Childhood is a time of rapid growth and change. Children have more well-child visits when they are younger. This is because development is faster during these years.
Each visit includes a complete physical exam. At this exam, the health care provider will check the child's growth and development in order to find or prevent problems.
The provider will record your child's height, weight, and other important information. Hearing, vision, and other screening tests will be part of some visits.
Even if your child is healthy, well-child visits are a good time to focus on your child's wellness. Talking about ways to improve care and prevent problems helps keep your child healthy.
At your well-child visits, you will get information on topics such as:
- Childhood diseases
- What to expect as your child grows
Write down your questions and concerns and bring them with you. This will help you get the most out of the visit.
Your provider will pay special attention to how your child is growing compared to normal developmental milestones. The child's height, weight, and head circumference are recorded on a growth chart. This chart remains part of the child's medical record. Talking about your child's growth is a good place to begin a discussion about your child's general health. Ask your provider about the body mass index (BMI) curve, which is the most important tool for identifying and preventing obesity.
Your provider will also talk about other wellness topics such as family relationship issues, school, and access to community services.
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 provider before the baby is born can be particularly important for:
- First-time parents.
- Parents with a high-risk pregnancy.
- Any parent who has questions about issues such as feeding, circumcision, and general child health issues.
After the baby is born, the next visit should be 2 to 3 days after bringing the baby home (for breastfed babies) or when the baby is 2 to 4 days old (for all babies who are released from a hospital before they are 2 days old). Some providers will delay the visit until the baby is 1 to 2 weeks old for parents who have had babies before.
After that, it is recommended that visits occur at the following ages (your provider may have you add or skip visits depending on your child's health or your parenting experience):
- By 1 month
- 2 months
- 4 months
- 6 months
- 9 months
- 12 months
- 15 months
- 18 months
- 2 years
- 2 1/2 years
- 3 years
- Each year after that until age 21
Also, you should call or visit a provider any time your baby or child seems ill or whenever you are worried about your baby's health or development.
Elements of the physical exam:
- Auscultation (listening to heart, breath, and stomach sounds)
- Heart sounds
- Infantile reflexes and deep tendon reflexes as the child gets older
- Neonatal jaundice -- first few visits only
- Standard ophthalmic exam
- Temperature measurement (see also normal body temperature)
- Immunizations -- general overview
- Babies and shots
- Diphtheria immunization (vaccine)
- DPT immunization (vaccine)
- Hepatitis A immunization (vaccine)
- Hepatitis B immunization (vaccine)
- Hib immunization (vaccine)
- Human papilloma virus (vaccine)
- Influenza immunization (vaccine)
- Meningococcal (meningitis) immunization (vaccine)
- MMR immunization (vaccine)
- Pertussis immunization (vaccine)
- Pneumococcal immunization (vaccine)
- Polio immunization (vaccine)
- Rotavirus immunization (vaccine)
- Tetanus immunization (vaccine)
- TdaP immunization (vaccine)
- Varicella (chickenpox) immunization (vaccine)
- Appropriate diet for age -- balanced diet
- Diet and intellectual development
- Fluoride in diet
- Infant formulas
- Obesity in children
Growth and development schedules:
- 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 similar to test and procedure preparation.
Preparation steps differ, depending on the child's age:
- Infant test/procedure preparation
- Toddler test/procedure preparation
- Preschooler test/procedure preparation
- School-age test/procedure preparation
Hagan JF Jr, Navsaria D. Maximizing children's health: screening, anticipatory guidance, and counseling. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 12.
Kelly DP, Natale MJ. Neurodevelopmental and executive function and dysfunction. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 48.
Kimmel SR, Ratliff-Schaub K. Growth and development. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 22.