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 1-2 days after you are discharged from the hospital.

We do a lot at this visit, including:

• Check your baby’s weight.
• Monitor for signs of jaundice.
• Check to see how your baby is feeding. We have an in-house Lactation Consultant to help!
• Answer questions about your new baby.
• Discuss Vitamin D supplementation in breastfeeding babies: either 400 IU per day for baby, or 5000 IU per day for mother along with prenatal vitamin. 
  

Immunizations:

• HepB#1 (if not given in hospital)

Tests/Screens/Assessments:

• Follow-up on Newborn Metabolic Screen (done in hospital)

Helpful Info:

• Caring for Your Newborn

The 3 Week Visit (sooner if you have concerns!) is a time to talk about how your family is acclimating to the newest addition. Feeding, bowel habits and sleeping are common topics. If you are breastfeeding, we will discuss how that is going and offer lacation support if needed. Babies usually lose weight right after birth. By 3 weeks of age, your baby will likely have regained his or her birth weight. Please remember that it is important to always put your baby to sleep on his or her back in a flat, firm and separate sleep space to reduce the risk of SIDS. As always, we are here to answer questions and offer anticipatory guidance.

We do a lot at this visit, including:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Remind you to give your baby a daily supplement of vitamin D - either with infant 400 IU drops or maternal 5000 IU supplement, if you are breastfeeding.
• Provide Lactation Support if needed.
• Discuss the importance of TUMMY TIME!
  

Immunizations:

• None

Tests/Screens/Assessments:

• Post Partum Depression Assessment (for Mom)

Helpful Info:

• Back to Sleep, Tummy to Play

This is a fun age as babies start to smile responsively and even make some coos. However, many babies seem more fussy or colicky at this age as well. 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 no one 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:

• Make sure your baby is developmentally meeting their milestones.
• 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.
  

Immunizations:

• Vaxelis #1
• PCV#1
• Rotavirus#1

Tests/Screens/Assessments:

• Post Partum Depression Assessment. TB surveillance; Ages and Stages Questionnaire

Helpful Info:

• Colic
• Crying and Your Baby: How to Calm a Fussy or Colicky Baby

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.

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 immunizations.
• Discuss when to start feeding your baby solid foods.
• Screen for post-partum depression.

Immunizations:

• Vaxelis #2
• Prevnar#2
• Rotavirus#2

Tests/Screens/Assessments:

• Post Partum Depression Assessment
• Ages and Stages Questionnaire

Helpful books:

• "What to feed your baby" by Tanya Altmann, MD
• Healthy Sleep Habits, Happy Child, 5th Edition: A New Step-By-Step Guide For A Good Night's Sleep
•  Marc Weissbluth M.D.

Helpful Info: Feeding:

• Baby Feeding Chart: How Much and When to Feed Infants the First Year
• Starting Solid Foods; Dr.YumProject; 
• Sleep:  Sleep training

Your baby will begin to move more and will be able to sit up independently for short periods of time. 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.

We do a lot at this visit, including:

• Make sure your baby is meeting their developmental milestones.
• 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.
  

Immunizations:

• Vaxelis#3
• Prevnar#3
• Rotavirus#3
• Influenza vaccine (during flu season)

Tests/Screens/Assessments:

• Post Partum Depression Assessment

Helpful Info:

• Teething
• Sleep Training
• Intro to Solids (see links in 4 month visit)

Babies are on the roll! 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.

We do a lot at this visit, including:

• Make sure they are meeting their developmental milestones.
• Measure your baby’s weight, length and head size and record on a growth curve.
• Discuss dental health and apply fluoride varnish to your baby’s teeth. Your baby should see a dentist at 1 year of age. You should be brushing your child's teeth with an infant toothbrush and a tiny smear of fluoride toothpaste. 
  

Immunizations:

• None

Tests/Screens/Assessments:

• Ages and Stages Questionnaire
• Oral Health Surveillance
• Fluoride Varnish

Helpful Info:

• Caring for Your Child's Teeth

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.

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 immunizations.
• Screen your baby for vision abnormalities with our ocular photoscreen device
  

Immunizations:

• HepA#1
• Varivax#1
• MMR#1

Tests/Screens/Assessments:

• Vision Photoscreen
• Hemoglobin Test
• Lead Test
• TB surveillance
• Ages and Stages Questionnaire

Helpful Info:

• Playing Is How Toddlers Learn

At this age, babies are into everything! 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. Ask us for a magnet if you need one!

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 immunizations.
• Discuss dental health and apply fluoride varnish to your baby’s teeth.
  

Immunizations:

• Pentacel#4 (DTaP, HIB, IPV)
• Prevnar#4

Tests/Screens/Assessments:

• Anemia Surveillance
• Fluoride Varnish

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.

We do a lot at this visit, including:

• Measure your child’s weight, length and head size and record on a growth curve.
• Provide your baby’s immunizations.
• Discuss temper tantrums.
  

Immunizations:

• DTaP#4
• HepA#2

Tests/Screens/Assessments:

• Ages and Stages Questionnaire
• MCHAT Questionnaire

Helpful Info:

• Is Your Toddler Communicating With You?

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

We do a lot at this visit, including:

• Measure your child’s weight, length, head size 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.
• Review your child’s development with you using the MCHAT (Autism screening tool) questionnaire.
• Screen for lead exposure and test if necessary with a finger prick in the office.
• Screen your baby for vision abnormalities with our ocular photoscreen device.
• Discuss dental health and apply fluoride varnish to your child's teeth.
• Discuss toilet training and time out.
  

Immunizations:

• Flu vaccine (during flu season)

Tests/Screens/Assessments:

• Ages and Stages Questionnaire
• MCHAT Questionnaire
• TB Surveillance
• Anemia Surveillance
• Lead Surveillance
• Oral Health Surveillance
• Lead Test
• Fluoride Varnish
• Vision Photoscreen

Helpful Info:

• Playground Safety

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."

We do a lot at this visit, including:

• 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.
• 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

Helpful Info:

• Snacks for Toddlers

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

We do a lot at this visit, including:

• 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 and apply fluoride varnish to your child's teeth if they have not been to the dentist.
  

Immunizations:

• Flu vaccine (during flu season)

Tests/Screens/Assessments:

• Ages and Stages Questionnaire
• Oral Health Surveillance
• Vision Testing
• Fluoride Varnish
• TB surveillance

Helpful Info:

• Toilet Training

Four year olds often like to sing, dance and act. They like to tell "tall tales" and make up 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.

We do a lot at this visit, including:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Provide your child's immunizations.
• Discuss dental health and refer you to dentist.
  

Immunizations:

• Option to get Kindergarten vaccines-
• MMRV
• Quadracel (DTaP, IPV)

Tests/Screens/Assessments:

• Pediatric Symptom Checklist (PSC 17)
• TB Surveillance
• Oral Health Surveillance
• Vision Testing
• Hearing Testing
• TB surveillance

Helpful Info:

• Encourage Your Child to Be Physically Active

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.

We do a lot at this visit, including:

• Measure your child’s weight, 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 and apply fluoride varnish to your child's teeth.
  

Immunizations:

• Kindergarten vaccines, if they didn't get at previous visit-
• MMRV
• Quadracel (DTaP, IPV)

Tests/Screens/Assessments:

• Pediatric Symptom Checklist (PSC 17)
• TB surveillance

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.

We do a lot at this visit, including:

• Measure your child’s weight, 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:

• None
  

Tests/Screens/Assessments:

• Pediatric Symptom Checklist (PSC 17)
• TB surveillance

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!

We do a lot at this visit, including:

• 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:

• None

Tests/Screens/Assessments:

• Pediatric Symptom Checklist (PSC 17)
• TB surveillance

Helpful Info:

• Growing Up Healthy: Fat, Cholesterol, and More

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

We do a lot at this visit, including:

• 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
• 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:

• Pediatric Symptom Checklist (PSC 17)
• TB surveillance

Helpful Info:

• Developing Your Child’s Self-Esteem

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.

We do a lot at this visit, including:

• 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:

• Pediatric Symptom Checklist (PSC 17)
• TB surveillance

Helpful Info:

• The Benefits and Tricks to Having a Family Dinner

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.

We do a lot at this visit, including:

• 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
• 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:

• Influenza vaccine (during flu season)

Tests/Screens/Assessments:

• Pediatric Symptom Checklist (PSC 17)
• TB surveillance
• Hearing Screening
• Lipid Screening

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.

We do a lot at this visit, including:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Provide your child’s immunizations.
• 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:

• Tdap#1
• MCV#1
• HPV#1 (if not previously completed; series of 2; 9-13 years)

Tests/Screens/Assessments:

• Pediatric Symptom Checklist (PSC 17)
• TB surveillance

Helpful Info:

• Substance Abuse Prevention

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.

We do a lot at this visit, including:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Review your child’s school performance and development.
• Complete sports physical forms and discuss sport 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#2 (if series has not been completed yet)

Tests/Screens/Assessments:

• Pediatric Symptom Checklist (PSC 17)
• TB surveillance

Congratulations! You are solidly in the teen years!  Though friends are becoming more important at this age, having a caring adult to provide a listening ear and from which to obtain accurate health information is equally important. Foster open communication with your child.

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

We do a lot at this visit, including:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Review your child’s school performance and development.
• Complete sports physical forms and discuss sport 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:

• Start HPV series if haven't already. 

Tests/Screens/Assessments:

• Pediatric Symptom Checklist (PSC 17)
• Adolescent Depression Screening
• TB surveillance

Helpful Info: 

• Teens
• Behavior

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. Make certain that they have an adult they can confide in if they are unable to communicate with you.

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

We do a lot at this visit, including:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Complete sports physical forms and discuss sport 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:

• HPV (if series has not been completed yet)

Tests/Screens/Assessments:

• Pediatric Symptom Checklist (PSC 17)
• TB surveillance

Helpful Info: 

• Teens
• Behavior

Your teen may be adjusting to the transition to high school. 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 this visit with the parent out of the room.

We do a lot at this visit, including:

• Measure your child’s weight and length and record on a growth curve.
• Complete sports physical forms and discuss sport 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:

• HPV (if series has not been completed yet)

Tests/Screens/Assessments:

• Pediatric Symptom Checklist (PSC 17)
• TB surveillance
• Hearing Screen

Helpful Info: 

• Teens
• Behavior

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 culture and peers. Keep the lines of communication open and give them additional responsibility while being present for them when they inevitably make mistakes. Be supportive and allow them to develop resilience and self-pride. 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.

We do a lot at this visit, including:

• 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:

• HPV (if series has not been completed yet)

Tests/Screens/Assessments:

• Pediatric Symptom Checklist (PSC 17)
• TB surveillance

Helpful Info: 

• A Message to Parents of Teen Drivers

Your child is getting closer to finishing high school and entering the adult world. Making mistakes are a normal part of growing up. Continue to provide emotional support and guidance for them during this time.

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

We do a lot at this visit, including:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Complete sports physical forms and discuss sport 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:

• MenB (optional)
• HPV (if series has not been completed yet)

Tests/Screens/Assessments:

• Lipid Risk Assessment
• Pediatric Symptom Checklist
• TB surveillance

Helpful Info: 

• Teens
• Behavior

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 provide the opportunity for your teen to have at least a portion of this visit with the parent out of the room.

We do a lot at this visit, including:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Provide immunizations.
• Discuss transitions to life after high school—whether that be work, travel, vocational school or college.
• Discuss 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.
  

Immunizations:

•  HPV
• MenB 

Tests/Screens/Assessments:

• Pediatric Symptom Checklist
• TB Surveillance
• Anemia Surveillance
• Dyslipidemia Surveillance 

Helpful Info: 

• Teens
• Behavior