Red Flags Bermuda
EARLY INTERVENTION
BIRTH TO AGE SIX

Nutrition & Oral Health
Nutrition
Problem
Signs
... if an infant/child experiences any of the following signs, it should be considered a red flag:
0-6 months
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Typical weight gain guidelines not met:
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0-3 months, 4-8 oz (140-227g)/week
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3-6 months, 3-5 oz (85-142g)/week
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Birth weight is expected to be regained by 10 days of age
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Crosses 2 percentile ranks on the growth chart
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Sudden and rapid weight loss or gain
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Diet includes anything other than breastmilk or iron fortified infant formula
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Breastmilk or formula is not being fed on demand
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Using softened, distilled or unsterilized water to make formula
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Infant formula is not stored or prepared correctly
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Formula fed baby is not held during feeding to ensure safety and promote bonding
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Pablum is offered in a bottle
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Honey is given under one year
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Sudden decrease in wet and soiled diapers
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Consistent green watery stool
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Hard pellet like stool
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Urine has a fishy smell
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Urine or stool has blood in it
6-9 Months
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Birth weight not doubled by six months
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Crosses 2 percentile ranks on the growth chart
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Typical weight gain guidelines not met - 1.5 – 3 oz (42-85 g)/week
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Complementary foods have not been introduced
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Drinking cow’s milk
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Drinking fruit juice/drinks or soft drinks
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Pablum is offered in a bottle
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Highly allergenic foods are offered (egg white, nuts, sesame, peanuts, shellfish)
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Honey is given under one year
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Formula fed baby is not held during feeding to ensure infant and mother/caregiver bonding
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Sudden decrease in wet and soiled diapers
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Consistent green watery stool
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Hard pellet like stool
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Urine has a fishy smell
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Urine or stool has blood in it
9-12 Months
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Crosses 2 percentile ranks on the growth chart
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Birth weight not tripled by 1 year old
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Typical weight gain guidelines not met - 1.5-3 oz (42-85 g)/week
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Baby is drinking lower fat milk (skim, 1%, 2%), unpasteurized milk, goat’s milk or soy/rice milks
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Drinking more than 4 oz (½ cup) of diluted fruit juice per day
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Consuming fruit drinks or soft drinks
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Honey is given under one year
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Formula fed baby is not held during feeding to ensure safety and promote bonding
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Still eating only pureed food
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Eating highly allergic foods (egg white, nuts, sesame, peanut, shellfish)
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Sudden decrease in wet and soiled diapers
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Consistent green watery stool
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Hard pellet like stool
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Urine has a fishy smell
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Urine or stool has blood in it
12-24 Months
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Crosses 2 percentile ranks on the growth chart
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Birth weight not tripled by 12 months
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Not eating a variety of foods
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Refuses mashed or chopped foods
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Still eating pureed food
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Drinking lower fat milk (skim, 1%, 2%), unpasteurized milk, goat’s milk or soy/rice drinks
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Drinking more than 4-6 oz (½-¾ cup) per day of diluted fruit juice
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Consuming fruit drinks or soft drinks
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Drinking less than 12 oz (1 ½ cups) or more than 20 oz (2 ½ cups) milk/day
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Not self-feeding
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Consuming nuts, peanuts, shellfish or sesame
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Not consuming snacks between meals
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Not supervised while eating
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Food allergy symptoms or reactions (e.g., diarrhea, vomiting, hives, swelling of tissues, anaphylaxis, etc.)
Toddlers 2-3 Years
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Crosses 2 percentile ranks on the growth chart
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Not eating a variety of foods.
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Drinking more than 6 oz (¾ cup) of juice per day
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Consuming fruit drinks or soft drinks
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Drinking less than 12 oz (1 ½ cups) or more than 20 oz (2 ½ cups) milk/day
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Still drinking from a bottle
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Parents/guardians restrict intake or demand increased food consumption
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Food is used as a reward or punishment
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Not self-feeding
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Food allergy symptoms or reactions (e.g., diarrhea, vomiting, hives, swelling of tissues, anaphylaxis, etc.)
Preschooler 3-6 Years
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Not eating a variety of foods
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Drinking less than 16 oz (2 cups) or more than 24 oz (3 cups) of milk per day
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Drinking more than 6 oz (¾ cup) of juice per day
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Consuming fruit drinks or soft drinks
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Still being spoon-fed
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Still drinking from a bottle
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Does not eat at regular times throughout the day (breakfast, lunch, and supper and 2-3 between meal snacks)
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Parents/guardians restrict intake or demand increased food consumption
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Family is experiencing problems around feeding – mealtimes are unpleasant
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Food is used as a reward or punishment