Well Child Care

Your baby is finally here—Congratulations! 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.

At this visit we will:

• Check your baby’s weight.
• Monitor for signs of jaundice.
• Check to see how your baby is feeding.
• If you need help or support with breastfeeding, please call our office to schedule time with our lactation consultant in addition to your pediatrician.
• Answer questions about your new baby.

Babies usually lose weight right after birth. By 2 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. If you are having difficulty getting your baby to sleep in their own space, please let us know.

At this visit we will:

• 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 400 IU of vitamin D drops if you are breastfeeding.

You have survived the first month!  By now, you should have developed some routines for your days and nights and feeding, whether breast or bottlefeeding, should be comfortable and familiar.  Tummy time is an excellent activity to include in your daily routine at least 3 times per day.  

At this visit, we will:

• Measure your baby's weight, lenght, and head size, and record it on the growth curve.
• Administer the second dose of your baby's Hepatitis B vaccination.  
• Screen for post-partum depression.  

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.

At this visit we will:

• 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.
• Provide the Ages and Stages Developmental Questionnaire.  Screen for post-partum depression.

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.
• Review your baby’s development with you using the Ages and Stages questionnaire.
• Discuss when to start feeding your baby solid foods.
• Screen for post-partum depression.

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.

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.
• Review your baby’s development with you using the Ages and Stages questionnaire.
• 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.
• Our Reach Out and Read program starts at 6 months of age. Your baby will be given an age appropriate book by their provider, and you will recieve direction on how to share books with your baby. Research has shown that 20 minutes per day of shared book time encourages optimal speech and language development. Start now if you haven't already incorporated reading time into your daily routine.
• Screen for post-partum depression.

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.
• Provide your baby’s third Hepatitis B vaccination.
• Review your baby’s development with you using the Ages and Stages questionnaire.
• Provide your baby with their Reach Out and Read book. Read to your baby 20 minutes every day!
• 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 a tiny smear of fluoride toothpaste. We will provide you with a list of dentists and encourage you to schedule your baby's first appointment.

At this age, your baby can transition from breastmilk or formula to cow’s milk, however it is healthy to continue breastmilk if that is what you prefer for your baby. Most babies need 3 meals, 2-3 snacks per day, and 16-24 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.
• Review your baby’s development with you using the Ages and Stages questionnaire.
• Test for anemia and lead exposure with a finger prick in the office.
• Discuss dental health and apply fluoride varnish to your baby’s teeth.
• Provide your baby with their Reach Out and Read book. Read to your baby 20 minutes every day!

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.
• Provide your baby’s immunizations.
• Review your baby’s development with you using the Ages and Stages questionnaire.
• Screen your baby for amblyopia (lazy eye) with our ocular photoscreen device.
• Provide your baby with their Reach Out and Read book. Read to your baby 20 minutes every day!

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 Questionairre.
• Discuss dental health and apply fluoride varnish to your baby’s teeth.
• Discuss temper tantrums.
• Provide your baby with their Reach Out and Read book.  Read to your baby 20 minutes every day!

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.

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.  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) and the Ages and Stages questionnaire.
• Test for anemia and lead exposure with a finger prick in the office.
• Screen your baby for amblyopia (lazy eye) with our ocular photoscreen device.
• Discuss dental health and apply fluoride varnish to your child's teeth.
• Discuss toilet training and time out.
• Provide your baby with their Reach Out and Read book.  Read to your baby 20 minutes every day!

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. 

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.  Your child may need immunizations if they are behind on their shots.
• Review your child’s development using the Ages and Stages questionnaire.
• Screen your child for amblyopia (lazy eye) with our ocular photoscreen device.
• Perform select picture audiometry to check your child's hearing.  
• Discuss dental health and apply fluoride varnish to your child's teeth.
• Provide your baby with their Reach Out and Read book.  Read to your child 20 minutes every day!

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.  

At this visit we will:

• Measure your child’s weight and length and record on a growth curve
• Provide your child's immunizations.
• Review your child’s speech and development using the Ages and Stages Questionairre.
• Screen your child for amblyopia (lazy eye) with our ocular photoscreen device.
• Perform select picture audiometry to check your child's hearing. 
• Check urinalysis (urine dip test) to screen for kidney disease and diabetes. 
• Discuss dental health and apply fluoride varnish to your child's teeth.
• Provide your child with their Reach Out and Read book.  Read to your child 20 minutes every day!

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 length and record on a growth curve
• Review your child’s speech and development
• Discuss exercise and nutrition
• Discuss kindergarten readiness
• Screen your child for amblyopia (lazy eye) with our ocular photoscreen device.
• Perform select picture audiometry to check your child's hearing.
• Discuss dental health and apply fluoride varnish to your child's teeth.
• Provide your child with their Reach Out and Read book. Read to your child 20 minutes every day!

Encourage good learning by helping your child organize a distraction-free time to do homework and ensuring eleven hours of sleep a 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 length 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

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 and length and record on a growth curve
• Review your child’s school performance and development
• Screen your child's vision and hearing
• Discuss exercise and nutrition
• Review safety issues

Ensure that your child ALWAYS wears a helmet when bicycling, skateboarding, scooter riding and skating. 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 length and record on a growth curve
• Screen your child's vision and hearing
• Review your child’s school performance and development
• Discuss exercise and nutrition
• Review safety issues

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. 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 length and record on a growth curve
• Screen your child's vision and hearing
• Review your child’s school performance and development
• Discuss exercise and nutrition
• Review safety issues

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. 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 length and record on a growth curve
• Screen your child's vision and hearing
• Review your child’s school performance and development
• Discuss exercise and nutrition
• Discuss puberty changes to expect or that may be starting to occur

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 and length and record on a growth curve
• Provide your child’s immunizations
• Screen your child's vision and hearing
• Screen your child for glucose and lipid profile 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

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 and length and record on a growth curve
• Screen your child's vision and hearing
• 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

Even 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. 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
• Screen your child's vision and hearing
• 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

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. 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
• Screen your child's vision and hearing
• 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

Your child 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 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
• Screen your teen's vision and hearing
• 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

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 culture and peers.

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
• Provide your child's immunizations
• 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

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. 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
• Screen your child's vision and hearing
• 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

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. 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
• Provide immunizations
• Screen your child's vision and hearing
• 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

We continue to recommend yearly physical exams. We are happy to continue to see our patients while they are still in school/college through the age of 21, but understand some of our patients feel more comfortable transitioning to an adult medicine provider at this age.