Well Child Visits

Congratulations! Your baby is finally here. Newborns are wonderful, but exhausting! Having friends or family around to provide extra help and support can be very helpful. Make sure all visitors wash their hands well. Your baby’s first visit to our office takes place during his or her first week of life, usually 1-2 days after you are discharged from the hospital.

We do a lot at this visit, including:

• Review the prenatal and perinatal history and hospital record
• Check your baby’s weight (it will be dropping, this is normal)
• Monitor for signs of jaundice
• Check to see how your baby is feeding
• Answer questions about your new baby
• Recommend vitamin drops for your baby and prenatal vitamins for breastfeeding parents
  

Immunizations:

• HepB#1 (if not given in hospital)
• RSV shot (October through March)

Tests/Screens/Assessments:

• Bilirubin testing is sometimes needed at this visit

Helpful Info:

• Caring for Your Newborn

The 2 Week Visit (sooner if you have concerns!) is a time to talk about how your family is acclimating to the newest addition. Feeding, bowel habits and sleeping are common topics. If you are breastfeeding, we can answer many questions you may have, or recommend a lactation consultant if needed for personalized breastfeeding assistance.

Babies lose weight right after birth, and are usually back to their birth weight by age 10-14 days.  Please remember that it is important to always put your baby to sleep on his or her back in a flat, firm and separate sleep space to reduce the risk of SIDS. As always, we are here to answer questions and offer anticipatory guidance.

We do a lot at this visit, including:

• Measure your baby’s weight and record on a growth curve
• Remind you to give your baby a daily supplement of 400 IU of vitamin D drops
  

Immunizations:

• RSV shot if not done yet (October through March)

Tests/Screens/Assessments:

• Follow-up on Newborn Metabolic Screen results (done in hospital)

Helpful Info:

• Back to Sleep, Tummy to Play

Families are usually settling in some by this visit. Feeding, sleeping and bowel habits are sometimes a concern. At this visit we will track your baby's growth and development and answer any questions. Your baby may be starting to smile now and that helps a lot!

Immunizations:

• Hep B #2
• RSV shot if not already done (October through March)

Tests/Screens/Assessments:

• Post Partum Depression Assessment

Helpful Info:

• Back to Sleep, Tummy to Play

Many babies seem more fussy or colicky at this age. Be patient. Colicky babies eventually outgrow their crying phase. Keeping your baby safe is the most important thing you can do. Even if you feel frustrated, handle your baby gently and reach out for help to friends, relatives or your pediatrician if the crying is getting to be too much. If you need a break and no one is available to help you, place your baby on his/her back gently in a safe space, such as a crib or bassinet and take a few minutes to calm down.

We do a lot at this visit, including:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Provide immunizations. Immunizations are safe, effective and keep your child and our community healthy. During this visit, you will be able to discuss any questions you may have about immunizations.
  

Immunizations:

• Pentacel#1 (DTaP, HIB, IPV)
• Prevnar#1
• Rotavirus#1
• RSV shot if not already done (October through March)

Tests/Screens/Assessments:

• None

Helpful Info:

• Crying and Your Baby: How to Calm a Fussy or Colicky Baby

This is a fun age!  Your baby's personality may start coming through, and many babies start to giggle or laugh at age 4 months.  If your baby has been colicky, it is usually resolving by around now. 

We do a lot at this visit, including:

• Measure your baby’s weight, length and head size and record on a growth curve
• Review your child’s development with you using the ASQ questionnaire. Please complete the developmental screening 2-3 days prior to the visit, which is on our website
• Provide your baby’s immunizations. Immunizations are safe, effective and keep your child and our community healthy. During this visit, you will be able to discuss any questions you may have about immunizations
• Screen for post-partum depression
• Discuss starting solid foods, which may begin before the next checkup
  

Immunizations:

• Pentacel#2 (DTaP, HIB, IPV)
• Prevnar#2
• Rotavirus#2
• RSV shot if not already done (October through March)

Tests/Screens/Assessments:

• Post Partum Depression Assessment
• Development Assessment

Helpful Info:

• Starting Solid Foods

Your baby will begin to move more and will be able to sit up independently for short periods of time. Now is the time to start baby-proofing your house - if you haven't already done so. You should move the mattress in your baby's crib down to the lowest level.

We do a lot at this visit, including:

• Measure your baby’s weight, length and head size and record on a growth curve
• Review your child’s development with you using the ASQ questionnaire. Please complete the developmental screening 2-3 days prior to the visit, which is on our website.
• Provide your baby’s immunizations
• Discuss the introduction of fluoridated vitamins to encourage the development of strong and healthy teeth. Most NJ towns do not have fluoridated water, as well as Rockland County in NY.  If you have well water,  you should have your water tested for fluoride before offering it to your baby.
• Screen for post-partum depression
  

Immunizations:

• Pentacel#3 (DTaP, HIB, IPV)
• Prevnar#3
• Rotavirus#3
• Influenza vaccine (during flu season)
• RSV shot if not already done (October through March)

Tests/Screens/Assessments:

• Post Partum Depression Assessment
• Development Assessment
• Baby's First Vision Screening

Helpful Info:

• Teething

Your baby may be starting to crawl, pulling to a stand and cruising on furniture. Babies will want to touch everything - this is how they learn. This is a messy time! Have fun and be patient.

We do a lot at this visit, including:

• Measure your baby’s weight, length and head size and record on a growth curve
• Review your child’s development with you using the ASQ questionnaire. Please complete the developmental screening 2-3 days prior to the visit, which is on our website.
• Discuss your baby's upcoming dental care. You should be brushing your child's teeth with an infant toothbrush and a tiny smear of fluoride toothpaste if you are not giving the prescription fluoride vitamins. 
  

Immunizations:

• HepB#3
• Influenza vaccine (during flu season)

Tests/Screens/Assessments:

• Developmental Assessment

Helpful Info:

• Teething

At this age, your baby can transition from breast milk or formula to cow’s milk. However, it is healthy to continue breast milk, if that is what you prefer, for your baby. Most babies need 3 meals, 2-3 snacks per day, and no more than 16-20 ounces of whole cow's milk per day. Your baby will be able to eat many of the foods you eat, but be careful to avoid small, hard foods that can cause choking.

It is time to wean your child from the bottle and offer all liquids in a cup. Open cups, 360 cups, or soft straw cups are preferred.  It is much easier to wean your child off bottles now than if you wait until they are older. Avoid cavities and additional tears and make the change now!

Your baby will be outgrowing the infant carrier car seat. Continue to have your baby in a rear facing car seat until age 3.

We do a lot at this visit, including:

• Measure your baby’s weight, length, and head size and record on a growth curve
• Review your child’s development with you using the ASQ questionnaire. Please complete the developmental screening 2-3 days prior to the visit, which is on our website.
• Provide your baby’s immunizations
• Discuss dental health

Immunizations:

• MMR#1
• Hib #4
• Influenza vaccine (during flu season)

Tests/Screens/Assessments:

• Development Assessment
• Vision screening
• Lead and anemia surveillance

Helpful Info:

Your child may be able to climb and run, so be sure to safety proof your home.

Poison control is available 24 hours a day: 1-800-222-1222 - keep this number handy in your cell phone and on your refrigerator.

We do a lot at this visit, including:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Review your child’s development with you using the ASQ questionnaire. Please complete the developmental screening 2-3 days prior to the visit, which is on our website.
• Provide your baby’s immunizations.
  

Immunizations:

• Varicella#1
• Prevnar#4
• Influenza vaccine (during flu season)

Tests/Screens/Assessments:

• Developmental Assessment

Helpful Info:

• Choking Prevention and First Aid for Infants and Children

At 18 months, your child understands much more than he or she can say in words. Use words to describe your child’s feelings and gestures. Read and sing to your child often. When reading, use simple words to talk about the pictures.

We do a lot at this visit, including:

• Measure your child’s weight, length and head size and record on a growth curve.
• Review your child’s development with you using the MCHAT (Autism screening tool) and ASQ questionnaires. Please complete the developmental screening 2-3 days prior to the visit, which is on our website.
• Provide your baby’s immunizations.
• Discuss dental health.
• Discuss temper tantrums.
  

Immunizations:

• Influenza vaccine (during flu season)
• HepA#1
• DTaP#4

Tests/Screens/Assessments:

• Ages and Stages Questionnaire
• MCHAT Questionnaire

Helpful Info:

• Is Your Toddler Communicating With You?

At this age, your 2 year old may go from trying to be independent to clinging to you; this is normal. It is better for toddlers to play than to watch TV. Even having television playing in the background interrupts healthy toddler play - background music is a better choice.

We do a lot at this visit, including:

• Measure your child’s weight, length, head size and body mass index and record on a growth curve.
• Review your child’s development with you using the MCHAT (Autism screening tool) and ASQ questionnaires. Please complete the developmental screening 2-3 days prior to the visit, which is on our website.
• Discuss dental health.
• Discuss toilet training and time out.
  

Immunizations:

• HepA#2
• Flu vaccine (during flu season)

Tests/Screens/Assessments:

• MCHAT Questionnaire
• Ages and Stages Questionnaire
• Lead and anemia Surveillance
• Dyslipidemia Surveillance
• Vision Photoscreen

Helpful Info:

• Playground Safety

Your baby is not really a baby anymore. They are firmly in the toddler years. One moment they seem so big and the next still very small. This is the "do-it-myself time."

We do a lot at this visit, including:

• Measure your child’s weight, length, head size and record on a growth curve
• Most of our patients do not have immunizations due at this visit.
• Evaluate your child’s development with the ASQ.  Please do the ASQ developmental screening 2-3 days prior to the visit, which is on our website.
• Discuss dental health  (if they have not yet seen a dentist, they should!)
• Discuss healthy meals/snacks, avoid food pouches and juice.
  

Immunizations:

• Flu vaccine (during flu season)

Tests/Screens/Assessments:

• Ages & Stages Developmental Screening

Helpful Info:

• Snacks for Toddlers

Your child will likely be moving into a world of make believe that they create with their imagination. Toys for dress up and make believe are important at this age. Read books, sing songs and play rhyming games with your child each day.

We do a lot at this visit, including:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Most of our patients do not have immunizations due at this visit.  Your child may need immunizations if they are behind on their shots or during flu season.
• We start measuring blood pressure at this well visit.
• Discuss dental health.
  

Immunizations:

• Flu vaccine (during flu season)

Tests/Screens/Assessments:

• Oral Health Surveillance
• Ages and Stages Questionnaire
• Vision Testing

Helpful Info:

• Toilet Training

Four year olds often like to sing, dance and act. They like to tell "tall tales" and make up stories.  Enjoy these fun moments with your little one!  Parents should continue to help with brushing teeth even though your child will want to do it all by themselves.

We do a lot at this visit, including:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Provide your child's immunizations.
• Discuss dental health
  

Immunizations:

• MMR#2
• VAR#2
• DTaP/IPV
• Flu vaccine (during flu season)

Tests/Screens/Assessments:

• Oral Health Surveillance
• Ages and Stages Questionnaire
• Vision Testing
• Hearing Testing

Helpful Info:

• Encourage Your Child to Be Physically Active

At this age, your child needs more independence. However, you need to set clear limits. A regular bedtime and consistent bedtime routine are important. Be a great role model. Show an interest in what they are learning.

We do a lot at this visit, including:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Review your child’s speech and development.
• Discuss exercise and nutrition.
• Discuss kindergarten readiness.
• Discuss dental health.
  

Immunizations:

• MMR#2 (if not already done)
• VAR#2 (if not already done)
• DTaP/IPV (if not already done)
• Flu vaccine (during flu season)

Tests/Screens/Assessments:

• Oral Health Surveillance
• Pediatric Symptom Checklist
• Vision Testing
• Hearing Testing

Encourage good learning by helping your child organize a distraction-free time to do homework and ensuring eleven hours of sleep each night. Teach your child what to do if there is a fire and have practice fire drills. There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

We do a lot at this visit, including:

• Measure your child’s weight, height and body mass index  and record on a growth curve.
• Screen your child's hearing and vision.
• Review your child’s school performance and development.
• Discuss exercise and nutrition.
• Review safety issues.
  

Immunizations:

• Flu vaccine (during flu season)

Tests/Screens/Assessments:

• Oral Health Surveillance
• Pediatric Symptom Checklist
• Vision Testing
• Hearing Testing

Continue to encourage good nutrition and exercise for your child. This is the time he or she is building good health habits for a lifetime! There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

We do a lot at this visit, including:

• Measure your child’s weight, height and body mass index  and record on a growth curve.
• Review your child’s school performance and development.
• Discuss exercise and nutrition.
• Review safety issues.
  

Immunizations:

• Flu vaccine (during flu season)

Tests/Screens/Assessments:

• Vision Surveillance
• Pediatric Symptom Checklist

Helpful Info:

Positive self-image is important as your child begins to enter the changes that come with puberty. Empower them to feel good about themselves, their interaction with others and praise their effort more than the outcome.

We do a lot at this visit, including:

• Measure your child’s weight, height and body mass index and record on a growth curve
• Review your child’s school performance and development
• Discuss involvement in activities
• Discuss sleep
• Discuss exercise and nutrition
• Review safety issues
  

Immunizations:

• Flu vaccine (during flu season)

Tests/Screens/Assessments:

• Vision Testing
• Hearing Testing
• Pediatric Symptom Checklist

Helpful Info:

• Developing Your Child’s Self-Esteem

Your child be is becoming more responsible and will be able to take on more tasks such as taking care of his/her own room. He or she may also start reading independently for pleasure.

We do a lot at this visit, including:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Review your child’s school performance and development.
• Discuss exercise and nutrition.
• Review safety issues.
  

Immunizations:

• Flu vaccine (during flu season)

Tests/Screens/Assessments:

• Vision Surveillance
• Pediatric Symptom Checklist
• Anemia Surveillance
• Lipid Profile testing (completed once between 9-11 years)

Helpful Info:

• The Importance of Family Routines

Your ten year old still requires adult supervision when you are away. Family mealtime is important to keeping communication open and fostering healthy lives.  It's important to limit exposure to screens and media.

We do a lot at this visit, including:

• Measure your child’s weight, height, and body mass index and record on a growth curve
• Review your child’s school performance and development
• Discuss involvement in activities and peer relationships
• Discuss sleep
• Discuss exercise and nutrition
• Discuss puberty changes to expect or that may be starting to occur
  

Immunizations:

• Flu vaccine (during flu season)

Tests/Screens/Assessments:

• Vision Testing
• Lipid Profile (completed once between 9-11 years)
• Pediatric Symptom Checklist

Your child may be transitioning to middle school at this age. He or she may be participating in more group activities. Expand your conversations about healthy living practices to include tobacco, drug and alcohol avoidance.

We do a lot at this visit, including:

• Measure your child’s weight, height, and body mass index and record on a growth curve.
• Provide your child’s immunizations.
• Review your child’s school performance and development.
• Complete sports physical forms and discuss sport safety.
• Discuss exercise and nutrition.
• Discuss puberty changes to expect or that may be starting to occur.
  

Immunizations:

• Tdap#1
• MCV#1

Tests/Screens/Assessments:

• Vision Surveillance
• Hearing Surveillance
• Lipid Profile (completed once between 9-11 years)
• Pediatric Symptom Checklist

Helpful Info:

Your child will be in middle school at this age. Continue your conversations about healthy living practices to include tobacco, drug and alcohol avoidance. Your child should be able to assume more responsibility for personal hygiene and chores.

We do a lot at this visit, including:

• Measure your child’s weight, height, and body mass index and record on a growth curve.
• Review your child’s school performance and development.
• Complete sports physical forms and discuss sport safety.
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet.
• Discuss puberty changes to expect or that may be starting to occur.
  

Immunizations:

• HPV#1
• Flu vaccine (during flu season)

Tests/Screens/Assessments:

• Adolescent Depression Screening
• Pediatric Symptom Checklist
• Substance Use Screening
• Vision Testing

Even though friends are becoming more important at this age, having a caring adult to provide a listening ear and from which to obtain accurate health information is equally important. Foster open communication with your child. There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

We do a lot at this visit, including:

• Measure your child’s weight, height, and body mass index and record on a growth curve.
• Review your child’s school performance and development.
• Complete sports physical forms and discuss sport safety.
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet.
• Discuss puberty changes to expect or that may be starting to occur.
  

Immunizations:

• HPV#2
• Flu vaccine (during flu season)

Tests/Screens/Assessments:

• Vision Surveillance
• Adolescent Depression Screening
• Pediatric Symptom Checklist
• Substance Use Screening

Helpful Info: 

• Teens
• Behavior

Your teen may be adjusting to the transition to high school. Have conversations about risk taking behaviors, driving, alcohol, drug use, family rules and expectations. Discuss media and internet safety. Make certain that they have an adult they can confide in if they are unable to communicate with you. There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

During the teen years, we provide the opportunity for your teen to have at least a portion of this visit with the parent out of the room.

We do a lot at this visit, including:

• Measure your child’s weight, height, and body mass index and record on a growth curve.
• Complete sports physical forms and discuss sport safety.
• Review your child’s school performance and development.
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet.
  

Immunizations:

• Flu vaccine (during flu season)

Tests/Screens/Assessments:

• Vision Surveillance
• Adolescent Depression Screening
• Pediatric Symptom Checklist
• Substance Use Screening

Helpful Info: 

• Teens
• Behavior

Development of family relationships continues to be important, but it is also normal for teens to place more and more emphasis on their peer relationships. There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

During the teen years, we provide the opportunity for your teen to have at least a portion of this visit with the parent out of the room.

We do a lot at this visit, including:

• Measure your child’s weight and length and record on a growth curve.
• Complete sports physical forms and discuss sport safety.
• Review your child’s school performance.
• Reinforce healthy choices and risk behavior avoidance.
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet.
  

Immunizations:

• Flu vaccine (during flu season)

Tests/Screens/Assessments:

• Adolescent Depression Screening
• Pediatric Symptom Checklist
• Substance Use Screening
• Hearing Testing
• Vision Testing

Helpful Info: 

• Teens
• Behavior

Congratulations! You are solidly in the teen years! It is exciting to see the wonderful person your child is becoming. Possible conflict can arise at this time as your teen assesses your family values versus those of culture and peers. Keep the lines of communication open and give them additional responsibility while being present for them when they inevitably make mistakes. Be supportive and allow them to develop resilience and self-pride. During the teen years, we provide the opportunity for your teen to have at least a portion of the visit with the parent out of the room.

We do a lot at this visit, including:

• Measure your teen’s weight, height and body mass index and record on a growth curve
• Complete sports physical forms and discuss sport safety.
• Review your teen’s school performance and development
• Discuss involvement in activities and peer relationships/dating
• Discuss sleep
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet
• Reinforce healthy choices and risk behavior avoidance
  

Immunizations:

• MCV4#2
• Flu vaccine (during flu season)

Tests/Screens/Assessments:

• Vision Testing
• Pediatric Symptom Checklist
• Substance Use Screening
• Adolescent Depression Screening

Helpful Info: 

• A Message to Parents of Teen Drivers

Your child is getting closer to finishing high school and entering the adult world. Making mistakes is a normal part of growing up. Continue to provide emotional support and guidance for them during this time.

During the teen years, we provide the opportunity for your teen to have at least a portion of this visit with the parent out of the room.

We do a lot at this visit, including:

• Measure your child’s weight, height, and body mass index and record on a growth curve.
• Complete sports physical forms and discuss sport safety.
• Review your child’s school performance.
• Reinforce healthy choices and risk behavior avoidance.
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet.
• Complete college physical forms and any required college screening labs/tests.
  

Immunizations:

• MenB
• Flu vaccine (during flu season)

Tests/Screens/Assessments:

• Vision Surveillance
• Adolescent Depression Screening
• Pediatric Symptom Checklist
• Substance Use Screening
• Lipid Profile
• Anemia Surveillance

Helpful Info: 

• Teens
• Behavior

Your child is now transitioning to adult life! They will still look to you for support and guidance, but will be more on their own when it comes to decision making. 

During the teen years, we provide the opportunity for your teen to have at least a portion of this visit with the parent out of the room.

We do a lot at this visit, including:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Discuss transitions to life after high school—whether that be work, travel, vocational school or college.
• Discuss importance of responsible decision making and recognizing healthy -vs- unhealthy relationships.
• Reinforce healthy choices and risk behavior avoidance.
• Transition your child to an adult care provider after the 21-year well visit.
  

Immunizations:

• Flu vaccine (during flu season)
• Tdap (age 21)

Tests/Screens/Assessments:

• Hearing Surveillance
• Depression Screening
• Substance Use Screening
• Vision Testing
• Universal HIV Testing

Helpful Info: 

• Teens
• Behavior