Your New Baby
IN C L U D E S Choosing A Child Care Provider
F O L D O U T Healthy Children & Immunizations G
R
O
W
T
H Nutrition & Healthy Living C
H
A
R
T
F
O Home Safety Tips
R
Your Child Y
O
U
A Guide to Your Child’s &
Car Safety For Children
Health and Safety Y
O
U
Revised text as of April 2019 R
C
H Additional Safety Topics
I
L
D
T
O
C
O Family Emergency Planning L
O
R !
Keeping Your Child Safe Away From Home
The Michigan Child Protection Law Dear Parent or Guardian,
This publication is a resource guide to your child’s health and safety. Topics include suggestions for choosing a child care provider, common developmental milestones from birth to age 5 years, and information on SIDS, SUID and shaken baby syndrome. Basic tips for home safety and emergency preparedness are also discussed as well as a section that promotes healthy living and good nutrition habits for the entire family. I have also included information on child abuse and neglect prevention and excerpts from the Michigan Child Protection Law, as currently amended.
A second part of this publication is a growth chart that will provide a fun activity for you and your child as they grow. I hope you will affix the chart to a wall or door in your home and enjoy coloring the pictures, writing notes and placing photos on it together.
I would like to thank the following national, federal, state and local organizations for their assistance in providing material for this publication: American Academy of Pediatrics Centers for Disease Control and Prevention ChooseMyPlate.gov Early On Michigan Grants and Community Services Division, Michigan State Police Healthychildren.org Michigan Department of Health and Human Services Michigan Incident Crime Reporting, Michigan State Police Michigan Office of Highway Safety and Planning National Center for Missing & Exploited Children National Center on Shaken Baby Syndrome National Highway Traffic Safety Administration Ready Michigan SafeKids Worldwide Your New Baby — page 3 Diapering Your Baby, The Period of PURPLE Crying, Shaken Baby Syndrome, SIDS & SUID, Sleep Safety, Pets & Your Family, Milestones Checklist
Choosing A Child Care Provider — page 17
Healthy Children & Immunizations — page 21 Why Vaccinate?, Recommended Immunization Schedule, The Vaccines for Children Program, Everyday Germ Prevention
Nutrition & Healthy Living — page 27 Michigan’s Health Care Programs, Feeding Your Child, Nutritional Guidelines, Staying Fit as a Family, Healthy at Home/Healthy at School
Home Safety Tips — page 33 Preventable Injuries, Battery Safety, Gun Safety in a Home Environment Table of Car Safety For Children — page 39 Car Seat Basics, Michigan Child Passenger Safety Laws, Contents Never Leave a Child Alone in a Car Revised text as of April 2019 Additional Safety Topics — page 43 Sports Safety, Internet Safety, Toy Safety & Recalls
Family Emergency Planning — page 47
Keeping Your Child Safe Away From Home — page 51 What Constitutes Child Abuse & Neglect, Mandatory Reporters of Child Abuse & Neglect, In Case of a Lost or Kidnapped Child, Free Child ID Kits, Students & Distracted Walking
The Michigan Child Protection Law — page 57
Prepared by the Michigan Legislature
This information is provided free to Michigan citizens and is not for reproduction for resale or profit. ii The Family Fill in the information below for babysitters, caregivers or family members who will be caring for your child(ren). Keep copies in accessible locations for quick review such as near the phone, on the fridge, or in your car, purse, briefcase, or diaper bag. Child Information Name: Allergies: Special Instructions: foods medicines Birth date:
Favorite activities & toys:
Name: Allergies: Special Instructions: foods medicines Birth date:
Favorite activities & toys:
Name: Allergies: Special Instructions: foods medicines Birth date:
Favorite activities & toys:
Emergency Contact Information CALL 9-1-1 IN AN EMERGENCY NATIONAL POISON CONTROL CENTER: 1-800-222-1222
Parent(s) /Guardian(s): Directions To This House:
Work Phone: Family Meeting Spot Near Home: Mobile Phone: Fire Extinguisher(s) Located: Nearest Hospital: Emergency Kit Located: Physician Name:
Physician Phone: HOUSE RULES:
Neighbor’s Phone: Your Child’s Health Your Child’s Health
Your New Baby!
Diapering Your Baby ...... page 3 The Period of PURPLE Crying ...... page 4 Shaken Baby Syndrome ...... page 5 SIDS & SUID ...... page 6 Sleep Safety ...... page 7 Pets & Your Family ...... page 8 Milestones Checklist ...... page 9
DIAPERING YOUR BABY Diaper Rash Tips Generally, you can count on 6-10 diaper changes a day until your child is fully toilet-trained. Different diapers have Diaper rash is a common form of advantages and disadvantages. Speak with your health care inflamed skin that looks like redness provider on options best for you and your baby. or small bumps in the diapering area of your baby. One of the best ways CONSIDER: to help prevent or treat diaper rash is to change diapers as soon as Cloth Diapers. they are wet or soiled. Soft cloth allows a baby’s skin to breathe, which may help heal diaper S Contact your health care provider. rash. However, cloth diapers may S Change diapers frequently – check be less convenient. your baby’s diaper often. S Clean your baby’s skin gently. Disposable Diapers. Don’t use diaper wipes on Disposable diapers are convenient and inflamed skin. Warm water or baby available at a variety of stores. They wick oil on a cotton ball can be used. moisture away from the skin and may keep your baby drier, therefore helping to prevent diaper rash. S Let your baby’s skin air dry or pat gently with a soft cloth before placing a clean diaper on. Hybrid Diapers. Hybrid diapers use a reusable cloth pant with an inner S Apply a protective ointment to absorbent liner. The inner liners in hybrid diapers can be the skin. thrown away, or sometimes they can be flushed in a toilet S Be careful with powders. Don’t let or even composted in the garden (wet liners only). Hybrid your baby breathe in the powder. diapers may reduce your baby’s exposure to chemicals Powders may retain moisture, commonly found in disposable diapers. worsening the rash.
3 Your Child’s Health
The Period of PURPLE Crying
PURPLE IS AN ACRONYM THAT HELPS PARENTS UNDERSTAND Tips to Try to Calm Your Baby A PERIOD OF PROLONGED, Check that your baby isn’t hungry, in pain or INTENSE CRYING THAT BABIES 1 discomfort, or in need of a diaper change. Try offering a pacifier. CAN GO THROUGH. Hold your baby in your arms, either on their left NOTE: IT IS IMPORTANT TO CHECK 2 side to help with digestion or on their stomach, WITH YOUR HEALTH CARE PROVIDER always supporting their head. Calming motions TO RULE OUT THE POSSIBILITY OF such as gently rocking and patting your baby’s SOMETHING SERIOUS. back may help. Avoid overstimulation like excessively patting, loud music or TV noise, Babies may cry for very long periods or rattling toys. of time, and nothing seems to help soothe them. Turn on calming white noise such as a fan, 3 vacuum, or even a recording of a heartbeat. Is something wrong These sounds may remind your baby of being with my baby? inside the womb. Avoid overfeeding your baby, which can make Am I doing something wrong? 4 them feel uncomfortable. Try to wait 2 to If your pediatrician has determined that 2 - 1/2 hours between feedings. your baby is healthy, try to remember that Food sensitivity may be a problem for both a period of crying can be a normal part of 5 breastfed and bottle-fed babies. Talk with your an infant’s development. It begins at about health care provider about possible diet changes. two weeks of age and usually continues until babies are three to four months old. Source: healthychildren.org and www.cdc.gov. It is important to remember that this crying will pass.
4 PURPLE graphic reprinted with permission from the National Center on Shaken Baby Syndrome. Your Child’s Health
Shaken Baby Syndrome
SHAKEN BABY SYNDROME (SBS) IS A PREVENTABLE, Take A Break, Don’t Shake! YET SEVERE, FORM OF Being the parent of a new baby Be aware of your anger and PHYSICAL CHILD ABUSE. is not easy. In addition to the frustration levels and watch IT OCCURS WHEN AN joy and excitement, there is for signs of these emotions also exhaustion, frustration, in others who may care for INFANT IS VIOLENTLY and uncertainty. your baby. SHAKEN, OFTEN IN When you are already tired and RESPONSE TO THE IF YOU BECOME your baby is crying, especially TOO FRUSTRATED BABY CRYING. long bouts of inconsolable S crying, it is normal to feel Put your baby down in a Babies, especially newborns to frustrated and helpless. safe place, such as their one-year-olds, are at an increased crib, and walk away. risk of sustaining an injury from However, it’s important to know S It’s okay to let your baby cry shaking. Babies have weak neck how to cope when you find for a bit while you regroup. muscles and their brains are yourself becoming too Take some deep breaths fragile and still developing. frustrated. This goes for anyone and try to calm down. Shaking a baby, even for a few who may be caring for your S Check on your baby every seconds, can cause serious baby, including the father, 10-15 minutes, but it’s okay damage and possibly even death. partner, grandparent, other to let them cry in their crib family members, or friends. while you take a break. It is crucial that you or anyone Everyone must understand that S It’s more important to stay who cares for your baby crying is normal for healthy calm than to stop your baby’s never become so frustrated babies, especially in the first crying. Remind yourself that that they shake your baby. four months of life. this will pass.
Sources For More Information
American Academy Circle of Parents, Prevent Child Abuse of Pediatrics Michigan America Phone: 1-847-434-4000 Phone: 517-241-7792 Phone: 1-800 CHILDREN www.aap.org www.circleofparents.org (244-5373) www.preventchildabuse.org Centers for Disease Control and Prevention National Center on Phone: 1-800-232-4636 Shaken Baby Syndrome State and local www.cdc.gov and health departments Period of PURPLE Crying Children’s Trust Fund are also good of Michigan Phone: 1-801-447-9360 Phone: 517-373-4320 www.dontshake.org resources. www.michigan.gov/ctf www.PURPLEcrying.info
5 Your Child’s Health
SIDS & SUID
SIDS (Sudden Infant Death Syndrome) is defined as the sudden death of an infant less than 1 year of age that cannot be explained after a thorough FACTS about SIDS & investigation is conducted, including a complete Safe Infant Sleep autopsy, examination of the death scene, and review of the clinical history.1 FACT: A baby cannot “catch” or spread SIDS. SIDS is not caused by an infection. SIDS IS THE LEADING CAUSE OF DEATH FACT: Babies who sleep on their back AMONG INFANTS AGES 1 - 12 MONTHS, are NOT more likely to choke if they spit AND IS THE THIRD LEADING CAUSE up or vomit during sleep. In fact, babies might clear these fluids better when they OVERALL OF INFANT MORTALITY IN sleep on their back because of the location of 2 THE UNITED STATES. the windpipe. Also, healthy babies naturally swallow or cough up fluids — it’s a natural SUID (Sudden Unexpected Infant Death) is the reflex all people have to make sure their death of an infant who is less than 1 year of age that airway is kept clear. If your baby has reflux or occurred suddenly and unexpectedly and whose congestion, consult your pediatrician. cause of death is not immediately obvious prior to investigation. After a thorough case investigation, FACT: Babies are at risk of SIDS only many of these sudden unexpected infant deaths until they are 1 year old. Most SIDS may be explained. Poisoning, metabolic disorders, deaths occur when babies are between hyper- or hypothermia, neglect, homicide, and 1 and 4 months old. suffocation are all explainable causes of SUID.3 About one-half of all SUID cases are SIDS, while FACT: Cribs themselves do not cause the cause of some SUID cases are never found. “crib death” or SIDS. However, the sleep environment, such as having a soft sleep surface, can increase the risk of SIDS and Where is the Safest Place other sleep-related causes of infant death. for Baby to Sleep? FACT: Crib bumper pads should NOT be The safest place for your baby to sleep used in your baby’s sleep area. Safety is in a crib or bassinet. Keep the crib in standards ensure that the crib slats are your bedroom so you can easily watch durable and not wide enough for a baby to or feed your baby. Do not put your slip through (on models from June 2011 and baby to sleep in an adult bed. newer). Therefore, bumper pads are not necessary and may pose a suffocation or Parents can roll over onto their babies, strangulation threat to your baby. or babies can become entangled in This information is general and may not cover the sheets or blankets. special health care needs of all children, especially those with anatomic abnormalities or those at a greater risk for SIDS. Please consult with your “Room share” — DON’T “bed share” health care provider for further guidance.
1-3 Centers for Disease Control and Prevention, www.cdc.gov. 6 Your Child’s Health
Sleep Safety
Creating a safe sleep environment for your baby is one of the most important things you can do to reduce SIDS and accidental suffocation. Many infants die during sleep from unsafe sleep environments. There are several things you can do to make sleep time as safe as possible. Share this information with anyone who cares for your baby.
1. ALWAYS* place babies to sleep on their backs– every night and for every nap. Be sure this is understood by all family members, babysitters, or anyone else who may care for your baby. This is what a Unaccustomed tummy sleeping is when a safe sleep environment baby who is used to sleeping on their back is looks like. placed to sleep on their tummy by a different caregiver. This greatly increases the risk of SIDS. No pillows, blankets, bumper pads, wedges, or toys. 2. NEVER put your baby to sleep in an adult bed with you or with other children. It is very easy to roll over on your baby or for your baby to become entangled in sheets or blankets. Always put babies to sleep in their own crib or bassinet. If you choose to use a baby monitor, don’t rely on it to keep your baby safe. While baby monitors can be helpful, they can offer a false sense of security. 3. ALWAYS place your baby in a safety-approved crib or bassinet and use a firm mattress. Use a tightly fitted sheet to cover the mattress. Your baby is not safe on a couch, in a doll bed, or in another improvised sleeping area. 4. NEVER place blankets, quilts, pillows, bumper pads, or use wedges or positioners in your baby’s crib. These can cause suffocation or entrapment. Clothing made for sleeping, such as sleep sacks or wearable blankets, is a good alternative. 5. AVOID overdressing your baby for sleep times. TUMMY TIME! Keep the room comfortable for you and dress It is important for your baby to spend your baby as you are dressed. Your baby could time on their tummy when they are be too hot if you notice sweating, damp hair, awake – but only when supervised. flushed cheeks or rapid breathing. This strengthens your baby’s neck and 6. NEVER smoke or let anyone else smoke around shoulder muscles and helps to avoid your baby. Keep your home and car smoke-free. flat spots on their heads. *Please consult with your health care provider for specific sleeping requirements your infant may have. 7 Your Child’s Health
Pets & Your Family
the baby into another Introducing Your room while you give your pet warm but calm New Baby to Your Pet affection. Over 60% of U.S. households have at least S After the initial greeting, one pet. A new baby affects all members of allow your pet to sit with your family, including your pets. Animals are you next to the baby. Reward your pet for good very sensitive to changes and a drop in human behavior. Remember, you want your pet to view attention can be greatly distressing. This may your new baby as a positive experience. cause pets to be surrendered to animal shelters. S Try to practice patience and never force your The following tips can help prepare your pet pet to get near the baby. Supervise all early for your new baby’s arrival. interactions between your pet and your baby.
BEFORE YOUR BABY COMES HOME Is My Child Ready for a Pet? S Begin to adjust your pet to a new schedule of Before agreeing to get your child a pet, consider feeding, walking and attention that can be your household’s routine, your willingness and your maintained when your baby comes home. child’s ability to care for a pet, as well as your child’s S Get your pet used to nail trims. disposition and maturity level. Younger children may have difficulty distinguishing an animal from a toy. S Spay or neuter your pet; typically, they will be calmer and less likely to bite. Consistently redirect Supervision will be needed so that the animal doesn’t any gentle nibbling, pouncing, or swatting frighten or injure your child, and that your child can behavior to appropriate toys or objects. treat your pet with the gentleness that animals S Accustom your pet to new smells and sounds. require. Also, consider the type and breed of an Allow your pet to inspect the baby’s room and animal and the animal’s typical temperaments. the items in there. Rattle any toys, wind up infant swings, or even play recordings of a baby PREGNANT? crying. Always make these positive experiences and reward your pet for good behavior. YES, YOU CAN KEEP YOUR CAT! S If the baby’s room will be off limits to your pet, You may have heard of Toxoplasmosis, which is an infection caused by a microscopic parasite called consider using a screen door or a pet gate Toxoplasma gondii. Cats can get Toxoplasma infection instead of closing the door. Your pet will feel by eating infected rodents, birds, or other small animals. less isolated from the family and can still see, It is unlikely to be exposed to the parasite from touching smell, and hear what’s going on in the room. an infected cat because it is generally not carried on fur. You can also contract Toxoplasmosis from eating or BABY IS COMING HOME! handling contaminated raw or undercooked meat, or by touching contaminated soil or eating unwashed fruits and Drastically reducing attention and frequently scolding vegetables from the garden. Do not eat undercooked meat or isolating your pet after your new baby comes and wash all kitchen supplies that have been in contact home will likely make your pet feel stressed. This with raw meat. Never feed cats raw meat as this can be may lead to seeking attention through negative a source of infection. behavior. Try to take into account your pet’s natural The Centers for Disease Control and Prevention (CDC) curiosity and include them in this exciting time! recommends that you always wash your hands thoroughly after cleaning litter boxes, or if you have been scratched S Bring home something with your baby’s scent or bitten by a cat. As an extra precaution, have another ahead of time. family member clean the litter box during your pregnancy. Cats kept indoors, that do not hunt prey, are not likely to S When you return home, your pet may be eager be infected. for your attention. Have a family member take 8 Your Child’s Health
Milestones Checklist
As Your Child Grows From birth to 5 years, your child should reach a Any concerns you may have regarding your child’s variety of developmental milestones such as development should be addressed as early as responding to loud noises, recognizing familiar possible. Research has shown that by addressing faces, and eventually crawling, walking and talking. delays early on – especially between birth and Pages 9-15 include checklists to use as a guide age 3 – more can be done to effectively impact to your child’s development.1 These should not be a child’s development, even into adulthood. used as a substitute for standardized, validated Don’t Worry. But Don’t Wait.2 development screening tools.
What Babies o Can hold head up and begins What Babies to push up when lying on Typically Do at stomach Typically Do at 2 MONTHS o Makes smoother movements 4 MONTHS o Begins to smile at people with arms and legs o Smiles spontaneously, o Can briefly calm themselves especially at people (may bring hands to mouth Tell your child’s doctor or nurse o Likes to play with people and and suck on hand) if you notice any of the following might cry when playing stops o Tries to look at parent signs at 2 months old • Doesn’t respond to loud o Copies some movements and o Coos, makes gurgling sounds sounds facial expressions, like smiling or frowning o Turns head toward sounds • Doesn’t watch things as o Pays attention to faces they move o Begins to babble o Begins to follow things with • Doesn’t smile at people Babbles with expression and eyes and recognize people • Doesn’t bring hands to o copies sounds heard at a distance mouth o Begins to act bored (cries, • When on stomach and o Cries in different ways to fussy) if activity doesn’t pushing up, unable to show hunger, pain, or change hold head upright being tired
1 Milestones Checklist provided by the Centers for Disease Control and Prevention. 2 Early On Michigan, www.1800earlyon.org. 9 Your Child’s Health
As Your Child Grows
What Babies What Babies o Rocks back and forth, sometimes crawling backward Typically Do at Typically Do at before moving forward 4 MONTHS (continued) 6 MONTHS Tell your child’s doctor or nurse o Responds to affection o Knows familiar faces and begins to know if someone if you notice any of the following o Reaches for toy with one hand is a stranger signs at 6 months old • Doesn’t try to get things o Uses hands and eyes together, Likes to play with others, o that are in reach such as seeing a toy and especially parents reaching for it • Shows no affection for o Responds to other people’s caregivers Recognizes familiar people emotions and often seems o • Doesn’t respond to sounds and things at a distance happy around them o Holds head steady, o Likes to look at self in a mirror • Has difficulty getting things unsupported o Responds to sounds by to mouth o Pushes down on legs when making sounds • Doesn’t make vowel sounds feet are on a hard surface o Strings vowels together when (“ah,” “eh,” “oh,” etc.) • Doesn’t roll over in either o May be able to roll over from babbling (“ah,” “eh,” “oh,” etc.) direction stomach to back and likes taking turns with parent while making sounds • Doesn’t laugh or make o Can hold a toy and shake it squealing sounds and swing at dangling toys o Responds to own name • Seems very stiff, with tight o Brings hands to mouth o Makes sounds to show joy muscles and displeasure When lying on stomach, • Seems very floppy, like a o Begins to say consonant pushes up to elbows o rag doll sounds ( jabbering with “m” and “b”) Tell your child’s doctor or nurse if you notice any of the following o Looks around at things What Babies signs at 4 months old nearby Typically Do at • Doesn’t watch things as o Brings things to mouth 9 MONTHS they move o Shows curiosity about things • Doesn’t smile at people and tries to get things that o May be afraid of strangers • Can’t hold head steady are out of reach o May be clingy with familiar adults • Doesn’t coo or make sounds o Begins to pass things from one hand to the other Have favorite toys • Doesn’t bring things to o mouth o Rolls over in both directions o Understands “no” (front to back, back to front) • Doesn’t push down with o Makes a lot of different sounds legs when feet are placed o Begins to sit without support like “mamamama” and on a hard surface o When standing, supports “bababababa” • Has trouble moving one or weight on legs and might o Copies sounds and both eyes in all directions bounce gestures of others 10 Your Child’s Health
As Your Child Grows
What Babies What Children o Put things in a container and Typically Do at Typically Do at take things out of a container o Lets things go without help 9 MONTHS (continued) 1 YEAR o Pokes with index (pointer) o Uses fingers to point at things o Are shy or nervous with finger o Watches the path of something strangers o Follows simple directions like as it falls o Cries when mom or dad “pick up the toy” o Looks for things they see leaves o Gets to a sitting position you hide o Have favorite things and without help o Plays peek-a-boo people o Pulls up to stand and walks o Puts things in their mouth o Shows fear in some situations holding on to furniture o Moves things smoothly from o Hands you a book when they o May take a few steps without one hand to the other want to hear a story holding on o Picks up things like cereal o’s o Repeats sounds or actions to o May stand alone between thumb and index get attention finger o Puts out arm or leg to help Tell your child’s doctor or nurse o Stands, holding on with dressing if you notice any of the following signs at 1 year old o Can get into sitting position o Responds to simple spoken requests • Doesn’t crawl o Sits without support • Can’t stand when supported Uses simple gestures, like Pulls to stand o o shaking head “no” or waving • Doesn’t search for things o Crawls “bye-bye” that they see you hide o Makes sounds with changes • Doesn’t say single words Tell your child’s doctor or nurse in tone (sounds more like like “mama” or “dada” if you notice any of the following speech) • Doesn’t learn gestures like signs at 9 months old waving or shaking head o Says “mama” and “dada” and • Doesn’t bear weight on legs exclamations like “uh-oh!” • Doesn’t point to things with support • Loses skills they once had • Doesn’t sit with help o Tries to say words you say • Doesn’t babble (“mama,” o Explores things in different “baba,” “dada”) ways, like shaking, banging, • Doesn’t play any games throwing What Children involving back-and-forth o Finds hidden things easily play Typically Do at o Looks at the right picture or • Doesn’t respond to own thing when it’s named 1-1/2 YEARS name Copies gestures (18 Months) • Doesn’t seem to recognize o familiar people o Starts to use things correctly; o Likes to hand things • Doesn’t look where you point for example, drinks from a to others as play cup, brushes hair • Doesn’t transfer toys from o May have temper one hand to the other o Bangs two things together tantrums 11 Your Child’s Health
As Your Child Grows
What Children o Can help undress themselves o Points to things or pictures when they are named Typically Do at o Drinks from a cup o Eats with a spoon o Knows names of familiar 1-1/2 YEARS people and body parts (18 Months) (continued) Tell your child’s doctor or nurse o Says sentences with 2 to o May be afraid of strangers if you notice any of the following 4 words o Shows affection to familiar signs at 1-1/2 years old (18 months) o Follows simple instructions people • Doesn’t point to show things o Repeats words overheard in to others o Plays simple pretend, such conversation • Can’t walk as feeding a doll o Points to things in a book o May cling to caregivers in • Doesn’t know what familiar Finds things even when new situations things are for o hidden under 2 or 3 covers • Doesn’t copy others o Points to show others something interesting • Doesn’t gain new words o Begins to sort shapes and colors o Explores alone but with • Doesn’t know at least parent close by 6 words o Completes sentences and rhymes in familiar books o Says several single words • Doesn’t notice or mind when a caregiver leaves or returns o Plays simple make-believe Says and shakes head “no” o • Loses skills they once had games o Points to show someone o Builds towers of 4 or more what they want blocks o Knows what ordinary things o Might use one hand more are used for (for example, What Children than the other a cup, a brush, or a spoon) Typically Do at o Follows two-step instructions o Points to get the attention such as “Pick up your shoes of others 2 YEARS and put them in the closet” Shows interest in a doll or o o Copies others, especially Names items in a picture stuffed animal by pretending o adults and older children book such as a cat, bird, to feed o Gets excited when with or dog o Points to one body part other children o Stands on tiptoe o Scribbles on their own o Shows more and more independence o Kicks a ball o Can follow one-step verbal commands without any o Shows defiant behavior o Begins to run gestures; for example, sits (doing what they have been o Climbs onto and down from when you say “sit down” told not to) furniture without help o Walks alone o Plays mainly beside other o Walks up and down children, but is beginning to May walk up steps and run stairs holding on o include other children, such o Pulls toys while walking as in chase games o Throws ball overhand 12 Your Child’s Health
As Your Child Grows
What Children o May get upset with major o Pedals a tricycle (3-wheel Typically Do at changes in routine bike) o Dresses and undresses self o Walks up and down stairs, 2 YEARS (continued) one foot on each step o Follows instructions with 2 or o Makes or copies straight lines 3 steps and circles Tell your child’s doctor or nurse o Can name most familiar if you notice any of the following things signs at 3 years old Tell your child’s doctor or nurse if you notice any of the following o Understands words like “in,” • Falls down a lot or has signs at 2 years old “on,” and “under” trouble with stairs • Doesn’t use two-word o Says first name and age • Drools or has very unclear speech phrases (for example, o Names a friend “drink milk”) • Can’t work simple toys • Doesn’t know what to do o Says words like “I,” “me,” (such as peg boards, simple with common things, like a “we,” and “you” and some puzzles, turning handle) brush, phone, fork, spoon plurals (cars, dogs, cats, etc.) • Doesn’t speak in sentences • Doesn’t copy actions and o Talks well enough for • Doesn’t understand simple words strangers to understand instructions most of the time • Doesn’t follow simple • Doesn’t play pretend or instructions o Carries on a conversation make-believe • Doesn’t walk steadily using 2 to 3 sentences • Doesn’t want to play with • Loses skills they once had o Can work toys with buttons, other children or with toys levers, and moving parts • Doesn’t make eye contact o Plays make-believe with dolls, • Loses skills they once had What Children animals, and people Typically Do at o Does puzzles with 3 or 4 pieces 3 YEARS What Children Understands what “two” o Copies adults and friends o means Typically Do at o Shows affection for friends without prompting o Copies a circle with pencil or 4 YEARS crayon o Takes turns in games o Enjoys doing new things o Turns book pages one at o Shows concern for a crying a time o Are more and more creative friend with make-believe play o Builds towers of more than o Understands the idea of 6 blocks o Would rather play with other “mine” and “his” or “hers” children than by themselves o Screws and unscrews jar lids o Shows a wide range of or turns door handle o Cooperates with other emotions children o Climbs well o Separates easily from mom o Often can’t tell what’s real and dad o Runs easily and what’s make-believe 13 Your Child’s Health
As Your Child Grows
What Children o Can tell what’s real and what’s Tell your child’s doctor or nurse make-believe Typically Do at if you notice any of the following 4 YEARS (continued) signs at 4 years old o Shows more independence • Can’t jump in place Are sometimes demanding and o Talks about what they like and o what they are interested in • Has trouble scribbling sometimes very cooperative • Shows no interest in Knows some basic rules of o Speaks very clearly o interactive games or grammar, such as correctly make-believe using “he” and “she” o Tells a simple story using full • Ignores other children or sentences o Sings a song or says a poem doesn’t respond to people from memory outside the family o Uses future tense (for example, “Grandma will Tells stories o • Resists dressing, sleeping, be here”) o Can say first and last name and using the toilet • Can’t retell a favorite story o Says name and address o Names some colors and some numbers • Doesn’t follow three-part o Counts 10 or more things commands Understands the idea of o Can draw a person with at counting • Doesn’t understand “same” o and “different” least 6 body parts o Starts to understand time • Doesn’t use “me” and “you” o Can print some letters or o Remembers parts of a story correctly numbers • Speaks unclearly Understands the idea of o o Copies a triangle and other • Loses skills they once had “same” and “different” geometric shapes o Draws a person with 2 to 4 body parts o Knows about things used every day, like money and o Uses scissors food Starts to copy some capital o Stands on one foot for letters o What Children 10 seconds or longer o Plays board or card games Typically Do at o Hops or may be able to skip o Tells you what they think will 5 YEARS happen next in a book o Can do a somersault Wants to please friends Hops and stands on one foot o o o Uses a fork and spoon and up to 2 seconds o Wants to be like friends sometimes a table knife o Catches a bounced ball most o More likely to agree with rules of the time o Can use the toilet on o Likes to sing, dance, and act their own o Pours, cuts with supervision, and mashes own food o Are aware of gender o Swings and climbs 14 Your Child’s Health
As Your Child Grows
What Children
Typically Do at • Unusually withdrawn • Can’t give first and last names 5 YEARS (continued) • Is easily distracted, has • Doesn’t use plurals or past trouble focusing on one tense properly activity for more than Tell your child’s doctor or nurse 5 minutes • Doesn’t talk about daily if you notice any of the following activities or experiences signs at 5 years old • Doesn’t respond to people, • Doesn’t draw pictures • Doesn’t show a wide range or responds only superficially of emotions • Can’t tell what’s real and • Can’t brush teeth, wash and what’s make-believe dry hands, or get undressed • Shows extreme behavior without help (unusually fearful, • Doesn’t play a variety of aggressive, shy or sad) games and activities • Loses skills they once had
Early On Michigan is a statewide system of early intervention services FOR MORE that specialize in evaluating and treating INFORMATION children (ages birth to 3 years) who are not developing at the same rate as other Early On Michigan kids. This can include physical, mental, Call: 1-800-EARLY ON communication, adaptive, social or (1-800-327-5966) emotional development. or visit: www.1800earlyon.org If you are concerned about the development or health of your child, Centers for Disease Control talk to a professional at your local health and Prevention department or consult with your child’s 1-800-CDC-INFO pediatrician. www.cdc.gov/concerned
15
Your Child’s Health Choosing A Child Care Provider There are many different child care choices and settings. An age-appropriate child care that provides a loving, safe, stable and stimulating environment while enhancing your child’s physical, emotional, social and intellectual development are all factors to consider when choosing a provider.
COMMON CHILD CARE SETTINGS Child Care Centers – classroom-based programs that provide care and education, including child care, prekindergarten, preschools, nursery schools, before- FOR MORE and after-school programs, Great Start Readiness Program INFORMATION (GSRP) and Head Start programs. Child care licensing, complaints, Group Child Care Homes – group homes for up to and provider information, Child 12 children with two or more adult caregivers. Development and Care Program, child care and family assistance, Family Child Care Homes – family homes that provide contact: care for up to 6 children with 1 adult caregiver. Department of Licensing and License-Exempt Providers – an adult who is 18 years or Regulatory Affairs (LARA) older and enrolled to provide care for up to 6 children at one michigan.gov/lara time in their home or the child’s home. To provide care in Child Development and Care, the provider’s home, the provider must be related to the Michigan Department of child(ren) by blood, marriage, or adoption as a grandparent / Education great-grandparent, uncle / great uncle, or aunt / great aunt or 1-866-990-3227 as a sibling not living with the child. michigan.gov/childcare Great Start to Quality Consider more than one provider Resource Center 1-877-614-7328 before making a final decision. greatstarttoquality.org Plan on staying at each location Michigan Department of Health for at least an hour. and Human Services 1-855-275-6424 Talk with providers and observe michigan.gov/mdhhs different interactions between You may apply for Michigan assistance online at: caregivers and the children www.mibridges.michigan.gov/access they care for.
17 Your Child’s Health
Choosing A Child Care Provider
QUESTIONS YOU MAY WANT TO ASK WHEN S Are all toxic substances S Are on-site play areas VISITING A CHILD CARE locked away and out of sight? inspected for safety, surrounded Are poison control sign(s) by a fence, and kept clean? PROVIDER displayed? S What is the provider’s visiting S S What are the qualifications What are the provider’s various policy? emergency plans for natural of the provider and staff? S disasters, fire, flood, etc.? If transportation is provided S What are the child-to-staff by the caregiver, are proper S Are there first aid kits? ratios and group size? car seats, booster chairs, and Fire extinguishers? enough seat belts available? S Are immunizations required S What type of background S before entry? Are healthy meal and snack checks have been done on choices provided? Is there S What methods of discipline staff? Are references available? clean, self-serve water always are used, and in what S What is the procedure for available? circumstances? medication dispensing if S What specific fees and needed? services will be charged? S Is proper sanitation and handwashing practiced, S Are all staff certified in CPR for Including especially when diapering infants and small children? – billing schedule multiple children? First aid? – extra /outside activities S Is supervision always S Are all staff aware of and do – snacks / meals provided, even when children they follow safe sleep – pick-up /drop-off times are napping? practices? – flexible scheduling
When choosing a child care environment or provider, you may want to consider the following: S Does the provider show respect for the children and their families?
S What is the adult-to-child ratio? Do you feel it is appropriate for the environment? Common guidelines: 1 adult to 4 infants 1 adult to 6 toddlers 1 adult to 9 preschoolers
S Will the provider present regular communication regarding my child’s progress and activities?
S Are healthy activities and goals established for the children?
18 Your Child’s Health
Choosing A Child Care Provider
Additional Things to Think About
S Does the provider smile, talk and laugh with the children? — TIPS —
S Is there one-on-one time spent with each child? WAYS TO STAY INVOLVED DURING S Do the children feel safe, look happy and are CHILD CARE YEARS comfortable?
S Does the daily routine include quiet time and Have parent and caregiver active play time? meetings regularly
S Is the caregiver respectful of your values and Offer to volunteer culture? Be present for birthday S Is the caregiver reliable? You may want to talk parties, holidays or special with parents of children already in the provider’s events put on by the care. caregiver
S If your child has unique needs, will these be Visit your child at the met as often as necessary? facility
S Is the child care facility and provider licensed by the State of Michigan? A licensed provider should be able to show you their current license.
For more information on choosing child care providers in your area, visit: www.michigan.gov/mde www.greatstarttoquality.org www.michigan.gov/mdhhs www.childcareaware.org www.michigan.gov/lara
19
Your Child’s Health Healthy Children & Immunizations
Why Vaccinate? ...... page 21 The Vaccines for Children (VFC) Program ...... page 22 Recommended Childhood & Adolescent Immunization Schedule ...... page 23 Everyday Germ Prevention ...... page 24
WHY VACCINATE? Vaccines reduce the risk of infection by developing your body’s natural FOR MORE immunity to disease. Vaccines INFORMATION protect not only individuals but entire communities. Michigan Department of Health and Human Services Vaccines help develop your body’s natural immune system by 1-855-275-6424 imitating an infection but not causing illness. Vaccines not michigan.gov/mdhhs only protect you and your family, but those around you in your community. If you are vaccinated and become ill, it is likely Vaccines for Children you will be contagious for a much shorter period of time, or Program perhaps not become sick at all. Likewise, when other people michigan.gov/vfc are vaccinated, they are less likely to pass a disease to you. michigan.gov/immunize Children in the United States still get vaccine-preventable diseases. Unfortunately, there has been a resurgence of Centers for Disease measles and whooping cough (pertussis) in the past few Control and Prevention years. However, widespread use of vaccines in the 1600 Clifton Road United States has eliminated or nearly eliminated many Atlanta, GA 30333 infectious diseases, such as polio and smallpox, that 1-800-CDC-INFO used to affect thousands of Americans every year. (1-800-232-4636) TTY: 1-888-232-6348 Some children may not be able to receive certain or all cdc.gov/vaccines vaccinations due to medical and non-medical reasons. It’s best to speak with your physician or county health department regarding vaccine immunizations.
21 Your Child’s Health
The Vaccines for Children (VFC) Program
The Vaccines for Children (VFC) Program offers vaccines at no cost for eligible children through doctors enrolled in Recommended the program. This helps to ensure that all children have a Vaccines Protect better chance of receiving their recommended vaccines on schedule. Check to see if your doctor or local health Against the Following department participates in the program and if your child 1 16 Diseases qualifies.
S Diphtheria WHO IS ELIGIBLE? A child is eligible for the VFC Program if he or she is S Haemophilus influenzae younger than 19 years of age and is one of the following: type b (Hib) S Medicaid-eligible S Hepatitis A S American Indian or Alaskan Native S Hepatitis B S Uninsured S Human Papillomavirus (HPV) S Underinsured, meaning a child has health insurance S Influenza (flu) but it: • doesn’t cover vaccines, or S Measles • doesn’t cover certain vaccines, or • covers vaccines but has a fixed dollar limit for S Meningococcal disease vaccines. Once that fixed dollar amount is reached, a child is then eligible. S Mumps
S Pertussis (whooping cough) Public Health Code (excerpt) S Pneumococcal disease (1) Michigan law states that beginning January 1, 2014, a parent, guardian, or person in loco parentis of a child S Polio entering the seventh grade shall present to school officials, at the time of registration or not later than the S Rotavirus first day of school, a certificate of immunization or statement of exemption under section 9215. S Rubella (German measles)
S Tetanus (lockjaw) (2) A teacher or principal shall not permit a child to enter or attend school unless a certificate indicating that a S Varicella (chickenpox) minimum of 1 dose of an immunizing agent against each of the diseases specified by the department has been received and certified to by a health professional 1 Centers for Disease Control and Prevention, www.cdc.gov. or local health department.
Public Health Code (excerpt) Act 368 of 1978, MCL 333.9208 (1), (2). Certificate of immunization or statement of exemption; presentation to school officials; minimum doses of immunizing agent; updated certificate. 22 . For Notes explanation, see pages 59-62. * www.cdc.gov/vaccines/schedules/hcp
, www.aap.org . www.acog.org , the American Academy of Pediatrics, www.cdc.gov/vaccines/acip School entry and adolescent vaccine age groups are marked with a star. , and the American College of Obstetricians and Gynecologists, g www.aafp.or Recommended Childhood & Adolescent Immunization Schedule Immunization Childhood & Adolescent Recommended For moreFor information, contact child’s physician, your county your health department or visit The schedule below indicates recommended ages for routine administration of currently licensed childhood immunizations, as of February 2019. This schedule is approved by the Advisory Committee on Immunization Practices, Physicians, Family of Academy American the
23 Your Child’s Health
Original graphic can be found at: http://phil.cdc.gov/PHIL_Images/18056/18056_lores.jpg. Modified with permission from the Centers for Disease Control and Prevention (CDC).
24 Your Child’s Health
Everyday Germ Prevention
PRACTICING EVERYDAY GERM PREVENTION AND TEACHING YOUR Handwashing is one of the best ways to CHILDREN HOW VIRUSES ARE SPREAD prevent the spread of many types of infection and illness. Wash your hands regularly and CAN HELP KEEP YOU AND YOUR thoroughly with soap and water. Wash for a FAMILY HEALTHY. minimum of 20 seconds (recite the alphabet while you wash so you know when scrub time There are sensible actions you can take to help is up). prevent contracting or spreading viruses like the flu. S Cover your nose and mouth with a tissue when you sneeze or cough. Always throw the used When Should You tissue in the trash. Wash Your Hands? S Sneeze or cough into your sleeve, rather than your hand, if you don’t have a tissue available. Before, during, and after preparing food S Wash your hands often and thoroughly with soap and water. Wash for a minimum of 20 seconds. Before eating food If soap and water are not available, use an Before and after caring for someone alcohol-based hand sanitizer. who is sick S Try to avoid close contact with sick people. S Avoid touching your eyes, nose and mouth. Before and after treating a cut or wound These are common ways for germs to enter your system. After using the toilet S Disinfect surfaces and objects that are After changing diapers or cleaning up frequently touched or used, such as phones, a child who has used the toilet light switches and doorknobs. S If you are sick, stay home from work; if your After blowing your nose, coughing, child is sick, keep your child home from school or sneezing or child care. It is recommended that you stay home for 24 hours after the fever is gone After touching an animal, animal feed, (without the aid of fever-reducing medicine). or animal waste After touching garbage GERM PREVENTION AT SCHOOL AND CHILD CARE If soap and water are not available, use an S Make sure your child’s school or child care alcohol-based hand sanitizer that contains at routinely cleans frequently touched objects and least 60% alcohol. Alcohol-based hand surfaces. sanitizers can quickly reduce the number of S Check if the school or child care has good microbes on hands in some situations, but supplies of tissues, soap, paper towels and sanitizers do not eliminate all types of germs. alcohol-based hand sanitizers. Hand sanitizers may not be as effective when S Ask how sick students and staff are separated hands are visibly dirty or greasy. from others and who cares for them until they can go home. S Adapted from the Centers for Disease Control and Prevention, Teach your child to contact you or another www.cdc.gov, “Wash Your Hands”. trusted adult if they begin to feel sick. 25
Your Child’s Health Nutrition & Healthy Living
Michigan’s Health Care Programs ...... page 27 Feeding Your Child ...... page 28 Healthy at Home/Healthy at School ...... page 29 Nutritional Guidelines ...... page 30 Staying Fit as a Family ...... page 31
Michigan’s Health Care Programs MICHIGAN OFFERS SEVERAL Healthy Kids MEDICAL ASSISTANCE This Medicaid health care program is available for low-income children under age 19 and for pregnant PROGRAMS. EACH PROGRAM women of any age. There is an income limit, but no COVERS DIFFERENT GROUPS OF monthly premium. Check for eligibility and apply online PEOPLE AND HAS DIFFERENT at www.michigan.gov/mibridges. ELIGIBILITY REQUIREMENTS. MIChild When you apply for a program, your age, The MIChild health care program is available for the income, financial resources, and other low-income, uninsured children (under age 19) of Michigan’s working families. This program is for children only and there is information will be used to determine if an income limit and monthly premium. For more information, you are eligible. You must also meet the call 1-888-988-6300 or visit www.michigan.gov/michild. financial and nonfinancial eligibility conditions for that program. Women, Infants and Children (WIC) Program WIC is a special supplemental nutrition program for women, Text4baby infants, and children. WIC provides supplemental foods, health care referrals, and nutrition education for eligible pregnant You can text BABY to 511411 and postpartum women and for children up to 5 years of age. (or BEBE for Spanish) and receive For more information, call 517-373-3740 or visit 3 free text messages a week, timed to www.michigan.gov/mdhhs. your due date or your baby’s birth date. The messages address topics such as labor signs, prenatal care, Children’s Special Health Care Services immunizations and nutrition. (CSHCS) This is a program that provides approved medical service Visit www.text4baby.org for more information, or download coverage to eligible children and adults with special health the app from the Apple and care needs. For more information, call the Michigan Google Play online stores. Department of Health and Human Services (MDHHS) at 517-373-3740 or leave a message at 1-800-359-3722. 27 Your Child’s Health
Feeding Your Child
Feeding Your Infant Give your baby breastmilk or formulas throughout the first year of life. Begin introducing solid foods between 6 and 12 months.
BREASTFEEDING Deciding whether or not to You should not breastfeed if: breastfeed your baby is a personal You are HIV positive (you can drink 4 ounces per feeding, every choice. Many authorities strongly pass the HIV virus to your infant 4 hours. Immediately refrigerate recommend breastfeeding and through breast milk); you have opened packages of liquid formula breast milk as it provides ideal active, untreated tuberculosis; and use them within 24 hours. nutrition for infants. It has a nearly you are receiving chemotherapy Mixed powder formula can be perfect mix of vitamins, protein, for cancer; or using an illegal drug. stored for 24 hours in the back of and fat – everything your baby the fridge. needs to grow – and contains If you are unsure how your antibodies that help your baby medication may affect your fight off viruses and bacteria. It is baby, consult with your REMEMBER: always at the right temperature, doctor or pharmacist. S If formula is left out more than clean, and free. Breastfeeding 1 hour, or is left over in a also lowers your baby’s risk of bottle, always throw it out. having asthma or allergies. CHOOSING A FORMULA Breastfed babies are more likely If you decide to feed your baby S Do not water-down formula. to gain the right amount of weight formula, you can buy powdered, as they grow rather than concentrated, or ready-to-use S Do not heat formula or breast becoming overweight children. formulas. Some formulas are milk in the microwave. Freshly pumped breast milk is made from cow’s milk, hydrolyzed, good for 5 hours at room or soy. Make sure you use one S ALWAYS test the formula’s temperature. Refrigerate breast that’s iron-fortified. By the end of temperature before feeding to milk for use within 3 days. the first month, your baby may prevent scalding.
Feeding Your Toddler Young children may need to eat 5 or 6 small meals a day to get the proper nutrition they need for growth.
This is the time to create healthy Serve at least 3 meals a day with they can easily choke. Do not give eating habits with your child. scheduled snacks in between. Be children under 3 years of age Offer new foods regularly and aware that children’s stomachs uncut, round or hard foods such are small and, therefore, need as raw carrots, grapes, hot dogs, in different forms. Reintroduce portion sizes 1/4 to 1/2 that of an popcorn, cheese sticks, raisins, foods your child may have at adult (see page 31 for a guide to marshmallows, or nuts. first disliked as they will often portion sizes). learn to like them if they are If you feel your child is not growing Always use close supervision when enough or is overweight, check regularly offered. young children are eating because with your health care provider. 28 Your Child’s Health
Healthy at Home!
What You Can Do Be Active Together! Physical activity is a great way to feel better about Keep Healthy Foods in the Kitchen! yourself. When you exercise, your body releases Keep foods in your house that you want your child chemicals called endorphins that trigger a positive to eat and try to have healthy snacks on hand. As feeling in your body. Being active can help you sleep you may know yourself, if it’s in the house – you’re better, boost self-esteem, and reduce depression, anxiety and stress. This works for kids too! Commit more likely to eat it. When cooking, try to including a fun and physical activity with your implementing herbs to add flavor instead of adding child each day. salt. Also, switch from solid fats (such as animal fats, butter, stick margarine, or hydrogenated oils) to healthier oils (for example, canola or olive oils) Make A New House Rule when preparing food. No sitting still during TV commercials! Cut Down on the Sodas and Sugary Drinks! There are about 10 packets of sugar in one Lead an Active Lifestyle! 12-ounce can of soda. Ten packets! Look for Both adults and children need moderate to vigorous naturally flavored water drinks without added sugar activity each day, but it doesn’t need to happen all and 100% fruit juice. at once! It can add up throughout your day. Give your kids toys that encourage physical activity, such as jump ropes, balls, and flying discs. Healthy at School! Eating nutritious foods and being active throughout the school day keeps kids healthy and their growing bodies strong. L This may also help to increaseU concentrationNC LUNC and focus as well as improve classroomH H behavior. LUNCH MENU 1 2 3 4 What You Can Do S Encourage your kids to find a physical activity 5 6 Find out how to get a they like, such as a school sport or an active menu each week from game at recess. 11 12 your child’s school. S Volunteer to help with after-school physical 17 18 With your child, activity programs or sports teams. choose which meals S Encourage your kids’ school to hold recess 23 24 they will buy at school before lunch to increase physical activity and which lunches to before they eat. NCH LU pack togetherNCH at home! S Let your kids help make their lunch. LU You can supervise what goes in, but they’ll be more apt to eat what they’ve helped to make!
29 Your Child’s Health
Nutritional Guidelines
There are countless tasty ways to improve your family’s eating habits. Below are some Vary Your Proteins. easy tips to keep in mind when shopping for Experiment with a variety of beans and legumes groceries, packing your kid’s lunch, and such as peas, lentils, and chickpeas, and all the deciding what meals to cook. ways they can be prepared. Other good sources of protein are fish, lean meats, poultry and soy products. Eat Your Colors. Fruit Makes a Great Dessert! Varying the colors of the vegetables served increases the vitamins and minerals you get and keeps kids The same as with vegetables, consuming a variety interested. Orange sweet potatoes, bright green of fruits ensures you will get more nutrients. Fresh, celery and red cherry tomatoes are great examples canned, or frozen fruits are all great options, but of fun foods to eat. look for those without any added sugars. Look for Whole Grains. Dairy Products Help Keep You Strong. Whole-grain versions of cereal, breads and crackers Dairy products provide calcium, protein and are good for your heart and digestion and can help vitamin D for strong bones, teeth and muscles. to maintain a healthy weight. Choose foods labeled Consider calcium-fortified juices, cereals and “100% whole wheat” or “100% whole grains.” Also, breads. Also try canned fish, rice beverages, check the ingredient list to see if the word “whole” is yogurt, cheese and vegetables such as collard before the first ingredient such as “whole-wheat flour.” greens, kale, broccoli, turnip greens, spinach and If so, the product contains whole grain. bok choy, which are naturally high in calcium.
MyPlate represents the five food groups that are the building blocks for a healthy diet using a familiar image – a place setting for a meal. It’s never too late to start eating healthier!
d groups: the five main foo g foods from choosin eals by our m lan y teins, and dairy. P grains, pro tables, 5 , vege 3 4 fruits 2 30 1 ChooseMyPlate.gov icon courtesy of the U.S. Department of Agriculture. Your Child’s Health
Staying Fit as a Family
MICHIGAN IS More easy and fun ways Childhood Obesity A GREAT PLACE to get exercise: Overweight kids are at risk for TO BE ACTIVE developing medical problems that S playing catch with balls or affect their present and future ALL YEAR! flying discs health and, possibly, quality of life. Common health problems are: Make your “family time” active S using a clothes line for S high blood pressure, high time together. volleyball or badminton games cholesterol and abnormal blood Make use of the skate parks, S taking a family walk after lipid levels, and type 2 diabetes biking and hiking trails, and dinner S shortness of breath, making playgrounds in your area. physical activity more difficult S hosting a family “mini Olympics” and possibly aggravating the REMEMBER: When biking, and creating fun categories of symptoms or increasing the everyone should wear a certified physical activities chances of developing asthma bicycle helmet. S sleep disorders such as Easy ways to get some exercise S renting or purchasing exercise obstructive sleep apnea can be as simple as cleaning up videos for kids; you can also S liver and gall bladder disease the yard, walking your child to look online for free videos S school, parking farther away to watch depression from entrances or climbing the If you have any concerns, contact stairs instead of using elevators. your child’s health care provider.
Guide to Serving Sizes
Peanut Butter = = 2 tablespoons golf ball of peanut butter 1 ounce of bread CD/DVD case = d groups: 1 ounce of cheese pencil eraser = the five main foo g foods from 3 ounces of meat deck of cards choosin eals by ur m The guide above offers some vi yo dairy. sual clues to h lan teins, and elp you an P ins, pro d your k , gra ids lear ables n prop eget er po s, v rtion fruit s. 31 Your Child’s Safety Your Child’s Safety
Home Safety Tips
Every year, there are thousands of preventable child injuries. Some injuries may even cause death. Keeping a child safe at home is a good place to start.
THE GOOD NEWS IS PREVENTABLE INJURIES CAN BE AVOIDED WITH THE RIGHT EDUCATION, FALLS AWARENESS AND PLANNING. BELOW ARE S Window screens will not prevent a SOME TIPS FOR MAKING YOUR HOME SAFER. child from falling out. Properly install window guards to prevent falls (for windows above the first floor, include BURNS an emergency release device that S Check your water heater’s thermostat and set it to adults and older children can easily 120 degrees Fahrenheit or the manufacturer’s operate in case of fire or emergency) recommended setting to help prevent the water or install window stops that keep from getting too hot out of the tap. windows from opening more than S Don’t hold a child while cooking at the stove. four inches. S Never leave food unattended on the stove. Keep all handles S Keep furniture and cribs away from of pots and pans turned away from the edge of the stove windows to prevent children from so they can’t be bumped or reached by children. climbing near them. S Avoid buying lighters that look like toys, and keep all matches and lighters well out of children’s reach. S Install and regularly check the smoke detectors in your Never move a child home. Replace batteries twice a year. who appears to be S Have a family fire escape plan and be sure everyone knows various ways to get out of your home and where seriously injured – to meet up in the event of a fire. CALL 9-1-1 DROWNINGS Let trained medical S Babies can drown in only an inch of water. Always be personnel determine if alert, and provide undistracted supervision when young there are injuries children are in or near bathtubs or swimming pools and while at the beach. to the child. S Immediately empty all containers, buckets, and wading or inflatable pools after use. S Immediately empty the bathtub after use. Keep all toilet seats closed. Toilet seat locks can also be used to keep the lid safely shut. 33 Your Child’s Safety
Home Safety Tips
FALLS (continued) MEDICATION SAFETY (continued) S Keep babies and young kids strapped in when using high S Do not give children medicine that is chairs, infant carriers, swings and strollers. If your baby packaged for adults unless specifically is in a carrier, remember to place it on the floor, not on told to do so by a physician. top of a table or other furniture. S If your child is prescribed an antibiotic, S Because baby walkers don’t have safety features that make sure they take all the medicine prevent them from rolling down stairs and they may allow prescribed, even if they begin to feel your baby to reach higher objects, try using a stationary better. Do not save the antibiotic activity center instead. Look for one that is on a stable, medicine “for later.” non-moveable base and place it away from stairs, hot S Use only the measuring device that is appliances or window cords. included with the medicine. A kitchen teaspoon or tablespoon is not a good POISONINGS measuring device for giving medicines Young children are often at eye level with items commonly to children. If a measuring device is not kept under kitchen and bathroom sinks or found in purses or included with the product, check with diaper bags set on the ground. Consider using safety locks on your pharmacy. cabinets and storing all items out of children’s sight and reach. Common household products to keep safely away from children: • single-load laundry and dishwasher packets/pods • cleaning supplies, pesticides, plants and flowers FOR MORE • make-up, personal care products, laxatives and INFORMATION diaper rash products • art supplies National Poison Help Line: • eye drops and vapor rubs with camphor 1-800-222-1222 • button (or coin) batteries and items that contain these Poison control centers offer batteries (see Button Battery Safety tips on page 36.) free, confidential help in English and Spanish. • ALL medications including vitamins and allergy medicines You can call anytime from anywhere in the U.S. MEDICATION SAFETY S An estimated 59,000 children under the age of 5 years are brought to emergency rooms each year due to CALL 9-1-1 unsupervised ingestion of medicines.1 Many times incidents happen when adults are distracted for just a if you suspect your child moment, for example when the phone or doorbell rings. has been poisoned; If distracted, take the medication with you or put it away, if your child has collapsed out of the reach of your child. or isn’t breathing. S Remember, “child-resistant” does not mean “child-proof.” Always re-cap medicines and vitamins and store in a place where children can’t reach – even in between doses. S Do not use cough and cold products with children under 4 years old unless specifically told to do so by a physician.
1 Centers for Disease Control and Prevention, www.cdc.gov. 34 Your Child’s Safety
Home Safety Tips
TV & FURNITURE TIP-OVERS CHOKING S TVs and appliances can be unstable. They can tip over S Infants and young children can easily if pulled on or climbed upon by children. Serious injuries, choke on some foods and small toys suffocation and death can occur when a child is crushed and household objects. You may want by or becomes pinned beneath a heavy piece of to get on your hands and knees and furniture. Injuries from TV and furniture tip-overs observe your home from your child’s have been rising for over a decade. perspective. Look for and remove small items such as buttons, beads, S Secure TVs in your home: jewelry, pins, nails, marbles, coins, stones and tacks. Mount flat-screen TVs to the wall by S Cut food for toddlers into tiny pieces. following the manufacturer’s instructions. Children under 5 years of age should This will avoid them toppling off stands not eat small, round or hard foods, or other furniture. including pieces of hot dogs, cheese sticks or chunks, hard candy, nuts, grapes, marshmallows, or popcorn. Place older-style TVs on low, stable pieces S of furniture. Push the TV back as far as Magnets can be especially dangerous if swallowed. Inspect toys and games possible from the edge. that may include small magnets, including adult desk items and refrigerator magnets.
S Secure furniture such as dressers, bookcases, CALL 9-1-1 TV stands and entertainment units to a wall stud IMMEDIATELY IF YOU SUSPECT with braces, brackets, anchors or wall straps. MAGNETS MAY HAVE BEEN SWALLOWED! S Install safety stops on dresser drawers to prevent them from being pulled all the way out. Children may pull out multiple drawers to climb up which can cause STRANGULATION the weight to shift, making the dresser easier to S Keep cords and strings, including those fall over. attached to window blinds, out of your child’s reach. Move all cribs, beds, S Keep remote controls, toys, food and other items that furniture, and toys away from windows might attract children off of TVs and other furniture. and window cords. S Do not tie strings or ribbons to S Keep electrical cords out of reach of children and teach pacifiers or toys. them not to play with the cords. S Do not dress infants and young S Rearrange items in your home so that heavier items are children in clothing with drawstrings on lower shelves or in lower drawers. or pull cords. Also, avoid necklaces, scarves, strap purses and similar S Consider using safety outlet plugs throughout your home items. to prevent children from putting objects or their fingers into electrical outlets. 35 Your Child’s Safety
Home Safety Tips
BUTTON BATTERY SAFETY
Each year in the United States, more than 2,800 kids are treated in emergency rooms after swallowing coin-sized lithium or “button” batteries. That’s one child every three hours. The number of serious injuries or deaths as a result of button batteries has increased ninefold in the last decade.1
THE NATIONAL BATTERY INGESTION HOTLINE: 1-202-625-3333
If you SUSPECT your child has ingested a battery, CALL 9-1-1 immediately. Don’t induce vomiting or have your child eat or drink anything until assessed by a medical professional.
Keep button battery-controlled devices out of sight and reach of small children.
Search your home for items that contain button batteries. These may include remote controls, singing greeting cards, digital scales, watches, hearing aids, thermometers, children’s toys, calculators, key fobs, flameless candles, or flashing holiday jewelry or decorations.
The Facts About Button Batteries S When a child swallows a button battery, the saliva triggers an electrical current. This causes a chemical reaction that can severely burn the esophagus in as little as two hours. S It may not be obvious at first that there is something wrong, since kids can still breathe and act normally after ingesting a button battery. Some symptoms include coughing, drooling and discomfort, or flu- and cold-like symptoms. S Repairing the damage from battery ingestion is painful and often involves multiple surgeries. Even after a battery is removed, kids can experience terrible side effects to their vocal cords and windpipe.
1 “Battery Safety Tips”, SafeKids Worldwide, www.safekids.org.
36 Your Child’s Safety
Gun Safety in a Home Environment
Guns are in more than a third of Project ChildSafe is a nationwide program U.S. homes. Chances are that even that promotes safe storage of firearms in the if you don’t own a gun at home, home. The program raises awareness you know someone who does. about firearm safety by distributing free This means gun safety is GUN gun locks and educational material to vital to improve your child’s gun owners. The Community safety at home or in Service Trooper at your local someone else’s home. SAFETY state police post can help you get a free kit that includes a cable-style gun-locking CHILDREN LESS FIRST device and a brochure that THAN THREE YEARS discusses safe handling and OLD ARE ABLE TO ZONE storage of firearms. HOLD A GUN AND For more information about this PULL THE TRIGGER. program visit www.projectchildsafe.org. If your child sees a gun or someone they know has a gun, teach them to: AS A PARENT OR GUARDIAN, Stop what they are doing; YOU CAN HELP PROTECT YOUR Don’t touch the gun; CHILD BY PRACTICING THESE Leave the area where the gun is; GUN SAFETY TIPS.
Tell a responsible adult right away. S A firearm should always be unloaded when not in use and the ammunition stored separately from the firearm. S Both the ammunition and the firearm A Message from should be locked in a safe place out the Michigan State Police of the reach of children – hidden guns may be found. www.michigan.gov/msp S Store the key(s) for the ammunition Firearm ownership carries with it a and gun in a different area from where responsibility of safeguarding the welfare of you store household keys. Keep the others and yourself when handling firearms. keys out of the reach of children. Some Accident prevention is the user’s responsibility. gun case models have digital locking and unlocking mechanisms. You may be criminally and civilly liable for any harm caused by a person less than 18 years S Lock away gun-cleaning supplies of age who lawfully gains unsupervised (these are often poisonous). access to your firearm if unlawfully stored. S Never leave the gun unattended. As such, a trigger lock, gun case or other device designed to prevent unauthorized access to a firearm is strongly recommended.
37
Your Child’s Safety Car Safety For Children
Car Seat Basics ...... page 39 Michigan Child Passenger Safety Laws ...... page 40 Never Leave a Child Alone in a Car ...... page 41
Rear-Facing Car Seat Car Seat Basics Babies and toddlers should ride in ALL CHILDREN UNDER a rear-facing car seat, installed in the back seat, until age 2 or until THE AGE OF 13 NEED TO they reach the highest weight or BE RESTRAINED IN THE 1 height limit of the car seat. BACK SEAT OF VEHICLES. Car seats should not be purchased at garage sales or second-hand Forward-Facing Car Seat stores since the history of the seat Next, children should ride in a is unknown. Never use car seats forward-facing car seat with a that have been in a crash, are harness, installed in the back seat, damaged or are missing parts, until they reach the highest weight 2 or height limit of the car seat. or have been recalled.
For more information, contact: Booster Seat National Highway Traffic Safety Next, children should use a Administration booster seat, installed in the back www.nhtsa.gov seat, until the child reaches 4'9" tall, typically at 8 - 12 years old. 1-888-327-4236 3 Booster seats must be used with 1-800-424-9153 (TTY) both a lap and shoulder belt. If you have a child with special health care needs, you can also Seat Belt contact the National Center for the A child is ready for an adult seat Safe Transportation of Children belt when the lap belt lies snugly with Special Healthcare Needs at across the upper thighs, not the 1-800-755-0912 or visit stomach. The shoulder belt should www.preventinjury.org/ 4 lie snugly across the shoulder and Special-Needs-Transportation. chest, not the neck or face.
39 Car seat graphics courtesy of Safercar.gov, a division of the National Highway Traffic Safety Administration. Your Child’s Safety
Michigan Child Passenger Safety Laws
BELOW ARE SOME COMMON CAR SEAT MISTAKES AND Michigan HOW TO AVOID THEM. Child Passenger The Harness Straps Are Not Tight Enough. Safety Laws Harness straps should fit snug to the child’s body and should pass the “pinch test” – that is, you should not be able to pinch any excess strap material. S Michigan law requires all children younger than age 4 to ride in a The Car Seat Isn’t Installed Tight Enough. car seat in the rear seat, if the Car seats, whether installed with the seat belt or LATCH vehicle has a rear seat. system, should not move more than one inch from side to side However: when tested at the point where the car seat attaches to the vehicle. — If all back seats are occupied by children under age 4, then Moving Children to the Next Step Too Soon. a child under 4 may ride in a Children should stay in their car seats until they outgrow car seat in the front seat. the height or weight limit of the seat before moving to the next step. — A child in a rear-facing seat may only ride in the front seat The Chest Clip is Too Low. if the air bag is turned off. The chest clip should be secured at the child’s armpits to ensure straps remain in the correct position. S Children must be properly buckled in a car seat or booster Putting Kids in the Front Seat Too Early. seat until they are 8 years old or Children should ride in the back seat of the vehicle until they reach 13 years old. The force of an air bag may be 4'9" tall. too intense for children under the age of 13. S All passengers under 16 years old must use a seat belt in any seating position. All front seat occupants must use a seat belt regardless of age. FOR MORE INFORMATION BE SURE YOUR CAR SEAT S Children should never ride on a IS PROPERLY INSTALLED! lap, in a portable crib, or in any other device not approved for Find an inspection station or safety event use in the vehicle. near you by visiting: www.nhtsa.gov www.safekids.org www.michigan.gov/msp then search for Child Passenger Safety.
This information was adapted from the Michigan Office of Highway Safety Planning, www.michigan.gov/ohsp. 40 Your Child’s Safety
Never Leave a Child Alone in a Car
STATE LAW IN MICHIGAN DEEMS IT ILLEGAL TO LEAVE A CHILD (UNDER THE NEVER leave an AGE OF 6) UNATTENDED IN A VEHICLE. infant or child in Children’s bodies overheat easily – three to five times a vehicle – faster than an adult’s body. Infants and children under 3 years old are at the greatest risk for heat Not for a few minutes – related illness. Child heatstroke in cars can lead to Not even if you open severe injury and death. the windows! S Call 9-1-1 if you see a child alone in a vehicle.
S A review of child heatstroke cases since 1998 by the National Highway Traffic Safety Administration (NHTSA) showed that 54% of fatalities occurred in vehicles where the child was forgotten by the parent or caregiver.
S Heatstroke can occur on cloudy days and in temperatures as low as 57 degrees. Below are some prevention tips to help keep kids safe in S Opening car windows will not prevent heatstroke. and around vehicles Signs of heatstroke include: red, hot, and moist or S Get in the habit of always opening the back dry skin; no sweating; strong, rapid pulse or a slow, door of your vehicle once you arrive at your weak pulse; nausea; confusion or strange behavior destination. This “look before you lock” behavior will help you determine if there are children still in the car. S Never leave children alone in or around cars, even for a moment. S Put an item you always carry (cell phone, laptop, Even at an outside brief case, etc.) in the backseat to help ensure temperature of 60 degrees, you will look in the back before leaving the car. your car’s inside temperature S Make arrangements with your child’s care can reach 110 degrees. center or provider that you will always call if your child will not be there on a scheduled day. Also, make sure the care center or provider A child dies when their contacts you if your child is not dropped off as body temperature scheduled. reaches 107 degrees. S Keep vehicles locked at all times, even in the garage or driveway, to help ensure children will not get in the vehicle or trunk on their own. S Keys and remote openers should not be left in reach of children.
Statistics from www.Safercar.gov, a division of the National Highway Traffic Safety Administration. 41
Your Child’s Safety Additional Safety Topics
Sports Safety ...... page 43 Internet Safety ...... page 44 Toy Safety & Recalls ...... page 45
Sports Safety FOR PARENTS, GUARDIANS AND REMEMBER TO HYDRATE COACHES, THERE ARE SIMPLE THINGS Learn the symptoms of dehydration. Always have water available and THAT CAN HELP REDUCE PREVENTABLE encourage children to drink water INJURIES. 3 before, during and after physical activity. It’s important to remember that children’s bones, muscles, tendons, and ligaments are still growing. PLAY IT SAFE AND BE INVOLVED This makes them more susceptible to injury. When Set aside time before every practice and compared to adults, kids have a lower sweating game for a proper warm-up session. capacity and produce more metabolic heat per unit Stretching before physical activity can of mass during physical activities. This puts kids at 4 help prevent sports-related injuries such an increased risk of heat illness. as sprains.
PREPARTICIPATION PHYSICAL EXAM S Make rest periods a priority for all players and Before playing any organized sports, your encourage them to communicate any pain, injury child should receive a preparticipation or illness they may have. It is recommended that 1 physical exam (PPE). This is composed young athletes have at least one to two days off of relating your child’s past medical history, family per week from any particular sport, as well as an medical history, sports-related history, and a physical “off-season” where they get ten consecutive exam given by a health care provider. weeks of rest each year from any one sport. S It is a good idea for coaches to be certified in KNOW THE SIGNS AND SYMPTOMS first aid and CPR. OF CONCUSSIONS S Parents and guardians should share contact Most concussions occur without loss information and any medical conditions or history 2 of consciousness. A player with a of asthma with the coach before the first practice. suspected concussion must be immediately sidelined until evaluated and released by a medical S Verify that an Automated External Defibrillator professional. It’s important to protect players who (AED) is on site and available for all practices have had a concussion from getting another one. and games. Learn the signs and symptoms of concussions: www.cdc.gov/headsup/parents Adapted from “Sports Safety Tips,” Safe Kids Worldwide, www.safekids.org. 43 Your Child’s Safety
Internet Safety
It’s Never Too Early to Learn the Basics of Internet Safety The internet has drastically enhanced the way kids interact with others. Children can access information from all over the world, search for in-depth knowledge and use online tools to express their creativity. Parents and guardians need to be aware of the potential risks and any laws against cyberbullying, exposure to inappropriate material, revealing too much personal information, and online predators. For more information visit www.NetSmartz.org, OnGuardOnline.gov, www.cdc.gov, and Michigan’s OK2SAY program www.michigan.gov/ok2say.
BASIC TIPS DISCUSSION STARTERS S Keep the computer in a high-traffic area of For internet beginners your home. S What are your favorite things to do online? S Make sure young children understand what their S What is personal information? Why should you personal information is and that they should not keep it private? share it online (name, phone number, home address, passwords, name of their school, photos S What would you do if anyone online asked to of themselves, private thoughts and feelings, etc.). meet you face to face? S Establish limits for which online sites children S Besides me, who do you feel that you can talk may visit and for how long. to if you are in a scary or uncomfortable situation? S Remember that internet technology can be mobile, so make sure to monitor cell phones, For older children gaming devices, and laptops. S Can I take a look at what you have been posting S Surf the internet with your children and let them online? show you what they like to do online and which websites are their favorites. S Does anyone else have access to your passwords? S Know who is connecting with your children S online and set rules for social networking, What could someone learn about you from what instant messaging, e-mailing, online gaming, and you post online? How might they use this using webcams. Periodically review the privacy information? settings on their social networking accounts. S Have you ever regretted anything you posted online? S Continually talk with your children about online Adapted from “Basic Internet Safety,” safety. National Center for Missing & Exploited Children. 44 Your Child’s Safety
Toy Safety & Recalls
IN 2017, THERE WERE OVER 250,000 KIDS TREATED IN STORE TOYS SEPARATELY FOR DIFFERENT AGE AN EMERGENCY ROOM GROUPS. FOR TOY-RELATED If you have children of different INJURIES. OF THESE, ages, store toys separately after 174,300 WERE AGE 12 play time is over. Keep different OR YOUNGER.1 bins or containers for each child’s toys and explain to older TOY-RELATED RECALLS children why their toys could be DO NOT EXPIRE, AND dangerous to their younger siblings. You may want to MONTHLY UPDATES consider one bin that has toys MAY BE FOUND ONLINE. that everyone can play with together. REQUIRE SAFETY EQUIPMENT Consider these FOR RIDING TOYS. If your child has their heart set on LOOK CLOSELY AT tips for your kids a new bike, skateboard, scooter “HAND-ME-DOWN” TOYS. and their toys: or other riding equipment, be sure Take a moment to examine all to include a helmet and other used toys for wear and for loose or LOOK FOR safety pads to help protect them sharp parts or edges. It is hard AGE-APPROPRIATE TOYS. if they fall or are in a collision. to know if older or used toys It’s worth the time to read the meet current safety standards. instructions and warning labels BE AWARE OF Check the toy with the on games and toys to help PRODUCT RECALLS. Consumer Product Safety determine if they are appropriate There are ways to check if toys or Commission for known defects. for your child. When purchasing products have been recalled or a new toy, be sure to review have consumer concerns. To view a ALWAYS USE YOUR the manufacturer’s age monthly list of child-related recalls recommendation. Look for collected from the major federal JUDGMENT BEFORE any small parts or potential agencies, visit the websites listed DECIDING ON A NEW TOY. choking hazards. below.
Product Recall Sign Up to Receive Websites Recall E-Mail Alerts Consumer Product Safety Commission, www.cpsc.gov/en/Newsroom/Subscribe www.cpsc.gov
Food and Drug Administration, www.fda.gov/ForConsumers/ www.fda.gov ConsumerUpdates
National Highway Traffic Safety www.healthychildren.org Administration, www.nhtsa.gov
www.saferproducts.gov www.safekids.org/recallnews
1 November 2018, “Toy-Related Deaths and Injuries Calendar Year 2017”, U.S. Consumer Product Safety Commission. 45
Your Child’s Safety Family Emergency Planning Emergencies can occur at any time with or without warning. Make sure your family is prepared. Every person needs to know what to do, how to communicate with each other and where to go.
Escape Routes & Family Communication Plan Family Meeting Places Because your family may not be together when an emergency occurs, it’s important to have a family Escape routes and family meeting places are communication plan. Be sure each family member important aspects of any emergency planning. In knows the steps to take to communicate with each the event of a disaster or an emergency at home, other. Each year, review your family’s meeting all family members need to know how to get out places, communication plan, and contact numbers. safely and where to go to meet up with each other. FOR MORE PREPAREDNESS INFORMATION: Escape routes should be determined for every room www.michigan.gov/michiganprepares in your home and practiced regularly. www.SMART911.com Practice what to do in case you are separated www.michigan.gov/miready during an emergency. CHOOSE TWO PLACES TO MEET: 1. Right outside your home in case of an emergency, such as a fire; ASK YOUR CHILD’S 2. Outside your neighborhood, in case you can’t return home or need to evacuate. SCHOOL OR CARE Make sure your family understands in which types PROVIDER of situations this applies and that all members know how to get to these locations. How do they communicate with families during a crisis? — TRY THIS! — Do they store adequate food, water and other basic Draw an outline of your home with supplies? each room on a separate piece of paper. Discuss with your family at Are they equipped and least two different escape routes from prepared to “shelter in place” your home. Post a copy at eye level or, if they do need to move, where do they go? in each room for quick reference.
47 Your Child’s Safety
Family Emergency Kit
A FAMILY EMERGENCY KIT CONTAINS FOOD AND SUPPLIES YOUR FAMILY MAY Basic Emergency Kit Items NEED IN THE EVENT OF DANGEROUS Store items in a sturdy, waterproof container. WEATHER OR EXTENDED PERIODS Every family member should know where the emergency kit is located and know how to use WITHOUT POWER OR UTILITIES. the items, as age appropriate. BE SURE TO CHECK YOUR KIT — TIP — REGULARLY AND RESTOCK WITH Have a full emergency kit at home, FRESH SUPPLIES TWICE A YEAR. and keep smaller kits at work or o Water (one gallon per person, per day) in your car and other places o Nonperishable food (canned fruits, you spend time. vegetables, meats, peanut butter, etc.) o Can opener (hand-crank type) o Portable radio (and/or NOAA weather radio) o Flashlights (include extra batteries) ® o Matches and lighters Learn how to shut off the utilities properly in your home. This may help prevent gas explosions, fires, o First aid kit (with fresh supplies) and unsafe water in your home during or after a o Blankets and/or sleeping bags disaster. Contact a licensed electrician and/or your utility company if you need assistance. o Hats, gloves, coats, and other clothing Consider tagging or marking shut-off valves and (be sure to update as your child grows) circuit breakers for easy identification. o Hand and feet warmers For your safety: DO NOT attempt utility shutoff without knowing the proper steps. o Personal family documents (copies of insurance cards, birth certificates, marriage license, etc.) o Cash and coins o Unique items ( 7-day supply of medications, FOR MORE eye glasses, hearing aid batteries, etc.) INFORMATION o Small tools (hammer, wrench, pliers, The following sources offer guidance and hand saw, shovel, etc.) advice on different types of emergencies, o Helmet(s) and reflective clothing their appropriate responses, and how to stay informed: o Rubber boots (or boots that go above the ankle) to help avoid foot injuries due to michigan.gov/miready broken glass and other debris fema.gov (connect with your mobile o GPS locater and/or compass and maps device at http://m.fema.gov) o Small fire extinguisher
48 Family Emergency Card Family Emergency Card
My family’s emergency meeting place My family’s emergency meeting place near home is: near home is:
My family’s emergency meeting place My family’s emergency meeting place away from our neighborhood is: away from our neighborhood is:
In case of an emergency, my family members’ In case of an emergency, my family members’ phone numbers are: phone numbers are: #1 #1 #2 #2 #3 #3 #4 #4 In case of an emergency, out-of-town family/ In case of an emergency, out-of-town family/ friends to make contact with: friends to make contact with: Name: Name: Phone #: Phone #: Name: Name: Phone #: Phone #:
Family Emergency Card Family Emergency Card
My family’s emergency meeting place My family’s emergency meeting place near home is: near home is:
My family’s emergency meeting place My family’s emergency meeting place away from our neighborhood is: away from our neighborhood is:
In case of an emergency, my family members’ In case of an emergency, my family members’ phone numbers are: phone numbers are: #1 #1 #2 #2 #3 #3 #4 #4 In case of an emergency, out-of-town family/ In case of an emergency, out-of-town family/ friends to make contact with: friends to make contact with: Name: Name: Phone #: Phone #: Name: Name: Phone #: Phone #:
Your Child’s Safety Keeping Your Child Safe Away From Home
What Constitutes Child Abuse & Neglect ...... page 51 Mandated Reporters of Child Abuse & Neglect . . . page 52 In Case of Lost or Kidnapped Child ...... page 53 Safety Tips & Child Identification Kits ...... page 54 Students & Distracted Walking ...... page 55
What Constitutes Abuse & Neglect
CHILD ABUSE OR NEGLECT COULD BE Anyone, including a child, who suspects AGAINST YOUR CHILD OR ANOTHER. child abuse or neglect can make a report WHETHER THE MALTREATMENT IS anytime day or night by calling PHYSICAL, MENTAL OR SEXUAL IN toll-free 1-855-444-3911 NATURE, THERE IS HELP AVAILABLE or 9-1-1 TO DETERMINE WHAT STEPS TO TAKE. For more information, visit www.michigan.gov/mdhhs. The Michigan Department of Health and Human Services (MDHHS) offers a wide range of services for families. This includes child protection services, shelter, food and other resources necessary to help you keep your child safe. (k) “Child neglect” means harm or threatened harm to a child’s health or welfare by a parent, legal THE CHILD PROTECTION LAW HAS guardian, or any other person responsible for the SPECIFIC DEFINITIONS OF CHILD child’s health or welfare that occurs through either ABUSE AND NEGLECT. of the following: (Public Act 238 of 1975, as amended (i) Negligent treatment, including the failure to MCL Sections 722.621 – 722.638) provide adequate food, clothing, shelter, or medical care. (g) “Child abuse” means harm or threatened harm to a child’s health or welfare that occurs through (ii) Placing a child at an unreasonable risk to the nonaccidental physical or mental injury, sexual child’s health or welfare by failure of the parent, abuse, sexual exploitation, or maltreatment, by a legal guardian, or other person responsible for the parent, a legal guardian, or any other person child’s health or welfare to intervene to eliminate responsible for the child’s health or welfare or by a that risk when that person is able to do so and teacher, teacher’s aide, or a member of the clergy. has, or should have, knowledge of the risk.
Note: This information is not a substitute for professional interpretation of the law, contacting authorities to report child abuse or neglect or seeking professional, emergency or medical advice or attention. 51 Your Child’s Safety
Mandated Reporters of Suspected Abuse or Neglect
The Michigan Child Protection Law requires The Michigan Bureau of Child and Adult certain professionals to report their suspicions Licensing serves as the contact source for of child abuse or neglect to Children’s Protective licensing information for child care facilities, Services (CPS). These people are mandated child caring institutions, children’s foster care reporters and have established relationships homes, child placing agencies, juvenile court with children based on their profession. operated facilities and children or adult foster care camps. S Physicians S Licensed emergency medical care providers For application requests and licensee inquiries, call: (517) 284-9738 or toll-free: 1-866-685-0006. S Licensed master’s social workers S School counselors Bureau of Children and Adult S Dentists Licensing Field Offices S Audiologists S Licensed bachelor’s social workers DETROIT MARQUETTE S Teachers Cadillac Place 234 West Baraga 3026 W. Grand Blvd. Marquette, MI 49855 S Physician’s assistants Suite 11-350 General: (906) 226-4171 Detroit, MI 48202 S Psychologists General: (313) 456-0380 PONTIAC S Registered social service technicians 51111 Woodward Ave. FLINT Suite 4B S Law enforcement officers 4809 Clio Rd. Pontiac, MI 48342 Flint, MI 48504 General: (248) 975-5053 S Registered dental hygienists General: (810) 787-7031 S Marriage and family therapists SAGINAW GRAND RAPIDS 411 E. Genesee S Social service technicians 350 Ottawa NW, Unit #13 P.O. Box 5070 Grand Rapids, MI 49503 Saginaw, MI 48605 S Members of the clergy General: (616) 356-0100 General: (989) 758-2717 S Medical examiners KALAMAZOO TRAVERSE CITY S Licensed professional counselors 322 East Stockbridge Ave. 701 S. Elmwood, Suite 11 Kalamazoo, MI 49001 Traverse City, MI 49684 S Persons employed in a professional capacity in General: (269) 337-5066 General: (231) 922-5309 any office of the Friend of the Court LANSING S Regulated child care providers 5303 S. Cedar St. S P.O. Box 30321 Nurses Lansing, MI 48909 S Social workers General: (517) 284-9720 S School administrators S Employees of an organization or entity that, as a result of federal funding statutes, regulations, or contracts, would be prohibited from reporting in the absence of a state mandate or court order (example: domestic violence provider) Information provided by the Michigan Department of Health and Human Services, April 2019, www.michigan.gov/mdhhs. 52 Your Child’s Safety
In Case of a Lost or Kidnapped Child
THE U.S. OFFICE OF JUVENILE JUSTICE The first 48 hours following the AND DELINQUENCY PREVENTION HAS disappearance of a child are the SEVERAL SUGGESTIONS most critical for finding and FOR PARENTS AND returning the child home safely. GUARDIANS WHO DISCOVER THEIR CHILD IS MISSING. The Michigan State Police lists several programs that assist families and law enforcement when investigating incidents of child abduction, such as helping to broadcast the incident to agencies Immediately report your across the country, working with the media for photo and flier 1. child as missing to your distribution and helping with press releases: local law enforcement agency. Ask investigators to enter your child into the National Crime S S Information Center (NCIC) THE CENTER FOR EAGLE EYE/CHILD NET Missing Persons File. MISSING & EXPLOITED PROGRAM There is no waiting period for CHILDREN A partnership between the children under age 18. 1-800-THE-LOST United States Postal Service (1-800-843-5678) and Michigan’s Missing Limit access to your www.missingkids.com Children Information 2. home until law Clearinghouse that utilizes enforcement arrives and has postal carriers to search for collected possible evidence. missing children. Postal Do not touch or remove S AMBER ALERT OF carriers are provided a missing anything from your child’s MICHIGAN child flier, and while they are on room or your home; there Stations receive the Amber their normal delivery routes, may be clues to your child’s Alert from the Michigan State they search for the child. whereabouts. Police. The State Police Write a detailed receive notice from local law S 3. description of the enforcement agencies when LOCATER clothing worn by your child and these agencies are A computerized program the personal items they had at investigating an abduction. supplied by the National Center the time of the disappearance. Only the State Police have the for Missing & Exploited Children Also, include a physical authority to issue an alert, and (NCMEC) that electronically description of your child and the State Police have a strict creates and disseminates any personal identifying guideline of criteria that must images and case information characteristics such as scars, be met in order for an Amber on a missing child. This system birthmarks, tattoos, or Alert to be activated. Once it is allows law enforcement to mannerisms. Provide a clear decided to activate an alert, the create missing children and recent photo of your child State Police also determine posters and to place the and any ID or fingerprint which regions of the state missing children images cards you may have. should be activated. on the NCMEC website.
53 Your Child’s Safety
Safety Tips & Child Identification Kits
THE MICHIGAN STATE Of the 23,500 runaways reported to The National Center for Missing & POLICE OFFERS TIPS Exploited Children in 2018, it is likely that one in seven are victims of child sex trafficking. Michigan currently has 658 missing children under the age FOR PARENTS AND of 18. Law enforcement in the state of Michigan take 75-100 new cases of GUARDIANS TO HELP missing persons each week throughout the state. — Reported by the Missing Persons Coordination Unit, May 2019. KEEP THEIR KIDS SAFE.
S Teach your children to ask S Assure your children that they S Come up with a code word your permission before going have the right to say “no” when that your children can use in anywhere or with anyone. they sense something is wrong. an emergency when they need you to contact them. They S Teach your children that if S Be sure your children know should understand this code something makes them feel their home address and how word is special and should not uneasy or uncomfortable, they to contact a parent or guardian be shared with their friends. should get away quickly and tell (cell or work phone numbers) their parents or a trusted adult in the event of an emergency. about what happened. S Be sure your children know how to dial 9-1-1 if they need help in S Teach your children that it is an emergency. Teach them to okay to be suspicious of an tell the 9-1-1 operator their adult asking for assistance. name and to not hang up until Many child predators use this instructed to do so by the 9-1-1 tactic to isolate and distract a operator or law enforcement possible child victim. officer.
The Michigan State Police offers free child identification kits! The kit includes a CD with your child’s fingerprints, photos, an audio recording of their voice, and vital description information.*
The CD can be given to law enforcement and be used with the Amber Alert system in the event your child goes missing.
If you would like information about child identification kits, check with your local law enforcement agency about safety events in your area. Each police post has a Community Service Trooper who will help you get a free ID kit for your child.
*The kit information, including fingerprints, is not maintained or saved by the Michigan State Police. Parents and guardians have full responsibility to safely store the CD and other supplied materials. 54 Your Child’s Safety
Students & Distracted Walking
TEACH YOUR KIDS TO PUT THEIR DEVICES DOWN BEFORE CROSSING STREETS. There is growing concern over the distracted walking behaviors and decide it is safe to cross, of children. Teens and preteens even while texting or wearing will often listen to music with headphones. Drive With headphones while walking to and from school. They may use their Extra Care phones to chat and text their Tips For Safe friends and to access the internet. Street Crossing S Be especially alert in While kids may be distracted for residential neighborhoods many reasons, technological S Put mobile devices down, and school zones when distractions directly impact a look up, and listen before driving. Bikers, walkers child’s capacity to hear and crossing a street. and runners may be see the changing environment wearing headphones and S around them. Take off headphones. may step into the street Teens and preteens may be more S Make eye contact with drivers unexpectedly. likely to take risks if they perceive before crossing and watch for S When driving, put cell their surroundings are safe. For approaching vehicles – don’t phones on “do not disturb” example, they might see a assume they see you. and other devices out of pedestrian signal or a traffic light sight to help avoid distractions. S Michigan law prohibits reading, typing or sending The Basics of Pedestrian Safety text messages with a TEACH KIDS EARLY 2-way communication device located in a S It’s always best to walk on S Watch out for cars that are person’s hand or lap while sidewalks or paths. turning or backing up. operating a moving motor vehicle. S If there are no sidewalks, S Children under 10 years of walk facing traffic and as age (approximately) should S If you need to respond to far away from vehicles as cross the street with an a call or alert, use hands- possible. adult – it can be hard for kids free options or stop and S Cross at street corners, to judge the speed and park the car safely. using traffic signals distance of cars. and crosswalks. S If walking in the dark, be S Do not cross in the middle extra alert; carry a flashlight of the block or between or wear reflective clothing or parked cars. shoes.
Adapted from “Teens and Distraction, An In-Depth Look at Teens’ Walking Behaviors,” August 2013 and “Pedestrian Safety Tips,” Safe Kids Worldwide, www.safekids.org. 55
Your Child’s Safety The Michigan Child Protection Law Child Protection Law Act 238 of 1975 MCL 722.621 – 722.638 AN ACT to require the reporting of child abuse and neglect by certain persons; to permit the reporting of child abuse and neglect by all persons; to provide for the protection of children who are abused or neglected; to authorize limited detainment in protective custody; to authorize medical examinations; to prescribe the powers and duties of the state department of social services to prevent child abuse and neglect; to prescribe certain powers and duties of local law enforcement agencies; to safeguard and enhance the welfare of children and preserve family life; to provide for the appointment of legal counsel; to provide for the abrogation of privileged communications; to provide civil and criminal immunity for certain persons; to provide rules of evidence in certain cases; to provide for confidentiality of records; to provide for the expungement of certain records; to prescribe penalties; and to repeal certain acts and parts of acts.
Listed below are excerpts from Michigan’s Child Protection law. Please visit the Michigan Legislature’s website, www.legislature.mi.gov for the full text of the law.
Please note: Excerpts of this law should not be used in place of legal advice or assistance from law enforcement, state departments or health professionals.
DEFINITIONS INDIVIDUAL REQUIRED TO MCL 722.622.amended (f), (g), (q) REPORT CHILD ABUSE OR *****722.622 THIS SECTION IS AMENDED NEGLECT EFFECTIVE FEBRUARY 15, 2018: MCL 722.623 3(1)-(a) See 722.622.amended***** An individual is required to report under this act The definition for “child” in this law means a person as follows: under 18 years of age. “Child abuse” means harm A physician, dentist, physician’s assistant, or threatened harm to a child’s health or welfare registered dental hygienist, medical examiner, that occurs through nonaccidental physical or mental injury, sexual abuse, sexual exploitation, or nurse, person licensed to provide emergency maltreatment, by a parent, a legal guardian, or any medical care, audiologist, psychologist, marriage other person responsible for the child’s health or and family therapist, licensed professional welfare, or by a teacher, a teacher’s aide, or a counselor, social worker, licensed master’s member of the clergy. The definition of “department” social worker, licensed bachelor’s social worker, means the department of health and human registered social service technician, social services. service technician, a person employed in a 57 Your Child’s Safety
The Michigan Child Protection Law professional capacity in any office of the friend of FAILURE TO REPORT SUSPECTED the court, school administrator, school counselor CHILD ABUSE OR NEGLECT or teacher, law enforcement officer, member of the clergy, or regulated child care provider who MCL 722.633 13(1)-(2) has reasonable cause to suspect child abuse or According to this section, a person who is required child neglect shall make an immediate report to to report an instance of suspected child abuse or centralized intake by telephone, or, if available, neglect and who fails to do so is civilly liable for through the online reporting system, of the the damages proximately caused by the failure. suspected child abuse or child neglect. Additionally, this person can be guilty of a misdemeanor punishable by imprisonment for not more than 93 days or a fine of not more than $500.00, or both. A CHILD MAY REPORT ABUSE OR NEGLECT REQUEST FOR TERMINATION MCL 722.624 (4) OF PARENTAL RIGHTS In addition to those persons required to report MCL 722.638. 18.1a(i-vi), (2) child abuse or neglect under section 3, any person, This excerpt pertains to the department submitting including a child, who has reasonable cause to a petition for authorization by the court under suspect child abuse or neglect may report the section 2(b) of chapter XIIA of 1939 PA 288, matter to the department or a law enforcement MCL 712A.2, if 1 or more of the following apply: agency. The department determines that a parent, guardian, or custodian, or a person who is 18 years of age or older and who resides for any length of time in the child’s home, has abused the child or a sibling of INVESTIGATIONS the child and the abuse included 1 or more of the MCL 722.632a (12a) following: abandonment, criminal sexual conduct, battering, torture, loss or serious impairment of an This act does not preclude or hinder a hospital, organ or limb, life threatening injury, or murder or school, or other agency from investigating reported attempted murder. Additionally, if the parent is a claims of child abuse or neglect by its employees suspected perpetrator or is suspected of placing or from taking disciplinary action based upon that the child at an unreasonable risk of harm or fails investigation against its employees. to eliminate that risk, “the department shall include a request for termination of parental rights.”
Law excerpts current at time of printing.
58 Recommended Childhood & Adolescent Immunization Schedule – NOTES EXPLANATION Page 1 Page | ter previous dose previous ter months) months) 14 series (through than routine = Less vaccinated Unvaccinated or only 1 dose before 12 months: 2 doses, 2 doses, 12 months: or only 1 dose before Unvaccinated apart8 weeks least 8 weeks dose at 12 months:1 doses before 2 or more af 1 dose procedure) before least 14 days at 1 dose (preferably 2 doses, age 12 months: or only 1 dose before Unvaccinated apart8 weeks least 1 dose at age 12 months: doses before 2 or more dose after previous 8 weeks 1 dose 2 doses, age 12 months: or only 1 dose before Unvaccinated apart8 weeks least 1 dose at age 12 months: doses before 2 or more dose after previous 8 weeks
------Anatomic or functional asplenia (including sickleAnatomic cell disease): 12–59 months Elective splenectomy: persons age 15 months or older Unvaccinated* HIV infection: 12–59 months component early Immunoglobulin deficiency, deficiency:complement 12–59 months Unvaccinated* persons age 5 years or older persons age 5 years Unvaccinated* persons age 5–18 years Unvaccinated*
Un or older) OR no doses (14 months * y y y y
Recommended Child and Adolescent Immunization Schedule, United States, 2019 States, ImmunizationUnited Schedule, Child and Adolescent Recommended | dose that was inadvertently given as inadvertently given was dose that th Centers for Disease Control and Prevention and Prevention Disease Control for Centers early as 12 months may be counted if at least 4 months have have least 4 months if at be counted early may as 12 months dose 3. elapsed since Dose 4 may be given as early as age be given Dose 4 may Prospectively: dose 3. elapsed since have least 6 months if at 12 months Retrospectively: A 4 2 doses, age 12 months: or only 1 dose before Unvaccinated apart8 weeks least 1 dose at age 12 months: doses before 2 or more dose after previous 8 weeks 3-dose apart series 4 weeks starting after 12 months 6 to history of Hib vaccination regardless transplant successful
- - - - - 5-dose 4–6 years series2, 4, 6, 15–18 months, at age Dose at 5 is not necessary administered if dose 4 was or older. 4 years 2. Table see guidance, other catch-up For 4-dose series2, 4, 6, at Hiberix, or Pentacel: ActHIB, 12–15 months 3-dose series2, 4, 12–15 months at PedvaxHIB: least 4 weeks dose 2 at Administer 7–11 months: Dose 1 at after or 8 weeks at 12–15 months and dose 3 (final dose) later is later). dose 2 (whichever at dose 2 (final dose) Administer 12–14 months: Dose 1 at after dose 1. least 8 weeks 15 months: and dose 2 before 12 months Dose 1 before after dose 2. dose 3 (final dose) 8 weeks Administer dose 3 Administer 12 months: before 2 doses of PedvaxHIB after dose 2. at least 8 weeks and at 12–59 months (final dose) 1 dose 15–59 months: at Unvaccinated 2. Table see guidance, other catch-up For treatment: or radiation Chemotherapy 12–59 months (HSCT): transplant cell stem Hematopoietic Diphtheria, tetanus, and pertussis (DTaP) and pertussis tetanus, Diphtheria, (DTaP) [4 years (minimum age: 6 weeks vaccination Haemophilus influenzae type b vaccination (minimum age: 6 weeks) for Kinrix or Quadracel]) for Doses within 14 days of starting or during administered therapy at least 3 months after should be therapy repeated therapy completion.
Routine vaccination Routine vaccination Routine vaccination Catch-up vaccination Catch-up vaccination Catch-up Special situations y y y y y y y y y y y y y ed. Itasca, ed. IL: American st Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger, United States, 2019 States, United or younger, ages 18 years Immunization Schedule for and Adolescent Child Recommended Notes Academy of Pediatrics; 2018:67–111). of Pediatrics; Academy Consult relevant ACIP statements for detailed for statements ACIP relevant Consult www.cdc.gov/vaccines/hcp/acip-recs/ at recommendations index.html. the for and precautions on contraindications information For Guidelines the General Best Practice consult use of a vaccine, www.cdc. at statements ACIP Immunization and relevant for gov/vaccines/hcp/acip-recs/index.html. = 28 days. 4 weeks intervals calculating doses, between For calendar months. Intervals by determined are of ≥4 months 12–18), a dash (–) should be read (e.g., a number range Within as “through.” the minimum before ≤4 days doses administered Vaccine vaccine Doses of any valid. age or interval considered are earlier than the minimum age or ≥5 days administered and should as valid minimum interval should not be counted dose should be repeat The as age-appropriate. be repeated minimum the recommended dose by after the invalid spaced 3-1, Recommended Table further see details, interval. For in and minimum ages intervalsdoses, vaccine between Immunization www. at Guidelines for General Best Practice cdc.gov/vaccines/hcp/acip-recs/general-recs/timing.html. and requirements vaccine on travel Information wwwnc.cdc.gov/travel/. at is available recommendations see of persons with immunodeficiencies, vaccination For of persons with primary and secondaryVaccination 8-1, Table Practice Guidelines in Best General immunodeficiencies, Immunization www.cdc.gov/vaccines/hcp/acip-recs/ at for and Immunization general-recs/immunocompetence.html, Brady (In: Kimberlinin Special Clinical Circumstances DW, Red Book: SS, eds. 2018 Report Long Jackson MA, of the MT, on Infectious DiseasesCommittee . 31 in the setting of a vaccination regarding information For or state disease outbreak, contactvaccine-preventable your local health department. (VICP) Injury Program is a Compensation Vaccine National The resolving for legal system the traditional to no-fault alternative vaccines injury child and adolescent vaccine routine All claims. polysaccharide pneumococcal for VICP except by covered are see www.hrsa.gov/ information, more (PPSV23). For vaccine vaccinecompensation/index.html.
For vaccine recommendations for persons 19 years of age and persons 19 years for recommendations vaccine For Immunization Schedule. Adult see the Recommended older, information Additional 02/22/19 y y y y y y y y y
59 Recommended Childhood & Adolescent Immunization Schedule – NOTES EXPLANATION
th Page 2 Page |
birthday least 6 months and at th . . However, a dose is still recommended after the 4 a dose is still recommended . However, birthday when a combination vaccine containing IPV containing birthday vaccine when a combination : 2-dose series initial vaccination at 14 years 9 through Age dose (minimum interval: 0, 6–12 months repeat at 5 months; soon) too if administered : 3-dose series initial vaccination or older at 15 years Age (minimum intervals: 6 months dose 1 to 0, 1–2 months, at dose / dose 1 to dose 3: 12 weeks / dose 2 to dose 2: 4 weeks soon) too dose if administered repeat 3: 5 months; th
- - after the previous dose. after the previous birthday dose. after least 6 months the previous and at HPV vaccination routinely recommended for all adolescents all adolescents for recommended routinely HPV vaccination age (can and through startage 11–12 years age 9 years) at vaccinated adequately if not previously 18 years 2- or 3-dose seriesinitial vaccination: depending on age at no HPV vaccine, series with any vaccination valid If completed additional doses needed including HIV conditions, Immunocompromising infection: 3-dose series as above History abuse or assault: Start of sexual age 9 years at after until not recommended Pregnancy: HPV vaccination pregnancy; while no intervention needed if vaccinated vaccination not needed before pregnancy testing pregnant; administer 4-dose 4–6 years; seriesages 2, 4, 6–18 months, at the final dose on or after the 4 the before doses of IPV can be administered 4 or more 4 use minimum ages and intervals In of life, the first 6 months a polio-endemic to or during an travel region only for outbreak. 18 years residents U.S. for recommended IPV is not routinely and older the series is the complete number of doses needed to Total See IPV schedule. the U.S. for recommended same as that www.cdc.gov/mmwr/volumes/66/wr/mm6601a6.htm?s_ cid=mm6601a6_w. is used Human papillomavirus vaccination vaccination Human papillomavirus (minimum age: 9 years) vaccination poliovirus Inactivated (minimum age: 6 weeks)
Routine and catch-up vaccination Routine and catch-up Routine vaccination Special situations vaccination Catch-up , either mixed OPV- , either mixed (OPV) polio vaccine oral Series containing IPV or OPV-only series: y y y y y y y y y y y Recommended Child and Adolescent Immunization Schedule, United States, 2019 States, ImmunizationUnited Schedule, Child and Adolescent Recommended | ) dose: 24 weeks ) dose: 24 weeks th or 4 rd HepB vaccine within 12 hours of birth, vaccine HepB regardless Centers for Disease Control and Prevention and Prevention Disease Control for Centers 0.5 mL of hepatitis B and 0.5 mL of hepatitis vaccine HepB Administer within sites) anatomic separate immune globulin (HBIG) (at infants 12 hours of birth, of birth For regardless weight. (total 3 additional doses of vaccine administer <2,000 grams, age 1 month. at of 4 doses) beginning If HepB age 9–12 months. at and anti-HBs HBsAg for Test after 1–2 months final dose. test series is delayed, Administer 0.5 mL of HBIG in administer <2,000 grams, infants For within 12 hours of birth. HepB vaccine addition to Administer at of 4 doses) beginning (total 3 additional doses of vaccine age 1 month. If as soon possible. status HBsAg Determine mother’s 0.5 mL of HBIG to administer mother is HBsAg-positive, than but no later as soon possible, ≥2,000 grams infants of age. 7 days of birth weight.
- - - - - Mother is HBsAg-positive: is unknown: status HBsAg Mother’s HepB 3-dose (use monovalent series0, 1–2, 6–18 months at age 6 weeks) before doses administered for vaccine a birth the Infants dose should begin who did not receive 2). Table (see series as soon feasible when a combination of 4 doses is permitted Administration HepB is used after the birth containing vaccine dose. the final (3 Minimum age for / dose 2 to Minimum dose 2: 4 weeks intervals: dose 1 to (when 4 doses dose 3: 16 weeks / dose 1 to dose 3: 8 weeks in these 3” “dose for 4” “dose substitute administered, are calculations) a 3-dose persons should complete 0, series at Unvaccinated 1–2, 6 months. 2-dose use an alternative may age 11–15 years Adolescents doses (adult between least 4 months schedule with at HB only). Recombivax formulation a 2-dose series of receive and older may 18 years Adolescents apart. least 4 weeks at HepB (Heplisav-B) the combined receive and older may 18 years Adolescents , as a 3-dose series (0, 1, and Twinrix HepA and HepB vaccine, a by followed or 4-dose6 months) series (0, 7, and 21–30 days, 12 months). dose at 2. Table see guidance, other catch-up For
Routine series vaccination Catch-up y y y y y y y y y y y y dose as soon st
birthday should be completed even if birthday even should be completed Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger, United States, 2019 States, United or younger, ages 18 years Immunization Schedule for and Adolescent Child Recommended nd in countries with high or intermediate endemic with high or intermediate in countries : 1 dose before departure; : 1 dose before age 6–11 months Infants 6–18 months, by separated with 2 doses, revaccinate of age. 23 months 12 to between and older : 1 age 12 months Unvaccinated travel considered travel Notes
- - the child turns 2 before the second dose is administered. the second the child turns 2 before 2-dose apart 6–12 months series ( Havrix or Vaqta apart,6–18 months minimum interval a series 6 months); the 2 begun before if HepA vaccine receive of age or older may 2 years Anyone Minimum intervaldesired. doses: 6 months between the combined receive and older may 18 years Adolescents , as a 3-dose series (0, 1, and Twinrix HepA and HepB vaccine, a by followed and 21–30 days, or 4-dose6 months) series (0, 7, 12 months). dose at or working with high or to in countries traveling Persons A (wwwnc.cdc.gov/travel/): endemic hepatitis intermediate disease liver Chronic factorClotting disorders with men sex Men who have Injection or non-injection use drug Homelessness laboratory or in research A virus with hepatitis Work A infection with hepatitis nonhuman primates Travel A hepatitis (e.g., adoptee personal with international contact Close, after arrival in first 60 days babysitting) household or regular A endemic hepatitis countryfrom with high or intermediate least at dose 1 as soon adoption is planned, (administer arrival) adoptee’s before 2 weeks 1 dose within 24 hours of Mother is HBsAg-negative: Infants birth ≥2,000 grams. all medically stable infants for age 1 month chronological 1 dose at administer <2,000 grams: or hospital discharge. Hepatitis A vaccination A vaccination Hepatitis B vaccination Hepatitis (minimum age: 12 months for routine vaccination) routine for (minimum age: 12 months (minimum age: birth)
Routine vaccination only) vaccine HepB Birth dose (monovalent Catch-up vaccination Catch-up travel International Special situations A infection: 2-dose hepatitis risk for series as above At 02/22/19 y y y y y y y y y y y y y
60 Recommended Childhood & Adolescent Immunization Schedule – NOTES EXPLANATION Page 3 Page |
dose at dose at rd . birthday) st are not interchangeable; the same not interchangeable; are and Trumenba Dose 1 at 8 weeks: 4-doseDose 8 weeks: 1 at series2, 4, 6, 12 months at 2-doseDose 7–23 months: 1 at seriesleast (dose 2 at after dose 1 and after 12 weeks the 1 2-dose after dose 1; seriesleast 12 weeks (dose 2 at after dose 1 in as early as 8 weeks be administered 2 may travelers)
Menveo (age 2–23 months): Menveo Menactra (age 9–23 months):
- - least 4 months afterleast 4 months dose 2. Children age less than 24 months: Children or Menactra or older: 1 dose Menveo age 2 years Children or Menactra 1 dose Menveo based on individual be administered may MenB vaccine risk age increased not at adolescents clinical decision to age 16–18 years): (preferred 16–23 years 2-dose apart seriesleast 1 month Bexsero: at 2-dose apart; seriesleast 6 months at if dose 2 is Trumenba: a 3 administer earlier than 6 months, administered 2-dose apart seriesleast 1 month Bexsero: at 3-dose series0, 1–2, 6 months at Trumenba: Meningococcal serogroup B vaccination serogroup Meningococcal [MenB-4C, (minimum age: 10 years Bexsero; Trumenba]) MenB-FHbp,
Clinical discretion Travel in countries with hyperendemic or epidemic with hyperendemic in countries Travel in the African including countries disease, meningococcal : meningitis belt or during the Hajj (wwwnc.cdc.gov/travel/) Special situations or functional asplenia (including sickleAnatomic cell deficiency, component complement disease), persistent eculizumab use: First-year college students who live in residential housing in residential who live students college First-year or older) age 16 years at vaccinated (if not previously military recruits: either before MenactraNote: should be administered dose MenACWY booster For the same time as DTaP. or at “Special situations” under listed groups for recommendations information, vaccination and additional meningococcal above www.cdc.gov/ at MMWR publications see meningococcal vaccines/hcp/acip-recs/vacc-specific/mening.html Bexsero all doses in a series. product should be used for see information, vaccination additional meningococcal For www.cdc.gov/vaccines/ at MMWR publications meningococcal hcp/acip-recs/vacc-specific/mening.html. y y y y y y y y
Recommended Child and Adolescent Immunization Schedule, United States, 2019 States, ImmunizationUnited Schedule, Child and Adolescent Recommended | birthday) st Centers for Disease Control and Prevention and Prevention Disease Control for Centers Age 9–23 months: 2 doses at least 12 weeks apart least 12 weeks 2 doses at 9–23 months: Age apart or older: 24 months least 8 weeks 2 doses at Age : Not recommended 9 – 23 months Age apart least 8 weeks or older : 2 doses at 24 months after least 4 weeks at Menactra must be administered of PCV13completion series.
Dose 1 at age 8 weeks: 4-doseDose age 8 weeks: 1 at series2, 4, 6, 12 months at 2-doseDose age 7–23 months: 1 at seriesleast (dose 2 at after dose 1 and after 12 weeks the 1 or older:Dose age 24 months 1 at 2-dose seriesleast at apart8 weeks deficiency: component complement Persistent or functional asplenia, sickledisease, Anatomic cell HIV infection:
- - - - - 2-dose 4–6 years series12–15 months, at after dose 1. as early as 4 weeks be administered Dose 2 may least 2 doses at and adolescents: children Unvaccinated apart4 weeks use of MMRV is 12 years. maximum age for The departure; 1 dose before age 6–11 months: Infants for (12 months 12–15 months with 2 doses at revaccinate later. and dose 2 as early as 4 weeks in high-risk areas) children 2-dose and older: age 12 months children Unvaccinated apart departureseries least 4 weeks at before 2-dose 16 years series: 11–12 years, age at and booster 1 dose now 13–15 years: Age (minimum interval:16–18 years 8 weeks) 1 dose 16–18 years: Age Menveo Menactra Measles, mumps, and rubella vaccination and rubella vaccination mumps, Measles, vaccination) routine for (minimum age: 12 months vaccination A,C,W,Y serogroup Meningococcal [MenACWY-CRM, (minimum age: 2 months Menactra]) [MenACWY-D, 9 months Menveo],
Routine vaccination Routine vaccination Catch-up vaccination Catch-up Special situations travel International vaccination Catch-up Special situations or functional asplenia (including sickleAnatomic cell component complement disease), HIV infection, persistent eculizumab use: deficiency, y y y y y y y y y y y
Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger, United States, 2019 States, United or younger, ages 18 years Immunization Schedule for and Adolescent Child Recommended years [RIV])years Notes Only trivalent OPV (tOPV) counts toward the U.S. vaccination vaccination OPV (tOPV)Only trivalent the U.S. toward counts as assess doses documented to guidance For requirements. see www.cdc.gov/mmwr/volumes/66/wr/mm6606a7. “OPV,” htm?s_cid=mm6606a7_w. 2. Table see guidance, other catch-up For for age and health appropriate vaccine influenza 1 dose any for least 4 weeks at by annually (2 doses separated status least at who did not receive years 6 months–8 children July 1, 2018) before vaccine 2 doses of influenza for appropriate vaccine influenza only : Any hives allergy, Egg annually age and health status angioedema, (e.g., than hives severe more allergy Egg for appropriate vaccine influenza Any respiratory distress): annually in medical setting under age and health status and who can recognize supervision provider of health care conditions allergic manage severe those with a historyLAIV should not be used for of of the vaccine component any reaction to allergic severe influenza dose of any a previous egg) or to (excluding concomitant receiving and adolescents children vaccine, aspirin or salicylate-containing age children medications, with a history 4 years of asthma or wheezing, 2 through cause any due to immunocompromised those who are and medications caused by (including immunosuppression and functional HIV infection), anatomic asplenia, cochlear fluid-oropharyngeal cerebrospinal communication, implants, immunosuppressed of severely close contacts and caregivers pregnancy, environment, a protected persons who require influenza antiviral received and persons who have 48 hours. within the previous medications (minimum age: 6 months [IIV],(minimum age: 6 months [LAIV], 2 years 18 Influenza vaccination vaccination Influenza
Routine vaccination Special situations 02/22/19 y y y y y y
61 Recommended Childhood & Adolescent Immunization Schedule – NOTES EXPLANATION Page 4 Page |
terval: 4 weeks). years for catch-up vaccination) catch-up for years : DTaP may count as part count may of catch-up : DTaP age 7–10 years Child 11–12 should be administered. dose at Tdap Routine series. as the dose of DTaP : Count age 11–18 years Adolescent booster. Tdap adolescent interval: (minimum : routine 3 months 7–12 years Ages interval: 4 weeks) interval: and older : routine 4–8 weeks 13 years Ages (minimum in use of MMRV is 12 years. maximum age for The
- - - - - Adolescents age 11–12 years: 1 age 11–12 years: dose Tdap Adolescents in preferably during each pregnancy, Tdap Pregnancy: 1 dose early part 27–36 weeks of gestational of the interval the since regardless be administered may Tdap vaccine. and diphtheria-toxoid-containing last tetanus- Tdap: not received who have age 13–18 years Adolescents every booster 10 years Td then Tdap, 1 dose with DTaP: not fully immunized age 7–18 years Persons the first as part series (preferably of the catch-up Tdap 1 dose Td. use needed, dose); if additional doses are inadvertently or Tdap who receive age 7–10 years Children Tdap the routine as part series should receive of the catch-up 11–12 years. dose at after the 7th birthday: given inadvertently DTaP 2. Table see guidance, other catch-up For in prophylaxis as tetanus Td or Tdap on use of information For see www.cdc.gov/mmwr/volumes/67/ management, wound rr/rr6702a1.htm. 2-dose 4–6 years series: 12–15 months, as earlyafter as 3 months dose 1 be administered Dose 2 may interval be counted). after may a 4-week (a dose administered of immunity without evidence persons age 7–18 years Ensure (see MMWR at www.cdc.gov/mmwr/pdf/rr/rr5604.pdf) have 2-dose series: Tetanus, diphtheria, and pertussis (Tdap) and pertussis diphtheria, (Tdap) Tetanus, vaccination vaccination, routine for (minimum age: 11 years 7 vaccination Varicella (minimum age: 12 months)
Routine vaccination Routine vaccination Routine vaccination Catch-up vaccination Catch-up vaccination Catch-up y y y y y y y y y y y y Recommended Child and Adolescent Immunization Schedule, United States, 2019 States, ImmunizationUnited Schedule, Child and Adolescent Recommended | dose of PPSV23 nd weeks after PCV13 8 weeks ered dose of PPSV23 5 years later dose of PPSV23 5 years nd
Centers for Disease Control and Prevention and Prevention Disease Control for Centers ecent PPSV23 dose and a 2 ecent weeks apart) 8 weeks dose and administered ecent V13 dose) y prior PCV13 dose) and a 2 y prior PCV13 dose) 3 PCV13 prior after doses: 1 dose PCV13 any least 8 weeks (at PC than 3 PCV13 doses: 2 doses PCV13Less after the (8 weeks most r
n incomplete series is defined as not having received received series is defined as not having n incomplete - - administered 5 years after least dose 1 of PPSV23 and at 5 years administered after a dose of PCV138 weeks and dose 2 of PPSV23 administered at least 5 years after dose least 5 years at and dose 2 of PPSV23 administered 1 of PPSV23) Any incomplete* series with: incomplete* Any No history after least 8 weeks of PPSV23: 1 dose PPSV23 (at an No history of either PCV13 or PPSV23: 1 dose PCV13, 2 doses PPSV23 (dose 1 of administ PCV13 but no PPSV23: 2 doses PPSV23 (dose 1 of Any dose of PCV13 after the most recent 8 weeks administered after dose least 5 years at and dose 2 of PPSV23 administered 1 of PPSV23) PPSV23 but no PCV13: after 1 dose PCV13 least 8 weeks at the most r No history after least 8 weeks of PPSV23: 1 dose PPSV23 (at an Rotarix: 2-dose series2 and 4 months. at 3-dose series2, 4, and 6 months. at RotaTeq: Do not start 0 days. the series on or after age 15 weeks, 0 days. the final dose is 8 months, maximum age for The 2. see Figure guidance, other catch-up For Rotavirus vaccination vaccination Rotavirus (minimum age: 6 weeks)
A series or an age-all doses in either the recommended 8, 9, and 11 in the ACIP Tables See series. catch-up appropriate (www.cdc.gov/ recommendations vaccine pneumococcal mmwr/pdf/rr/rr5911.pdf) schedule details. complete for Routine vaccination associated with treatment with immunosuppressive drugs drugs with immunosuppressive with treatment associated multiple transplantation; solid organ therapy; or radiation myeloma: 2–5 years Age vaccination Catch-up Age 6–18 years Age Chronic liver disease, alcoholism: disease, liver Chronic 6–18 years Age * or unknown, default dose in the seriesIf is either RotaTeq any 3-doseto series. y y y y y y y y y y y
Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger, United States, 2019 States, United or younger, ages 18 years Immunization Schedule for and Adolescent Child Recommended weeks apart) 8 weeks dose and administered ecent apart 8 weeks dose and administered ecent ecent dose of PPSV23 ecent V13 dose) V13 dose) y prior PCV13 dose) y prior PCV13 dose) y prior PCV13 dose) ter the most recent dose of PCV13 the most recent ter 3 PCV13 prior after doses: 1 dose PCV13 any least 8 weeks (at PC than 3 PCV13 doses: 2 doses PCV13Less after the (8 weeks most r 3 PCV13 prior after doses: 1 dose PCV13 any least 8 weeks (at PC than 3 PCV13 doses: 2 doses PCV13,Less after the 8 weeks most r Notes
- - - - 4-dose series2, 4, 6, 12–15 months at with any age 24–59 months children healthy 1 dose for PCV13 incomplete* series 2. Table see guidance, other catch-up For series with: incomplete* Any No history after least 8 weeks of PPSV23: 1 dose PPSV23 (at an No history after least 8 weeks of PPSV23: 1 dose PPSV23 (at an series with: incomplete* Any No history after least 8 weeks of PPSV23: 1 dose PPSV23 (at an No history of either PCV13 or PPSV23: 1 dose PCV13, 1 dose later least 8 weeks PPSV23 at PCV13 least 8 weeks but no PPSV23: 1 dose PPSV23 at Any af PPSV23 but no PCV13: after 1 dose PCV13 the least 8 weeks at most r Pneumococcal vaccination vaccination Pneumococcal [PCV13], [PPSV23]) (minimum age: 6 weeks 2 years
Routine vaccination with PCV13 Routine vaccination Catch-up vaccination with PCV13 vaccination Catch-up Special situations both PCV13When and PPSV23 below: High-risk conditions PCV13 PCV13 administer first. and PPSV23 indicated, are during same visit. should not be administered heartChronic disease (particularly cyanotic congenital heart lung chronic failure); disease and cardiac with high-dose, oral disease (including asthma treated mellitus: diabetes corticosteroids); 2–5 years Age 02/22/19 Age 6–18 years Age cochlear implant: fluid leak, Cerebrospinal 2–5 years Age 6–18 years Age Sickle cell disease and other hemoglobinopathies; Sickle disease and other hemoglobinopathies; cell or functional or acquired anatomic asplenia; congenital immunodeficiency; renal failure; HIV infection; chronic leukemias, neoplasms, malignant syndrome; nephrotic and other diseases Hodgkin lymphomas, disease, y y y y y y y y y y y
62 The information in this publication is available, upon request, in an alternative, accessible format. For more information regarding the Michigan Legislature, scan this QR code with your smartphone.