dogs (unmashed), peanuts, and hard candies.

* Use fences that go all the way around pools and keep gates to pools locked.


Sudden Infant Death Syndrome (SIDS) is the leading cause of death for infants. Some authorities believe that placing sleeping infants on the side or back, instead of the stomach, decreases the risk of SIDS.


* Use car safety belts at all times. Use with a booster seat if your child weighs less than 70 lbs. The lap belt should be snug and low on the hips. The shoulder belt should cross the chest, not the face, neck, or stomach. If it does not fit properly, tuck it behind the shoulders instead.

* Make sure your child uses a safety helmet while riding on a bicycle or motorcycle.

* Make sure your child uses protective equipment (such as mouth guards, pads, sports goggles, and helmets) when playing contact sports, rollerskating, or skateboarding.

* Don't let your child use alcohol or illegal drugs. Many driving-, sports-, and violence-related injuries are caused by the use of alcohol or drugs.

* Read all instructions for safe handling of household tools, such as saws and lawn mowers. Teach your child to use these tools safely.

* Don't allow your child to ride on or drive heavy farm equipment, such as tractors, without special training.

* Teach your child to deal with anger and conflict without using violence. Set a good example for your child.

Child Abuse

Child abuse is a hidden, serious problem. It can happen in any family. The scars, both physical and emotional, can last for a lifetime. Because children can't protect themselves, we must protect them.

Ways to Prevent Child Abuse

* Teach your child not to let anyone touch his or her private parts.

* Tell your child to say "No" and run away from sexual touches.

* Take any reports by your child of physical or sexual abuse seriously. Report any abuse to your local or state child protection agency. Local Hotline:______________________________________

* If you feel angry and out of control, leave the room, take a walk, take deep breaths, or count to 100. Don't drink alcohol or take drugs. These can make your anger harder to control.

* If you are afraid you might harm your child, get help now! Call someone and ask for help. Talk with a friend or relative, other parents, or your health care professional. Take time for yourself. Share child care between parents, trade baby-sitting with friends, or use day care.

As Your Child Grows Up

As your child grows up, he or she will have to begin dealing with many important health issues not included in the Child Health Guide. Some examples of these issues are:

* Alcohol

* Drugs

* Tobacco

* Sexuality


* Birth Control

Talk to your child's doctor or other health care provider about these important issues even while your child is still young. You may also get assistance from authorities listed on the next two pages.

Start early to teach your child to make responsible choices--not mistakes that can have a lifelong effect. Take the time to "be there for your child--listening, advising, and supporting. The rewards will be well worth the effort.

For More Information

If you would like more information about how to help your child stay healthy, talk with your child's doctor or other heath care provider. You can also get information by calling your local health department (look in the phone book) or the authorities listed below, many of which have toll-free numbers.


* CDC National AIDS Hotline

(800) 342-AIDS

Alcohol and Drugs

* National Clearinghouse for Alcohol and Drug Information
(800) 729-6686

Child Abuse

* National Child Abuse Hotline
(800) 422-4453

Counseling/Crisis Intervention

* National Youth Crisis Hotline
(800) HIT-HOME

Food and Drug Safety

* Food and Drug Administration, Office of Consumer Affairs
(301) 443-3170

General Child Health Information

* American Academy of Family Physicians
(800) 274-2237

* American Academy of Pediatrics
(800) 433-9016


* General Information: Centers for Disease Control and Prevention
(404) 332-4553

* Vaccine Adverse Event Reporting System
(800) 822-7967

Maternal and Child Health

* National Maternal and Child Health Clearinghouse
(703) 821-8955 ext. 254

Safety and Injury Prevention

* Consumer Product Safety Commission
(800) 638-CPSC

* National Highway Traffic Safety Administration Auto Safety Hotline
(800) 424-9393

* The Children's Safety Network
(703) 524-7802

Sexually Transmitted Diseases

* CDC National STD Hotline
(800) 227-8922

Health Care Visit and Illness Record

Use this chart to keep track of your child's visits to doctors or other health care providers. Also use this chart to keep track of your child's illnesses (such as chicken pox, measles, or mumps) and injuries (such as broken bones). A record of childhood illnesses and injuries will be useful even when your child is an adult.

Health Care Visit and Illness Record

Date:_____    illness/Reason:_____

Treatment/ for Visit:_________________________________________________________


Put Prevention Into Practice

"Put Prevention Into Practice" is a national initiative of the U.S. Department of Health and Human Services' Public Health Service in partnership with public and private health care organizations.*

The goal of "Put Prevention Into Practice" is to preserve the health of all Americans by improving the preventive care they receive.

You can help to put prevention into practice by working with your health care providers to make sure you get all the preventive care you need.

You can also do your part by following the health advice in this Personal Health Guide. Take charge of your health and live a longer and healthier life!

* Neither the Public Health Service nor the U.S. Department of Health and Human Services endorses any particular product, service or organization.

For more information about the Put Prevention Into Practice campaign, write:

Put Prevention Into Practice
National Health Information Center
P.O. Box 1133
Washington, DC 20013-1133

For sale by the U.S. Government Printing Office
Superintendent of Documents, Mail Stop: SSOP,
Washington, DC 20402-9328

Information provided by the NIH.