Over the past 30 years, the idea of a “wellness visit” for children, adolescents and young adults has evolved significantly because of changing views on health prevention, immunization protection and antibiotic therapies, and childhood development.
There was a newfound focus on the importance of childhood development and parenting in helping produce physically and emotionally healthy adults. In 1990, the American Academy of Pediatrics began to enshrine the issues that should be discussed at each “wellness visit” from birth to age 21 years in its Bright Futures initiative. The fourth edition, released in 2017, has become the standard of care for such visits.
The following are some practical recommendations for how to make the most of your child’s next “wellness visit.”
Get Ready for the Visit
- Think about and Google issues that concern you the most and trust your intuition. If you are concerned, it is important to ask.
- Write down your questions electronically or on paper. Come in with a list of questions on feeding, bowel and bladder issues (toilet training, bedwetting, constipation), sleeping, development, school-related issues, mental health (depression and anxiety), or skin problems. Be prepared to get answers to all your questions before you leave.
Prepare Your Child
- Explain the difference between a “wellness” and “illness” visit to your child. Explain that the point of the visit is to make sure they are healthy and to give them ideas on how to keep healthy. Have them think of their own questions.
- Describe the visit process: First, they will be called back by a person called a nurse or medical assistant. Their height and weight will be measured on a scale. After age 3, they will have their blood pressure measured. Then, they will be put in an exam room. Exam rooms these days should have books and toys to help make the experience as homey as possible and to provide as many distractions as possible in case there is a wait. Explain why the provider may be late (he/she is taking care of other children).
- Most pediatric care providers like to do “wellness exams” on the lap of a parent at least until age 4 or 5. Point out that the table is sometimes necessary for the abdominal exam.
- Pediatric providers examine all parts of the body, including the private areas. Prior to hearing it from the pediatric care provider, it is helpful for a child to have heard from you the list of people who can look at their private areas and why (just like doctors check your eyes and ears to make sure they are healthy, they have to check your private areas).
Ease Your Kids’ Fear of Shots
Most kids care about “shots” and what happens during that time of the visit.
Infant vaccines should be completed by age 24-30 months. The next set is the pre-kindergarten series of three shots at age 5. There are no shots (except annual flu vaccines) from ages 6-10. Then, there are two at age 11 (meningitis and whooping cough) with a blood draw for cholesterol, two HPV shots by age 14, and two meningitis vaccines by age 17.
For most visits, parents can explain beforehand that there will be no shots. For the few visits in which there are shots, show your child what it will feel like by poking them briefly with a pen. Bring along a favorite toy or “lovey.” Most pediatric providers do not give shots themselves. If there is a shot, the medical assistant or nurse will return and clean their shoulder (it is only in the thigh up until the child is 2 years old) — it will smell a little funny — and they will get a poke and a bandaid (or a series of pokes). When it’s all over, they put on their shoes and go to the front desk, often to get a toy or a sticker.
Dr. Shelly Senders started his practice in 1987 in an attempt to bring back some of the old-time values that had been lost in the quest for greater productivity. He has succeeded in building a team of pediatric doctors and nurse practitioners who share his vision. Visit senderspediatrics.com for more information.