Other Pediatric Recommendations

• Alternative Immunization Schedules - the AAP strongly endorses universal immunization and supports immunization requirements for school entry. The AAP does not endorse or recommend any alternative immunization schedules.
  
  
• Cough and Cold Medicines - children younger than two to four years of age shouldn't be given over-the-counter cough and cold medicines.
  
  

• First Visit to the Dentist - can be as early as six to 12 months of age, especially for children at high risk for cavities, including those with special health care needs, mothers with a lot of cavities, or if they already have staining, cavities, or plaque buildup. Children who sleep with a bottle or breastfeed at night, have older siblings, or in families with low socioeconomic status, should also see a dentist at an early age. Other kids might have their pediatrician evaluate their teeth and see a pediatric dentist by the time they are two or three years old.
  
  
• First Visit to the Gynecologist - unless there is another indication for a speculum or bimanual examination, teen girls may be able to wait for first visit to the gynecologist until they are twenty-one years old, the time when the first pap test is now recommended. Even if a pelvic examination is needed at an earlier age, such as for persistent vaginal discharge, abnormal vaginal bleeding, or UTI symptoms in a sexually active girl, etc., a gynecologic exam is something that your teen's pediatrician might do.
  
  

• Fluoride - infants need supplementary fluoride, usually from fluoridated tap water, beginning when they are six months old.
  
  
• Fruit Juice - children between the ages of one and six years should be limited to no more than four to six ounces of 100% fruit juice each day, while older children should have no more than 8 to 12 oz or 2 servings per day. Infants under age six months should not have any juice and kids of all ages should be encouraged to eat whole fruit instead of drinking juice.
  
  
• Milk - kids should switch to low-fat milk when they are two years old, although they can make the change to low-fat milk as early as twelve months (if not continuing to breastfeed) if obesity is already a concern or if there is a family history of obesity, dyslipidemia, or cardiovascular disease.
  
  
• Pacifiers - since they may reduce a baby's risk of SIDS, a baby may be given a pacifier when he is going to sleep, although you should delay giving a pacifier to your baby until he is one month old and breastfeeding well. Also, you should not force your baby to take a pacifier, and you should not reinsert the pacifier in your baby's mouth once he falls asleep.
  
  
• SIDS - infants should be placed to sleep on their back to help reduce their reduce their risk of SIDS.
  
  
• Physical Activity - kids should be physically active for at least 60 minutes each day, including age-appropriate active free play (less than six years), organized sports (six to nine years), and more complex sports and weight training (tweens and teens) as they get older.
  
  
• Vitamin D - parents should not rely on sunlight exposure for their kids' vitamin D needs. Kids who aren't getting enough vitamin D from a vitamin D-fortified food, including exclusively breastfeeding newborns and infants, should get a vitamin D supplement.
  
  
• Wait-and-See - the AAP discourages pediatricians from taking a wait-and-see approach when evaluating kids' developmental problems, especially when parents are concerned about autism.