Well-child Visits

Congratulations! Your baby is finally here. Newborns are wonderful but exhausting! Having friends or family around to provide extra help and support can be very helpful. Make sure all visitors wash their hands well. Your baby’s first visit to our office takes place during his or her first week of life, usually 2-3 days after you are discharged from the hospital. 

• We do a lot at this visit, including:
• Check your baby’s weight/growth/head circumference.
• Monitor for signs of jaundice.
• Check to see how your baby is feeding.
• Provide a personalized breastfeeding consultation with one of our Lactation Consultants.
• Answer questions about your new baby.
  
  

Immunizations: HepB#1 (if not given in hospital)
Tests/Screens/Assessments: Follow up on Newborn Metabolic Screen done in hospital. Return to the lab at 8-14 days of life for this.

Families are usually settling in some by this visit. Feeding, sleeping and bowel habits are sometimes a concern. At this visit we will track your baby’s growth and development and answer any questions. Your baby may be starting to smile now and that helps a lot!

Many babies seem more fussy or colicky at this age. Be patient. Colicky babies eventually outgrow their crying phase. Keeping your baby safe is the most important thing you can do. Even if you feel frustrated, handle your baby gently and reach out for help to friends, relatives or your pediatrician if the crying is getting to be too much. If you need a break and noone is available to help you, place your baby on his/her back gently in a safe space such as a crib or bassinet and take a few minutes to calm down.

We do a lot at this visit, including:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Provide your baby’s first set of immunizations. Immunizations are safe, effective, and keep your child and our community healthy. During this visit, you will be able to discuss any questions you may have about immunizations.
• Screen for post-partum depression.
• Please do the ASQ developmental screening 2-3 days prior to the visit, which is on our website.
  
  

Immunizations: Pentacel #1 (DTap#1, HIB#1, IPV #1), PCV#1, Rotavirus#1
Tests/Screens/Assessments: Post Partum Depression Assessment, Ages and Stages Questionaire

Your baby is becoming more active and verbal. Be careful not to leave your baby unattended, especially on a bed, couch, or counter. They move faster than you think! Babies need only breast milk or iron-fortified formula for the first 4-6 months of life. We will talk at this appointment about the appropriate time to introduce solid foods and what foods to introduce first.

At this visit we will:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Provide your baby’s immunizations.
• Discuss when to start feeding your baby solid foods.
• Screen for post-partum depression.
• Please do the ASQ developmental screening 2-3 days prior to the visit, which is on our website.
  
  

Immunizations: Pentacel #2 (DTap#, IPV#2, HIB#2), PCV#2, Rotavirus#2
Tests/Screens/Assessments: Post Partum Depression Assessment, ASQ developmental screening.

Your baby will begin to move more and will be able to sit up independently for short periods. Now is the time to start baby-proofing your house if you haven’t already done so. You should move the mattress in your baby’s crib down to the lowest level.

At this visit we will:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Provide your baby’s immunizations.
• Discuss the introduction of fluoridated water to encourage the development of strong and healthy teeth. If you have city or rural water, your water is fluoridated. If you have well water, you should have your water tested for fluoride before offering it to your baby.
• Screen for post-partum depression.
• Please do the ASQ developmental screening 2-3 days prior to the visit, which is on our website.
  
  

Immunizations: Pentacel #3 (DTaP#3, IPV#3, HIB#3), HepB#3, PCV#3, Rotavirus#3, Influenza vaccine (during flu season with booster 30 days later)
Tests/Screens/Assessments: Post Partum Depression Assessment, Lead Surveillance, Oral  Health Surveillance, ASQ screening

Your baby may be starting to crawl, pulling to a stand, and cruising on furniture. Babies will want to touch everything; this is how they learn. This is a messy time! Have fun and be patient.

At this visit we will:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Discuss your baby’s upcoming dental care. Your baby should see a dentist at 1 year of age. You should be brushing your child’s teeth with an infant toothbrush and water or infant toothpaste. 
• Discuss nutrition and saftey.
• Please do the ASQ developmental screening 2-3 days prior to the visit, which is on our website.
  
  

Immunizations: Influenza vaccine (during flu season)
Tests/Screens/Assessments: ASQ, Oral Health Surveillance

At this age, your baby can transition from breast milk or formula to cow’s milk, however, it is healthy to continue breast milk if that is what you prefer for your baby. Most babies need 3 meals, 2-3 snacks per day, and no more than 16-20 ounces of whole cow’s milk per day. Your baby will be able to eat many of the foods you eat, but be careful to avoid small, hard foods that can cause choking. It is time to wean your child from the bottle and offer all liquids in a sippy cup. It is much easier to wean your child now than if you wait until they are older – avoid cavities and additional tears and make the change now!

Your baby will be outgrowing the infant carrier car seat. Continue to have your baby in a rear facing car seat until age 2.

At this visit we will:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Provide your baby’s immunizations.
• Discuss dental health and recommend starting to use a smaller than rice sided smear of fluoride toothpaste.  See a pediatric dentist anytime now.
• Screen your baby for amblyopia (lazy eye) with our ocular photoscreen device.
• Please do the ASQ developmental screening 2-3 days prior to the visit, which is on our website.
  
  

Immunizations: HepA#1, PCV#4, HIB#4, MMR#1, Varicella#1, Influenza vaccine (during flu season)
Tests/Screens/Assessments: Lead Surveillance, Oral Health Surveillance, test for anemia with hemoglobin screen in office, Vision Photoscreen, ASQ

Your child may be able to climb and run, so be sure to safety proof your home. Poison control is available 24 hours a day: 1-800-222-1222 – keep this number handy in your cell phone and on your refrigerator.

At this visit we will:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Please do the ASQ developmental screening 2-3 days prior to the visit, which is on our website.
• Provide your baby’s immunizations.
  
  

Immunizations: Influenza vaccine (during flu season)
Tests/Screens/Assessments: Anemia Surveillance questions, ASQ, Vison Photoscreen
Helpful Info: Choking Prevention and First Aid for Infants and Children

At 18 months, your child understands much more than he or she can say in words. Use words to describe your child’s feelings and gestures. Read and sing to your child often. When reading, use simple words to talk about the pictures.

At this visit we will:

• Measure your child’s weight, length and head size and record on a growth curve.
• Provide your baby’s  immunizations.
• Review your child’s development with you using the  M-CHAT developmental questionnaire (autism screening tool) and the Ages and Stages Questionnaire. Please do the ASQ developmental screening 2-3 days prior to the visit, which is on our website.
• Discus temper tantrums.
  
  

Immunizations: DTaP#4, HepA#2, Influenza vaccine (during flu season)
Tests/Screens/Assessments: Ages and Stages Questionnaire, MCHAT Questionnaire, Anemia Surveillance, Lead Surveillance, Oral Health Surveillance

At this age, your 2-year-old may go from trying to be independent to clinging to you; this is normal. Toddlers should play than to watch TV. Even having television playing in the background interrupts healthy toddler play – background music is a better choice.

At this visit we will:

• Measure your child’s weight, length, head size and record on a growth curve.
• Most of our patients do not have immunizations due at this visit.  Your child may need immunizations if they are behind on their shots.
• Review your child’s development with you using the MCHAT (Autism screening tool) questionnaire.
• Screen your baby for amblyopia (lazy eye) with our ocular photoscreen device.
• Discuss dental health and ensure a dental visit is performed if not already done.
• Discuss toilet training and time out.
• Please do the ASQ developmental screening 2-3 days prior to the visit, which is on our website.
  
  

Immunizations: Flu vaccine (during flu season)
Tests/Screens/Assessments: ASQ and  MCHAT Questionnaire, Anemia Surveillance, Lead Surveillance, Oral Health Surveillance, Vision Photoscreen

Your baby is not really a baby anymore. They are firmly in the toddler years. One moment they seem so big and the next still very small. This is the “do-it-myself time.”

At this visit we will:

• Measure your child’s weight, length, and head size and record on a growth curve
• Most of our patients do not have immunizations due at this visit.
• Evaluate your child’s development with the ASQ.   Please do the ASQ developmental screening 2-3 days prior to the visit, which is on our website.
• Discuss dental health  (if they have not yet seen a dentist, they should!)
• Discuss healthy meals/snacks, avoid food pouches and no or little juice
  
  

Immunizations: Influenza vaccine (during flu season)
Tests/Screens/Assessments: Ages & Stages Developmental Screening

Your child will likely be moving into a world of make believe that they create with their imagination. Toys for dressing up and making believers are important at this age. Read books, sing songs and play rhyming games with your child daily.

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Most of our patients do not have immunizations due at this visit.  Your child may need immunizations if they are behind on their shots or during flu season.
• Discuss dental health. 
• Discuss behaviors that commonly occur at this age.
• Vision testing and blood pressure are now done yearly.
  
  

Immunizations:  Flu vaccine (during flu season)
Tests/Screens/Assessments: Anemia Surveillance, Lead Surveillance, Oral Health Surveillance, Vision Photoscreen

Four-year-olds often like to sing, dance and act. They like to tell “tall tales” and makeup stories.  Enjoy these fun moments with your little one!  Parents should continue to help with brushing teeth even though your child will want to do it all by themselves.

At this visit we will:

• Measure your child’s weight and height and body mass index and record on a growth curve.
• Provide your child’s immunizations.
• Discuss dental health.
• Please do the ASQ developmental screening 2-3 days before the visit, which is on our website.
  
  

Immunizations: Proquad (MMR#2, Var#2), Quadracel (DTaP#5, IPV#4), Influenza vaccine (during flu season)
Tests/Screens/Assessments: Anemia Surveillance, Lead Surveillance, Oral Health Surveillance, Vision Testing, Hearing Testing, ASQ

At this age, your child needs more independence. However, you need to set clear limits. A regular bedtime and consistent bedtime routine are important. Be a great role model. Show an interest in what they are learning.

At this visit we will:

• Measure your child’s weight and height and body mass index and record on a growth curve.
• Review your child’s speech and development.
• Discuss exercise and nutrition.
• Discuss kindergarten readiness.
• Discuss dental health.
• Please do the ASQ developmental screening 2-3 days prior to the visit, which is on our website.
  
  

Immunizations: DTaP#5, IPV#4, and MMR #2 and Varicella #2 (if not received at 4 years), Influenza vaccine (during flu season)
Tests/Screens/Assessments:  ASQ, Anemia Surveillance, Lead Surveillance, Oral Health Surveillance, Vision Testing, Hearing Testing

Encourage good learning by helping your child organize a distraction-free time to do homework and ensuring eleven hours of sleep each night. Teach your child what to do if there is a fire and have practice fire drills. There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

At this visit we will:

• Measure your child’s weight and height and body mass index  and record on a growth curve.
• Screen your child’s hearing and vision.
• Review your child’s school performance and development.
• Discuss exercise and nutrition.
• Review safety issues.
  
  

Immunizations: Influenza vaccine (during flu season)
Tests/Screens/Assessments: Anemia Surveillance, Lead Surveillance, Oral Health Surveillance, Vision Testing, Hearing Testing

Continue to encourage good nutrition and exercise for your child. This is the time he or she is building good health habits for a lifetime! There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

At this visit we will:

• Measure your child’s weight, height and body mass index  and record on a growth curve.
• Review your child’s school performance and development.
• Discuss exercise and nutrition.
• Review safety issues.
  
  

Immunizations: Influenza vaccine (during flu season)
Tests/Screens/Assessments: Vision Surveillance, Hearing Surveillance, Anemia Surveillance

Positive self-image is important as your child begins to enter the changes that come with puberty. Empower them to feel good about themselves, and their interaction with others and praise their effort more than the outcome.

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve
• Measure your child’s blood pressure and heart rate
• Screen your child’s vision and hearing
• Review your child’s school performance and development
• Discuss involvement in activities
• Discuss sleep
• Discuss anticipating pubertal changes
• Discuss exercise and nutrition
• Review safety issues
  
  

Immunizations: Influenza vaccine (during flu season)
Tests/Screens/Assessments: Vision Testing, Hearing

Your child be is becoming more responsible and will be able to take on more tasks such as taking care of his/her own room. He or she may also start reading independently for pleasure.

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Review your child’s school performance and development.
• Discuss exercise and nutrition.
• Review safety issues.
  
  

Immunizations: HPV (first of a two dose series), Influenza vaccine (during flu season)
Tests/Screens/Assessments: Vision Surveillance, Hearing Surveillance, Anemia Surveillance, Lipid Profile testing (completed once between 9-11 years)

Your ten year old still requires adult supervision when you are away. Watching TV with your child allows you to discuss any controversial topics that may come up, but limit screen time to 2 hours per day. Family mealtime is important to keeping communication open and fostering healthy lives.

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve
• Measure your child’s blood pressure and heart rate
• Screen your child’s vision and hearing
• Provide your child’s immunizations if behind on shots.
• Review your child’s school performance and development
• Discuss involvement in activities and peer relationships
• Discuss sleep
• Discuss exercise and nutrition
• Discuss puberty changes to expect or that may be starting to occur
  
  

Immunizations: HPV, Influenza vaccine (during flu season)
Tests/Screens/Assessments: Vision Testing, Hearing Testing, Lipid Profile (completed once between 9-11 years)

Your child may be transitioning to middle school at this age. He or she may be participating in more group activities. Expand your conversations about healthy living practices to include tobacco, drug and alcohol avoidance.

At this visit we will:

• Measure your child’s weight. height and body mass index and record on a growth curve.
• Provide your child’s immunizations.
• Screen your child for anemia and dysipidemia per AAP recommendations.
• Review your child’s school performance and development.
• Discuss exercise and nutrition.
• Discuss puberty changes to expect or that may be starting to occur.
  
  

Immunizations: MCV#1, dap#1, HPV (if not completed already), Influenza vaccine (during flu season)
Tests/Screens/Assessments: Vision Surveillance, Hearing Surveillance, Anemia Surveillance, Dyslipidemia Surveillance, Lipid Profile (completed once between 9-11 years)

Your child will be in middle school at this age. Continue your conversations about healthy living practices to include tobacco, drug and alcohol avoidance. Your child should be able to assume more responsibility for personal hygiene and chores. There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Screen your child’s vision/hearing.
• Review your child’s school performance and development.
• Complete sports physical forms and discuss sports safety (if your child is participating in sports).
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet.
• Discuss puberty changes to expect or that may be starting to occur.
  
  

Immunizations: HPV if not already completed, Influenza vaccine (during flu season)
Tests/Screens/Assessments:  Anemia Surveillance, Adolescent Depression Screening (PHQ), Adolescent questionnaire, Vision/hearingTesting

Your child may be showing an increasing interest in extracurricular activities. Have conversations about risk taking behaviors, driving, alcohol, drug use, family rules and expectations. Discuss media and internet safety. Ensure that they have an adult they can confide in if they cannot communicate with you. There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

During the teen years, we allow your teen to have at least a portion of the visit with the parent out of the room.

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Complete sports physical forms and discuss sports safety (if your child is participating in sports).
• Review your child’s school performance and development.
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet.
  
  

Immunizations: Influenza vaccine (during flu season)
Tests/Screens/Assessments: Vision Surveillance, Hearing Surveillance Anemia Surveillance, Adolescent Depression Screening (PHQ) and Adolescent Questionnaire.

Your child may be adjusting to the transition to high school. The development of family relationships continues to be important, but it is also normal for teens to place more and more emphasis on their peer relationships. There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

During the teen years, we provide the opportunity for your teen to have at least a portion of the visit with the parent out of the room.

At this visit we will:

• Measure your child’s weight and length and record on a growth curve.
• Complete sports physical forms and discuss sports safety (if your child is participating in sports).
• Review your child’s school performance.
• Reinforce healthy choices and risk behavior avoidance.
• Perform any recommended yearly screening tests (depending on family history, sexual activity etc.).
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet.
  
  

Immunizations: Influenza vaccine (during flu season)
Tests/Screens/Assessments: Anemia Surveillance, Adolescent Depression Screening(PHQ) and Adolescent Questionnaire, possible Urine Chlamydia/GC Screen (females), Vision and hearing testing

Congratulations! You are solidly in the teen years! It is exciting to see the wonderful person your child is becoming. Possible conflict can arise at this time as your teen assesses your family values versus those of your culture and peers. Keep the lines of communication open and give them additional responsibility while being present when they inevitably make mistakes. Be supportive and allow them to develop resilience and self-pride. During the teen years, we allow your teen to have at least a portion of the visit with the parent out of the room.

At this visit we will:

• Measure your teen’s weight, height and body mass index and record on a growth curve
• Measure your teen’s blood pressure and heart rate
• Complete sports physical forms and discuss sport safety (if your teen is participating in sports, please bring any forms to the appointment)
• Review your teen’s school performance and development
• Discuss involvement in activities and peer relationships/dating
• Discuss sleep
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet
• Reinforce healthy choices and risk behavior avoidance
• Perform any recommended yearly screening tests (depending on family history, sexual activity etc.)
  
  

Immunizations: MCV4 #2, Influenza vaccine (during flu season)
Tests/Screens/Assessments: Vision Testing, Hearing Testing, Depression Screening (PHQ) and Adolescent Questionnaire.

Your child is getting closer to finishing high school and entering the adult world. Making mistakes is a normal part of growing up. Continue to provide emotional support and guidance for them during this time. There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

During the teen years, we allow your teen to have at least a portion of the visit with the parent out of the room.

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Complete sports physical forms and discuss sports safety (if your child is participating in sports).
• Review your child’s school performance.
• Perform any recommended yearly screening tests (depending on family history, sexual activity etc.).
• Reinforce healthy choices and risk behavior avoidance.
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet.
  
  

Immunizations: Men B (0ptional for college students), given the summer before college and a booster 6 months later. Influenza vaccine (during flu season)
Tests/Screens/Assessments: Vision Surveillance, Hearing Surveillance, Anemia Surveillance, Adolescent Depression Screening(PHQ) and Adolescent Questionnaire, Lipid Profile (once between 17-21 yrs of age), HIV testing and Urine Chlamydia/GC Screen.

Your child is now transitioning to adult life! They will still look to you for support and guidance but will be more on their own when it comes to decision making. 

During the teen years, we allow your teen to have at least a portion of the visit with the parent out of the room.

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Provide immunizations.
• Screen your teen’s vision and hearing.
• Discuss transitions to life after high school whether that be work, travel, vocational school or college.
• Discuss the importance of responsible decision making and recognizing healthy -vs- unhealthy relationships.
• Complete college physical forms and any required college screening labs/tests.
• Perform any recommended yearly screening tests (depending on family history, sexual activity etc.).
• Reinforce healthy choices and risk behavior avoidance.
• Transition your child to an adult care provider.  We see our patients through age 21 yrs but not once they are 22 yrs old. We provide a potential list of providers to transition to locally.
  
  

Immunizations: Men B (optional if in college, with a booster 6 months later), Influenza vaccine (during flu season)
Tests/Screens/Assessments: Hearing Surveilllance, Anemia Surveillance, Dyslipidemia Surveillance (once between 17-21 yrs of age), Adolescent Depression Screening (PHQ) and Adolescent Questionnaire. Possible Urine Chlamydia Screen, Universal HIV Testing.