Well-Child Checkups

Editor's note: This article was sponsored by the Washington State Department of Health.

There are many reasons why people avoid seeing their doctor until someone gets sick. But regular checkups are a powerful line of defense that can prevent illness in the first place. Regular health care is especially important for young children.

“Well-child visits focus on growth, development and preventative care tailored to the child’s age,” says Andrea Donalty, M.D., medical director of the Mary Bridge Primary Care Network for Mary Bridge Children’s Hospital. When you take a sick child to the doctor, the doctor may not be able to perform early-detection screenings or provide preventive care, such as vaccinations. Skipping well-child visits also delays the opportunity to build a long-term relationship with a care team who understands what is normal for your child and who knows your family’s medical history.

Prioritizing routine care

Although we call it routine, a lot of preventive care is age-dependent and individualized. Even routine elements of a wellness visit — such as measuring height and weight — are checking for a healthy trajectory of growth over time that is unique to your child. For newborns and infants, routine visits can teach parents and guardians about healthy feeding and sleep practices, and what symptoms may warrant an emergency visit.

As children grow, well-child visits include a variety of age-appropriate screenings that can catch many health concerns before they become serious. For example, many pediatric providers are beginning to see children with a reduced sense of balance, spatial awareness and spatial orientation because of screen time replacing physical play. Some are now giving “prescriptions for green time” — that is, outdoor play as an antidote to counteract the mental impacts of too much screen time. For older children and teens, mental health screenings are becoming standard. The U.S. Preventive Services Task Force recommends that children ages 8–18 be screened for anxiety, and children ages 12–18 be screened for depression and suicide risk.

“We have seen a huge rise in anxiety and depression in adolescents. We try to identify these things early so we can get them connected with the right help and prevent more significant health concerns from developing in the future,” says Donalty.

Well-child visits can also include screening for lifestyle determinants of health, such as traumatic events, food insecurity and even caregivers’ mental health. Health-care providers can provide coaching, resources and referrals for concerns ranging from postpartum depression to hunger. Patients are more likely to share these types of health concerns with a trusted care team with whom they have developed an ongoing relationship.

“Obviously we can’t talk about every one of these things at every visit, which is why seeing the same care team over time is helpful, when possible. Then you can have ongoing conversations and build that trusting relationship together,” says Donalty. The importance of routine preventive care and an ongoing relationship with a care team is nowhere more evident than vaccination. If the same provider can’t be seen, sharing the previous medical records or out of state/country immunization records with the new provider in advance of the next visit can help inform medical history and keep the conversation and momentum going toward healthy development.

Standard vaccinations

The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices maintains the standard schedule of basic vaccinations. The result of decades of research to identify the safest and most effective way to protect children from disease, the schedule is endorsed by the American Academy of Family Physicians and the American Academy of Pediatrics. Many schools and day-care facilities require children to follow the standard vaccination schedule to enroll. Some families are uncomfortable with this and wish to avoid, reduce or delay their child’s vaccinations; however, “not following the recommended schedule leaves your children vulnerable to illness,” says Donalty.

Getting your child vaccinated not only protects them, it protects others, too. “The higher the vaccination rate in the community, the more protected the vulnerable can be.” Keeping up to date on vaccination is the best way to prevent serious illness from childhood diseases. Vaccinations are even more strongly recommended for immunocompromised children, because their risk from infections is higher.

“Vaccines are safe. They are effective, and we don’t see a lot of these illnesses anymore because of the success of vaccines. It is so immensely important for people to get in for their well-child visits and to stay on schedule with their vaccines. It’s advantageous to have that trusting relationship with your primary care pediatrician, family physician or nurse practitioner to be empowered towards vaccinations,” says Donalty.

Safeguarding against flu

The flu vaccine is recommended annually for everyone ages 6 months and older. In homes with infants younger than 6 months, vaccinating the rest of the family can help protect the infant by reducing exposure to infection. Although the flu vaccine does not guarantee that an individual will not contract the flu, it does reduce the chances and intensity of infection.

“Not only does it lessen the course of the disease, greatly reducing the risk of hospitalization, but it provides some carryover protection from year to year,” says Donalty. Even if someone has already had the flu this season, it is possible to catch another strain. Getting vaccinated now will protect against other strains of the virus. (Learn more about protection for the flu at KnockOutFlu.org.)

COVID-19 vaccinations

While available COVID-19 vaccinations may reduce the likelihood of infection, they are no guarantee against becoming sick. Donalty notes, “You get the COVID-19 vaccine to prevent significant health issues from infection.” Vaccination decreases the risk of hospitalization or death from infection and may also reduce the risk of long COVID.

The current recommendation is that everyone ages 6 months and older complete their primary vaccine series and stay up to date on eligible booster doses. There are different brands and doses of each vaccine, so the exact number of injections and timing for receiving them will vary. The timing of a dose may be adjusted to leverage natural immunity for people who have recently recovered from a COVID-19 infection. Communicate with your primary care provider to work out the best COVID-19 vaccination schedule for you and your family. Visit TakeCareWA.org for more information about protecting yourself and loved ones from COVID-19.

Making healthy choices

Healthier choices to prioritize good nutrition, adequate sleep and exercise are the foundation of overall health. But when it comes to avoiding viruses, it’s about following “things told to us when we were little,” says Donalty. Wash hands well and frequently, and use hand sanitizer when you can’t wash. Cover your coughs and sneezes, and avoid touching your face. Stay home when you’re sick. The only recent addition to the recommendations is masking to prevent the spread of germs.

“It’s become politicized, but the medical community has been masking for a very long time. When worn properly over the mouth and nose, the physical barrier does help,” says Donalty.

Building the routine of going to well-child visits not only prevents illness through vaccination and early detection, it can result in better-informed parents and guardians who build habits that keep the whole family healthier.