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| Birth to 24 Months of Age
Schedule
At least four
visits are required for immunizations: 2, 4, 6, and 12-18 months
of age. Because of lack of data and differing patient risk profiles,
the scheduling of additional visits and the frequency of the individual
preventive services are left to clinical discretion (except as indicated).
The preventive services are listed below.
DISCLAIMER:
Coverage of preventive services varies under PPO and indemnity plans.
Members covered under these policies need to refer to their Certificate
of Coverage or contact a customer service representative for information
regarding covered services.
Screening
- Length and
weight head circumference
High Risk
Groups:
- Hearing
[HR1] at age 18 months visit, if not tested earlier (Parental
perception of hearing, awakes to loud noises, head turning with
noise, repeats sounds, three to four words other than mama/dada,
observational screening with noisemakers, and an ear exam including
pneumatic otoscopy. Tympanometry is optional.)
- Serum Lead
[HR2] lead history age 9-15 months and level if appropriate
- Hemoglobin
OR hematocrit [HR6]
Immunizations
and/or Chemoprophylaxis
- Hepatitis
B vaccine-at birth, 1-4 months and 6-18 months OR 0-2 months,
1-2 months later, and 6-18 months later
- Diphtheria-tetanus-pertussis
(DTP) vaccine-at ages 2, 4, 6, and 12-18 months
- Measles-mumps-rubella
(MMR)-at age 12-15 months
- IPV at 2
and 4 months with OPV at 6-18 months (preferred) OR OPV-at ages
2, 4, and 6-18 months OR IPV at 2, 4, and 12 months
- Hemophilus
b Conjugated Vaccine (Hbc)-at ages 2, 4, 6, and 12-15 months
- Varicella
at 12-18 months
High Risk
Groups:
- Fluoride
supplements [HR3]
- Influenza
vaccine [HR5]
First Week:
- Ophthalmic
antibiotics-at birth
- Hemoglobin
electrophoresis or comparable test [HR4]-at birth
- T4/TSH-days
3 to 6 preferred for testing (if done in hospital repeat at 7-14
days age)
- Phenylalanine-days
3 to 6 preferred for testing (if done in hospital repeat at 7-14
days age)
Patient and/or
Parent Counseling
Diet:
Remain Alert
for:
- Ocular misalignment
- Tooth decay
- Signs of
child abuse or neglect
Leading Causes
of Death:
- Conditions
originating in the perinatal period
- Congenital
anomalies
- Sudden infant
death syndrome (SIDS)
- Unintentional
injuries (non-motor vehicle)
- Motor vehicle
injuries
Definitions
of High Risk Patients
These definitions
apply to the category of Birth to 18 Months of Age only.
TERM DEFINITION
- HR1:
Infants with a family history of childhood hearing impairment
or a personal history of congenital perinatal infection with herpes,
syphilis, rubella, cytomegalovirus, or toxoplasmosis; malformations
involving the head or neck (e.g. dysmorphic and syndromal abnormalities,
cleft palate, abnormal pinna); birthweight below 1500 g; bacterial
meningitis; hyperbilirubinemia requiring exchange transfusions;
or severe perinatal asphyxia (Apgar scores of 0-3, absence of
spontaneous respirations for 10 minutes or hypotonia at 2 hours
of age).
- HR2:
Infants who live in or frequently visit housing built before 1960
that is dilapidated or undergoing renovation; who come in contact
with other children with known lead toxicity; who live near lead
processing plants or whose parents or household members work in
a lead-related occupations; or who live near busy highways or
hazardous waste sites.
- HR3:
Infants living in areas with inadequate water fluoridation (less
than 0.6 parts per million).
- HR4:
Newborns of Caribbean, Latin American, Asian, Mediterranean, or
African descent.
- HR5:
Residents of chronic care facilities or persons suffering from
chronic cardiopulmonary disorders, metabolic diseases (including
diabetes mellitus), hemoglobinopathies, immunosuppression, or
renal dysfunction.
- HR6:
Infants age 6-12 mo. who are: living in poverty, African American,
Native American or Alaska native, immigrants from developing countries,
preterm or low birth weight, infants whose principal dietary intake
is unfortified cow's milk.
  
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