Problem
A 6-month-old male infant is brought to your office by his mother for a routine well-child visit. His mother is concerned that he is not yet saying "mama," because her best friend's baby said "mama" by age 6 months. Your patient was born via an uncomplicated pregnancy to a 23-year-old G1 P1 mother. He was delivered by a spontaneous vaginal delivery at full term and there were no complications in the neonatal period. You have been following him since his birth. He has had appropriate immunizations. He had one upper respiratory infection at 5 months that was treated symptomatically. There is no family history of any developmental, hearing, or speech disorders. He has been fed since birth with iron-fortified infant formula. Cereals and other baby foods were added starting at age 4 months. He lives with both parents, neither of whom smokes cigarettes.
On exam, he is a vigorous infant who is at the 50th percentile for length and weight and 75th percentile for head circumference. His physical examination is normal. On developmental examination, he is seen to sit for a short period of time without support, reach out with one hand for your examining light, pick up a Cheerio with a raking grasp and put it in his mouth, and he is noted to babble frequently.
Answer questions using course resources and at least one additional scholarly resource found outside the course resources.
I. What immunizations would be recommended at this visit?
II. By what age should an infant say "mama" and "dada"?
III. What are some milestones to discuss with the parent during this visit?
IV. The child's mother asks when she can place him in a front-facing car seat. What is your recommendation?
V. Discuss health maintenance in infancy.