Infants and Children 0 to 10

Infants and Children, 0-10

Newborns require check-ups and routine examinations several times within the first two years of their lives, and physicians recommend annual or bi-annual ‘well-child visits’, as well as several immunizations for children through the age of six.

These appointments will help protect children against a wide range of diseases and infections, as well as monitor and evaluate their young bodies as they grow and develop. Despite the proven effectiveness of these patient visits, the U.S. Department of Health & Human Services estimates that more than 10% of young children do not receive the recommended level of preventive medical care.

Well-Child Visits

According to Medline Plus (a website administered by the National Institute of Health), a well-child visit involves a routine physical examination to evaluate the young child’s physical growth and bodily development. Typical visits include the following examinations:

• Auscultation: Physicians use a stethoscope to monitor the child’s heart for murmurs and other irregularities, as well as the lungs, intestines, liver, and other internal areas.
• Palpation: The physician uses his/her hands and fingers to evaluate the texture and consistency of different areas of the child’s body.
• Percussion: This exam involves the physician tapping areas of the child’s body using his/her hands or a small instrument to detect irregular patterns or presence(s) of fluid.
• Ophthalmic Exam: Also known as a vision test, child patients can begin testing their vision as soon as they learn the alphabet. After that, doctors recommend check-ups every one to two years.
• Hearing Test:According to the NIH, roughly 95% of newborns in the U.S. receive a hearing test shortly after they are born, and receive a follow-up hearing exam with each well-child visit.
• Temperature: The child’s temperature is checked with an electronic thermometer placed in either the ear, mouth or armpit.
• Weight: Every well-child visit will include a weigh-in, including physician recommendations if the patient is below or above the healthy weight for his/her respective age.
• Newborn Jaundice: Doctors look for signs of jaundice during a baby’s first well-child visits. The disease is caused by high levels of a substance called bilirubin following birth. Although newborn jaundice is quite common, physicians will monitor high bilirubin levels and (if necessary) perform follow-up exams and treatments to ensure the levels stabilize during the first days/weeks of life.
• Infant Reflexes: Beginning with young infants, physicians will stimulate different areas of the body (such as the knees and mouth) to ensure the patient is properly reflexive.

Scheduling Check-ups

Pre-birth: Expecting parents (particularly first-time parents) should visit a physician before the baby is born. During this appointment, the mother- and father-to-be can inquire about future visits, vaccinations, feeding, and circumcision for boys.

Newborn: Parents whose baby is breastfed should schedule a doctor’s visit two to three days after the baby is released from the hospital; babies released from the hospital before their second day of life should visit a physician when they are two to four days old.

First six months: Parents should schedule four well-child visits during the first six months of their baby’s life. Doctors recommend checkups at these intervals:

• 1 month
• 2 months
• 4 months
• 6 months

Nine months:The CDC recommends screenings for Autism Spectrum Disorder (ASD) and other developmental delays to begin at nine months. Additional screenings may be required for babies with a low birthweight, children with at least one sibling who has been diagnosed with ASD, or other patients considered at high-risk for developmental delays. The screening typically involves a test or evaluation administered to the parents, caregivers, and medical professionals who have observed the patient in question; the following diagnostic tools are commonly used during these screenings (although the CDC does not officially endorse any of them):

• Autism Diagnostic Interview (ADI): Geared toward children whose mental age is 18 months or older, this interview focuses on three core areas: reciprocal social interaction; communication and language; and restricted and repetitive, stereotyped interests and behaviors.
• Autism Diagnostic Observation Schedule (ADOS): This four-tiered exam focuses on socialization, imagination, and communication.
• Childhood Autism Rating Scale (CARS): Primarily used for children 2 years and older, this scale emphasizes the relationship between developmental delays and individual characteristics, habits, and abilities.
• Gilliam Autism Rating Scale (GARS): This scale (3 to 22) measures the severity of ASD and other developmental delays.

One year: In addition to the well-child visit marking the patient’s first year of life, the American Academy of Pediatric Dentistry recommends that parents schedule their child’s first dental visit either when the first tooth appears or the child reaches one year in age. According to WebMD, a child’s first visit to the dentist’s office will include the following:

• Oral exam to detect tooth decay, irregular bite, or potential problems with the gums, jaw, or tongue.
• If needed, a tooth cleaning and fluoride rinse.
• A tutorial on proper oral health for the parent in attendance.
• Parents should schedule subsequent dental check-ups every six months after the initial visit.

One to two years: Most infants one year or older are ready to make the transition from breast milk or formula to whole milk; lowfat milk is not recommended for children under the age of two years. Most one-year-olds are also prepared to consume fruits and vegetables, meats, and grains (provided these foods have been chopped or otherwise prepared for infantile consumption). Pediatricians will assist parents with adopting proper diet and nutrition for their one- to two-year olds.

2 ½ years to 10 years: From the ages of 30 months to 10 years, parents should schedule well-child visits as follows.

• 2 ½ years
• 3 years
• 4 years
• 5 years
• 6 years
• 8 years
• 10 years

Recommended Vaccinations

Most physicians recommend the following vaccinations for children from birth to six years of age:

• Diphtheria, Tetanus, and Pertussis (DTAP): The DTAP immunization effectively protects children against three diseases: diphtheria, an airborne illness that causes the heart to swell; tetanus, an infectious disease spread through cuts in the skin; and pertussis (whooping cough), an airborne illness that can lead to pneumonia. Five doses are recommended using the following benchmarks:
  • 2 months
  • 4 months
  • 6 months
  • 15 to 18 months
  • 4 to 6 years
• Hepatitis A: Hepatitis A is an acute viral infection transmitted through contaminated fecal matter. Two doses are recommended, administered 6 months apart, for children between the ages of 12 and 23 months.
• Hepatitis B: Hepatitis is a bloodborne disease that can lead to liver infection and failure if untreated. The vaccine was shown to be the first effective at preventing liver cancer. Three doses are recommended using the following benchmarks:
  • Birth
  • 1 to 2 months
  • 6 to 18 months
• Haemophilus Influenzae Type b (Hib): This airborne disease (which is often asymptomatic) can cause meningitis, developmental disability, epiglottis, and pneumonia. Three to four doses (depending on physician’s diagnosis) are recommended using the following benchmarks:
  • 2 months
  • 4 months
  • 6 months
  • 12 to 15 months
• Influenza (Flu): Influenza is a common ailment among children and adults that can cause a wide range of symptoms, such as nausea, diarrhea, body aches, and swollen glands. Two doses are recommended, one month apart, during the first year (in 6 month intervals), followed by one dose for every subsequent year during childhood and adulthood.
• Measles, Mumps, and Rubella (MMR): The MMR immunization effectively protects children against three diseases: measles, an airborne disease characterized by a severe rash that can lead to pneumonia and brain swelling; mumps, an airborne disease that can cause meningitis, brain swelling, and inflammation of the testicles/ovaries; and rubella, an airborne disease with similar symptoms as measles. Two doses are recommended using the following benchmarks:
  • 12 to 15 months
  • 4 to 6 years
• Polio: This vaccination (introduced in the 1940s) prevents polio, an airborne disease that, when untreated, commonly causes partial or full paralysis. Four doses are recommended using the following benchmarks:
  • 2 months
  • 4 months
  • 6 to 18 months
  • 4 to 6 years
• Rotavirus: Rotavirus is transmitted through the mouth, and can lead to severe diarrhea and dehydration. Two to three doses (depending on physician’s diagnosis) are recommended using the following benchmarks:
  • 2 months
  • 4 months
  • 6 months
• Varicella (chickenpox): Chickenpox is a common childhood disease characterized by a severe rash and body fatigue; if untreated, it can lead to shingles, brain swelling, cellulitis, pneumonia, and adult ailments like zoster. Two doses are recommended using the following benchmarks:
  • 12 to 15 months
  • 4 to 6 years