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Children's Medical Services - Special services for children with special needs
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Infant Toddler Development Training
Module 6, Lesson 2


Immunizations provide infants and toddlers with immunity against disease. It is important to understand the specified times when immunizations are most beneficial. Please refer to the Facts and Myths about Immunizations The CDC publishes the schedule each January.

The following is a general guideline of when immunizations are due. The schedule may vary based on location. The primary medical provider will determine when any vaccination is contraindicated for specific conditions.

The ITDS, in concert with the service coordinator, can check on the status of immunizations at the specified times. When should the first set of immunizations be given? What medical conditions require modifications to the schedule of immunizations?

Dental Care

Dental health care begins before the first tooth erupts usually between 4 - 7 months, but this varies and can be as late as 10 - 11 months. Usually the bottom front teeth are the first to emerge. It is recommended that parents can assist dental care early by washing the gums and tongue with a soft damp cloth or gauze after bottle-feeding. This reduces the bacteria left in the mouth. As the teeth erupt, the teeth should also be cleansed with the cloth.

baby brushing teethIf there are problems with cavities or the gums, the first visit to the pediatric dentist is usually scheduled around the first year birthday and every six months thereafter, or as prescribed by the dentist. If the teeth and gums are healthy, with good healthy feeding and brushing practices, the first dental visit can be as late as three years old.

An important consideration for dental care is not putting a baby to sleep with a bottle in the mouth. The sugar in the formula will increase bacteria and will wear away the teeth's enamel. The primary or baby teeth are very prone to the acid created by these sugars. If a baby is left with a bottle there is also danger of aspiration and formula entering the Eustachian tubes and causing ear infections. Thus it is best to feed the baby first and then put the baby to bed.

A consideration during the first year of life is that infants often show discomfort when cutting their teeth. There are tips that the ITDS can share with families on reducing teething discomfort. Please refer to the article on Teething Tots. This will provide helpful information (e.g., cool washcloths and teething rings) that you can provide to parents.

If a tooth is lost prematurely, (e.g. a fall at age 2), the tooth should be wrapped in a clean wet cloth and the pediatric dentist and primary medical provider should be called immediately.


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