G&D day 2

Water Intake
- Infants should not consume water before four months old.
- Pedialyte is permissible for infants experiencing tummy bugs due to its electrolyte content.
Formula Mixing Precautions
- Parents may miscalculate the formula-water ratio, leading to improper mixing.
- Over dilution can cause water intoxication or hyponatremia.
- Possible symptoms of hyponatremia include:
  - Fluid volume overload.
  - Decreased activity or lethargy in the infant.
  - Hypoglycemia due to inadequate sugar in diluted formula.
- Example: A recent case showed a baby's sugar level dropping significantly due to improper formula mixing.
Juice and Food Introduction
- 100% fruit juice can be introduced after six months but in moderation.
- Limit juice intake to avoid nutritional imbalances.
- Solid Food Introduction
- Begin introducing solids at six months when the infant has:
  - Good head, neck, and trunk control to support sitting.
  - Disappearance of the extrusion reflex (the instinct to push food out of the mouth).
- Foods should be introduced one at a time to monitor for allergies.
- Suggested finger foods:
  - Mashed bananas (not circularly cut).
  - Cooked noodles.
  - Cooked or steamed soft vegetables.

After solid food introduction, the amount of formula or breast milk should gradually decrease.
Typically by one year, transition to full whole milk.
Nighttime bottle weaning is often the last step in this transition.
For infants not consuming adequate nutrition, a Vitamin D supplement may be recommended to prevent rickets.

Aspiration Prevention
- Avoid bottle propping for infants who can't hold bottles without choking.
- Keep small objects and toys away from infants to prevent choking hazards.
- Monitor for safe toy selection for infants to avoid small toys that pose choking risks.
Bodily Harm Prevention
- Ensure furniture is anchored to prevent accidents.
- Do not leave infants unattended with pets as animals can react unpredictably.
- Supervise infants when moving to prevent falls or injuries.
Burns and Drowning Prevention
- Test the temperature of bottles or baths before using them on an infant.
- Never leave infants unattended near any water sources, including sinks or bathtubs.

Poisoning Risks
- Child-proof cabinets to keep hazardous substances away from infants.
- Educate families about potential toxic plants and poisonous substances at home.
- Always have the Poison Control number readily available.
Car Safety
- Car seats must be correctly installed and used according to age and weight guidelines:
- Infants under two years should be rear-facing.
- Ensure proper installation of the car seat in the vehicle for effective safety.
Suffocation Risks
- Place infants on their backs to sleep and ensure their sleeping environment is free of soft bedding and toys.
- No co-sleeping on soft surfaces like sofas or air mattresses.

Placement of infants in close proximity to nurses' stations is recommended for monitoring.
Advocate for routine caregivers whenever possible to build a rapport with the infant.
Minimize painful procedures and utilize comfort measures during care, such as sucrose solutions for pain relief.

Physical Growth
- Toddlers experience slower physical growth, gaining usually 4-6 lbs and 3 inches a year.
Motor Skills Development
- By the age of one, they may begin cruising along furniture and can walk independently by twelve to fifteen months.
By two, they can help feed themselves and hold objects such as forks or spoons.

Toddlers begin to learn from their environment, transitioning from observers to active participants.
- They gain a sense of independence and start to understand object permanence.

By eighteen months, they should be able to follow simple directions and have a language vocabulary of around 50 words.