Sixth Well Child Visit

33 Key Points to Expect During the Sixth Well-Child Visit

1. Identify New Risk Factors
   The doctor will assess any new risk factors related to both the baby and parents (Refer to Appendix 1).
2. Discuss Baby’s Diet
   In addition to breastfeeding, the doctor will inquire about your baby’s diet, particularly the introduction of solid foods (Refer to Appendix 6).
3. Childproofing Discussion
   You’ll be asked about childproofing measures in your home, including sleeping areas, furniture, and play zones, as well as ensuring toys are safe for your baby (Refer to Appendix 5).
4. Measure Growth
   The baby’s weight, length, and head circumference will be measured and plotted on the growth chart to monitor growth.
5. Check the MCP Card
   The doctor will review the completed MCP card (Green/Red zone). If not filled out, they will complete it with the mother and interpret the findings.
6. Assess Parent-Child Attachment
   Observations will be made regarding the quality of attachment and the parent’s responsiveness to the baby’s cues and movements (Refer to Appendix 2).
7. Monitor Baby’s Response to Separation
   The baby’s reaction when the parent leaves and returns will be observed to assess emotional and social development (Refer to Appendix 2).
8. Observe Play and Interaction
   The doctor will watch how the parents engage in spontaneous play with the baby. If necessary, a play activity from the CCD card will be suggested. This includes observing how parents communicate with the baby, show love, and comfort the baby after immunization (Refer to Appendix 11).
9. Review Previous Visit’s Notes
   Instructions and notes from the last visit will be reviewed to ensure progress and follow-up on earlier recommendations.
10. Checklist Review
    The office staff’s completed checklist will be reviewed for key points to focus on during the consultation.
11. Health Concerns
    Parents will be asked if they have any specific health concerns about the baby.
12. Behavioral Concerns
    The doctor will inquire about any behavioral concerns and how the parents address those behaviors.
13. Vitamin D Prophylaxis
    The baby’s vitamin D supplementation will be checked.
14. Parent-Baby Play Interaction
    Parents will be asked how they engage in play with their baby, focusing on interaction and stimulation.
15. Parent-Baby Communication
    Parents will be asked how they talk with the baby and promote communication and emotional bonding.
16. Encouraging Smiles
    The doctor will inquire how parents make their baby smile and interact with them to elicit positive responses.
17. Growth Chart Interpretation
    The updated growth chart will be interpreted to track the baby’s physical development.
18. Physical Examination
    A general physical examination will be conducted to check for signs of anemia, rickets, and tooth eruption.
19. Systemic Examination
    A systemic examination will be performed to ensure the baby’s organs and body systems are functioning properly.
20. Neurodevelopmental Assessment
    If any concerns arise from the MCP card, a neurodevelopmental assessment will be conducted.
21. Vision Check
    The baby’s vision will be checked for squint or other abnormalities, and the red reflex will be reassessed if it wasn’t done during the 6-month visit.
22. Hearing Test
    A hearing test will be conducted by ringing a bell above and behind the baby’s ear to check responsiveness.
23. Immunizations and Vitamin A
    The baby will receive scheduled immunizations and a vitamin A prophylactic dose.
24. Look for Red Flags of Neglect
    The doctor will assess for any signs of neglect or physical, emotional, or sexual abuse (Refer to Appendix 4).
25. Counseling on Complementary Feeding
    Parents will be counseled on the introduction of complementary feeding alongside continued breastfeeding. Encouragement of self-feeding with finger foods under supervision during family meals will be discussed. Parents will be advised to allow messiness and spillage as part of learning. The doctor will also explain the benefits of a proper diet and the consequences of poor nutrition.
26. Developmental Stimulation
    Parents will be guided on age-appropriate developmental activities based on the MCP card.
27. Anticipatory Guidance
    Parents will receive tips on recognizing and responding appropriately to their baby’s verbal, non-verbal, and emotional cues. This includes:

• Safe Toys: Give the baby clean, safe household items like spoons, bowls, or utensils with lids to handle, bang, and drop.
• Interactive Play: Engage in interactive lap games, make funny faces, and follow the baby’s interests.
• Encourage Independence: Allow the baby to sit independently, stand with support, and play with cause-and-effect toys or musical toys. Hide objects for the baby to uncover and show them how to use day-to-day items, such as drinking from an empty cup or stirring with a spoon in a bowl.
• Avoid Walkers: Parents will be advised not to use walkers or mobiles as they can hinder the baby’s natural development.

28. Promoting Self-Feeding
    Parents will be encouraged to allow the baby to self-feed using finger foods and to involve the baby in family mealtimes to foster independent eating habits.
29. Tummy Time
    The doctor will emphasize the importance of tummy time to strengthen the baby’s muscles and improve motor skills.
30. Social Play
    Parents will be encouraged to engage in social play activities that foster interaction, such as peek-a-boo or hide-and-seek.
31. Reading and Visual Stimulation
    Parents will be advised to show picture books or family photo albums to stimulate the baby’s interest in visuals and language development.
32. Copying Actions
    Demonstrating daily activities, such as drinking from a cup or stirring with a spoon, will help the baby develop an understanding of cause-and-effect and practical skills.
33. Monitor Baby’s Sleep Environment
    Parents will be advised on creating a safe and childproof sleep environment to prevent accidents.