What to expect during your child's wellness visit and how to prepare

Caitlin Mlynarek, DO, a pediatrician at Metro Health’s Hudsonville primary care office, explains what parents can expect during well-child visits and offers ways to ease children’s anxiety before appointments.

Children grow quickly! Because of this, it’s important to schedule a yearly well-child check so that your child’s physical and mental wellness can be assessed annually by a pediatrician you trust. These appointments allow your provider to monitor developmental milestones and growth, as well as provide an opportunity to identify early signs of illness or disease, which can prevent more serious outcomes.

What happens during a well-child visit?

• Weight and height are reviewed
• Blood pressure, heart rate and breathing are checked
• A head-to-toe physical exam is performed
• Necessary immunizations are given
• The pediatrician asks questions, addressing any concerns and offering advice about how your child is growing and developing

In addition to the above standard procedures, your provider also assesses your child a little further, based on his or her age.

At an infant well-check visit, your pediatrician looks for developmental milestones and completes a full physical exam, which includes close monitoring of weight, length and head circumference, assessing for any signs of infection, checking for birthmarks or rashes, evaluating head shape, looking for hip abnormalities, assessing visual tracking, or any muscle or tone changes.

When your child reaches the toddler years, the doctor completes vision and hearing screenings and asks questions about your child’s mental, emotional and social development, including any behavioral changes, how your child reacts to strangers, how your child interacts and plays with peers, and questions regarding your child’s language, hearing and social skills.

At school-age check-ups, your pediatrician also asks questions regarding your child’s mental, emotional and social development. These conversations are focused on how much physical activity your child is getting per day, sleep habits, motor and language skills.

As teens reach puberty, they experience many changes. During a well-child visit, your provider assesses for alcohol, tobacco or drug use, looks for signs of anxiety/depression and discusses your teenager’s sexual health, including risk for sexually transmitted infections (STIs) or unintended pregnancy. Birth control, abstinence and sexual responsibility are discussed, if necessary. For females, your provider may recommend a breast or gynecologic exam, and for males, a testicular exam to assess for hernias or testicular cancer.

Children are often worried and intimidated about going to the doctor. While some of these feelings can be observed and addressed, others are kept secret and held inside.

How Can Parents Help Their Children Prepare for Wellness Visits?

Encourage your child to express their fears about visiting the doctor, and then help alleviate these feelings in ways they understand. Here are some tips that may help do this:

1. Talk about why your child is visiting the doctor and set expectations. Prepare kids by giving them advance notice of a wellness visit and explain what will happen during their exam. (see above)
2. Be upfront about vaccines. A lot of children worry about getting shots, but it’s best to prepare them ahead of time. Infants and young children may be comforted after vaccination by nursing or being fed a bottle. In older children, the use of distractions while receiving vaccines is helpful. A way to trick the brain while receiving a shot is to hold a cold ice pack in your hand or pinch yourself.
3. Talk about any negative feelings. No matter the reason for visiting the doctor, wellness exam or illness, be sure to explain to kids that going to the doctor is not a punishment. Help kids understand that adults go to doctors just like kids in order to stay healthy and address any problems.
4. Use a children’s book to explain the doctor visit or role play to show the child how the doctor will examine them. Young children learn best through play, using dolls to role play or a children’s book may allow children to express any fears they may have about going to the doctor and may help to better explain what will take place at the wellness visit. Reinforce that the privacy of their body is still true, but doctors, nurses, and parents must sometimes examine these areas to ensure they are healthy. Emphasize these people are the only exceptions, and that you will be in the room with them the entire time.
5. Ask your child to come prepared with a list of questions that they have for the doctor. This allows children to take an active role in their medical care and promotes independence and comfortability with their providers. 

As a pediatrician, I try to create a friendly atmosphere for my patients to feel open and comfortable during their wellness visits. I think it is important to communicate clearly using simple, age appropriate language so that children understand what is going on with their bodies and how they can lead healthier lives. When choosing a pediatrician for your child, find one who understands children’s needs and fears and is able to clearly communicate in a caring and compassionate manner.