Well Child Visits

Congratulations! Your baby is finally here! Having a new baby is a wonderful, but exhausting experience. This is a great time to involve family and friends to provide extra help and support. Make sure all visitors wash their hands well before touching the new baby. Your baby’s first visit to our office takes place during his or her first week of life, usually 1-3 days after you are discharged from the hospital.

We do a lot at this visit, including:

• Check your baby’s weight.
• Monitor for signs of jaundice.
• Go over birth history
• Check to see how your baby is feeding.
• Answer questions about your new baby.

Immunizations: 

• Hep B #1 (if not given in hospital)
• Beyfortus ( if not already done, October - March, RSV season)

Tests/Screens/Assessments:

• Check baby for jaundice.  If present do a bilirubin test.  

Nutrition Advice:

• Newborn infants should be fed every 2 to 3 hours. Breast milk is best. Breast fed babies should be fed 8 to 10 times per day.  If you experience breast pain or tenderness, sore nipples or difficult feedings consult us.  We can help!  
• Bottle fed babies most often should be fed a milk-based formula which is fortified with iron. We do not recommend European formulas due to inadequte iron levels.  Mix formula according to the instructions on the container with unfiltered tap water. In Little Rock tap water has added fluoride to help protect the developing teeth. Boiling bottles and nipples is not necessary.  Just wash these thoroughly. 
• Only give your baby breast milk or infant formula. Plain water should not be given to babies until they are at least 6 months of age because of the risk of a low sodium level and a risk of seizures.
• Babies who are breast fed need Vitamin D3, 400 IU once each day.  
• Do not use a microwave to heat milk. It can cause uneven temperature in the milk and cause burns of the mouth.  

When to call us:

• Rectal temp >100.4 F (38C)
• Crying excessively or inconsolably
• Difficulty breathing
• Excessive sleepiness or poor feeding
• Forceful or frequent vomiting
• If you have any questions or concerns

Next visit at 1 month of age (unless other follow up is needed)

Helpful Info: 

• Accident prevention
• Caring for Your Newborn
• Back to Sleep, Tummy to Play

The 2 Week Visit (sooner if you have concerns!) is a time to talk about how your baby is adjusting to life outside the womb. Feeding, growth, bowel habits and sleeping are common topics to be covered in this visit. 

If you are breastfeeding, your baby's weight measurement is important to insure your baby is growing well. Babies usually lose weight right after birth, and by 2 weeks of age, your baby will likely have regained his or her birth weight. 

Please remember that it is important to always put your baby to sleep on his or her back in a flat, firm and separate sleep space to reduce the risk of SIDS. 

We do a lot at this visit, including:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Follow up on any issues that were identified at the 3 to 5 day check-up.  Common issues are monitoring for adequate growth and follow up for premature babies and their unique problems.
• Remind you to give your baby a daily supplement of 400 IU of vitamin D drops if you are breastfeeding.

Immunizations:  

• Beyfortus ( if not already done, October - March, RSV season)

Tests/Screens/Assessments: 

• None

When to call us:

• Rectal temp >100.4 F (38C)
• Crying excessively or inconsolably
• Difficulty breathing
• Excessive sleepiness or poor feeding
• Forceful or frequent vomiting
• If you have any questions or concerns

Helpful Info: 

Accident prevention

Caring for Your Newborn

Back to Sleep, Tummy to Play

Next visit at 1 month of age (unless other follow up is needed)

Families are usually settling into their new roles by this visit. Feeding, sleeping and bowel habits are topics of concern. At this visit we will track your baby's growth and development and answer any questions. Your baby may be starting to smile now and that helps a lot!

Babies usually begin to get a little more fussy at this time. Crying begins to increase. This is a normal developmental phase that you should expect.

Immunizations: 

• Beyfortus ( if not already done, October - March, RSV season)

Tests/Screens/Assessments: 

• Post Partum Depression Assessment
• Physical exam to check for the presence of a heart murmur.  A new heart murmur can develop in a baby about the time that they are 1 month of age. We check carefully for this development in one month old babies.
• The newborn screen is a state health department test that screens for several inherited diseases.  The test results can take several weeks to come back to us. This visit is a good time to check that this test is normal.  

Nutrition:

• Breastfeeding: offer the breast every 2-3 hours, 7-8x feedings per 24 hour period
• Formula: offer 3-4oz every 3 hours. End the feeding when your baby closes his mouth or truns away from the bottle.  
• There is no need to wake at night for feedings for most babies
• There is no need to sterilize bottles
• 400 IU Vitamin D daily for breastfed babies is needed (available as liquid drops)

Development:

• Raises head slightly when on stomach
• Startles easily
• Babies can respond to your face and voice
• Babies can see things 8-12 inches away
• Babies calm when swaddled and rocked
• Tracks light with their eyes

Common concerns:

• Stools can be yellow, green or brown
• Babies grunt and appear to strain with stooling- if the baby has soft stool it is not constipation. Breast fed babies may go a week without having a bowel movement.
• Babies are gassy
• Congestion and sneezing can be sign of a mild cold. This is concerning if your child gets a fever or develops wheezing and any difficulty breathing. Make an appointment if that happens.  
• Always put babies to sleep on their backs
• No toys or blankets in the crib
• Crying/colic: babies have periods of crying (usually toward the end of the day) that starts around 3 weeks of age, peaks at 6-8 weeks, then tapers off by 3 months. There is generally no reason for the crying except to perhaps “let off steam”
• Babies can appear cross-eyed at this age- this is normal until 6 months of age

When to call us:

• Rectal temp >100.4 F (38C)
• Crying excessively or inconsolably
• Difficulty breathing
• Excessive sleepiness or poor feeding
• Forceful or frequent vomiting
• If you have any questions or concerns

Next visit in 1 month (at 2 months old)

Helpful Info: 

• Back to Sleep, Tummy to Play

Many babies seem more fussy or colicky at this age. Be patient. Colicky babies eventually outgrow their crying phase. 

Even if you feel frustrated by your baby's crying, handle your baby gently and reach out for help to friends, relatives or us here at All For Kids if the crying is getting to be too much. If you need a break and no one is available to help you, place your baby on his/her back gently in a safe space, such as a crib or bassinet and take a few minutes to calm down. Never ever shake your baby for any reason. The Shaken Baby Syndrome, a form of child abuse, is a known cause of death and disability in babies. 

We do a lot at this visit, including:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Provide your baby’s first set of immunizations. Immunizations are safe, effective and keep your child and our community healthy. During this visit, you will be able to discuss any questions you may have about immunizations.
• Screen for post-partum depression.

Immunizations: 

• Pediarix #1 (DTaP, HIB, Hep B)
• Prevnar 20 #1
• Rotavirus#1
• Injectable Polio Vaccine
• Beyfortus (if not already done, October - March, RSV season)

Tests/Screens/Assessments: 

• Post Partum Depression Assessment

Development:

• Social smile may begin
• Coos
• Holds head when on belly (prone)
• Follows object past midline
• Reacts to loud noises
• Moves both arms and both legs
• Opens hands briefly
• Talk and sing to your baby. Start reading books to your baby. We do not recommend screen time until the child is 18 months of age. Place rattles and squeak toys in front of your baby to play with.

Nutrition:

• Breastfeeding – 5-8x/day. Feedings are every 2-4 hours. Your baby might sleep in longer stretches now (3-5 hours) and feed more during the day. 
• Do not microwave breast milk or formula to prevent burns in the baby. Thaw frozen breast milk in the fridge or in a cup of hot water. Use it within 24 hours. 
• Breast milk can be stored: at room temperature for 4-6 hours, in the back of a refrigerator at 39 degrees for up to 4 days, or frozen in a freezer for up to 9 months.
• Fomula feeding- 3-5 oz per bottle, 5-8x/day
• 400 IU Vitamin D for breastfed babies (available as liquid drops)
• Do NOT add cereal to bottles
• No solid foods yet
• No water until 6 months
• No honey until 12 months of age because of the high risk of botulism poisoning in this age group

Sleep:

• Place babies on their back to sleep to prevent SIDS
• Tummy time when awake
• Let your baby self settle for sleep. Place your baby in the crib drowsy but awake.
• Nighttime sleep stretch of 4-8 hours

When to call us:

• Rectal temperature >101 for 24 hours
• Crying excessively or inconsolably
• Difficulty breathing
• Excessive sleepiness or poor feeding
• Vomiting forcefully or frequently
• Limp or sluggish
• OR if you have any other questions or concerns

Next visit in 2 months (at 4 months old)

Helpful Info: 

• Crying and Your Baby: How to Calm a Fussy or Colicky Baby

Your baby is becoming more active and verbal. Be careful not to leave your baby unattended, especially on a bed, couch or counter. They move faster than you think!

Babies need only breast milk or iron fortified formula for the first 4-6 months of life. We will talk at this appointment about the appropriate time to introduce solid foods and what foods to introduce first.

At this visit we will:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Provide your baby’s immunizations.
• Discuss when to start feeding your baby solid foods.
• Screen for post-partum depression.

Immunizations: 

• Pediarix #2 (DTaP, HIB, Hep B)
• Prevnar 20 #2
• Rotavirus #2
• Beyfortus ( if not already done, October - March, RSV season)

Tests/Screens/Assessments: 

• Post Partum Depression Assessment

Nutrition:

• Less feedings are needed: Breast or formula feedings 4-7x/day but in larger amounts. Let your baby tell you when they are full.  
• Continue vitamin D for breastfed infants
• Babies may become distracted while feeding, interested in things and people around them. If the feedings become difficult, try feeding in a quiet, darkened room.
• Don't prop a bottle in your baby's mouth while he or she is in bed
• Spitting up is common and normal at this age if your baby is acting normally and gaining weight well
• Babies can start solids between 4-6 months: signs of a baby’s readiness are; good head control, interest in watching others eat, opening their mouth as food nears and not sticking their tongue out when offered the spoon (extrusion reflex). Give one new food at a time and wait 2-3 days before starting another new food.  If your child gets a rash, vomiting or diarrhea after a new food, don't give it any more and let us know this information.
• After a few first foods have been tolerated, you can start more allergenic foot such as peanut butter (peanut butter powder), eggs and fish.
• Avoid honey until your child is 12 months old

Development:

• Smiles and chuckles
• Vocalizes, starting to babble, makes sounds back when you talk to them
• Good head control
• Sits with support
• Rolling to side or completely over
• Reaches for objects/ holds a toy
• Hands open at rest
• Hands to midline/ looks at their hands

Teething:

• The first tooth erupts usually between 4 and 12 months (even up to 18 month in rare instances)
• A cold damp washcloth and chew toys are helpful for teething
• Once teeth erupt, start wiping them with a soft cloth or finger brush and water

Sleep:

• Develop a sleep/bedtime routine
• Put your baby to sleep while awake and drowsy (self settling)
• Baby’s can sleep 10-12 hours overnight at this age if they are gaining weight well
• It's ok to start “sleep training”

When to call us:

• Rectal temp >101 for 72 hours
• Crying excessively or inconsolably
• Difficulty breathing
• Lethargic or poor feeding
• Vomiting forcefully or frequently
• If you have any other concerns or questions

Helpful Info: 

• Starting Solid Foods
• Accident prevention

Your baby will begin to move more and will be able to sit up independently for short periods of time. Now is the time to start baby-proofing your house - if you haven't already done so. You should move the mattress in your baby's crib down to the lowest level.

At this visit we will:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Provide your baby’s immunizations.
• Discuss the introduction of fluoridated water to encourage the development of strong and healthy teeth. If you have city or rural water,  your water is fluoridated. If you have well water,  you should have your water tested for fluoride before offering it to your baby.
• Screen for post-partum depression.

Immunizations: 

• Pediarix #3 (DTaP, HIB, Hep B)
• Prevnar 20 #3
• Rotavirus #3
• Influenza vaccine (during flu season

Tests/Screens/Assessments: 

• Post Partum Depression Assessment
• Fluoride Varish

Development:

• Babbles/ Squeals
• Rolls over
• Sits with or without support, tripods
• Transfers objects between hands
• Reaches/grabs objects/ puts things in mouth to explore them
• Likes to look at themselves in the mirror
• May show signs of separation anxiety/ Knows familiar faces

Sleep:

• Develop sleep/bedtime routine
• Put baby to sleep awake but drowsy

Solids:

• Start solids between 4-6 months
• Juice is NOT needed or recommended
• Offer water in a cup

Teething:

• The first tooth erupts between 4 and 12 months (even up to 18 month in rare instances).
• A cold damp washcloth and chew toys are helpful
• Once teeth erupt, start wiping them with a soft cloth or finger brush and water. No toothpaste is necessary at this age.

Safety:

• Begin childproofing: baby gates for stairs, cover electric outlets, keep medication and cleaning supplies in locked or high cupboard
• DO NOT use walkers, push toys are ok
• Never leave a baby on a high surface (changing table, bed, couch…) even for “a second”. Babies wiggle and often fall.
• Block cords attached to heavy objects that can be pulled down
• TV stands and dressers should be mounted or tethered to walls so that they won't fall on your child

When to call:

• Rectal temp >101 for 72 hours
• Crying excessively or inconsolably
• Difficulty breathing
• Lethargic or poor feeding 
• OR any other concerns or questions

Helpful Info: 

• Teething

Your baby may be starting to crawl, pulling to a stand and cruising on furniture. Babies will want to touch everything - this is how they learn. This is a messy time! Have fun and be patient.

At this visit we will:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Discuss your baby's upcoming dental care. Your baby should see a dentist at 1 year of age. You should be brushing your child's teeth with an infant toothbrush and a tiny smear of fluoride toothpaste. 

Immunizations: 

• Influenza vaccine (during flu season)

Tests/Screens/Assessments: 

• Ages and Stages Questionnaire
• Oral Health Surveillance
• Fluoride Varnish

Helpful Info: 

• Teething

At this age, your baby can transition from breast milk or formula to cow’s milk. However, it is healthy to continue breast milk, if that is what you prefer. The WHO recommends breast feeding until age two years.  Most babies need 3 meals, 2-3 snacks per day, and no more than 16-20 ounces of whole cow's milk per day. Your baby will be able to eat many of the foods you eat, but be careful to avoid small, hard foods that can cause choking.

It is time to wean your child from the bottle and offer all liquids in a sippy cup. It is much easier to wean your child now than if you wait until they are older. Avoid cavities and additional tears and make the change now!

Your baby will be outgrowing the infant carrier car seat. Continue to have your baby in a rear facing car seat until age 2.

At this visit we will:

• Measure your baby’s weight, length, and head size and record on a growth curve.
• Provide your baby’s immunizations.
• Discuss dental health and apply fluoride varnish to your baby’s teeth.
• Ages and Stages Questionnaire

Immunizations: 

• HepA#1
• MMR#1
• VAR#1
• Prevnar 20 #4
• Influenza vaccine (during flu season)

Tests/Screens/Assessments: 

• TB Surveillance
• Lead Surveillance
• Oral Health Surveillance
• Fluoride Varnish

Development:

• May say first word (“mama”, “dada”)
• Waves bye-bye
• Looks for things they see you hide
• Maintains eye contact
• Pulls to stand, cruises or may take first solo steps
• Good pincer grasp

Safety:

• Re-childproof your home based on the height your child is now walking and climbing…
• Check car seat maximum measurements and remain rear facing until 2 years of age

Discipline:

• Setting limits is important, Children understand “No”
• Use the word “no” for danger to self or others. If no is said too frequently, it loses its meaning.
• Use positive reinforcement for good behavior
• Be an effective parent. Be selective. Control the important things (safety and sleep)
• Try not to reinforce negative behavior. Removing your attention usually works

Nutrition/Food:

•  It is now ok to have honey, whole milk and other foods that have been avoided due to age
• Food preferences and struggles may arise
• The amount of food intake varies day to day
• Do not force children to eat and do not become a short order cook. Children will eat when they become hungry. Also, don't give them too many snacks.
• Your child knows when he/she is hungry and full
• Do not watch TV during mealtime or use electronics for distraction

Helpful Info: 

• Playing Is How Toddlers Learn

Your child may be able to climb and run, so be sure to fully safety proof your home.

Poison control is available 24 hours a day: 1-800-222-1222 - keep this number handy in your cell phone and on your refrigerator.

At this visit we will:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Provide your baby’s immunizations.
• Ages and Stages Questionnaire
• MCHAT Questionnaire

Immunizations: 

• DTaP #4 
• HIB #4
• Influenza vaccine (during flu season)

Tests/Screens/Assessments: 

• Fluoride Varnish

Development:

• May walk/takes a few step
• Claps when excited
• Self feeds with fingers
• Shows you an object they like
• Says 2-5 words
• Follows simple one step commands
• Cuddles/hugs
• Starts to say “no” and may have tantrums

Discipline:

• Children at this age start to test limits and have temper tantrums
• They begin to demonstrate negativistic behaviors (hitting, pulling hair, head
• banging…)
• In response to above behaviors, limit setting is important. Say “NO”.
• Praise good behavior and set consistent limits.

Nutrition/Food:

• Let child self-feed
• Wean off bottle
• Offer mostly table foods in conjunction with some purees if child enjoys them
• Juice is not recommended
• Whole milk- max of 20-24oz/day (600-720ml)

Tooth brushing- 1-2x/day with a soft toothbrush and a rice grain size of fluoride toothpaste

Helpful Info: 

• Choking Prevention and First Aid for Infants and Children

At 18 months, your child understands much more than he or she can say in words. Use words to describe your child’s feelings and gestures. Read and sing to your child often. When reading, use simple words to talk about the pictures.

At this visit we will:

• Measure your child’s weight, length and head size and record on a growth curve.
• Provide your baby’s immunizations.
• Discuss dental health and apply fluoride varnish to your baby’s teeth.
• Ages and Stages Questionnaire
• MCHAT Questionnaire

Immunizations: 

• Influenza vaccine (during flu season)

Tests/Screens/Assessments: 

• Ages and Stages Questionnaire
• MCHAT Questionnaire
• Oral Health Surveillance
• Fluoride Varnish

Development:

• Walks
• Tries to throw or kick a ball
• Self feeds with fingers
• Speaks 10 words
• Keeps good eye contact/ “Joint Attention”
• Says “no”, test limits and has tantrums
• Follows a one-step command without gestures
• Shows you an object they like
• Points/claps when excited

Safety:

• Toddlers at this age are explorers and have no sense of fear
• Constant supervision and guidance is important

Discipline:

• Children at this age continue to test limits and have temper tantrums
• They demonstrate negativistic behaviors (hitting, pulling hair, head banging…)
• Praise good behavior and set consistent limits

Nutrition/Food:

• Let child self-feed
• Cup drinking for milk and water (no bottle)
• Offer mostly table foods in conjunction with some purees if child enjoys them
• Juice is not recommended
• Whole milk- max of 24oz/day (720ml)

Tooth brushing- 1-2x/day with a soft toothbrush and a rice grain size of fluoride toothpaste

Helpful Info: 

• Is Your Toddler Communicating With You?

At this age, your 2 year old may go from trying to be independent to clinging to you; this is normal. It is better for toddlers to play than to watch TV. Even having television playing in the background interrupts healthy toddler play - background music is a better choice.

At this visit we will:

• Measure your child’s weight, length, head size and body mass index and record on a growth curve.
• Most of our patients do not have immunizations due at this visit.  Your child may need immunizations if they are behind on their shots.
• Ages and Stages Questionnaire
• Review your child’s development with you using the MCHAT (Autism screening tool) questionnaire.
• Test for lead exposure with a finger prick in the office.
• Discuss dental health and apply fluoride varnish to your child's teeth.

Immunizations: 

• HepA#2
• Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• MCHAT Questionnaire
• Ages and Stages Questionnaire
• TB Surveillance
• Anemia Surveillance
• Lead Surveillance
• Oral Health Surveillance
• Lead Test
• Fluoride Varnish

Helpful Info: 

• Playground Safety
• Time Out
• Toilet Training

Your child will likely be moving into a world of make believe that they create with their imagination. Toys for dress up and make believe are important at this age. Read books, sing songs and play rhyming games with your child each day.

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Most of our patients do not have immunizations due at this visit.  Your child may need immunizations if they are behind on their shots or during flu season.
• Discuss dental health and apply fluoride varnish to your child's teeth.

Immunizations: 

• Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• TB Surveillance
• Lead Surveillance
• Oral Health Surveillance
• Fluoride Varnish

Helpful Info: 

• Toilet Training

Four year olds often like to sing, dance and act. They like to tell "tall tales" and make up stories.  Enjoy these fun moments with your little one!  Parents should continue to help with brushing teeth even though your child will want to do it all by themselves.

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Provide your child's immunizations.
• Discuss dental health and apply fluoride varnish to your child's teeth.

Immunizations: 

• MMR#2
• VAR#2
• Kinrix (DTaP, IPV)
• Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• TB Surveillance
• Oral Health Surveillance
• Fluoride Varnish

Helpful Info: 

• Encourage Your Child to Be Physically Active

At this age, your child needs more independence. However, you need to set clear limits. A regular bedtime and consistent bedtime routine are important. Be a great role model. Show an interest in what they are learning.

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Review your child’s speech and development.
• Discuss exercise and nutrition.
• Discuss kindergarten readiness.
• Discuss dental health and apply fluoride varnish to your child's teeth.

Immunizations: 

• MMR#2  (if not done)
• Var#2  (if not done)
• Quadracel (DTaP, IPV) (if not received at 4 years)  (if not done)
• Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• TB Surveillance
• Oral Health Surveillance
• Vision Testing
• Hearing Testing
• Fluoride Varnish

Encourage good learning by helping your child organize a distraction-free time to do homework and ensuring eleven hours of sleep each night. Teach your child what to do if there is a fire and have practice fire drills. There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

At this visit we will:

• Measure your child’s weight, height and body mass index  and record on a growth curve.
• Screen your child's hearing and vision.
• Review your child’s school performance and development.
• Discuss exercise and nutrition.
• Review safety issues.

Immunizations: 

• Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• TB Surveillance
• Oral Health Surveillance

Continue to encourage good nutrition and exercise for your child. This is the time he or she is building good health habits for a lifetime! There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

At this visit we will:

• Measure your child’s weight, height and body mass index  and record on a growth curve.
• Review your child’s school performance and development.
• Discuss exercise and nutrition.
• Review safety issues.

Immunizations: 

• Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• TB Surveillance

Helpful Info: 

• Growing Up Healthy: Fat, Cholesterol, and More

Positive self-image is important as your child begins to enter the changes that come with puberty. Empower them to feel good about themselves, their interaction with others and praise their effort more than the outcome.

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve
• Measure your child’s blood pressure and heart rate
• Review your child’s school performance and development
• Discuss involvement in activities
• Discuss sleep
• Discuss exercise and nutrition
• Review safety issues

Immunizations: 

• Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• None

Helpful Info: 

• Developing Your Child’s Self-Esteem

Your child be is becoming more responsible and will be able to take on more tasks such as taking care of his/her own room. He or she may also start reading independently for pleasure.

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Review your child’s school performance and development.
• Discuss exercise and nutrition.
• Review safety issues.

Immunizations: 

• Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• None

Helpful Info: 

• The Importance of Family Routines

Your ten year old still requires adult supervision when you are away. Watching TV with your child allows you to discuss any controversial topics that may come up, but limit screen time to 2 hours per day. Family mealtime is important to keeping communication open and fostering healthy lives.

At this visit we will:

• Measure your child’s weight, height, and body mass index and record on a growth curve
• Measure your child’s blood pressure and heart rate
• Review your child’s school performance and development
• Discuss involvement in activities and peer relationships
• Discuss sleep
• Discuss exercise and nutrition
• Discuss puberty changes to expect or that may be starting to occur

Immunizations: 

• Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• None

Your child may be transitioning to middle school at this age. He or she may be participating in more group activities. Expand your conversations about healthy living practices to include tobacco, drug and alcohol avoidance.

At this visit we will:

• Measure your child’s weight, height, and body mass index and record on a growth curve.
• Provide your child’s immunizations.
• Screen your child for dysipidemia per AAP recommendations.
• Review your child’s school performance and development.
• Discuss exercise and nutrition.
• Discuss puberty changes to expect or that may be starting to occur.

Immunizations: 

• Tdap#1
• MCV#1
• HPV#1 (series of 2; 11-12 years)

Tests/Screens/Assessments: 

• Lipid Profile (completed once between 9-11 years)

Helpful Info: 

• Substance Abuse Prevention

Your child will be in middle school at this age. Continue your conversations about healthy living practices to include tobacco, drug and alcohol avoidance. Your child should be able to assume more responsibility for personal hygiene and chores. There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

At this visit we will:

• Measure your child’s weight, height, and body mass index and record on a growth curve.
• Review your child’s school performance and development.
• Complete sports physical forms (if your child is participating in sports).
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet.
• Discuss puberty changes to expect or that may be starting to occur.

Immunizations:  

• HPV#2 (if not previously completed; series of 2; 11-12 years)
• Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• Adolescent Depression Screening

Even though friends are becoming more important at this age, having a caring adult to provide a listening ear and from which to obtain accurate health information is equally important. Foster open communication with your child. There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

During the teen years, we provide the opportunity for your teen to have at least a portion of this visit with the parent out of the room.

At this visit we will:

• Measure your child’s weight, height, and body mass index and record on a growth curve.
• Review your child’s school performance and development.
• Complete sports physical forms and discuss sport safety (if your child is participating in sports).
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet.
• Discuss puberty changes to expect or that may be starting to occur.

Immunizations: 

• Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• Adolescent Depression Screening

Helpful Info:  

• Teens
• Behavior

Your child may be showing an increasing interest in extracurricular activities. Have conversations about risk taking behaviors, driving, alcohol, drug use, family rules and expectations. Discuss media and internet safety. Make certain that they have an adult they can confide in if they are unable to communicate with you. There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

During the teen years, we provide the opportunity for your teen to have at least a portion of this visit with the parent out of the room.

At this visit we will:

• Measure your child’s weight, height, and body mass index and record on a growth curve.
• Complete sports physical forms (if your child is participating in sports).
• Review your child’s school performance and development.
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet.

Immunizations: 

• Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• Adolescent Depression Screening

Helpful Info: 

• Teens
• Behavior

Your teen may be adjusting to the transition to high school. Development of family relationships continues to be important, but it is also normal for teens to place more and more emphasis on their peer relationships. There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

During the teen years, we provide the opportunity for your teen to have at least a portion of this visit with the parent out of the room.

At this visit we will:

• Measure your child’s weight and length and record on a growth curve.
• Complete sports physical forms (if your child is participating in sports).
• Review your child’s school performance.
• Reinforce healthy choices and risk behavior avoidance.
• Perform any recommended yearly screening tests (depending on family history, sexual activity etc.).
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet.

Immunizations: 

• Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• Adolescent Depression Screening
• Urine Chlamydia Screen
• Hemoglobin Test (females, optional)

Helpful Info: 

• Teens
• Behavior

Congratulations! You are solidly in the teen years! It is exciting to see the wonderful person your child is becoming. Possible conflict can arise at this time as your teen assesses your family values versus those of culture and peers. Keep the lines of communication open and give them additional responsibility while being present for them when they inevitably make mistakes. Be supportive and allow them to develop resilience and self-pride. During the teen years, we provide the opportunity for your teen to have at least a portion of the visit with the parent out of the room.

At this visit we will:

• Measure your teen’s weight, height and body mass index and record on a growth curve
• Measure your teen’s blood pressure and heart rate
• Complete sports physical forms and (if your teen is participating in sports, please bring any forms to the appointment)
• Review your teen’s school performance and development
• Discuss involvement in activities and peer relationships/dating
• Discuss sleep
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet
• Reinforce healthy choices and risk behavior avoidance
• Perform any recommended yearly screening tests (depending on family history, sexual activity etc.)

Immunizations: 

• MCV4#2
• Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• Urine Chlamydia Screen

Helpful Info: 

• A Message to Parents of Teen Drivers

Your child is getting closer to finishing high school and entering the adult world. Making mistakes are a normal part of growing up. Continue to provide emotional support and guidance for them during this time. There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

During the teen years, we provide the opportunity for your teen to have at least a portion of this visit with the parent out of the room.

At this visit we will:

• Measure your child’s weight, height, and body mass index and record on a growth curve.
• Complete sports physical forms and discuss sport safety (if your child is participating in sports).
• Review your child’s school performance.
• Perform any recommended yearly screening tests (depending on family history, sexual activity etc.).
• Reinforce healthy choices and risk behavior avoidance.
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet.

Immunizations: 

• MenB
• Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• Adolescent Depression Screening
• Urine Chlamydia Screen
• Hemoglobin Test (females)

Helpful Info: 

• Teens
• Behavior

Your child is now transitioning to adult life! They will still look to you for support and guidance, but will be more on their own when it comes to decision making. 

During the teen years, we provide the opportunity for your teen to have at least a portion of this visit with the parent out of the room.

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Provide immunizations.
• Screen your child's vision.
• Discuss transitions to life after high school—whether that be work, travel, vocational school or college.
• Discuss importance of responsible decision making and recognizing healthy -vs- unhealthy relationships.
• Complete college physical forms and any required college screening labs/tests.
• Perform any recommended yearly screening tests (depending on family history, sexual activity etc.).
• Reinforce healthy choices and risk behavior avoidance.
• Transition your child to an adult care provider. (age 21 years)

Immunizations: 

• MenB (optional)
• Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• Dyslipidemia Surveillance
• Adolescent Depression Screening
• Urine Chlamydia Screen
• Hemoglobin Test (females)
• Universal HIV Testing

Helpful Info: 

• Teens
• Behavior