This is a question that I often hear in my office. Many parents seem to think a checkup is just to get caught up on shots. Some parents feel like the pediatrician’s office is just for when their child is sick. These are just a few of the common misconceptions.
Well-child visits help pediatricians (and family doctors who care for children) to care for your whole child. This visit is really to focus on getting to know your child. Part of being a medical home for a child is establishing a true relationship with a family. In my experience, people tend to feel more comfortable asking questions of someone they know and trust. Seeing a familiar face in the exam room gives some comfort during those times when you are exhausted after being up all night with a crying child who has ear pain, for example.
Well visits give us a chance to see your child the way you see them every day. Checkups give us a chance to see your child at their “baseline”—not what they look like with a fever, when they’re vomiting or have an ear infection. One question I might ask upon seeing a child with a sore throat and fever is, “Are the tonsils always this big?” Sometimes parents tell me, “Yes, they said he had big tonsils at his last checkup.” This is a reassuring thing for both of us in the acute care setting. One benefit of routine well visits is that we can know and document normal physical exam findings for that child. Then, when your child is sick, we can compare to the previous exams, not just what we see in other children their age.
The American Academy of Pediatrics (AAP) recommends frequent well checks in the first few years. Your child’s regular physician can go over the specific schedule for their office, but in general, your child will be seen at least once upon hospital discharge, at 2-4 weeks of age, 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18 months, 24 months, 30 months and then once yearly till adulthood. Don’t worry, your child’s physician will remind you at each checkup when the next one is due!
At a well check, your child will have his or her height and weight measured. Depending on age, we may measure head circumference and, once he or she turns 3, blood pressure. We also will calculate BMI (body mass index), and your child might have a blood test to check hemoglobin. In the teen years, he or she might need to provide a urine specimen to screen for certain sexually transmitted diseases (STDs). Sometimes he or she may have a vision or hearing screen as well.
At every well visit, the child will be examined head to toe to check for normal findings and screen for any health concerns. This means your infant will need to be undressed down to a diaper, and your older child will be asked to remove clothing and put on a gown. It’s a good idea to prep your child for this process, because many children become very anxious about having to change into a gown, but you can make it into a fun process by saying something such as, “Let’s change into that fun shirt we only get to wear at the doctor’s office!”
Parents are encouraged to point out any physical concerns at the well visit, so we can take a close look at things like skin rashes, birthmarks or worrisome bumps or lumps.
Your child’s doctor will ask questions about what new things your child is doing. They may ask about behavior, diet and any general well-being concerns. This is your time to ask about the things you have been wondering about. It is a good idea to make a list prior to the visit so that you don’t forget anything. No question is too silly—we have probably heard it before! We will talk about how school or other activities are going and upcoming development to look for. The physician will also talk about dental health and age-appropriate safety concerns. Adolescent patients may want speak to the doctor alone to ask questions in private. Finally, we will discuss any needed immunizations or other tests recommended for your child.
One caveat to remember is this is a preventive care visit and exam. If you have specific health or behavioral concerns for your child, they need a separate appointment. Well visits aren’t the right time to discuss these things. We want to be able to focus the entire visit on health maintenance.
Having regular well-child visits with your child’s doctor and raising the concerns that matter most to you are key ingredients to helping the doctor know you and your child and in forming a reliable and trustworthy relationship. Parents and pediatricians share the goal of healthy children—let us help you meet the needs of your child and family!
Mary T. Martin, MD, is a pediatrician with Pediatric Associates-Easley.