Wellstar Children's of Georgia

× Newborn

Developmental & social milestones

• Cries to communicate discomfort or needs
• Calms when held, rocked or hearing a familiar voice
• Alerts to unexpected sounds
• Makes brief, short vowel sounds
• Focuses on faces within 8–12 inches
• Moves arms and legs
• Has strong reflexes (rooting, sucking, grasping)

Nutrition

• Breast milk is the ideal sole source of nutrition—when breast milk is unavailable, iron-fortified infant formula is recommended.
• Feed on demand, typically 8–12 times per day.
• Breastfed infants should receive a daily supplement of 400 IU of vitamin D.
• No water, juice, cow's milk or solid foods.

What to expect at wellness visits

• Visits at 3–5 days of life (within 48–72 hours of hospital discharge) and at 1 month
• Weight, length and head circumference measured and plotted on growth charts
• Newborn metabolic and hearing screening results reviewed
• Physical exam including heart, hips, eyes (red reflex) and skin
• Feeding assessment and breastfeeding support
• Hepatitis B vaccine (first dose given at birth)
• Guidance on safe sleep (back to sleep, firm surface, no loose bedding), car seat safety and recognizing signs of illness

× Infants

Developmental & social milestones

• 2 months: Social smile, makes cooing sounds, briefly calms self and follows things with eyes
• 4 months: Spontaneous smile, babbles with expression (“oooo,” “aahh”), holds head steady and reaches for toys
• 6 months: Recognizes familiar faces, takes turns making sounds, rolls over, begins to sit without support and blows “raspberries”
• 9 months: Shows stranger anxiety, makes different sounds (“mamama,” “bababa”), looks when name is called, plays peek-a-boo, sits without support and pulls to stand
• 12 months: Waves “bye-bye,” calls parent “mama” or “dada,” understands “no,” may take first steps and uses pincer grasp

Nutrition

• Give breast milk or iron-fortified formula as the primary nutrition source through 12 months.
• Introduce nutrient-dense complementary foods at 6 months, prepared to reduce choking risk.
• Prioritize iron- and zinc-rich foods, especially for breastfed infants.
• Introduce potentially allergenic foods (peanut, egg, soy, etc.) around 6 months—early introduction may reduce allergy risk.
• No honey and cow's milk as a drink until 12 months.
• Avoid foods and beverages with added sugars—no juice before 12 months.

What to expect at wellness visits

• Visits at 2, 4, 6, 9 and 12 months
• Growth monitoring (weight, length, head circumference) at every visit
• Developmental surveillance at every visit and formal developmental screening at 9 months
• Screening for maternal/postpartum depression at infant visits up to 6 months
• Immunizations: DTaP, IPV, Hib, PCV, rotavirus, hepatitis B series and influenza (flu)
• Guidance on safe sleep

× Toddler

Developmental & social milestones

• 15 months: Tries to say 1–2 words besides “mama/dada,” points to ask for things, follows simple directions with gestures, takes a few steps independently
• 18 months: Tries to say 3+ words, follows 1-step directions without gestures, scribbles, walks independently and begins to show desire for independence
• 2 years: Says at least 2-word phrases (“more milk”), points to things in a book, kicks a ball, begins parallel play, begins developing autonomy and gains awareness of others' feelings
• 30 months: Says about 50 words, uses 2-word sentences regularly and jumps with both feet3 years: Talks in short sentences, plays alongside other children, follows 2-step instructions, can name familiar things and begins to show interest in other children

Nutrition

• Transition from breast milk/formula to whole foods as the primary calorie source.
• Introduce whole cow's milk (or dairy alternative) when weaning from breast milk or formula.
• Daily targets:
  • Around two-thirds to 1 cup vegetables
  • Half a cup to 1 cup fruits
  • 1¾–3 ounces grains 
  • 1⅔–2 cups dairy and 2 ounces protein
  • No more than 4 ounces of 100% juice per day
• Avoid soda or sweetened drinks until age 2.
• After age 2, keep added sugars below 10% of daily calories.
• Offer a variety of textures and flavors—taste preferences are established in early childhood.

What to expect at wellness visits

• Visits at 12, 15, 18, 24 and 30 months
• Growth monitoring and BMI tracking starting at age 2
• Formal developmental screening at 18 and 30 months
• Autism-specific screening at 18 and 24 months
• Lead screening (risk assessment at 6 months, blood test at 12 and 24 months if at risk)
• Immunizations: MMR, varicella, hepatitis A series, DTaP (4th dose), PCV booster, Hib booster and annual influenza (flu)
• Guidance on dental health (first dental visit by age 1), weaning to a cup, car seat safety (rear-facing until age 2 or until height/weight limit is reached) and limiting screen time

× Preschool

Developmental & social milestones

• Engages in cooperative and pretend play with other children
• Tells stories and speaks in full sentences (four to five words)
• Understands the concept of counting and knows some colors and shapes
• Draws a person with two to four body parts and uses scissors
• Hops on one foot and catches a bounced ball
• Begins to understand that others have different thoughts and feelings
• Emerging self-concept, initiative and awareness of differences among people
• May develop specific fears (dark, monsters)

Nutrition

• Daily targets: 
  • 1–2 ½ cups vegetables
  • 1–2 cups fruits
  • 3–6 ounces grains
  • 2–2 ½ cups dairy
  • 2–5 ½ ounces protein
• Emphasize whole, minimally processed foods like vegetables, fruits, whole grains, lean proteins and dairy.
• Limit added sugars to less than 10% of daily calories. Limit saturated fat and sodium.
• Encourage family meals and self-regulation of appetite—let children decide how much to eat.
• Limit juice to 4–6 ounces per day—water and milk are the best beverages.

What to expect at wellness visits

• Annual visits at ages 3, 4 and 5
• Growth monitoring including BMI
• Vision screening between ages 3 and 5 (to detect amblyopia)
• Hearing screening
• Blood pressure measurement begins at age 3 (annually)
• Behavioral, social and emotional screening
• Immunizations: DTaP (5th dose), IPV (4th dose), MMR (2nd dose), varicella (2nd dose) at 4–5 years and annual influenza (flu)
• Guidance on school readiness, physical activity (at least 3 hours of active play daily for preschoolers), screen time (limit to 1 hour per day of high-quality programming) and safety (bike helmets, water, stranger awareness)

× Grade school

Developmental & social milestones

• Growing sense of self-efficacy and competence
• Understanding of rules, fairness and moral reasoning
• Developing friendships and navigating peer relationships
• Increasing independence in self-care (hygiene, homework and chores)
• Early stages of identity development
• School performance reflects cognitive, social and emotional growth
• By ages 11–12: beginning of puberty for many children, a shift toward preferring friends over family and concrete-to-abstract thinking transition

Nutrition

• Daily targets for ages 6–8: 
  • 1–2½ cups vegetables
  • 1–2 cups fruits
  • 3–6 oz grains
  • 2–2 ½ cups dairy
  •  2–5 ½ ounces protein
• Daily targets for ages 9–13: 
  • 1 ½–3 ½ cups vegetables
  • 1 ½–2 cups fruits
  • 5–9 ounces grains
  • 3 cups dairy
  • 4–6 ½ ounces protein
• At least half of grains should be whole grains.
• Encourage nutrient-dense foods and limit ultraprocessed foods, sugary drinks and excess sodium.
• Calcium and vitamin D are especially important during the growth spurt years.
• Promote healthy eating habits and family meals—involve children in meal planning and preparation.

What to expect at wellness visits

• Annual visits
• Growth monitoring including BMI, screening for obesity (BMI ≥95th percentile)
• Blood pressure screening annually
• Vision and hearing screening approximately every 1–2 years
• Cholesterol screening once between ages 9 and 11
• Behavioral, social and emotional screening—anxiety screening begins at age 8
• Depression and suicide risk screening begins at age 11
• Immunizations: 
  • Annual influenza (flu)
  • Catch-up vaccines as needed
  • Ages 9-10: HPV vaccine (2-dose series)
  • Ages 11–12: Tdap and meningococcal conjugate vaccine (MenACWY, 1st dose)
• Guidance on physical activity (at least 60 minutes daily), screen time management, sleep (9–12 hours for ages 6–12), bullying prevention, internet safety, puberty education
• and injury prevention (seatbelts, helmets, and water safety)

× Teen

Developmental & social milestones

• Abstract and moral thinking develops
• Identity formation accelerates (personal, occupational, sexual)
• Peer relationships become central—desire for independence increases
• Risk-taking and experimentation may occur (substance use, driving)
• Developing capacity for intimate relationships
• Increasing responsibility and decision-making skillsEmotional intensity—mood fluctuations are common but persistent changes warrant attention

Nutrition

• Daily targets for ages 14–18: 
• 2½–4 cups vegetables
• 1½–2½ cups fruits
• 6–10 ounces grains
• 3 cups dairy
• 5–7 ounces protein
• Caloric needs increase significantly, especially during growth spurts and for active teens.
• Iron needs increase, particularly for menstruating teens.
• Calcium (1,300 milligrams/day) and vitamin D are critical for bone development.
• Discourage skipping meals, fad diets and excessive caffeine or energy drink consumption.
• Discuss healthy body image and recognize warning signs of disordered eating.

What to expect at wellness visits

• Annual visits with confidential time alone with the clinician
• Growth monitoring including BMI
• Blood pressure, vision and hearing screening
• Depression screening annually starting at age 11
• Suicide risk screening annually
• Psychosocial assessment using frameworks like SSHADESS (Strengths, School, Home, Activities, Drugs, Emotions/Eating, Sexuality, Safety) or HEADSS (home, education, activities/employment, drugs, suicidality and sex)
• Screening for substance use (vaping, tobacco, alcohol and drugs)
• STI screening for teens (chlamydia and gonorrhea annually, HIV screening at least once starting at age 15)
• Immunizations: MenACWY booster at age 16, MenB vaccine (shared clinical decision-making, ages 16–23), annual influenza (flu), catch-up HPV if not completed
• Guidance on safe driving, healthy relationships, contraception, consent, mental health, sleep (8–10 hours), physical activity (60 minutes daily) and responsible use of social media and technology

× Young adult

Developmental & social milestones

• Applied abstract thinking and mature decision-making
• Establishing intimate, stable relationships (emotional and sexual)
• Taking on adult roles and responsibilities (education, career, finances, independent living)
• Developing a personal identity separate from parents
• Forming a personal values system and ethical standards
• Strong sense of individuality

Nutrition

• Daily targets for adults: 
• 2–4 cups vegetables
• 1½–2½ cups fruits
• 5–10 ounces grains
• 3 cups dairy
• 5–7 ounces protein
• Macronutrient distribution should aim for10–35% protein, 20–35% fat, 45–65% carbohydrates.
  Limit added sugars to less than 10% of calories and saturated fat to less than 10% of calories.
  Maintain adequate calcium, iron, and folate intake (especially important for those who may become pregnant).
  If consuming alcohol, do so in moderation (less than one drink per day for women and two drinks per day for men).
  Prioritize whole, minimally processed foods and limit ultraprocessed foods.

What to expect at wellness visits

• Annual or periodic preventive visits
• Blood pressure, BMI and general physical exam
• Depression screening
• Screening for alcohol and tobacco use—counseling on substance use
• STI screening: chlamydia and gonorrhea annually, HIV screening, hepatitis C screening (at least once for adults 18+)
• Cholesterol screening once between ages 17 and 21
• Immunizations: annual influenza (flu), catch-up vaccines as needed (HPV through age 26, Tdap if not previously received, MenB if not completed)
• Guidance on mental health and stress management, healthy relationships, reproductive health planning, physical activity (150 minutes of moderate-intensity exercise per week), sleep (7+ hours), financial wellness and transitioning to independent healthcare management