Whether you are a parent to a newborn or to a teenager, it is necessary to have well child visits at the recommended ages, and to educate yourself about your child’s development and important milestones. At well child visits, the pediatrician (or family doctor or nurse) will discuss a number of health topics concerning your child, in addition to conduct tests and a physical examination. These may include growth, diet and nutrition, sleep, appropriate milestones and safety—to name just a few. In the first couple years of your child’s life, there are many well child visits to ensure healthy development. A typical schedule involves visits at:
- 2-5 days or first week
- Months 1, 2, 4, 6, and 9
- 1 year
- Months 15 and 18
- 2 years
- 2-21 years (annually)
What to Expect at Each Stage
For each of the recommended stages of your child’s life, you will encounter new items for discussion, including challenges and milestones. Be prepared to engage in the health of your growing child at each well visit.
Newborn and Toddlers
For newborns and toddlers in the first few years of life, topics of discussion may include the following:
- Growth, Nutrition and Diet: You and the pediatrician will have conversations about your baby’s growth including length, weight and head circumference. You may also discuss newborn feedings including bottle vs. breast and how often to feed, as well as introduction of milk and food.
- Milestones: The doctor will ask questions to determine that your child is developing appropriately. He or she will also let you know what to expect developmentally between the current visit and the next visit so you are aware of what to look for. During these years expect to be asked about your child’s first steps, speaking, potty training (for toddlers), preschool program, and playgroups or playdates.
- Safety: You may discuss choking prevention, poison control information, car seat safety, smoke detectors, child-proofing the home when the child starts crawling, window guards, and bath and burn safety.
- Sleep: You and the pediatrician will likely discuss sleep cycles for newborns and young infants; sleep schedules and naps for young children and toddlers. Topics may also include maintaining a consistent bedtime and nighttime routine and when to wean off of bottles.
- Vaccines: The pediatrician will inform you on specific vaccines, including the schedule they will be given according to American Academy of Pediatrics guidelines, what each vaccine is for, possible side effects, what to look for after the vaccination, and when to call the doctor if there is a problem. The pediatrician may give you handouts or direct you to a website to learn about the vaccine. In case of a fever from the vaccine, your doctor will discuss medications and age appropriate dosages.
Children through Pre-teens
For children through the pre-teen years, you may expect to discuss the following:
- Growth, Nutrition and Diet: Discussions will include checking growth, height, weight, routine blood tests, blood pressure and vision readings. Your pediatrician will also discuss your child’s diet and exercise plan.
- Milestones: At this age, your pediatrician will ask about milestones include group play and socialization, self-esteem, reading, writing, physical activity, and how much television and screen time is best.
- Safety: Discussions may include helmets for bicycles and scooters, water safety in the summer, car seat and/or booster seats.
- Sleep: Your pediatrician may discuss bed times and routines before bed, ensuring adequate sleep.
- Vaccines: Continued discussions on vaccines are given at each visit and when to call the doctor due to potential side effects.
For teenagers, you may expect to discuss the following:
- Growth, Nutrition and Diet: Continued discussions on height, weight, blood pressure and vision take place during each well visit. Diet discussions may include balanced food intake and appropriate weight, ensuring enough calcium is in the diet and avoiding soda and junk foods. They may also include your teen’s level of activity and exercise. During these years, the pediatrician may also discuss increased growth during puberty and what to expect with body changes.
- Social/Development: Your pediatrician may talk about some or all of these topics including school, limited television, friends, chores, self-esteem and peer pressure issues.
- Safety: Your pediatrician will discuss avoidance of drugs, alcohol and smoking, Sexually Transmitted Diseases (STDs) and contraception, as appropriate, and assess for depression and potential suicide risks.
- Sleep: Topics for discussion with your pediatrician can include ensuring your teenager is getting enough sleep, plus appropriate television and screen time.
- Vaccines: Important discussions may include specific vaccines given to adolescents, as well as any vaccination “catch-up” as necessary.
Remember that your well child visit is your time to ask questions and to learn from the pediatrician. Always ask your questions at each visit. If you think of questions after you leave the office, call to speak with your pediatrician about the concerns that cannot wait unit the next visit. Between visits it is also a good idea to jot down your questions that can wait until the next well checkup.
Also, a lot of information is discussed while you are at your appointment so it is a good idea to take notes.
A Few Additional Thoughts
Some younger children and toddlers may be afraid of doctor visits (which is totally normal!) because they associate them with getting shots, blood draws, and physical exams. Some preparation to limit the fear of the doctor can include “playing doctor” with doctor toy kits and using books to teach young children about what will happen at the visit.
Let older children and teenagers know that they can have private time with the doctor so they can talk confidentially and ask the doctor questions without parents in the room. They can also call the pediatrician after the visit if they have questions that arise later.
Well child care visits are important for your child’s health. A pediatrician you trust for open and honest conversations can be a great partner for helping to ensure your child’s health.
Alison Mitzner, MD is a former practicing pediatrician and a Senior Director at Pfizer’s Worldwide Safety & Regulatory Operations.
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