Regular well-child examinations by your child's doctor are essential to keep your child healthy and up-to-date with immunizations against many dangerous childhood diseases. A checkup also gives your child's doctor an opportunity to talk to you about developmental and safety issues and gives you an opportunity to ask any questions you might have about your child's overall health.
What Happens at the Doctor's Office?
At a typical well-child visit, your child's doctor will weigh and measure your child to make sure he or she is progressing along a normal pattern of growth. The doctor will take a family and medical history and perform a complete physical examination. If indicated or if it has not been done previously, your child may be screened for anemia, lead poisoning, tuberculosis, high cholesterol, or other specific conditions. The doctor will also ask about your child's eating habits.
Your child's teeth will be examined for tooth decay, abnormal tooth development, malocclusion (abnormal bite), dental injuries, and other problems. Although the American Academy of Pediatrics recommends that all children visit the dentist no later than age 3, many dentists and pediatricians feel that children should be examined between 2 and 3 years of age - or earlier if problems are suspected.
At this age, most children should have had the following recommended immunizations:
- four doses of DTaP (diphtheria, tetanus, and pertussis) vaccine
- three doses of polio (IPV) vaccine
- four doses of Haemophilus influenzae type B (Hib) vaccine
- one dose of MMR (measles, mumps, and rubella) vaccine
- three doses of hepatitis B vaccine (Hep B)
- one dose of varicella (chickenpox) vaccine
Your child's doctor will make sure your child's immunizations are up-to-date.
Your child's doctor will also check developmental progress. He or she will ask a number of questions to see if your child's everyday behavior is age appropriate, including how well your child communicates with others, how he or she behaves around other children, and whether he or she can identify family members or follow simple instructions without gestured cues (such as "Come here"). The doctor may also check for specific milestones: Can your child kick a ball? Use two-word phrases? Imitate adults? Stack seven blocks?
Child safety is another topic doctors discuss at well-child visits. Your child's doctor will reinforce the importance of using age-appropriate car seats, closely supervising children around swimming pools, preventing poisoning, not smoking around children, using sunscreen, and protecting children against exposed wires, outlets, and heat sources. In homes with firearms, guns and ammunition should be stored separately and kept locked at all times.
What Should I Do if I Suspect a Medical Problem?
Although parents often can tell by their child's appearance if they are ill, there are certain symptoms that warrant contacting your child's doctor. Some of these symptoms may indicate a possible infection or a chronic medical condition. These include:
- changes in weight or eating habits
- changes in behavior or sleep patterns
- failure to grow in height as expected
- temperature over 102 degrees Fahrenheit (38.9 degrees Celsius) that persists or recurs
- persistent or frequent vomiting or diarrhea
- severe or persistent irritability or tiredness
- signs of a skin infection or a persistent rash
- persistent cough, wheezing, shortness of breath, or other breathing problems
- localized pain, such as that often seen with an ear infection
Typical Medical Problems
On average, preschoolers in child care get about six to 12 colds (upper respiratory infections) a year as well as several bouts of diarrhea and vomiting. Ear infections are also common. After children reach age 3, they usually have fewer episodes of such illnesses.
Sleep difficulties and behavior or discipline concerns are very common at this age and are a frequent source of questions for parents - as well as frustration. Your doctor can be a great resource for you with regard to any questions that you may have, or if it is just to doublecheck that your child's behavior is normal.
Reviewed by: Barbara Homeier, MD
Date reviewed: January 2005
Originally reviewed by: Steven Dowshen, MD
