Well Child Checks

Well-child checks are an important part of a routine healthcare schedule for children, with the specific aim of ensuring your child enjoys a healthy, happy childhood leading to a healthy, happy life in which they thrive. These important checks serve three main purposes:

  1. To ensure your child is growing and developing as expected
  2. To pick up problems that need intervention or support
  3. To provide guidance and health information on what to be mindful of at each stage of life

 
I would be delighted to perform these for you and I hope you find the following information useful.
 

Importance

Few parents and virtually no paediatrician would dispute the importance of timely well-child checks as part of an effective programme of healthcare to ensure that children develop and thrive. This importance isn’t just ‘in theory’ either. A large study involving 37,000 infants, examined the relationship between having regular well-child checks and the need for hospitalisations (ACSH – Ambulatory Care Sensitive Hospitalizations i.e. for things that are often preventable). It found an increasing rate of ACSHs with decreasing attendance for well-child visits, which was even more pronounced where children had 1 or more chronic conditions e.g. asthma. The same study also showed that continuity of care (CoC) was influential too i.e. seeing the same paediatrician (the effect probably being down to the relationship with the child and having a ‘perspective’ over time). Reduced hospitalisations is just one measure but obviously an important one!

(Reference and definitions included at the page end)

 

Early is Almost Always Better

Well-child checks are an important means for identifying potential problems as early as possible. Us mums should be only to aware of ‘early is better’, given we readily accept the importance of regular Pap Smears, with the specific aim of picking up important problems BEFORE they are outwardly symptomatic. It’s the same with well-child checks – an opportunity to identify problems, and therefore intervene, as early as possible to produce the best possible outcomes. Well-child checks are an important part of spotting certain types of things before they are outwardly obvious.

Although many are really rare, many genetic problems and certain rare diseases only become identifiable at certain stages of childhood. We use our well-child checks to look for signs of these too. Most of these are progressive i.e. they become more prominent over time, so a regular opportunity to check is really important.

 

More than Vaccines & Growth Charts

You may associate well-child visits primarily with vaccines and growth charts. These two are part of our effective monitoring and prevention strategies for healthy children. However, as my mums will know, we view these as ‘in addition to’ rather than ‘instead of’ well-child checks. I like to plot growth charts whenever I can, whereas well-child checks tend to be at specific time points that research suggests are good points at which to assess developmental milestones or times when certain conditions become identifiable.

These visits also give parents an opportunity to discuss concerns, including nutrition, sleeping issues, toilet training, and social problems, as well as gain guidance on what to be on guard against or mindful of in the next stage of development. When parents only bring children to see a paediatrician when the child is unwell, the focus on this often means there isn’t time to discuss many other matters. Moreover, the presence of sickness e.g. Hand, Foot & Mouth, Flu etc, means this isn’t the best time to assess the longer term things we look for. We wouldn’t want to over-diagnose because of current symptoms and at the same time we wouldn’t want to inadvertently miss something important because it was masked by current symptoms. A separate well-child check works best.

An important benefit of a well-child visit is developmental monitoring. Whilst interacting with children, good paediatricians may spot problems with playing, speaking, or interacting. Such signs may allude to autism, attention-deficit/hyperactivity disorder, or a learning disability. Identifying children with these problems early can help ensure they receive much-needed care and support and can make the difference between remaining in mainstream school versus needing more complicated schooling arrangements. As recent news articles in Cayman have highlighted, we are under-served when it comes to special educational needs and so early support can be really important. My own son has an autistic spectrum disorder and the right support has been vital to his schooling (he is now doing GCSEs and projected to do very well, if we can separate him from his X-Box).

 

Schedule

The American Academy of Pediatrics recommends 14 well-child visits in the first 5 years of life, and then annually up to the age of 21 years. It’s a robust schedule with distinct milestones and checks that differ or progress from visit to visit. The recommended schedule is:

  • 2 to 5 days old
  • 1 month
  • 2 months
  • 4 months
  • 6 months
  • 9 months
  • 12 months
  • 15 months
  • 18 months
  • 24 months
  • 30 months
  • 36 months
  • Annually thereafter to age 21

 

My Well-Child Checks

I am both a paediatrician and a neonatologist (newborn and preterm specialist). Preterm infants have a higher chance of developing certain conditions e.g. wheeze or asthma, and so neonatologists place special importance on regular checks and take a comprehensive approach (as should all paediatricians for all infants!). I take that same comprehensive approach for ALL children, to ensure we really use the sessions well.

If you aren’t familiar with me, you can find out more here: http://babydoctor.ky/grand-cayman-paediatrician-dr-sara-watkin/

 

Booking a Well-Child Appointment

Please contact your paediatrician’s office to schedule at appointment. Where children are registered with my own practice (or where parents would like me to conduct the check), you can book an appointment directly online or use the form below to request one.

 

ONLINE BOOKING

Please use the booking scheduler below to make your booking directly, including live availability.

 


 

BOOKING REQUEST FORM

Please provide details below and we’ll respond swiftly with available times matched as closely as possible to your preferences.

 

 


 

REFERENCE

MISSED WELL-CHILD CARE VISITS, LOW CONTINUITY OF CARE, AND RISK FOR AMBULATORY CARE SENSITIVE HOSPITALIZATIONS IN YOUNG CHILDREN
Dr. Jeffrey Tom, MD, MS, Dr. Chien-Wen Tseng, MD, MPH, Dr. James Davis, PhD, Dr. Cam Solomon, PhD, Dr. Chuan Zhou, PhD, and Dr. Rita Mangione-Smith, MD, MPH
Arch Pediatr Adolesc Med. 2010 Nov; 164(11): 1052–1058.
doi:  10.1001/archpediatrics.2010.201

DEFINITION

ACSH – Ambulatory Care Sensitive Hospitalizations
Age-standardized acute care hospitalization rate for conditions where appropriate ambulatory care may prevent or reduce the need for admission to hospital, per 100,000 population.