It’s 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 father who has done his homework and is prepared.”
What those questions might be, Dr. Weiermiller said, vary depending on your child’s age and stage of development.
“Every physical for your child is working to build a bridge to the next visit,” she said. “We’ll talk about what to anticipate before the next visit, what to look for, and that goes for any age.”
Here are some questions parents might consider asking.
Is my child’s development on track?
During childhood, visits are frequent, weeks or months apart. Providers monitor babies’ gross and fine motor skills and social and emotional milestones as they grow.
“In that first year, it’s all about development, diet, how they progress,” Dr. Weiermiller said. “As the child grows, we talk about exercise and diet, about social progress.”
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 the questions vary depending on the age of the child.
Pediatricians can address any delays during these visits, he said.
“For growth, we plot weight and height percentiles, and take head measurements up to age 2, then BMI charts from age 2,” Dr. Al-Rufaie said.
Dr. Al-Rufaie, like most pediatricians, uses the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) tables for growth and development percentiles.
They refer to the standard WHO growth charts for children under 2 years of age. CDC growth reference charts apply to children ages 2-19.
Are the vaccines safe and when should my child receive them?
“Vaccines are important because a lot of our work as pediatricians is disease prevention,” said Dr. Al-Rufaie. “We are hearing more concerns these days; bring your concerns to the pediatrician to discuss.”
She uses the CDC tables for immunization schedules.
There is a lot of misinformation out there and we can talk about it, he said.
“I find that, most of the time, when parents learn more facts, they are happy that their children are vaccinated,” said Dr. Al-Rufaie.
“Often the concerns I hear from parents about immunizations are emotional rather than factual,” Dr. Weiermiller said.
He recommends talking to your pediatrician about your concerns.
“A lot of parents just need information,” she said. “We may be able to adjust the schedule so that your child gets the vaccines if she doesn’t want them all at once or wait until the child is older, but it’s important that your children get them.”
What tests should my child receive?
Eye exams begin at age 3 or 4 when children can articulate what they are seeing. Hearing tests start around age 4.
“As children get older, we do more tests,” Dr. Al-Rufaie said.
These may include academic assessments, attention, and mental health.
“We used to do mental health screenings on an as-needed basis, starting at age 12, but in recent years, with the isolation of the pandemic, we are testing all children,” he said.
Older children may not always talk openly and honestly about their suicidal feelings or thoughts when parents are around.
“I speak directly with the older child to get a sense of his emotions,” Dr. Weiermiller said.
We use a questionnaire for mental health assessment, and many children may experience symptoms that appear on the questionnaire, but their parents may not be aware of it, Dr. Al-Rufaie said.
“It is important that the pediatrician foster a good relationship with the child and build trust. I often ask parents to leave the room when I ask the child about their feelings,” she said.
At the same time, Dr. Al-Rufaie said, it’s important for parents to understand that they can’t always fix their children’s problems for them, nor should they try.
“Allowing the child to manage 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 growing popularity of screens (cell phones, tablets, and laptops), parents are increasingly asking pediatricians about screen time.
“Our world is based on screens,” said Dr. Weiermiller. “Even babies search for mom’s phone. It may be impossible to keep children away from screens, but we can modulate their use and encourage other activities.”
Parents can gain more from distraction rather than ditching screens altogether, he said.
His advice includes signing kids up for sports and other activities and teaching good screen habits instead of ditching screens altogether.
“Sleep is important for a growing child, so parents should keep screens out of the bedroom,” said Dr. Al-Rufaie.
He said to keep kids off tablets and phones at least an hour before bed.
How can I best prepare for my child’s annual visit?
Both doctors encourage parents to prepare questions before 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 encourage those milestones, and what kinds of things to watch for as their child gets older.”
The specific questions will vary for each child and for different ages and stages of development.
“When parents are prepared with their questions, we can make the most of their time with the doctor,” said Dr. Weiermiller.