A nurse is preparing to administer the first measles, mumps, and rubella (MMR) immunization to 15-month-old toddler. Which of the following findings is a contraindication for this immunization?

A.Toddlers experience slowed growth compared to infancy, leading to a natural decrease in appetite (physiologic anorexia). Instead of increasing caloric intake, parents should be encouraged to offer nutrient-dense foods in small, frequent meals and avoid pressuring the child to eat.

B.Tantrums are common in toddlers as they begin to assert independence but struggle with emotional regulation. Parents should use strategies such as remaining calm, setting clear limits, offering choices when appropriate, and using positive reinforcement to help manage tantrums effectively.

C.Establishing trust is a key developmental task of infancy (Erikson’s trust vs. mistrust stage). In toddlerhood (autonomy vs. shame and doubt stage), the focus is on developing independence, so guidance should focus on setting boundaries, providing choices, and allowing safe exploration rather than trust-building alone.

D.Cooperative play is typically aimed at older preschoolers and not toddlers, who are still developing social skills and tend to engage in parallel play rather than cooperative play.

E.Early dental hygiene is crucial for preventing cavities and establishing good oral health habits. Parents should begin brushing their toddler's teeth with a soft toothbrush and a small amount of fluoride toothpaste and schedule the first dental visit by 12 months of age or within 6 months of the first tooth eruption.

These foods are rich sources of iron, which is important for treating and preventing iron deficiency anemia. Meats, such as beef, poultry, and fish, provide heme iron, which is more easily absorbed by the body. Eggs and green vegetables, such as spinach and broccoli, contain non-heme iron, which is also beneficial.

While fruits, whole grains, and rice are nutritious foods, they are not as rich in iron as meats and green vegetables. Therefore, they may not provide sufficient iron to address the child's iron deficiency anemia.

Drinking 32 oz of whole cow's milk per day is not recommended for a 2-year-old with iron deficiency anemia. Excessive cow's milk intake can lead to iron deficiency anemia because it can interfere with iron absorption and displace iron-rich foods from the diet. Similarly, consuming 8 oz of juice, three times a day is not recommended for a child with iron deficiency anemia. Juice does not provide significant amounts of iron and can contribute to decreased appetite for iron-rich foods. It is generally recommended to limit juice intake and prioritize whole foods for iron intake.