Well child visits important for children of all ages

“Not only is a well child exam more comprehensive, it’s often paid for by insurance."

A regular check-up for a child under the age of 18 is often referred to as a “well child visit.” These visits help ensure that infants, children and teens are getting the proper care they need to stay healthy. They give the doctor, parents and child an opportunity to talk about nutrition, safety, immunizations and many important age-appropriate topics.

Here, Sanford Health physicians Krista Hoyme and Laura Whittington offer advice on scheduling well child visits and what to expect.

What takes place at a well child visit for kids ages 0-3?

During the first months and years of life, growth and development are happening rapidly. Parents typically have a lot of questions during this time frame, and we are here to help. Regular checkups allow us to stay in contact with patients and families regarding these issues and any other concerns they may have.

There is a set schedule for parents to follow for well child visits in this age range. We ask to see a newborn a few days after delivery. Then you should come in again five times before his or her first birthday. This happens at months 2, 4, 6, 9 and 12. Then we like to see kids when they are 15, 18, 24 and 30 months of age. After that, the visits can occur on an annual basis.

When you arrive, the registrar will ask you to fill out some forms. These give us an idea of where your child is at in this stage of his or her development.

Then a nurse will take your child’s vital signs and measurements. After that, your doctor or pediatrician will do a physical exam of your child to look for anything out of the ordinary.

During these young well child checks, we monitor growth and development, eating habits, the transition from breast milk/formula into solid foods, sleep patterns, bowel habits, behavioral concerns and vaccination updates. We also spend time discussing the importance of things like dental checkups and precautionary measures such as safety around the home and in the community.

Ask any questions you might have; feel free to write them down beforehand, too, to be sure we cover everything that’s on your mind.

What do annual well child visits for kids older than age 3 involve?

As your child grows, his or her body is going through a lot. It is important for us to monitor these changes closely so we can know if the development is happening at a normal rate. If your child seems to be falling behind in certain areas, the earlier we know, the earlier we can help get him or her back on track.

From an educational standpoint, we make sure children have hit all of their milestones for preschool and kindergarten. This ensures that they’re on track to properly progress and have positive experiences that will set them up for better success later on in life.

Because behavioral issues can become a problem during and after the toddler phase, we like to stay in touch with parents to address or diminish any of those concerns, especially with school approaching.

Safety issues such as bike safety, water and car safety and stranger danger are also discussed. We also make sure vaccinations are up to date.
Plus, as your child is going through all of these changes, you’re experiencing parenting changes as well. Having an opportunity to talk to the doctor about concerns you have as your child grows can help put your mind at ease.

What does a well child visit do for a tween or teen?

Growth patterns tend to change as children enter the pre-pubescent/adolescent stage of life. Kids begin to experience changes in hormones, develop acne, and the girls start their menstrual cycles. Well child checks continue to be beneficial in providing education to middle schoolers and high schoolers — as well as their parents — on these changes and any challenges that may be present.

For parents or students with concerns about grades or classwork, these checks also provide an opportunity to intervene early on from an intellectual and educational standpoint and further address any potential behavioral or academic issues.

We will discuss any hearing or vision concerns and remind kids about healthy sleep patterns, eating habits and food choices.

We’ve also started screening preteens and teenagers for cholesterol and high blood pressure to test for high risks of cardiovascular disease.

What types of immunizations does my older child need?

Immunizations are one of the best, most effective ways to keep you and your family healthy and protected from dangerous illnesses. Here is a list recommended for older children. They may not all appear on the list of required vaccinations for your child’s school, because schools focus on vaccine-preventable diseases that are easily transmitted while school is in session. However, they’re still important for a child’s lifelong health, particularly the cancer-prevention vaccine HPV.

Hepatitis B: In recent years, this vaccine has been given to infants, but many teens may not have been vaccinated. Hepatitis B is still widespread and is acquired through contact with body fluids and blood. Ask your doctor if this three-shot series is necessary.

Chickenpox booster shots: To help further decrease chicken pox infections, it is recommended that children get a second dose of the chickenpox vaccine. This booster dose is now routinely given when kids are 4 to 6 years old. Older kids, including teenagers, can get a chickenpox booster shot if they have never had chickenpox.

Tdap: Tdap versions combine vaccines against tetanus and diphtheria with a booster dose of an acellular pertussis vaccine. Pertussis is the bacteria that causes whooping cough. A dose of Tdap is needed at age 11 or 12, followed by a booster of Td every 10 years.

Measles/mumps/rubella: To ensure protection, a child needs two doses of the MMR vaccine. The first is administered around age 1 and the second at age 4 or 5. If your teen has not had the second shot, it is important to get it now.

Flu: It is especially important for teenagers with chronic conditions to receive the flu vaccine. Since influenza spreads rapidly in a school setting, healthy teens are also encouraged to receive this seasonal vaccine.

Meningitis vaccine: MCV4 protects children from several strains of meningococcal bacteria, which can cause meningitis. This vaccine should be given at ages 11-12. Children between the ages of 2 and 10 who have certain chronic illnesses also need this vaccine, with a booster shot a few years later, depending on the age at which the first dose was given.

HPV: This vaccine prevents cancer. The human papillomavirus (HPV) vaccine has been approved by the FDA to prevent diseases including oropharyngeal cancer in males between the ages of 9 and 21 and cervical cancer in females between the ages of 9 and 26. Given in a series of three shots over six months, HPV is recommended for both girls and boys.

Is a back-to-school exam different?

Back-to-school exams can benefit all children who are headed back to the classroom. This is essentially the same as a well child visit but can be completed in the summertime to address any upcoming concerns regarding the new school year.

How is a well child visit different from an athletic physical?

In the sports medicine field, the sports physical exam is known as a preparticipation physical examination (PPE). The exam helps determine whether it’s safe for a child to participate in a particular sport. Most states require that kids and teens have a sports physical before they can start a new sport or begin a new competitive season.

The sports physical focuses on your well-being as it relates to playing a sport. It’s more limited than a regular physical.

A well child exam is much more comprehensive and includes reviewing immunization records, past history and family history. The provider also discusses behaviors, school issues and proper nutrition with the child.

“Many parents don’t know that a well child exam will qualify as a sports physical,” said Dr. Michelle Johnson, a family medicine physician for Sanford Health. “Just bring the required paperwork from your school, and we will complete it for you.”

In addition, wellness exams will be filed with insurance. Check with your insurance company; many pay 100% for a wellness exam.

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Posted In Back to School, Children's, Health Information, Healthy Living, Sports Medicine

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