After the flurry of newborn visits and vaccination appointments, it can be easy to forget to book your kid for an annual check-up. And even though I’m a stickler for getting my two kids to their yearly appointments, I must admit that life is hectic and sometimes I wonder if it’s really necessary for us to miss work and school when they seem generally healthy to me.
Here’s the official recommendation: The Canadian Paediatric Society (CPS) says parents and caregivers should bring their babies in at one week old, and then at two, four, six, nine, 12 and 18 months. From ages two to five, the CPS recommends a check-up every year. After age five, they should see a doctor every one to two years until they turn 18.
Jolanda Turley, a family physician in Ottawa, says that, even though growth slows after age two (so those frequent weight and height measurements become less important), healthcare providers will start screening for behavioural issues and developmental milestones. She agrees with the CPS that once kids hit school age, around five or six years old, going every year isn’t always necessary. “If you have an absolutely healthy child who is not on any medications, has no chronic conditions and is doing well at school, it’s probably OK to see a doctor every two years,” says Turley.
Julia Orkin, a paediatrician at the Hospital for Sick Children in Toronto and chair of the Community Paediatrics Committee at the CPS, says those regular visits are important for a few reasons. “Not only are you dealing with medical issues that might be at hand but you’re also screening for possible concerns,” she explains.
One of the big things that a healthcare provider will continue to monitor is growth. “Growth is a very good indicator of how healthy a child is, including if they’re underweight or overweight and their trend of weight,” she says.
In fact, a study recently published in the journal Preventive Medicine Reports found that some children who become obese later on have a body mass index in the normal range at age four and five, so it’s important for a doctor to watch for signs that weight is becoming a problem. Orkin adds that growth issues can also be a sign of other illnesses, such as celiac disease and inflammatory bowel disease.
Doctors also ask screening questions at each visit, which can help pick up on milestones that aren’t being met, like speech and walking, and behavioural issues that parents and caregivers might not think to talk about to their healthcare providers. Turley notes that behavioural concerns at school could be the result of anxiety, hearing difficulties and vision challenges, which are medical issues that a doctor can treat.
Aside from dealing with health and development concerns, a doctor can be an invaluable resource for the whole family's wellbeing. Healthcare practitioners promotes good health by providing information on injury prevention, nutrition and physical activity, and over the years they get to know the family, so if there is a concern in the future, it will be easier to deal with and communicate about because they’ll have built a relationship and trust. The CPS just released guidance to doctors that they should proactively ask parents about relationships, routines and family function to help parents with challenges they face, which, in turn, will improve kids’ social and emotional development.
Turley adds that as your child gets closer to their teen years, seeing a doctor regularly can make them more comfortable with them. “It lets them know they can talk to their physician about different things as they enter that age of sexual health, including mental health stuff they may not want to talk about in front of their parents,” she explains.
To make a doctor’s visit easier on everyone, it’s a good idea to prepare your kid ahead of time. “We often encourage families to talk about the appointment with their children at home and explain what might happen to ensure that they feel comfortable and know what to expect,” explains Orkin. Tell them that the doctor may listen to their heart, look in their ears and examine their genitals.
During the appointment, Turley suggests encouraging kids from an early age to speak for themselves. “It’s almost like you’re teaching your kids that this is what happens when you go to the doctor,” she says. “The doctor is going to ask you some questions and you’re going to answer them as best as you can. That sort of socializes them to the idea that when you go to the doctor, you say what’s on your mind and what’s wrong with you, so the doctor can figure out what the issue is.”
It’s a good idea to keep a running list of questions you want to ask and bring that in for the visit. If you don’t go to the same healthcare provider every year (for example, if you don’t have a regular family physician), take a picture of any medications your child takes and bring it in, along with your child’s immunization records. If you see the same healthcare provider regularly but your child was prescribed medication at an urgent-care facility, it’s important to let your provider know so they can add it to their records.
Starting at the age of 12 or 13, Turley recommends allowing children to be alone with the doctor for part of the visit. “The doctor will invariably ask them some embarrassing things that they won’t want to talk about in front of their parents,” she explains. “Even at 12 or 13, we start to ask about sexual behaviour and substance use and if everything is OK at home. You want the child to be able to talk about those things freely.”
There really is no right or wrong time to book a check-up for your child, says Orkin. “It depends on the family and their own needs,” she explains. “Many families choose to go before school starts to talk about social and emotional development or readiness for school. Other people prefer to go at the end of the year to talk about any learning challenges or concerns that came up.” A number of people take their kids in when it’s time to get flu vaccines, she notes. Turley agrees that the timing is totally up to the parent but says that she sees lots of her school-aged patients for check-ups during winter, March and summer breaks, which means they don’t miss school. For younger kids, Orkin suggests avoiding scheduling the appointment during naptime and bringing something for them to play with in the waiting room. Whatever time you choose, make it one that’s easy for you to remember, whether that means lining it up with their birthday or some other event. I know I’ll continue to make the effort—I believe healthcare practitioners should be part of the village that helps you raise a healthy and happy kid, and they can’t do that if they don’t see them often enough.