From the Guidelines
At the 2-month well-child visit, parents should be counseled on feeding, sleep, and physical activity, with an emphasis on sustained breastfeeding, avoiding bottle propping, and introducing tummy time for 30 minutes spread throughout the day.
Key Counseling Points
- Feeding:
- Exclusive breastfeeding or formula feeding (approximately 3-4 ounces every 3-4 hours) 1
- No solid foods yet recommended
- Sleep:
- 14-17 hours of quality sleep, including naps 1
- Sleep safety, including sleeping on their backs on a firm surface without pillows, blankets, or toys to reduce SIDS risk
- Physical activity:
- Variety of interactive activities/movement and floor-based play (more is better) 1
- Tummy time for 30 minutes spread throughout the day to strengthen neck muscles and prevent flat spots on the head
Additional Recommendations
- Parents should be advised about normal stooling patterns, which vary widely from multiple daily stools to one every few days
- Safety counseling should include proper car seat use, avoiding falls, and never shaking a baby
- Parents should also be screened for postpartum depression and offered support resources as needed These recommendations help ensure proper infant development and strengthen the parent-child relationship during this critical period, with a focus on reducing the risk of morbidity, mortality, and improving quality of life 1.
From the Research
Counseling at 2-Month Well-Child Visit
- At a 2-month well-child visit, counseling is recommended to include information about birth history, prior screenings, diet, sleep, dental care, and medical, surgical, family, and social histories 2.
- Screening for postpartum depression in mothers of infants up to six months of age is also recommended 2.
- Developmental surveillance should be performed at each visit, with formal developmental screening at nine, 18, and 30 months and autism-specific screening at 18 and 24 months, as recommended by the American Academy of Pediatrics 2.
- Anticipatory guidance is an important function of well-child visits and can be provided verbally or through handouts, with the use of well visit forms or other prompts associated with better provision of anticipatory guidance 3, 4.
- A study using human-centered design found that a personalized "Brain Building Guide" can be an effective tool for providing guidance on early cognitive and language development during well-child visits 5.
- The American Academy of Pediatrics recommends that screen time be avoided, with the exception of video chatting, in children younger than 18 months and limited to one hour per day for children two to five years of age 2.
- Counseling on car seats, fluoride use, and dental health is also recommended, with car seats remaining rear facing until two years of age or until the height or weight limit for the seat is reached 2.