Preparing for a well-child visit: a checklist

The AAP’s own suggestion is to bring your top 3 to 5 questions and raise them at the start of the visit, before the exam takes the time. A well-child visit covers growth, development, immunizations and whatever you have been wondering about, and the appointment is short enough that the list in your hand decides what gets discussed. Writing it down in the week beforehand works better than remembering in the room.

Around this age

The schedule comes from the Bright Futures and AAP periodicity schedule, a list of screenings and assessments recommended at each visit. From birth to 5, the visits are at 3 to 5 days old, then 1, 2, 4, 6 and 9 months, then 12, 15 and 18 months, 2 years, 2½ years (30 months), and 3, 4 and 5 years.

Certain visits carry specific screenings. The AAP recommends general developmental screening with a validated tool at 9, 18 and 30 months, and screening specifically for autism at 18 and 24 months. Screening at a visit is different from the monitoring you do at home, which the CDC describes as watching how a child plays, learns, speaks, acts and moves over time.

Vaccines follow their own schedule, and the CDC’s parent-facing version for children through 6 years maps doses to ages: birth, 1, 2, 4, 6, 12, 15 and 18 months, then 19 to 23 months, 2 to 3 years, and 4 to 6 years. Flu vaccine is seasonal, so it does not always land on a visit.

What to try

Before you go. Write the 3 to 5 questions you actually want answered. The AAP’s examples of what parents raise are development, behavior, sleep, eating and getting along with other family members. Add anything that has repeated: a rash that keeps coming back, three bad nights in a row, a word that disappeared.

Note what you have seen your child do lately, in their own words and movements, and the CDC’s milestone checklist for the age if you use one. “She points at the dog and says ‘da’” is more useful to a pediatrician than “her speech seems fine”.

Bring the immunization record, the insurance card, the name of any medicine or vitamin your child takes, and the name of anyone else the child sees, such as a dentist or early intervention provider. If someone else does part of the caregiving, ask them what they would want asked.

At the visit. Lead with the list. Expect measurements, a physical exam, questions about feeding, sleep and behavior, any screening scheduled for that age, and the vaccines due.

A practical detail: get the vaccines part done at the end if your child finds it upsetting, and dress them in something easy to take off for weighing.

Before you leave. Ask what the growth measurements mean for your child rather than in general, when the next visit falls, what would count as a reason to call before then, and how to reach the practice after hours. Ask for anything discussed to be written down if you know you will be up at 3 a.m. trying to remember it.

When to call your pediatrician

Concerns do not wait for the next appointment. The CDC’s guidance is not to wait: if your child is not meeting one or more milestones, has lost a skill they once had, or you have another concern, talk with the doctor and ask about developmental screening.

If a question comes up between visits and it can wait until office hours, most practices have a time of day for routine calls. If it cannot wait, that is what the after-hours line is for.

Sources

• AAP Schedule of Well-Child Care Visits — HealthyChildren.org (AAP)
• Developmental Monitoring and Screening — CDC
• Recommended Vaccines for Young Children — CDC

This is educational information from public sources, not a replacement for advice from your child’s healthcare professional.

In Withya, the three things you keep forgetting to ask can go into Care as they occur to you, and the weeks before the visit are already there in order.