Well Visits

Congratulations! Your baby is finally here. Newborns are wonderful, but exhausting! Having friends or family around to provide extra help and support can be very helpful. Make sure all visitors wash their hands well. Your baby’s first visit to our office takes place during his or her first week of life, usually 1-2 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.
• Check to see how your baby is feeding.
• Answer questions about your new baby.

Immunizations: 

• HepB#1 (if not given in hospital)

Tests/Screens/Assessments:

• Follow-up on Newborn Metabolic Screen done in hospital

Your Baby's Development:

Gross Motor Skills:

• When your baby is lying on her stomach, she may be able to raiser her head and turn it from side to side.
• Your baby may be able to blink in reaction to bright light and respond to sounds.
• Your baby may become more active, moving her arms and legs.

Fine Motor Skills:

• For the first few weeks of his life, your baby’s hands will often be lightly fisted.
• He will have “newborn reflexes” like grasping fingers and becoming startled by loud noise.

Language Skills:

• Your baby will communicate by crying.
• It is not too early to start reading to your child.

Visual Skills:

• Focuses 8-12 inches away
• Eyes wander and occasionally cross
• Prefers black and white or high contrast patterns, as the color vision is not yet developed
• Prefers to look at the human face to all other patterns

Families are usually settling in some by this visit. Feeding, sleeping and bowel habits are sometimes a 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!

Immunizations: 

• Hep B #2

Tests/Screens/Assessments: 

• Post Partum Depression Assessment

Your Baby's Development;

Gross Motor Skills:

• When your baby is lying on her stomach, she should be able to lift or turn her head. 
• Your baby will move her arms, legs, and head. 

Fine Motor Skills:

• Your baby’s hands will be tightly fisted. 
• Your baby may watch people and be able to follow a moving object. 

Language Skills:

• Your baby will communicate by crying. 
• Over the next month, your baby may begin to coo or make vocal sounds. 
• It is important to read to your baby. 

Social Skills:

• When your baby cries, holding, cuddling, or talking can calm him.  Learn your baby’s temperament and what is most comforting for him.  He might react to noises in the environment by becoming more alert or blinking. He may also cry or pay attention to the noises around him, especially the voices of caretakers. 
• Many babies will begin to smile in response to your smile. 

Activities:

• Baby massage:  use baby lotion and gently rub his back, arms, legs, hands and feet.
• Put your baby on her tummy when you are awake and there to watch her. 
• Show him photos of family members. 
• Show her images with high-contrast patterns. 
• Give consistent warm, physical contact-hugging, skin-to-skin, body-to-body contact-to establish your infant’s sense of security and well-being. Talk or sing to your baby during dressing, bathing, feeding, playing, walking, and driving. Use simple, lively phrases and address your baby by name. Respond to his gestures, as well as to the faces and sounds he makes.

Many babies seem more fussy or colicky at this age. Be patient. Colicky babies eventually outgrow their crying phase. Keeping your baby safe is the most important thing you can do. Even if you feel frustrated, handle your baby gently and reach out for help to friends, relatives or your pediatrician 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.

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.

Immunizations: 

• Pentacel#1 (DTaP, HIB, IPV), Prevnar#1, Rotavirus#1

Your Baby's Development:

Gross Motor Milestones:

• Raises head and chest when lying on stomach
• Supports upper body with arms when lying on stomach
• Stretches legs out and kicks
• Opens and shuts hands
• Pushes down on legs when feet are on firm surface
• Brings hands to mouth
• Takes swipes at dangling objects
• Grasps and shakes hand toys

Visual Milestones:

• Watches faces intently
• Follows moving object
• Recognizes familiar objects and people at a distance
• Starts using hands and eyes in coordination

Language Milestones:

• Smiles at the sound of parent’s voice
• Starts to imitate some sounds
• Turns head toward the direction of sound
• Social and Emotional Milestones:
• Begins to develop social smile
• Enjoys being played with; may cry when playing stops
• Becomes more communicative with face and body
• Imitates some movements and facial expressions

Activities:

• Play a variety of music for your baby. 
• Make funny faces at your baby.  He will soon try to imitate you!
• Attach unbreakable mirror to the inside of the crib. 
• Show her rattles, brightly colored books, and mobile. 

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.

Immunizations: 

• Pentacel#2 (DTaP, HIB, IPV), Prevnar#2, Rotavirus#2

Your Baby's Development:

Gross Motor Milestones:

• Rolls from front to back and back to front
• Sits with support and grabs feet and brings them to his mouth
• Transfers objects from hand to hand
• Supports weight on legs

Visual Milestones:

• Develops full color vision
• Distance vision matures
• Ability to track moving objects improves
• Language Milestones:
• Responds to own name and begins to respond to “no”
• Uses voice to express joy and displeasure
• Responds to other people’s expressions of emotion and appears joyful often
• Cognitive Milestones:
• Finds partially hidden object
• Explores world with hands and mouth
• Struggles to get objects that are out of reach

Social and Emotional Milestones:

• Enjoys social play
• Interested in mirror images

Activities:

• Mirror Talk:  Provide baby with a safe mirror or show him his reflection in a mirror.  
• Imitate sounds:  When your baby says, “Baaa”, you say “baaa”.  This can be quite interactive and amusing. 
• Baby Sit-Ups:  Lay your baby on his back on a soft surface. Sit facing her. Gently lift her to a sitting position by holding her under her armpits. Then slowly lower her back down.  Say, “Baby sits up.   Baby lies down.” 
• Rug Rat:  Put your baby on a safe surface such as a carpeted floor and let him explore. Get down and join him as he creeps.   
• Splash Time:  Allow extra time in the bathtub to play.  Talk to her about the water and let her feel the water over her belly and hands. 

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.

• Cover the electrical sockets. 
• Put gates on any stairs in your home. 
• Move chemicals and cleaning agents out of reach. 

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.

Immunizations: 

• Pentacel#3 (DTaP, HIB, IPV), Prevnar#3, Rotavirus#3, Influenza vaccine (during flu season)

Tests/Screens/Assessments: 

• Oral  Health Surveillance, Fluoride Varish

Your Baby's Milestones:

Gross Motor Milestones:

• Sits without support
• Can get into sitting position from stomach
• May begin creeping and/or crawling

Visual Milestones:

• Enjoys peek-a-boo games
• Language Milestones:
• Turns in direction of a voice
• Babbles combining vowels and consonants like “ga-ga-ga” or “da-da-da”

Cognitive Milestones:

• Looks for a dropped object
• Develops stranger anxiety
• Understands the word “no”, but does not always obey it (this does not change!)

Safety:

• Now your baby will really start to move around!  It is important to observe her any time she is moving because there is always a possibility of danger.  A playpen or enclosed area is often helpful for those times that you cannot give your baby your full attention.  
• He will also want to explore EVERYTHING with his mouth.  Carefully watch what goes into his mouth. 
• This is a great time to safety proof your house. Get on your hands and knees and look for potentially exciting (to baby) and dangerous things such as small objects, electric cords, unprotected electric sockets, drapery and blind cords, sharp edges on coffee tables, etc. and keep them out of your baby’s reach.  

Activities:

• Touching:  Offer your infant different textures to feel such as smooth, soft, furry, rough, etc. and tell your baby the word that goes with the texture.   
• Hide and Seek:  While he is watching you, hide his favorite toy under a towel or blanket.  Encourage him to remove the cover to find the toy. Praise him. He will be so happy with himself.   
• Cushion Climb:  Remove all of the cushions from your sofas and chairs. Heap them in a pile on the floor and give her a chance to do some climbing.  This can be a good way to get your baby tired out! 
• Noise Making:  Banging is a natural activity for your baby.  Use a pot or a plastic container with a wooden spoon to make a drum.    
• Reading:  Make a habit of reading to your baby every day!  Start with bright picture books with no or few words per page.  Let him “turn” the pages—you will see a great improvement of the fine motor skills over time.  

Helpful Info:

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.
• You should be brushing your child's teeth with an infant toothbrush and a tiny smear of fluoride toothpaste. 

Immunizations: 

• HepB#3, Influenza vaccine (during flu season)

Tests/Screens/Assessments: 

• 2 days before your appointment, please complete the Developmental screening test online:
• PEDS Developmental Screening Test
• Please complete the PEDS  developmental screen online 2-3 days before your child's appointment
• User name is: newarkpeds_portal
• Password will be sent to you via portal message 2-3 days before your child's appointment. 

Your Baby's Development:

Gross Motor Milestones:

• Gets to sitting position without assistance and assumes hands and knees position, may crawl
• Pulls himself up to stand and “Cruises”-Walks holding on to furniture
• Stands momentarily without support

 

Fine Motor Milestones:

• Uses pincer grasp (thumb and forefinger) and bangs objects together
• Puts objects into container and takes them out

Language Milestones:

• Responds to simple verbal requests
• Responds to “no” and uses simple gestures, such as shaking head for “no”
• Says “mama” and “dada” and uses exclamations, such as “uh-oh!”

Cognitive Milestones:

• Explores objects in many different ways (shaking, banging, throwing, dropping)
• Finds hidden objects easily
• Looks at correct picture when the image is named

Social and Emotional Milestones:

• Shy or anxious with strangers.  Cries when mother or father leaves.  May be fearful in some situations. 
• Shows preferences for certain people and toys. 
• Tests parental response to certain actions and behaviors (What do you do if he cries after you leave the room or if he refuses a food?) 

Activities:

• Shake, Rattle, and Roll:  Give your baby a circular oatmeal canister or a coffee can (make sure there are no sharp edges) with lid filled with non-choking items (blocks, spools from thread, balls). Show her how she can put things in and spill them out and put the lid on to make a rattle. 
• Ball rolling:  Sit your child across from you. Have fun rolling a large ball back and forth.  
• Learning to climb the stairs:  This is a good time to practice going up and down the stairs with your child.  To encourage her to climb, put a toy a step or two higher than he is.  To help him learn how to descend, put the toy on a lower step.  Baby should learn to go up head first and come down feet first.   Your stairs should remain gaited and climbing should be supervised until your child is proficient (usually by two years old).  You may want to have gates up longer at nighttime if you have a long staircase or your child leaves his room at night. 
• Kitchen Play:  Reserve a cabinet or shelf for your child with large, safe items that you do not mind rolling around on your floor. Plastic containers, empty food boxes, paper towel rolls, and measuring spoons can occupy your child while you work. 

Helpful Info: 

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, for your baby. 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. 

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.

Immunizations: 

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

Tests/Screens/Assessments: 

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

Your Baby's Milestones:

Gross Motor Milestones:

• Walks holding on
• Bends down without falling

 

Fine Motor Milestones:

• Puts block in cup
• Scribbles

Language Milestones:

• Says 2-3 words
• Follows simple commands

Cognitive Milestones:

• Brings toy over to show you
• Finds hidden objects easily

Social and Emotional Milestones:

• Tries to do what you do and imitates your behavior 
• Helps around the house
• Listens to a story 

 

Activities:

• Making her Mark:  Provide her with paper and big, fat crayons. It may help to tape down the paper.  Supervise this activity so that your child does not eat the crayons.  Make sure crayons are not contaminated with lead. (Crayola brand or others made in the USA do not contain lead.) 
• Water Play:  Water play may occur at bathtime or playtime. You can try setting up a basin of water outside in nice weather or in a bowl on the highchair tray.  Items form the kitchen often make great toys:  measuring spoons and cups, tea strainers, spoons, funnels, etc.    
• Bubbles:  Blow bubbles for your child and let him try and catch them. Try blowing bubbles together.  Save empty containers and wands. If it is off season for bubbles, mix together these ingredients to make bubbles at home:  ¼ cup clear liquid dishwashing detergent, ¼ cup glycerine (from the drugstore; keep out of reach), ¾ cup water, 1 tablespoon sugar. 
• Hide and Seek:  Take turns hiding and looking for each other.  Say, “Where is (your baby’s name)? Where could she be?  THERE she is!”  and give her a hug. Even when you can easily see her, pretend to look in several other areas first. When it is your turn to hide, do so in an obvious place or where she can see a bit of you. Reward her with your praise when she finds you. 
• Singing and Dancing:  Now that your baby is starting to move, put on some good music and dance.  This is great for coordination, balance, and general enjoyment.  Kids are just learning about music, so try different types-it does not strictly need to be kid stuff.

You may find that your child is so active and full of energy. Rest up, if you can during nap times.  Your child, now a toddler, is able to begin activities by himself, but needs your help to carry them through. He is still trying to imitate you and yet wants the freedom to try things on his own. This can be trying for both of you!  Often, your toddler becomes more easily frustrated when he is hungry, tired, or over-stimulated. It is a good idea to provide quiet time after intense play and before naps to help your child ease into sleep.  

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.

Immunizations: 

• Pentacel#4 (DTaP, HIB, IPV), Varicella #1, Influenza vaccine (during flu season)

Tests/Screens/Assessments: 

• Anemia Surveillance (if not completed at last visit)
• Lead Surveillance (if not completed at last visit)

Your Child's Development:

Gross Motor Milestones:

• Runs 
• Walks up steps
• Walks backwards

 

Fine Motor Milestones:

• Stacks 2 blocks
• Uses spoon and cup without spilling most of the time

Language Milestones:

• Says 6 words
• Understands what you say

Cognitive Milestones:

• Points to one body part
• Follows simple commands

Social and Emotional Milestones:

• Starts to express defiant behavior
• Imitates behaviors of others 
• Laughs in response to others

Activities:

• Finger Painting:  MESSY, but fun!  A good outdoor activity or work indoors with newspaper spread out in your work area.  Shiny paper works best.  Paper and non-toxic, washable paints are available in many local stores.  All you need is red, yellow, and blue to create all of the colors of the rainbow! 
• First Playdough:  Modeling uses fine motor skills and imagination-a great combination!  The following is a recipe for soft homemade dough. Keep it in the refrigerator between playtimes to increase its lifespan.  Mix 3 cups flour, ½ cup cooking oil, and enough water to bind (about ½ cup).  Kneed well. You may add food coloring and even mint extract to enhance aroma. 
• Create your own books and picture albums:  Children love pictures of themselves and the people and things that they know.  A photo album or scrap book with sturdy pages will provide entertainment again and again when filled with the photos of your child, her family, and even cutouts of things she is learning the names of (such as dog, cat, house, etc.). 

Your baby is growing up!  Toddlers  understands“no”, but can still make the same mistakes again and again.  They are not old enough to understand the full consequences of their actions, thus they should still not be trusted around hot items (curling irons, irons, stoves), medications, cleaning supplies and other chemicals, and pools or other bodies of water. This is actually true for the next several years.  Their curiosity can also be an asset as they continues to learn about their world and expand their vocabulary and ability to communicate.  

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.
• Discuss temper tantrums.

Immunizations: 

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

Tests/Screens/Assessments: 

• PEDS developmental screen
• MCHAT Questionnaire
• Please complete the PEDS and MCHAT developmental screen online 2-3 days before your child's appointment
• User name is: newarkpeds_portal
• Password will be sent to you via portal message 2-3 days before your child's appointment. 

Your Child's Development:

Gross Motor Milestones: 

• Walks up and down the stairs 1 step at a time alone while holding on to the wall or railing
• Kicks a ball and throws it overhand
• Jumps up

Fine Motor Milestones:

• Stacks 5-6 blocks
• Turns the pages in a book 1 page at a time

Language Milestones:

• Begins to combine 2 words together (eg. “my book”)

Cognitive Milestones:

• Names 1 picture in a book (dog, cat, ball)
• Follows 2-step commands

Social and Emotional Milestones:

• Copies things that you say and do
• Plays pretend 
• Plays alongside other children, but may have a hard time sharing

Activities:

• Junk Mail:  Everyone enjoys receiving mail.  Share those extra coupon packages and credit card offers with your little one. They can “deliver” mail or just open it up while you are going through your own.  Just make sure there are no small objects that could be choking hazards in the mail. 
• Plastic Animals:  Buy inexpensive plastic insects, mammals, birds, dinosaurs, etc. (check for size and small parts).  Explain what the creatures are, how they live and what sounds they make. If your child shows an interest in a particular animal, then try finding a simple book to expand your and her understanding and enjoyment of it. 
• Follow the leader:  Have your toddler copy you as you walk, march, shuffle, tramp, and tiptoe around. As he improves his skills, add clapping your hands, touching your nose, and making funny sounds.  Allow him to be the leader. He will enjoy watching you follow his requests.
• Pretend Play:  Pretend play is so fun at this age.  Pretend with dolls, cars, play kitchen sets.  Let your child imitate the behaviors that she sees.  

At this age, your child’s speech continues to develop in leaps and bounds.  Children  can understand opposites (yes/no, up/down, fast/slow, in/out, etc.).  Try to include these ideas in your play. They enjoy playing with objects, taking them apart and putting them together.  They test everything constantly:  the limits you set, their own physical skills and their own abilities.  They want to try and do everything themselves. Let them, as long as it is safe.  If you are rushed to get to work or meet a deadline, then explain briefly and clearly why you need to help them and create opportunities when time is more available for them to do it their way.

At this visit we will:

• Measure your child’s weight, length, head size and body mass index and record on a growth curve.
• Review your child’s development with you using the MCHAT (Autism screening tool) questionnaire.
• Please complete the PEDS and MCAT developmental screen online 2-3 days before your child's appointment
• User name is: newarkpeds_portal
• Password will be sent to you via portal message 2-3 days before your child's appointment. 
• Test for lead exposure with a finger prick in the office.
• Discuss dental health and apply fluoride varnish to your child's teeth.
• Discuss toilet training and time out.

Immunizations: 

• HepA#2 (if not completed), Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• MCHAT Questionnaire, TB Surveillance, Anemia Surveillance, Lead Surveillance, Dyslipidemia Surveillance, Oral Health Surveillance, Lead Test

Your Child's Development:  

Gross Motor Milestones: 

• Climbs well
• Walks up and down stairs alternating feet

 

Fine Motor Milestones:

• Able to make straight lines and circular strokes with a pencil or crayon
• Screws and unscrews jar lids (be careful of medications!)

Language Milestones:

• Understands most sentences, uses pronouns and some plurals and can say name, age, and sex
• Non-parent listeners can understand 50-75% of spoken language

Cognitive Milestones:

• Makes mechanical toys work
• Sorts objects by shape and color

Social and Emotional Milestones:

• Understands concept of “mine” and “his” or “hers”-but may not like it! Can have temper tantrums. 
• Spontaneously shows affection 

Activities:

• Home Shopping Network:  Save empty food boxes (cereal, pasta, toothpaste, etc.), plastic juice and milk containers, egg cartons, and so forth.  Set up a store so your child can buy groceries or be the salesperson. Add interest by using a play cash register or pretend money. 
• Puzzles:  Start with large piece wood or plastic puzzles with clear pictures and work on up as your child demonstrates interest and increasing ability. 
• Scissors and cutting:  Offer your child some colored paper and a pair of children’s scissors (some are made to just cut paper, but they shouldn’t be so dull that they don’t cut at all.  Blunt or curved edges are better than pointy tipped scissors.)  Supervise any cutting that she may do.  She may need help figuring out where to put her fingers initially, especially if she has a left-handed preference.  Some scissors are made to use with either hand and some aren’t.  Old greeting cards and pictures from magazines are also good cutting material.  If you both are feeling artistic, glue the cut pieces together into a collage.  
• The Great Outdoors:  Go for a walk together and try to see the world as your child does.  Take time to enjoy the treasures he discovers:  leaves, stones, insects, etc. Carry a magnifying glass or flashlight to see details and to poke in hidden spots. 

Your baby is not really a baby anymore. They are firmly in the toddler years. One moment they seem so big and the next still very small. This is the "do-it-myself time."

At this visit we will:

• Measure your child’s weight, length, head size and record on a growth curve
• Most of our patients do not have immunizations due at this visit.
• Evaluate your child’s development with the ASQ.  Please do the ASQ developmental screening 2-3 days prior to the visit, which is on our website.
• Discuss dental health  (if they have not yet seen a dentist, they should!)
• Discuss healthy meals/snacks, avoid food pouches and no or little juice

Immunizations: 

• Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• Lead Surveillance (if not done previously)
• PEDS test and MCHAT
• Please complete the online PEDS developmental test and Autism screen 2-3 days prior to your appointmet
• User name: newarkpeds_portal
• Password will be sent to you through your portal 2-3 days before your child's appointment. 

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.
• Measure your child's blood pressure. 
• Most of our patients do not have immunizations due at this visit.  Your child may need immunizations if they are behind on any vaccines  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

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: 

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

Tests/Screens/Assessments: 

• TB Surveillance, Oral Health Surveillance, Vision Testing

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: 

• Quadracel (DTaP, IPV) (if not received at 4 years), Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• TB Surveillance, Anemia Surveillance, Lead 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.

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.

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: 

• Vision Surveillance, Hearing Surveillance, TB Surveillance, Anemia Surveillance

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.

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
• Screen your child's vision and hearing
• Provide your child’s immunizations
• 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)
• HPV #1

Tests/Screens/Assessments: 

• Vision Testing, Hearing Testing, 
• Lipid Profile (completed once between 9-11 years)

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 anemia and 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#2 

Tests/Screens/Assessments: 

• Vision Surveillance, Hearing Surveillance, TB Surveillance, Anemia Surveillance, Dyslipidemia Surveillance, Lipid Profile (completed once between 9-11 years)

Your child should be able to assume more responsibility for personal hygiene and chores. 

Development of family relationships continues to be important, but it is also normal for preteens and teens to place more and more emphasis on their peer relationships.

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. 

Make certain that they have an adult they can confide in if they are unable to communicate with you.

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.

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.

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 vision.
• 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

Immunizations: 

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

Tests/Screens/Assessments: 

• Hearing Surveillance, TB Surveillance, Anemia Surveillance, Dyslipidemia Surveillance, Adolescent Depression Screening, Vision Testing

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 discuss sport safety (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.)
• Complete PA driver's permit. (If you do not do this at your well visit, your teen must be present and sign in the presence of the physician at another time)

Immunizations: 

• MCV4#2, Meningitis B #1, Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• Vision Testing, Hearing Testing
• Adolescent Depression Screening

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. 

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.

We will continue to care for your teen until he/she graduates from high school. 

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: 

• Meningitis B#2 (2 dose series) Flu vaccine (during flu season)

Tests/Screens/Assessments: 

• Vision Surveillance, Hearing Surveilllance, TB Surveillance, Anemia Surveillance, Adolescent Depression Screening, Lipid Profile, Urine Gonorrhea and  Chlamydia Screen , Hemoglobin Test (females)