Editor's note: This article was sponsored by the Western Washington Medical Group.
An apple a day is a healthy snack choice, but it’s no excuse for avoiding the doctor. Medicine is invaluable when a person is sick, but the primary job of health care is to stay healthy. If you (like so many of us) have let your family’s routine health care slide during the past couple of years, this back-to-school season is a perfect time to get back on track.
“Well-child checks are one of the most important steps in a child’s health care. These visits meet the standards for physical exams, for assessment of growth and development, emotional health and mental health,” says Christina Nelson, MSN, ARNP, a family nurse practitioner at the Western Washington Medical Group’s Everett Family Medicine Office. But she adds that those routine visits are about much more than just keeping paperwork up to date. “They establish the importance of routine, preventive care, and the value of a strong, trusting relationship with a health-care provider.”
As a mother herself, Nelson says, “I know and understand how hard it is to get everybody in for an appointment.” When family members use the same primary care provider, you can stack appointments to save trips. The providers at a family care clinic and pediatric care specialists have the same basic training. Family medicine providers can care for both adults as well as children. Pediatricians won’t treat parents, but they can care for all of your children, even if one or more of them requires specialized care. Pediatricians can see children through age 18 — including care for sexual health.
While your health-care provider is assessing your child’s development and screening for underlying health problems, they are also getting to know your child and your family. Knowing what’s normal for a specific child can help them catch problems early.
It’s also a chance for you to get answers to your own questions. When your child is sick or injured, you’re not going to ask the doctor for the latest COVID-19 guidelines or whether their child’s aversion to green vegetables is causing a nutritional imbalance.
“A well-child visit is a prime window of opportunity for a parent to ask questions about their child’s health and development. Because the child’s not sick, you’re able to do a deep dive into the full health and well-being of the child. I recommend that families bring in their top three questions they want to ask and present those questions at the beginning of the visit,” says Nelson. A well-child visit is a great opportunity to get answers about sleep, school, development, nutrition, exercise or behavioral issues; and finding out what you are concerned about is helpful for your health-care provider, too.
“Anxiety and depression are so much more on our radar, and I am really glad for that spotlight on mental health,” says Nelson. With this rise in awareness, well-child checks have evolved to include age-appropriate screening questions about depression and anxiety (which are not only problems for adolescents). Older children may be given an opportunity to speak with the health-care provider privately, but parents should bring up any red flags. Nelson recommends watching for:
- Evidence of self-harm or destructive behavior
- Loss of interest in activities your child previously enjoyed
- Changes in sleeping and eating habits
- Extreme fears, especially accompanied by physical symptoms such as a stomachache
- Increased negative emotions, such as irritability, hopelessness, worthlessness or guilt
If your child is suffering from any mental health issues, your primary care provider can refer them to a specialist.
“A big focus right now is the fallout of lack of care during the pandemic; vaccine rates have declined in Washington state,” says Nelson. After missing routine appointments during the pandemic, many Washington children in all age groups are no longer fully immunized. Because few parents have memorized vaccination schedules, parents are often unaware that their child has missed important vaccinations.
With the return to classrooms and in-person activities, “It’s critical that we get those immunizations up to date,” says Nelson. A well-child visit is the best time to review vaccination records and correct any gaps.
Most sports programs in middle and high school require physical exams for a child to be allowed to participate.
“The sports physical can be part of a well-child visit,” says Nelson. In fact, she adds that most of the time, a regular well visit covers everything needed for a sports physical. If you know your child will be playing sports, your visit may include more questions about family history to identify risk factors for injury, as well as education about concussion precautions. But you don’t have to put off making an appointment until you know what teams your child will be joining. If your child has already had their well visit for the current year, you can fax the forms to the health clinic to have your primary care provider fill them out at the beginning of the sports season.
It’s all routine
The annual well-child check is a chance to review healthy habits.
“Routine is probably the number one healthy habit to establish. A predictable routine in terms of their everyday activities — eating, playing, sleeping — is really important to establish safety, which really does help kids with mental health and gets kids into a rhythm where they are regulated,” says Nelson.
Sleep is especially important. Follow the CDC guidelines for how much sleep your child needs, and wean them off of excessive screen time during the day and any screens close to bedtime. Nutrition is also a high priority. Three meals a day cooked at home is ideal, but trying to live up to Martha Stewart isn’t good for parents’ mental health.
“We oftentimes in our busy lives will neglect to give our kids the nutrition that they need,” says Nelson. Children’s nutrition needs change as they grow, and well visits are a good time to learn about those changes. But at any age, try to give your kids lots of protein and whole foods.
“Introduce them to different flavors and textures to expand their palate,” says Nelson. For snacks, rely on fruits and vegetables, but when packaged snacks are all you can manage, at least try to avoid options containing high fructose corn syrup. And encourage everyone in the family to drink plenty of water and practice good oral hygiene.
It’s normal if your healthy routines fall apart a bit — or a lot — during the summer. Nelson says that screen time, lack of sleep and a deteriorating diet are all common issues requiring attention as families try to get back into healthy school-year routines. She recommends setting a date in August to evaluate habits and start gradually working your way back to school-ready routines. Introducing a new bedtime the day before school starts is not a recipe for success.
“That does not do a lot for kids’ anxiety and does not help kids transition easily into the school year. None of us like to be caught off guard. Give kids an opportunity to be successful at the transition by helping them make a plan.”
And while you’re making that plan, don’t forget to schedule your well-child exam!