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navigation bar. Keep Your Child WellThe first time your healthcare professional examines your baby will be in the hospital or birthing center. Often the exam takes place in the nursery where you may not have the opportunity to observe it. The first checkup or well-child visit may be in your home within a few days of discharge or when you take your baby in to visit your healthcare professional, usually before he is one week old. You might schedule the appointment before you leave the hospital but, usually, you're asked to call after you're discharged. You'll want to make sure the day and time of the appointment are convenient for you and that you plan for enough time so you're not rushed. If your pediatric practice has more than one office, be sure to confirm the location of your appointment. The First CheckupOnce you arrive, you'll be requested to sign in at the front desk. Be prepared to show your insurance card and make any required payments at that time. There is often a separate waiting room for well-child visits. You'll want to make sure you bring feeding supplies (a blanket to use while breastfeeding, or a bottle) and changing supplies with you. If you have questions for your healthcare professional, it's a good idea to write them down beforehand and bring them with you. Throughout the visit, you should feel free to ask questions about anything that is concerning you. Once you get to the examining room a medical assistant or nurse will take measurements for weight, length and head circumference (to see if baby is growing at a healthy rate) and check the baby's heart rate, breathing rate and temperature. Your healthcare professional will count on you to provide information about how your baby is adjusting. Below are some questions you may be asked:
Some mothers record their baby's first-week feeding and sleep patterns and show the healthcare practitioner at this visit. After talking to you about the baby's adjustment at home, your healthcare professional will begin the physical examination. A thorough physical examination includes:
Your baby should have a hearing screening at this visit if it was not done in the hospital. If a Hepatitis B vaccine wasn't given in the hospital, your baby's first shot will be given now. You'll receive written information about it and possible side effects before it is given. It's very important that you begin to keep a record of your child's immunizations now. Bring it to each visit. As the visit wraps up, feel free to ask your practitioner how your baby is doing. You may want to ask about your baby's newborn screen, the blood test done in the hospital before discharge. Your healthcare professional may provide you with information on car seats, safety, putting your baby to sleep on his back and signs of illness. If you receive handouts or pamphlets, take time later to review the information. Once your appointment is over, you'll check out at the desk. It's a good idea to schedule your baby's next appointment at that time. Your baby will be tired from this outing, so you'll want to plan on going home to get some rest! Other First-Year VisitsAfter the first well-baby visit, you can expect to see your healthcare professional many times throughout your child's first year. The usual schedule for appointments is:
Some pediatric practices will schedule you to see the same healthcare provider with each visit. In other practices, the providers may rotate, and you will see a different provider each time. If you have a preference, request the provider of choice when scheduling your appointments. Most practices will try to accommodate your requests. Although your insurance information will be kept on file after your first visit, it's a good idea to bring your insurance card with you each time. Check with your insurance company to make sure your new baby is added to the plan and provide a copy of your baby's card to your practitioners. Also, if your insurance changes, you'll need to check that your practitioner is still approved for your new plan. At each visit, your baby will be undressed, weighed and measured, and the measurements will be plotted on a growth chart to see if your baby is gaining weight and growing at a healthy rate. Additionally, your baby's heart rate, breathing rate and temperature will be checked. At each visit, your healthcare professional will usually ask several questions about how your baby is doing. They'll vary with each visit, based on your child's age, expected developmental behaviors and past history. As a parent, you are the most significant source of information about your child's everyday activities. The information you provide is crucial to the overall assessment of your child's health. There will not be time at each visit to cover all of the topics, so if you have any specific concerns, make sure you bring them up. You can expect to be asked:
After your discussion, your healthcare professional will complete a thorough physical, similar to the first visit, also checking for progress of developmental milestones. At each visit, immunizations will be administered. You will want to bring your baby's immunization record with you at each visit so that you have a current record. As the visit wraps up, again feel free to ask how your baby is doing. Your healthcare professional will provide you with information about what changes to expect in your baby over the next few months, ways to prevent injury and illness, nutrition and other issues. Charting GrowthAt each well-baby checkup, your healthcare provider will weigh and measure your child and then plot his length and weight on a chart. Growth charts, developed by the National Center for Health Statistics, provide a reference point as your child develops. They consist of a series of curves called “percentiles” that show the growth patterns of many ethnically diverse children across the country. Values for height, weight and head circumference are plotted, and your child’s measurements are compared with those of other children the same age. For example, when a 6-month-old is at the 75th percentile for weight, it means that 75 percent of the nation’s children that age weigh less than that child, while the other 25 percent weigh more. In spite of parents’ fascination with them, these percentiles are not a “score,” and there is no perfect weight or height for any particular age. Actually, there are a variety of growth charts (blue for boys and pink for girls). There are separate charts for infants from birth to 36 months that record the basics. Additional charts are sometimes used to evaluate skinfold thickness and arm circumference. Still another chart, called BMI (Body Mass Index), is used for children 2 through 20 years as an evaluation of a child’s weight in relation to height. It is a screening tool used by practitioners to assess whether a child is underweight, overweight or at risk of becoming overweight. Growth charts use the 5th and 95th percentile as normal parameters. In general, children whose height or weight falls below the 5th percentile are considered underweight or small in stature, while those whose measurements are above the 95th percentile are considered overweight or large in stature. However, this is not set in stone, as a small or large size may also be affected by ethnic and family factors. Because growth is a continuous but uneven process, general growth patterns over a period of time are more important than a single measurement plotted at any one well-baby checkup. Your healthcare provider will be more concerned with keeping an eye on your baby’s steady growth rather than his particular percentile. If he’s at one percentile for a while but then suddenly switches to one that’s quite different, your provider will surely take a closer look. If you have questions, you should absolutely ask. Your healthcare provider will be more than happy to help you understand what he’s looking for.
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