Pediatric Primary Care

Well-Child Checkups

Doctor listens to a young girls heart

National healthcare today emphasizes preventive health and health maintenance over the old model of treatment of illnesses. An integral part of this thrust is the well-child checkup program, with early monitoring of an infant and child's health, continuing up through age 21.

Doctor Visits

The American Academy of Pediatrics (AAP) https://www.healthychildren.org/English/family-life/health-management/Pages/Well-Child-Care-A-Check-Up-for-Success.aspx outlined the comprehensive health guidelines of well- child care for use by pediatricians. They listed the ages at which well-child visits are recommended. These consist of 30 visits at the following ages.

  • Two to five days old
  • One month
  • Two months
  • Four months
  • Six months
  • Nine months
  • One year
  • 15 months
  • 18 months
  • Two years
  • 30 months
  • Three years
  • Each year thereafter until age 21

AAP has produced age appropriate pre-visit questionnaires covering physical and mental health issues that parents and older children complete guiding private discussions with the physician. Checklists are provided on indicators of wellness or illness and potential health problems.

Each questionnaire gives an opportunity to bring up parenting issues while seeking the doctor's advice. The questionnaires for ages 15 and over contain handouts of health information for these age groups. Topics covered in the handouts are daily life, health behavior choices, violence and injuries, feelings, and school and friends.

Physical Examination

The examination will record basic information such as height, weight, and screening for hearing and vision. Up to age 36 months, the head circumference will be measured; good growth shows that the child is healthy. After this age, blood pressure is checked.

Questions raised by the responses to the pre-visit questionnaire are discussed and the doctor checks whether the behaviors reported are age appropriate.

A thorough examination from head to toe follows, which include eyes, ears, mouth, teeth and organs as well as muscles and joints. The child may be asked to perform some tasks or physical movements to check motor skills.

Immunizations

Completion of standard immunizations is a part of the well-child checkup. The following vaccinations are administered at age appropriate times.

  • Diphtheria; DPT
  • Hepatitis A
  • Hepatitis B
  • Hib (Haemophilus influenzae type b)
  • Human papilloma virus
  • Influenza immunization
  • Meningococcal immunization
  • MMR: measles, mumps, rubella
  • Pertussis
  • Pneumococcal
  • Polio
  • Rotavirus
  • Tetanus
  • Tdap: tetanus, diphtheria, pertussis
  • Varicella - chicken pox

Immunization and Other Health Records

Parents should keep an up-to-date immunization record. This, which will be required to register the child for school, for childcare, summer camp or for, sports teams. The doctor's office can provide a tracking card.

For children up to age 6, the Center for Disease Control (CDC) has a helpful Immunizations and Developmental Milestones for Your Child from Birth Through 6 Years Old. This form http://www.cdc.gov/vaccines/parents/downloads/milestones-tracker.pdf provides a checklist for each of the vaccines recommended at the appropriate age. It also has spaces to record weight, length, and head circumference at the recommended ages. Developmental milestones at appropriate ages are listed to be checked off for example, Begins to smile at people at age two months, or Rolls over in both directions at six months.

Other Health Topics

Other topics covered in the examination are diet appropriate for the child's age, developmental milestones at the different ages, safety, and parenting. Wellness topics such as family relationships, school experiences, and mental health issues may be covered. In discussing ways to improve care and prevent problems, parents are helped to keep children healthy.