Well-baby exam: 7 important questions you should ask

So, it is time to head to the doctor for the well-baby exam. You are trying to remember all those questions you've filed away in your mind to ask the doctor when she checks out your child. Hopefully, your concerns will be addressed without you having to ask, but undoubtedly there may be some that questions you will still need to ask. The well-baby exam is your chance to get an overall view of the health and welfare of your child. Here is a list of some questions you should have answered by the end of the visit:

1. Is my child's growth appropriate and expected?
It doesn't necessarily matter where your child falls on the growth curve as much as how the trend has been over time. The child who has always been at the 5th percentile for height is less concerning (if there is even any concern) than the child who used to be at the 75th percentile and is now at the 10th. The child who has held steady at the 95th percentile for weight is not as worrisome (if there is any worry at all) as the one who has gone from the 25th to the 90th percentile. Keeping track of this trend on the growth curves is an absolute essential for any professional who cares for children. Ask to see your child's growth curve to get a general idea of the trend.



2. Is my child due for any immunizations?
Colds, low grade fevers, and minor illnesses are no cause to delay immunizations. Remember to ask about the flu vaccine in the months of October through January. Does the doctor recommend the chicken pox vaccine?

3. Is my child's diet appropriate?
Most parents are concerned that their child's diet is lacking in something. The well-child visit is the perfect time to either confirm these concerns and get some guidance on how to correct them or be reassured that the diet is indeed appropriate. Suggestions about the diet come from a lot of sources: magazines, the grandparents, friends, and books. The well-baby check is the time to confirm whether this advice is good guidance or antiquated rubbish.

4. Is this thing on my child's body normal?
The thing may be anything, but many parents have certain minor concerns that they aren't really worried about but wonder if it is normal. A toenail that is shaped funny, a birthmark that seems different, or perhaps how ears are shaped are all examples of things that parents usually suspect are normal but need some reassurance. The well-baby exam is the perfect time to inquire about these concerns.

5. Is my child's blood pressure normal?
Starting at three years of age, it is recommended that each child have the blood pressure checked as part of the well-child exam. High blood pressure typically causes problems without causing a whole lot of symptoms, and it may be the first sign of something that needs further investigation.

6. Is that test really necessary?
There are very few "routine" tests that are recommended in children. A hemoglobin, usually done once at 9 or 12 months and an analysis of the urine, done once anytime between the ages of four to six years, are the only recommended routine tests. A pelvic exam and pap smear are recommended for sexually active adolescent females. A lead test at one year of age, a tuberculosis skin test and a cholesterol test are done only for those with risk factors. Aside from these, no other additional tests have been deemed necessary for routine care.

7. Does my child's development seem appropriate? Development is generally broken down into four categories:

* Gross motor skills
* Fine motor skills
* Social skills
* Speech and Language Development

Your doctor should ask about and observe your child enough to give you feedback in all of these categories.

by Robert Steele, MD