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Well baby consult

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Well-child visits (or exams) are routine checkups done to monitor a child's development, as well as assess the general well-being of a child's health. Well-child visits play a key part in preventive health care, measuring a child's growth, tracking developmental progress, and receiving medical advice that assists with the wellness of the child. In the first year of life, the American Academy of Pediatrics recommends well-child visits every few weeks to every few months. After the first year, these office visits are recommended every three months. Once the baby is 2 years old, it is recommended that these visits are done annually. The Centers for Disease Control and Prevention (CDC) assert that well-child visits are crucial for immunization against highly contagious diseases, as well as the developmental milestones of a child.

Well-child visits are recommended every few weeks during a baby's first year of life. After that, it is recommended that the child sees their pediatrician every few months, then every year after that. These visits help prevent disease and illness and track developmental progress through growth charts.

Here's what to expect at a well-child visit:

- Physical exam: The pediatrician or family medicine physician will perform a full-body physical exam to check for infections and abnormalities. The skin of the child will be visually checked for jaundice. A stethoscope will be used to check for breathing difficulty and heartbeat regularity. The organs in the abdomen, as well as the genitalia, will be checked for infection or abnormal lumps. The bone structures in the head are lightly examined to make sure that the bones in the skull are forming and joining properly.

- Measurements: During the physical exam, the pediatrician, or family medicine physician, will measure certain areas of the child's body to track development and growth. For example, a special tape will be used to measure the child's head circumference. The child will also be weighed. These measurements are recorded on a growth chart that tracks the child's growth curve. This helps determine if the child is growing normally, and what the child's growth is like compared to other children of a similar age.

- Immunizations: At certain times during the child's growth, it will need vaccines to help protect against disease and illness. Both the CDC and the AAP have released recommended immunization schedules to help parents stay on schedule with vaccinations and disease prevention. Immunizations help boost a child's immune system while protecting against diseases such as tetanus, polio, measles, hepatitis B, mumps, chickenpox, diphtheria, and pertussis (whooping cough).

The CDC strongly recommends following the immunization schedule listed above. While immunizations may cause mild side effects, these are expected and typically go away quickly. There are many common misconceptions about the risks of vaccination for children, and the dangers of not vaccinating a child against contagious, harmful diseases far outweigh these potential side effects. Studies have shown that vaccines do not cause autism, or sudden infant death syndrome, which are two commonly held misapprehensions about vaccination.

- Motor skills and development: Doctors will check the child's developing motor skills with a few simple tests. This includes checking whether or not a child turns toward sound, and if their eyes follow a certain sight. A doctor may ask about social behaviors (such as imitation of sounds and facial expressions), and skills such as crawling, standing, and reaching.

Bright Futures, from The American Academy of Pediatrics, have released a periodicity schedule that clearly outlines the recommended timetable for screening tests and checkups for a newborn infant up through childhood. The first well-baby visit is done 3-5 days after birth. Then, visits are recommended every month-2 months for the first year of life. After that, visits should be done at 3-month intervals until the baby is 2 years old. Then visits are recommended every 6 months-1 year. This continues through adolescence.

The periodicity schedule outlines different tests, vaccinations, and checkups needed for each specific visit. Not every visit will require a vaccination, and some will only consist of a physical exam. Tests and procedures may vary depending on the needs of the child, medical history, and specific wellness concerns.

A 1-year well-baby visit is a key part of understanding a child's development, as well as immunizing the child against a number of diseases. Doctors will ask a number of questions, perform a physical exam, and give the child vaccines for:

  • MMR (measles, mumps, and rubella)

  • Chickenpox

  • Hepatitis A & B.

Children will be weighed and measured, with these measurements being recorded on their growth chart to track their development. Vital signs will be checked, as well as the lungs and heart. The pediatrician, or family medicine physician, will often ask questions to help understand the child's developmental milestones. They will also simply observe the baby to watch for natural behavior and abilities. Some developmental milestones that the doctor might be looking to observe include:

  • Can the baby walk/ crawl/ and pull themselves up?

  • Can the baby eat solid food?

  • Can the baby reach for things with their fingers? Can they pick objects up with their hands?

  • How many teeth have come in for the baby?

  • Can they respond to their own name?

  • Can they play games?

  • Do they try to imitate facial expressions/ sounds that they observe?

These small observations can help the doctors determine where a baby may be at in their development of motor skills and cognition. It can also help judge the quality of a baby's vision and their ability to hear.

The AAP strongly recommends that babies receive wellness checkups every two months until that 1-year checkup, and then every three months after that until the child is 2 years old. This helps the pediatrician track the child's growth, while playing a key role in disease prevention.

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