When do well child visits take place

The history should include a brief review of birth history; prematurity can be associated with complex medical conditions. Sleep, urination, defecation, nutrition, dental care, and child safety should be reviewed. Medical, surgical, family, and social histories should be reviewed and updated. For newborns, review the results of all newborn screening tests Table 1 4 — 7 and schedule follow-up visits as necessary.

Measure pulse oximetry for preductal and postductal saturation 24 hours after delivery 4. Diagnostic echocardiography 4. Obtain blood work after 24 hours of age 5. Evaluate and stabilize infant if necessary; refer to regional subspecialist for further evaluation 5. Screen by auditory brain-stem response 6. Refer to audiologist 6.

Obtain serum or transcutaneous bilirubin level 7. Repeat bilirubin based on previous level and risk factors 7. Information from references 4 through 7. A comprehensive head-to-toe examination should be completed at each well-child visit. Interval growth should be reviewed by using appropriate age, sex, and gestational age growth charts for height, weight, head circumference, and body mass index if 24 months or older.

Percentiles and observations of changes along the chart's curve should be assessed at every visit. Insufficient evidence to screen children without clinical concerns Grade I 9. Screen at and month visits SOR C Oral fluoride supplementation if water is fluoride deficient Grade B 11 Primary care physicians apply fluoride varnish to primary teeth beginning at tooth eruption Grade B Insufficient evidence to screen for speech and language delays without clinical concerns Grade I Screening at 9-, , and month visits SOR C Insufficient evidence Grade I Risk-based screening at 2, 4, and 6 years of age SOR C Screen annually beginning at 3 years of age SOR C Screen at 12 months; consider supplements for preterm or exclusively breastfed newborns SOR C 3.

Insufficient evidence to recommend screening in children 1 to 5 years of age without increased risk Grade I 20 Recommend against screening in children 1 to 5 years of age with average risk Grade D Screen high-risk individuals 6 months to 6 years of age SOR C Screen postpartum women Grade B Screen at 1-, 2-, 4-, and 6-month visits SOR B Insufficient evidence to recommend screening for depression Grade I Screen for mental health disorders and perform psychosocial assessment at each well-child visit SOR C Insufficient evidence to screen before 3 years of age Grade I 26 Screening once between 3 and 5 years of age Grade B Preventive Services Task Force.

Information from references 3 , and 9 through The USPSTF does not specify a screening schedule; however, based on expert opinion, the AAP recommends screening mothers at the one-, two-, four-, and six-month well-child visits, with further evaluation for positive results. With nearly one-half of children in the United States living at or near the poverty level, assessing home safety, food security, and access to safe drinking water can improve awareness of psychosocial problems, with referrals to appropriate agencies for those with positive results.

If results are abnormal, consider intervention or referral to early intervention services. The AAP recommends completing the previously mentioned formal screening tools at nine-, , and month well-child visits. The AAP also recommends autism-specific screening at 18 and 24 months. Multiple reports have associated iron deficiency with impaired neurodevelopment.

Therefore, it is essential to ensure adequate iron intake. Based on expert opinion, the AAP recommends supplements for preterm infants beginning at one month of age and exclusively breastfed term infants at six months of age. Lead poisoning and elevated lead blood levels are prevalent in young children.

The AAP recommends screening for serum lead levels between six months and six years in high-risk children; high-risk children are identified by location-specific risk recommendations, enrollment in Medicaid, being foreign born, or personal screening. Testing options include visual acuity, ocular alignment test, stereoacuity test, photoscreening, and autorefractors.

The AAFP recommends that all children be immunized. Immunizations are usually administered at the two-, four-, six-, , and to month well-child visits; the four- to six-year well-child visit; and annually during influenza season. Additional vaccinations may be necessary based on medical history. Injuries remain the leading cause of death among children, 34 and the AAP has made several recommendations to decrease the risk of injuries.

Infants need a rear-facing car safety seat until two years of age or until they reach the height or weight limit for the specific car seat. Children should then switch to a forward-facing car seat for as long as the seat allows, usually 65 to 80 lb 30 to 36 kg. Young children should wear bicycle helmets while riding tricycles or bicycles. Having functioning smoke detectors and an escape plan decreases the risk of fire- and smoke-related deaths.

Swimming pools and spas should be completely fenced with a self-closing, self-latching gate. Infants should not be left alone on any high surface, and stairs should be secured by gates. Firearms should be kept unloaded and locked. Young children should be closely supervised at all times. Small objects are a choking hazard, especially for children younger than three years.

Latex balloons, round objects, and food can cause life-threatening airway obstruction. Infants should never have a bottle in bed, and babies should be weaned to a cup by 12 months of age. Children should visit a dentist regularly, and an assessment of dental health should occur at well-child visits.

Hands-on exploration of their environment is essential to development in children younger than two years. Video chatting is acceptable for children younger than 18 months; otherwise digital media should be avoided.

Parents and caregivers may use educational programs and applications with children 18 to 24 months of age. If screen time is used for children two to five years of age, the AAP recommends a maximum of one hour per day that occurs at least one hour before bedtime. Longer usage can cause sleep problems and increases the risk of obesity and social-emotional delays.

To decrease the risk of sudden infant death syndrome SIDS , the AAP recommends that infants sleep on their backs on a firm mattress for the first year of life with no blankets or other soft objects in the crib. Early transition to solid foods before six months is associated with higher consumption of fatty and sugary foods 50 and an increased risk of atopic disease. Cessation of breastfeeding before six months and introduction of solid foods before six months are associated with childhood obesity and are not recommended.

Intake of other sugar-sweetened beverages should be discouraged to help prevent obesity. Regular well child visits help parents, children and physicians: Identify and address concerns of parents and patients Identify and address possible concerns in the child's environment that may affect parenting and the child's well-being Identify and address developmental, behavioral, and health concerns that are identified through measurements, screens, tests, history, and physical examination at the visit Follow up on prior concerns and ongoing conditions Provide information, guidance and resources The most important purpose is developing a trusting, caring relationship between parents, children, and their health care team.

What happens at a well child appointment? Based on your child's age, we may perform screening tests, such as blood tests or hearing and vision tests, to look for potential problems Your child's growth and vital signs will be obtained and evaluated Your provider will perform a thorough history and physical examination Any concerns identified through the above processes will be addressed A personalized plan of care and follow-up will be created between you and your child's health care provider Please plan for minutes at our office for each well child visit.

You also can ask your pediatrician about nutrition and safety in the home and at school. Tracking growth and development. See how much your child has grown in the time since your last visit, and talk with your doctor about your child's development. You can discuss your child's milestones, social behaviors and learning. Raising concerns.

Make a list of topics you want to talk about with your child's pediatrician such as development, behavior, sleep, eating or getting along with other family members. Bring your top three to five questions or concerns with you to talk with your pediatrician at the start of the visit. Team approach. Regular visits create strong, trustworthy relationships among pediatrician, parent and child. The AAP recommends well-child visits as a way for pediatricians and parents to serve the needs of children.

This team approach helps develop optimal physical, mental and social health of a child. Back to School, Back to Doctor. Recommended Immunization Schedules. Milestones Matter: 10 to Watch for by Age 5. You may be trying to access this site from a secured browser on the server.