A nurse is reinforcing education about nutrition for a patient who has HIV and has a newborn. Which of the following statements should the nurse provide in the teaching?

A. Allergic rhinitis. Allergic rhinitis is the most common allergic reaction in children, often triggered by environmental allergens such as pollen, dust mites, and pet dander. It presents with symptoms like sneezing, nasal congestion, runny nose, and itchy eyes, affecting a large number of children worldwide.

B. Systemic reaction. Systemic allergic reactions, which affect multiple organ systems, are less common than localized reactions such as allergic rhinitis. They are more severe but do not occur as frequently in children as mild to moderate allergic responses.

C. Hives. Hives (urticaria) are a common allergic skin reaction, often triggered by food, medications, or insect stings. However, while common, they occur less frequently than allergic rhinitis, which is a more persistent condition.

D. Anaphylaxis. Anaphylaxis is a severe and life-threatening allergic reaction, but it is relatively rare compared to allergic rhinitis. It requires immediate medical intervention and is most commonly triggered by food allergies, insect stings, or medications.

Language Delay: "No attempt to communicate verbally. Makes repetitive noises that change pitch but do not seem to be associated with trying to communicate." By 12–13 months, toddlers typically say 1–2 words, attempt to mimic sounds, and use gestures (e.g., pointing, waving) to communicate. The lack of verbal communication and repetitive vocalizations without meaning raise concerns about delayed expressive language development, which is an early sign of ASD or speech delay

Lack of Social Reciprocity: "Parent picks up toddler and gives them a hug and a kiss on the cheek. Toddler does not respond or cuddle them back." By this age, toddlers typically enjoy physical affection, seek comfort, and show attachment to caregivers. A lack of reciprocal affection or engagement may indicate social communication deficits, which are hallmark features of ASD.

Nutrition: Likes fruit like blueberries and peaches, but spits out vegetables." Food preferences at this age are common, and rejecting vegetables alone is not necessarily concerning. However, extreme food selectivity (avoiding entire food groups, refusing textures) can be a sign of sensory processing issues, which are more common in ASD.

Fine Motor: "Drinks from a cup when parent holds it but does not pick up the cup or try to hold it." By 12–13 months, toddlers typically attempt to hold and drink from a cup independently.Delayed self-feeding skills may indicate fine motor delays or lack of interest in independent eating, which can be seen in neurodevelopmental disorders like ASD.

Lack of Joint Attention: "Does not respond when asked to point to a body part or show the nurse the toy they are playing with." At 12–13 months, toddlers should be able to follow simple commands and engage in joint attention (e.g., pointing to objects, responding to names). Failure to follow basic commands or lack of engagement with others is a red flag for delayed receptive language development or social communication deficits.Lack of joint attention is one of the earliest indicators of ASD and warrants immediate follow-up.

"Uses one finger to repetitively spin a wheel on a toy truck". This behavior is another important red flag for autism spectrum disorder (ASD) and requires immediate follow-up. This child’s repetitive spinning of a wheel using one finger suggests fixated, repetitive behaviors, which are hallmark features of ASD.