How to Make the Most of Your Child's Visit to the Pediatrician
It's that time of year again: Camp is over, the humidity is high and the school supply list has arrived -- it's back-to-school season. For pediatricians, August and September mean a waiting room filled with children needing their school forms completed.
One of my first appointments of the day recently was with Christian, a healthy 8-year-old boy with mild asthma who came in with his mother for a well-child visit -- or physical. His mom explained he was only here because the school wanted an updated medical form. I started the visit by asking if he had any new health problems or general concerns. His mom denied any new issues. We then talked about Christian's diet, elimination and sleep. Mom and Christian continued to deny any concerns. I showed them Christian's growth chart -- his growth was healthy for his age. Next, I asked Christian how he likes school. He immediately looked down at his shoes and quieted -- he shrugged his shoulders and said, "It's fine." I asked him and his mom additional details and learned he had to participate in summer school because he failed many of his classes. His mom noted that he struggles with his assignments and has started to dread school because he's so far behind.
[See: 10 Cold and Flu Myths Debunked.]
My next patient was a 5-year-old, Ana, who has not been seen in two years because her family was living out of the country. They came in because they needed a physical form to enroll in kindergarten. Ana is happy and playful, and her mom denied any concerns. But when I reviewed her growth chart with the family, her weight was well below expected for her age. When I showed her mom the growth chart, she was relieved to discuss it. She too had been worried about Ana's weight and what she could do to help her eat more.
As these two patient's cases highlight, sometimes parents don't think to discuss all of their concerns with their pediatrician. In the first year of a child's life, parents come to the doctor with hundreds of questions -- from poop color to sleep patterns. Initially, they're at the clinic as frequently as every two months -- based on the American Academy of Pediatrics' scheduled well visits. But after age 3, physicals are only recommended once a year for healthy children. These "school aged" visits are where parents often seem less prepared. Parents can make the best use of a well-child visit by learning its purpose.
So ... What Is the Purpose of a Well-Child Visit?
The well-child visit is a preventive session that is recommended based on the American Academy of Pediatrics' guidelines. The appointments are scheduled around critical times of growth and development and when vaccinations are due.
What Happens During a Well-Child Visit?
It's a time for the patient and parent to discuss any concerns they have. This includes physical, developmental, emotional and social issues. It is a time for the doctor to review any medical changes and all chronic illnesses. Typical diet, elimination and sleep patterns for the child will be discussed. Development and school performance are monitored. It is a time to look at family dynamics and review any social changes at home. The pediatrician evaluates height, weight, body mass index, blood pressure, vision and hearing. A head-to-toe exam is completed. Catch-up or required vaccines are given based on age. Screening blood work is done when appropriate. Lastly, pediatricians give age-appropriate guidance to families and patients.
[See: 13 Tips for Getting Kids Health-Ready for Back to School.]
How Can You Best Prepare for the Well-Child Visit?
1. Keep organized. Have a medical folder for each of your kids. Keep their vaccine records in it, any school evaluations or reports and any emergency room visits or hospital discharge paperwork. Remember to bring this folder to each of your children's pediatrician visits.
2. Before your visit, sit down with your child and discuss if you or they have any concerns about their body, their health, school or their development. Write them down, and bring your list with you.
3. Prepare your child by letting him or her know they will have their body checked from head to toe to make sure they are healthy. Warn them that they will need to get fully undressed. If you're expecting blood work or vaccines, prepare them for this as well.
4. Make sure whoever brings the child to the visit is familiar with their day to day routine and habits -- as the pediatrician will want to know a typical day's diet, sleep, behavior and activity.
Because Christian came in for his visit, we were able to make a plan for a school evaluation and give him resources for extra help. I can follow up with him closely to make sure that he progresses.
Ana's mom now has some tips for increasing fat and calories in her diet. Ana was given all the vaccines she needed for school entry. I will see Ana back in several months to make sure her weight is improving.
While back-to-school is a very busy time of year, preparing for your child's physical will make it more worthwhile for your family. As pediatricians, it is our mission to try to prevent future illness by careful and routine monitoring. It is also our absolute joy to watch our patients grow and mature during these school years.
[See: 10 Concerns Parents Have About Their Kids' Health.]
For more resources on healthy child development, please visit: healthychildren.org.
Jillian Parekh, M.D. is attending pediatric physician, Family Care Center, Montefiore Health System.
