As a parent, you want what’s best for your children, which means keeping them healthy. Bringing them to a yearly well-child check can help. This comprehensive exam promotes healthy habits, ensures that your children’s development is on track, and helps to identify any potentially chronic medical problems, explains Jane Nestler, M.D., instructor in pediatrics.
“These visits are extremely important,” Dr. Nestler says. “We review a lot of information, including any chronic medical problems such as asthma, headaches, or ADHD, your children’s eating, sleep, and hygiene habits, and how school is going for them,” she says.
Physicians typically begin a well-child exam by plotting children’s height and weight on a growth chart. “We don’t look for any particular or special number or percentile,” Dr. Nestler says. “The most important thing is that their percentiles or BMIs (body mass index) remain consistent from visit to visit,” she says. This also gives your children’s physician the opportunity to discuss their eating habits and recommend improvements. “A lot of kids go through picky stages, but as long as they're having a well-varied diet and are gaining weight well on their curve, there’s nothing to be concerned about,” she says.
Well-visits feature screening tests for hearing and vision and may include referrals to an ophthalmologist for vision concerns, or an audiologist (ear, nose, and throat doctor) for any concerns about hearing. “We send children to specialists only if they fail a screening test, if parents or patients have specific concerns about their hearing or vision, or if physicians are concerned about any findings from their physical exam,” Dr. Nestler says.
Vaccination is another key part of the well-child check-up. Children between ages four and six receive two main vaccines: MMRV for measles, mumps, rubella, and chicken pox; and dTap IPV, for diphtheria, tetanus, pertussis, and polio. “These vaccines are very effective and prevent children from getting these potentially dangerous illnesses,” Dr. Nestler says.
“We also recommend a flu shot,” she adds. “If your child is younger than nine years old and it’s their first time getting the flu vaccine, they’ll need two doses at least four weeks apart. Thereafter, it’s just one flu shot annually.”
Physical health is just one part of a well-child visit. Physicians also address psychological and emotional issues that your children may be experiencing, such as separation anxiety or school avoidance. Encouraging socialization is extremely important in school-age children because it promotes skills and concepts that are critical to their development, such as sharing, patience, empathy, and creativity. “It’s very important to start socializing children through playdates and other interactions at an early age,” Dr. Nestler says.
The importance of exercise--at least 60 minutes daily—is another focus of the well-child visit. “We tell the parents to encourage their kids to walk whenever possible, even if it’s only for a few blocks,” Dr. Nestler says. Families can support this by taking hikes, biking, or swimming together. “In our media age, it’s important to schedule media free time,” she notes.
School-age children need plenty of sleep--anywhere from 9 to 12 hours of sleep each night--and the well-visit covers this, too. “The most important thing in this age group is to have a consistent schedule,” Dr. Nestler says. “It’s important for kids to go to bed each night at roughly the same time and to wake up at roughly the same time in the morning,” she says. A pre-bedtime ‘wind-down’ routine after dinner should include taking a shower and reading a book. “There should be no screen time for at least two hours before going to sleep,” she says. And children should not read, watch TV, or do homework in their bed. “They should associate bed with sleeping only,” she says.