From the Guidelines
Anticipatory guidance materials should be printed and provided to the mother during the visit, containing age-appropriate information about child development, safety measures, nutrition guidelines, and common health concerns, as recommended by the American Academy of Pediatrics 1. The materials typically include milestones to expect in the coming months, recommended safety precautions such as childproofing the home, nutritional advice including feeding schedules and appropriate foods, and guidance on sleep patterns and behavior management.
- Key areas to cover in anticipatory guidance include:
- Breastfeeding support and benefits, as breastfeeding is associated with a reduced risk of SIDS 1
- Safe sleep practices, such as back to sleep for every sleep and room-sharing with the infant on a separate sleep surface 1
- Infant safety, such as use of an appropriate car safety seat and supine positioning for sleeping 1
- Signs of illness and common infant problems, particularly jaundice 1 Providing written materials supplements verbal counseling and allows the mother to reference the information later when questions arise. This practice is considered standard of care in pediatric visits as it empowers parents with knowledge, potentially reducing anxiety and improving child health outcomes by promoting preventive care and early intervention when concerns arise. The most recent and highest quality study on this topic is from 2017, which emphasizes the importance of breastfeeding-friendly pediatric office practices, including providing anticipatory guidance that supports the continuation of breastfeeding as long as desired 1.
From the Research
Anticipatory Guidance Provided to Mothers
- Anticipatory guidance is a crucial aspect of pediatric practice, and research shows that parents expect and value the information and advice they receive from their pediatric health care providers 2.
- A study found that provision of anticipatory guidance to parents during well-child visits is a defining component of pediatric primary care, and it was directly associated with decreased maternal stress and directly and indirectly associated with effective parenting practices in child development, discipline, and safety 3.
- Another study showed that anticipatory guidance initiated during pregnancy was successful in reducing the incidence of severe early childhood caries (S-ECC) in young children, with the incidence of S-ECC in the test group being 1.7% and in the control group being 9.6% (P < 0.001) 4.
Content and Delivery of Anticipatory Guidance
- The content of anticipatory guidance may include information on oral health changes during pregnancy, proper nutrition, the importance of primary teeth, the use of pacifiers, and sleeping patterns of the child 4.
- Anticipatory guidance can be provided through various means, including printed information, telephone consultations, and face-to-face discussions with pediatric health care providers 4, 2, 5.
- A study found that parents who received anticipatory guidance were more likely to report excellent care, and those who could use more information on a larger number of topics were more willing to pay for additional care 6.
Parental Needs and Preferences
- Parents have varying needs and preferences for anticipatory guidance, with some reporting unmet needs for guidance on topics such as discipline and development 2.
- Disadvantaged parents may report fewer unmet needs for anticipatory guidance, but may still benefit from targeted interventions 2.
- Parents may prefer to receive anticipatory guidance through different sources, including pediatric health care providers, printed materials, and online resources 2, 6.