Well-Child Visits

Regular well-child doctor exams are essential to keeping kids healthy and up-to-date with immunizations against many dangerous diseases.

A checkup also is a chance for you to talk with the doctor about developmental and safety issues and to ask any questions you have about your child's overall health.

What to Expect at the Doctor's Office

At a typical well-child visit, your doctor will weigh and measure your child to chart progress 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 (AAP) recommends that all kids visit the dentist no later than age 3, many dentists and pediatricians feel kids should have a first exam between 2 and 3 years of age — earlier if problems are suspected.

At this age, most kids should have had these 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
• two or three doses of rotavirus (RV) vaccine
• four doses of pneumococcal (PCV) vaccine
• one or two doses of hepatitis A vaccine (HAV)

Developmental Progress

The doctor will make sure all immunizations are up-to-date and 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 your child communicates with others, behaves around other kids, 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. The doctor will reinforce the importance of using age-appropriate car seats, closely supervising kids around swimming pools, preventing poisoning, not smoking around kids, using sunscreen, and protecting kids against exposed wires, outlets, and heat sources. In homes with firearms, guns and ammunition should be stored separately and kept locked at all times.

When to Call the Doctor

Certain symptoms warrant a call to your doctor, as they 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°F (38.9°C) that lasts or recurs
• persistent or frequent vomiting or diarrhea
• severe or persistent irritability or tiredness
• signs of a skin infection or a persistent rash
• long-lasting cough, wheezing, shortness of breath, or other breathing problems
• localized pain, such as that often seen with an ear infection

Common Medical Problems

On average, preschoolers in childcare can get up to 12 colds (upper respiratory infections) a year as well as several bouts of diarrhea and vomiting. Ear infections are also common. After kids 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, and can answer your questions or just double-check that your child's behavior is normal.

Reviewed by: Steven Dowshen, MD
Date reviewed: September 2011