Understanding well-child checkups: The whens, whats and whys

Aug 22, 2013 at 12:00 a.m. ET

Well-child checkups are an important way to ensure the continued health of your growing children. But what should (and shouldn't) you be doing to make the most of these appointments? We asked mom pediatricians to share their advice on making the most of your well-child visits.

Young girl getting a wellness exam

What is a well-child visit?

Well-child visits are an essential part of maintaining your child's good health. These visits to the pediatrician include vision and hearing screenings, evaluation of your child's physical growth and developmental milestones, assessment of the child's social skills and academic concerns, blood and urine check, and vaccines (when and if needed).

Well visits were designed so that the pediatrician can follow your child’s progress, says Dyan Hes, M.D., medical director at Gramercy Pediatrics and board member, American Board of Obesity Medicine. "Pediatricians want to see that your child is meeting developmental milestones. They can be as subtle as laughing at 2 months of age or scribbling with a crayon at 18 months of age." Most well visits are associated with vaccines, so it is important not to miss these visits, says Hes. "Exposing your child to a vaccine-preventable disease could be dangerous." Recently, there has been much more awareness about screening for developmental delay and autism.

Dorothy Wiggins, M.D., F.A.A.P., mother of two and pediatrician at Atlantic Pediatric Partners, says it's important for children under the age of 6 to obtain well-child checkups because it is during these formative years that healthy habits are developed. "Additionally, with so much technology available to children of all ages," says Wiggins, "these visits serve as a great time to discuss appropriate amounts of screen time and to ensure that children are engaging in daily physical activity."

What's the schedule for well visits?

Well visits are a key part of ensuring your child's well-being and should begin right away. The American Academy of Pediatrics recommends scheduling well visits for children at the following ages: Newborn, first week, 1 month, 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18 months and annually from age 2 through 21.

Making the most of your well visit: Tips from pediatrician moms

  • Talk it up. Act it out. Play with dolls/stuffed animals and doctor kits. Read a book or watch a video about the child's favorite character going to the doctor. Elmo Goes to the Doctor and Doc McStuffins have relieved many anxious children prior to a doctor's appointment.— Dorothy Wiggins, M.D., F.A.A.P.
  • Limit questions. Lots of parents jot down questions that they would like to be addressed before they come in for the visit. I think this should be limited to two or three issues. — Dyan Hes, M.D.
  • Be appropriately empowered. It's okay to insist on fewer shots at once, pain control or other accommodations to make your child less fearful of doctor visits in the future. The age where most needle phobia forms is 4 to 6, when kids can get up to five shots at once. Make sure your doctor knows you're fine to come back for a shot-only visit. (The AAP and CDC guidelines require a child to be immunized between the ages of 4 and 6, so there is no reason to do them all at age 4-years-one-day.) — Dr. Amy Baxter, pediatrician and CEO of MMJ Labs
  • Know what's covered. Parents must remember that the majority of insurance companies do not pay for a well visit and a "sick visit" in the same day. So the parent may not consider untreated eczema or behavioral issues a "sick visit;" however, once these are placed into the electronic record, it is no longer just a well-child visit.— Dyan Hes, M.D.

What not to do: Well-visit horror stories

Remember — the visit is for your child, not you! "I actually have a parent who when he brings his child in for a visit, will usually start the session by sitting on the bed and stretching out," says Dr. Wiggins. "He always has questions about his own health status. I try to lightheartedly transition dealing with his issues by focusing on his child, first by gently moving his child to the table (sort of squishing him out of the way!) so we can begin the exam. Then I refer him to a physician more suited for his medical needs."
Keep your questions focused. "Just this past week, I had a father in the office with about 100 typed questions about products to buy for his newborn," says Dr. Hes. "I tried to calm him down and explain to him that he was focusing on minutia and products instead of bonding with his baby and enjoying her. I think parents often think pediatricians know every product on the market, and sadly we don’t. We try not to endorse a product or company."

Expert Tip:

"Try to find a practice that uses electronic medical records and gives you a printout summary when you leave," says Dr. Dyan Hes. "This printout should have parenting tips based on your child’s age. This is very helpful."

More kids health tips:

Real moms share: How we beat the Dr. blues
How to find a good pediatrician
Drink more water to stay healthy