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Child’s First Visit to the Pediatrician

Having a baby usually means that the near and distant future will be peppered with plenty of doctor’s visits, starting just days after birth. A pediatrician is a parent’s partner in health, wellness and prevention for their children. It is important to maintain all pediatric appointments, which serve to evaluate a child’s growth and development, as well as immunize babies and children against dangerous diseases.

Did you know…

that it is normal for a new baby to lose some weight between birth and the first pediatrician’s visit? In fact, nearly all newborn babies lose weight during their first week of life. Pediatricians monitor this weight loss at initial appointments to ensure babies are feeding properly and adequately. Generally, a breastfed baby can lose as much as 7 to 10 percent of birth weight in the first week without causing alarm. Formula-fed babies, on the other hand, should lose no more than 5 percent of birth weight.

Frequently Asked Questions

When should I take my child to the pediatrician?

Your child’s pediatrician will probably schedule a visit sometime between 3 and 5 days after birth. However, it is important to wait no more than one week to schedule an initial pediatric visit. This is a crucial time – especially for babies who were discharged from the hospital at less than 48 hours old. This first visit, which is arguably the most important, is when your pediatrician checks your baby for jaundice and health conditions that may not have been detected in the hospital, such as congenital heart disease.

What should I expect during our visit?

Your first visit may be one of the longest. If your child did not receive the hepatitis B shot at birth, it will be administered in the office at the first visit. Your child will also be measured and weighed, and the pediatrician will conduct a physical exam. Be prepared to answer questions about your child’s eating habits, including how frequently your baby is feeding and how long. Your child’s pediatrician may spend time talking with you about related topics, such as developmental milestones, teaching a child to sleep through the night, and baby-proofing your home and car.

How often will I need to return to my child’s pediatrician?

Most parents schedule subsequent pediatric appointments before leaving the office at each visit. After your child’s initial visit, he or she will need to return for wellness check-ups and immunizations multiple times over the next two years, and then once annually after that. The American Academy of Pediatrics recommends pediatric check-ups at 1, 2, 5, 6, 9, 12, 15, 18, 24, and 30 months of age. Your schedule may vary slightly from the AAP’s recommendations but should keep the same general timeline.

Immunizations

Immunizations are a foundation part of preventive healthcare for children and teens. The American Academy of Pediatrics and the Centers for Disease Control each has recommendations that suggest immunizing children starting at birth. The current vaccination schedule for children contains a list of 12 vaccines that protect against 16 dangerous diseases. The vaccines contain components designed to help the immune system develop antibodies that can fight against future infections. These components may be weakened or inactivated versions of a virus or bacteria or they may contain only parts of a bacterium combined with other proteins. Others, such as the tetanus and diphtheria vaccines, do not contain the bacteria, but rather introduce an inactivated toxin produced by them.

Did you know…

that your child may need a modified vaccination schedule if you plan to travel outside of the country with him or her? According to the Centers for Disease Control, nearly 2 million children travel internationally every year. Those children are susceptible to diseases that are all but eradicated in the U.S. and Canada. For example, there has not been a documented case of Polio in America in 20 years, yet the disease still plagues many people in Africa and parts of Asia. If your child has not yet completed the recommended vaccination schedule, talk to your pediatrician about an accelerated schedule prior to travel. Other preventive measures, such as medications that help prevent malaria, may also be necessary depending on your destination.

Frequently Asked Questions

When should my child get an immunization?

Your child will probably get his or her first vaccination – the hepatitis B shot – in the hospital after birth. A second dose may be administered at the 2 month check-up, during which time your child may also receive immunizations for rotavirus, diphtheria, pertussis, tetanus, HIB, PCV, and polio. Additional booster vaccines will be necessary periodically. Beginning at age 1, your child will also start receiving vaccinations for chicken pox, measles, mumps, rubella and hepatitis A. Vaccines for meningitis are not given until age 11 or 12. Be sure to speak with your child’s pediatrician about when to start administering annual flu shots.

How can I calm my child during a vaccination visit?

Vaccinations are not pleasant for children. Once children are old enough to associate shots with the doctor’s office, they may resist going. Try distracting your child with a favorite toy or book brought along for play in the waiting room. You can also comfort your child by holding him or her while the shot is administered. Finally, offer a reward your child can look forward to after the appointment, such as dinner at a favorite restaurant.

Will my child experience any side effects as a result of immunizations?

Although vaccines are considered safe by the AAP and CDC, there is a possibility of side effects. Of those children who do experience side effects, most have only minor symptoms, such as a low-grade fever or soreness at the site of the injection. Other temporary symptoms may include joint pain, headaches, nausea, cough, diarrhea and upper respiratory infections. The risk of serious or severe side effects is very low but you should discuss them with your child’s pediatrician prior to getting vaccines.

Expectant Parents

Did you know?

Parents can benefit from the advice of a pediatrician concerning:

  • The umbilical cord
  • Difficulty with breastfeeding
  • Immunizations
  • Developmental milestones
  • Baby-proofing the house
  • Sudden health scares, such as a first fever
  • Teaching a child to sleep through the night
  • Teething
  • Behavioral issues
  • Discipline
  • Water and sun safety
  • And much more

Frequently Asked Questions

Should I consult with my child’s pediatrician about my role as a parent?

Yes. While it is true that no one knows your child better than you do, your pediatrician can offer helpful advice that could benefit both you and your child. If possible, meet with your child’s pediatrician in a prenatal consultation prior to birth. This is an excellent time to get to know your child’s doctor and ask any questions you may already have.

What type of counsel should I expect from my child’s pediatrician?

Your child’s pediatrician is a resource for all topics pertaining to your child’s health and development. You should feel comfortable with your pediatrician and feel at ease communicating your questions or concerns.

When can I discuss my concerns with my child’s pediatrician?

Your child will visit the pediatrician’s office for frequent wellness exams during the first two years of life. While this is an opportunity to ask some questions, you may want to schedule a separate appointment to have a complete discussion with your child’s doctor. Your child’s pediatrician may also provide you with a phone number that you can call to speak with a physician’s assistant or nurse about any symptoms your child is experiencing.

Pediatric Nutrition

Nutrition plays an important role in a healthy childhood and can set the foundation for wellness in adulthood. A balanced and nutritious diet helps facilitate growth among children during a time in their lives when they are developing at a rapid rate. Education is an essential part of teaching parents and children about the importance of nutrition. Your child’s pediatrician can be your greatest resource in ensuring that your child lives healthfully from birth and into the adolescent years.

Did you know…

that obesity has become an epidemic among American children? Currently, more than 1 in 3 children are overweight due to poor diets and lack of physical exercise. More and more children and teens are developing the risk factors of cardiovascular disease as a result of being overweight. Other complications associated with being overweight in childhood include pre-diabetes, sleep apnea, and joint problems.

Frequently Asked Questions

When should I begin giving my child solid foods?

Your child should be breastfed or formula-fed exclusively for the first few months of life. Formula or breast milk should continue to be available until age least the first birthday, although parents may begin introducing solid foods gradually and individually beginning at approximately 4 to 6 months of age. Before introducing solid foods, your child should show interest in food and be capable of holding his or her head up alone.

What types of foods should my child be eating?

Children need balanced diets full of vitamins and nutrients. Although babies younger than 1 should not be given certain foods like honey, it is important to ensure that no major food groups are being excluded from an older child’s diet. Toddlers and young children need at least 2 servings of fruits and vegetables each day, as well as 4 servings of whole grains, 3 servings of dairy and 2 servings of protein. School-age children follow similar guidelines, only doubling the servings of fruits, vegetables and whole grains. Make an effort to restrict processed foods, high sodium foods, and foods high in sugar when possible.

Is there anything else I should know about teaching my child to live healthfully?

Yes. Exercise is good nutrition’s best friend. What better time to teach your child about the importance of exercise and physical activity than during childhood. Remember, children model what they see their parents do, so make exercise a family activity. Play tag, ride bikes together or go swimming. Exercise can be fun!

Water and Sun Safety

Nearly everyone loves warm weather when plenty of time is spent outdoors swimming under the hot summer sun. But the warmer months of the year are also a time to be vigilant about water sun and safety. Children are especially susceptible to the dangers of the sun and water; and it is up to parents and caregivers to ensure they are protected outdoors. According to the Centers for Disease Control, children between the ages of 1 and 4 are at the greatest risk of drowning – usually in a home swimming pool. In fact, drowning is the number one cause of death in this age group aside from birth defects. With regard to the sun, the Environmental Protection Agency reports that a blistering sunburn during childhood substantially increases risk of developing skin cancer at some point in life.

Did you know?

Babies have different water and sun safety needs than older children. Infants should be protected from the sun using lightweight clothing that covers the skin, as well as wide brimmed hats. Babies should be kept in the shade at all times to avoid burning. Babies should also never be allowed to float in ‘floaties’ without a life vest on. Finally, children living in homes with swimming pools should never be left unattended. An alarm or chime should be installed on the door that leads to the pool area.

Frequently Asked Questions

When should I begin teaching my child about water and sun safety?

It is never too early to begin teaching your children about the importance of water and sun safety. However, the American Academy of Pediatrics reports that no evidence is available to support that swimming lessons are beneficial for children under age 1. Talk with you pediatrician if you have questions about protecting your child in the water and sun.

Should I enroll my child swimming lessons?

Yes. Swimming instruction can save a child’s life, or at least, buy time for a child struggling in the water. Your child will learn to never swim alone and to call for help if a fellow swimmer is in trouble. Even if your child does not learn the basic swimming techniques during early childhood, he or she can still benefit from swimming instruction simply from learning how to float.

What other steps should I take to ensure my child is protected in the sun and water?

If possible, never allow your child to be in the water without a CPR-certified adult nearby. Ensure that your child wears a life vest while boating – regardless of whether he or she has taken and passed swimming lessons. Be sure to apply sunscreen adequately and at least 15 minutes prior to swimming. Reapply every 2 hours or as necessary.

Apnea, including Obstructive Sleep Apnea and Central Apnea

sleepapnea

There are many different types of sleep apnea, including obstructive sleep apnea (OSA) and central sleep apnea (CSA). In obstructive sleep apnea, a child struggles to inhale properly because the airway is partially collapsed. In central sleep apnea, a child’s brain fails to send signals to breathe, resulting in short periods of sleep when he or she is unable to breathe at all.

Did you know…

between 1 and 4 percent of all children have sleep apnea? Though it can occur in kids of any age, it is most common in children between the ages of 2 and 8. Children who are overweight or have enlarged tonsils or adenoids are at the greatest risk of developing OSA, which is the most common type of sleep apnea in children. However, some kids with OSA also develop central sleep apnea – a condition known as mixed sleep apnea.

Frequently Asked Questions

How do I know if my child has sleep apnea?

A child with sleep apnea will show signs of labored breathing. Often, this includes snoring, pauses between breaths and gasping. During the day, a child with sleep apnea may be drowsy or have difficulty staying awake due to restless sleep during the night.

What are the treatments for sleep apnea?

Treatment for sleep apnea varies depending on the type of apnea a child has. For example, obstructive sleep apnea is typically easily resolved with continuous positive airway pressure (CPAP), which is administered at night using a specialized mask. Central sleep apnea, however, is more complicated and may require oxygen supplementation or assisted breathing to treat.

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