Make the most of your child’s well visit

It is time for your child to see the pediatrician again, perhaps for an annual visit.

How can you make the most of your visit?

“I want parents to ask me questions, lots of questions,” Richard Weiermiller, MD, internal medicine and pediatrics at Corewell Health in Southeast Michigan. “I love a parent who has done their homework and is prepared.”

What those questions might be, Dr. Weiermiller said, vary with your child’s age and development stage.

“Each physical for your child is working to build a bridge to the next visit,” he said. “We will talk about what to anticipate before the next visit, what to look for, and that applies to any age.”

Here are a few questions parents might consider asking.

Is my child’s development on track?

During infancy, visits are frequent, from weeks to months apart. Providers check infants for gross motor skills, fine motor skills, and for social and emotional milestones as they get older.

“In that first year, it’s all about development, diet, how they are advancing,” Dr. Weiermiller said. “As the child gets older, we talk about exercise and diet, social advancement.”

After infancy, we see children annually, he said.

Zeena Al-Rufaie, MD, in pediatrics and obesity medicine at Corewell Health in Southeast Michigan, agreed that questions vary with the child’s age.

Pediatricians can address any delays during these visits, she said.

“For growth, we plot weight and height percentiles, and we take head measurements up to age 2, then BMI charts from 2 years on up,” Dr. Al-Rufaie said.

Dr. Al-Rufaie, like most pediatricians, uses the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) charts for growth and development percentiles.

They reference WHO growth standard charts for children younger than 2 years. The CDC growth reference charts apply for children 2 to 19 years old.

Are immunizations safe and when should my child get them?

“Immunizations are important because a lot of our work as pediatricians is the prevention of diseases,” Dr. Al-Rufaie said. “We are hearing more concerns these days—bring your concerns to the pediatrician to discuss.”

She uses CDC charts for immunization schedules.

There is a great deal of misinformation out there and we can talk about that, she said.

“I find that, most of the time, when parents learn more facts, they are happy to have their children immunized,” Dr. Al-Rufaie said.

“Often the concerns I hear from parents about immunizations are emotional issues rather than factual,” said Dr. Weiermiller.

He recommends talking to your pediatrician about your concerns.

“Many parents just need information,” he said. “We might be able to adjust the schedule for your child to receive immunizations if you don’t want them all at once or to wait until the child is older, but it is important that your children get them.”

What screenings should my child receive?

Vision screenings begin at age 3 or 4 when children are able to articulate what they are viewing. Hearing screenings begin around age 4.

“As children get older, we do more screenings,” said Dr. Al-Rufaie.

These may include academic screenings, attention and mental health.

“We used to do mental health screenings as needed, starting at age 12, but over the last few years, with the isolation of the pandemic, we are screening all children,” she said.

Older children may not always speak openly and honestly about their feelings or suicidal thoughts when parents are present.

“I talk to the older child directly to get a sense of their emotions,” Dr. Weiermiller said.

We use a questionnaire for mental health assessment, and many kids may experience symptoms that show up on the questionnaire, but their parents may not be aware, Dr. Al-Rufaie said.

“It’s important for the pediatrician to foster a good relationship with the child and build trust. I often ask parents to step out of the room when I ask the child questions about their feelings,” she said.

At the same time, Dr. Al-Rufaie said, it is important for parents to understand that they can’t always fix their child’s problems for them—nor should they try.

“Allowing the child to handle and navigate their problems on their own teaches critical thinking and problem-solving skills,” she said.

How much is too much screen time?

With the fast-growing popularity of screens—cell phones, tablets, and laptops—parents are increasingly asking pediatricians about time spent on screens.

“Our world is based on screens,” said Dr. Weiermiller. “Even babies are reaching out for Mama’s phone. It can be impossible to keep children away from screens, but we can modulate their use and encourage other activities.”

Parents can gain more with distraction rather than ruling out screens completely, he said.

His advice includes signing up kids for sports and other activities and teaching good screen habits rather than ruling out screens completely.

“Sleep is important for a growing child, so parents should keep screens out of the bedroom,” Dr. Al-Rufaie said.

She said to keep kids off tablets and phones at least an hour before bedtime.

How can I best prepare for my child’s annual visit?

Both physicians encourage parents to prepare questions ahead of the visit.

“We call it anticipatory guidance,” Dr. Al-Rufaie said. “I ask parents what questions they might have, and then we talk about upcoming milestones, how to foster those milestones, and what kinds of things to watch for as their child grows.”

Specific questions will vary for each child, and for different ages and development stages.

“When parents are prepared with their questions, we can make the most of your time with the doctor,” Dr. Weiermiller said.