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Well-child visits

Definition

Childhood is a time of rapid growth and change. Pediatric well-child visits are most frequent when the child’s development is most rapid.

Each visit includes a complete physical examination. This will assess the infant or young child's growth and development and help identify problems early. Height, weight, and other important information is recorded and considered. Hearing, vision, and other tests will be a part of some visits. Such preventive care is important for raising healthy children.

Information

Well-child visits are also key times for communication. Expect to be given information about normal development, nutrition, sleep, safety, infectious diseases that are "going around," and other important topics for parents.

Make the most of these visits by writing down your most important questions and concerns to bring with you.

Special attention is paid to whether the infant has met the normal developmental milestones. The height, weight and head circumference is recorded on a graph, which the health care provider keeps with the infant's chart. You also can keep your own graphs of the height, weight, and head circumference. This can be a great start for discussion. Ask your doctor about the body mass index (BMI) curve, which is the most important tool for identifying and preventing obesity.

There are several schedules for routine well-child visits. One schedule, recommended by the American Academy of Pediatrics, is given below.

PREVENTIVE HEALTH CARE SCHEDULE

A visit with a pediatrician before the baby is born is important for first-time parents, those with high-risk pregnancies, and any other parent who wishes to discuss common issues such as feeding, circumcision, and general questions.

After the baby is born, the next visit should be 2-3 days after bringing the baby home (for breast-fed babies) or when the baby is 2-4 days old (for all babies discharged from a hospital before 2 days old). For experienced parents, some practitioners will delay the visit until 1-2 weeks of age.

Thereafter, visits should occur at the following points:

• By 1 month (although experienced parents can wait until the next time, 2 months)
• 2 months
• 4 months
• 6 months
• 9 months
• 1 year
• 15 months
• 18 months
• 2 years
• 3 years
• 4 years
• 5 years
• 6 years
• 8 years
• 10 years
• Each year after that until age 21

Of course, visits and phone calls to a health care provider should be made any time a baby or child seems ill or whenever the parent is concerned about a baby's health or development.

RELATED TOPICS

Physical examination:

• Temperature measurement (see also normal body temperature)
• Auscultation
• Breath sounds
• Heart sounds
• Percussion
• Palpation
• Infantile reflexes
• Standard ophthalmic exam
• Neonatal jaundice

Immunizations:

• Immunizations - general overview
• Babies and shots
• Diphtheria immunization (vaccine)
• Pertussis immunization (vaccine)
• Tetanus immunization (vaccine)
• DPT immunization (vaccine)
• Hib immunization (vaccine)
• Polio immunization (vaccine)
• Hepatitis B immunization (vaccine)
• MMR immunization (vaccine)
• Influenza immunization (vaccine)
• Pneumococcal immunization (vaccine)
• Hepatitis A immunization (vaccine)
• Varicella (chickenpox) immunization (vaccine)
• Meningcococcal (meningitis) immunization (vaccine)
• Human papilloma virus (vaccine)

Nutrition:

• Diet and intellectual development
• Appropriate diet for age
• Infant formulas
• Breast feeding
• Balanced diet
• Fluoride in diet
• Obesity in children

Growth and development:

• Infant - newborn development
• Toddler development
• Preschooler development
• School age child development
• Adolescent development
• Developmental milestones
• Developmental milestones record - 2 months
• Developmental milestones record - 4 months
• Developmental milestones record - 6 months
• Developmental milestones record - 9 months
• Developmental milestones record - 12 months
• Developmental milestones record - 18 months
• Developmental milestones record - 2 years
• Developmental milestones record - 3 years
• Developmental milestones record - 4 years
• Developmental milestones record - 5 years

Preparing a child for an office visit is much like test and procedure preparation. See:

• Infant test/procedure preparation
• Toddler test/procedure preparation
• Preschooler test/procedure preparation
• School age test/procedure preparation

Review Date:7/26/2007
Reviewed By:Daniel Rauch, M.D., FAAP., Director, Pediatric Hospitalist Program, New York University School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network.

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