9 Ways to get the most out of your child's check up

By Connie Jeske Crane on February 19, 2013
When our kids are young, a trip to the doctor can be, let’s face it, sheer chaos. Baby wailing, you dash to your doctor’s office. On a good day, you’re clutching your child’s health card and some snacks, or even – if you got some sleep the night before – an extra diaper or two. In the waiting room, as you pull your little one away from blocks and puzzles other kids have sneezed all over, you realize you should have brought some toys. The actual visit is a blur and sometimes, in all the madness, you forget to raise your biggest concern. “Why doesn’t my baby sleep through the night yet?” or “Is he gaining enough weight?”

Checkups, well-baby or well-child appointments are regularly scheduled visits with your family doctor or pediatrician. They average about 10 to 20 minutes. And while they seem to go by in a flash, visits are designed to cover a lot of territory.

Dr. Leslie Rourke, a family physician in St. John’s, NL, is one of the authors of the Rourke Baby Record (RBR), a system many doctors across the country use to guide checkups. She describes the well-baby, well-child visit as “a time to do an overall check of the child and to try to do some education and discussion of preventive issues.”

As parents, we’ll go through a lot of them. According to the Canadian Paediatric Society (CPS), “your baby’s first visit to the doctor is usually by two months. Regular visits will follow at four, six, nine, 12 and 18 months, two years, and then once every year until five years of age.” After age five, kids should see their doctor every one or two years until age 18. Ottawa pediatrician Dr. Alyson Shaw thinks it’s a great idea to stick with annual checkups even after age five: “I think most pediatricians would agree to see children yearly, just to monitor their growth and make sure that any questions are being addressed.”

Dr. Rourke says typical visits include answering your questions and concerns about your child, monitoring his or her growth, discussing nutrition and developmental milestones and a physical exam. The doctor can provide education around safety (for example, the best way to put your baby in his crib), child behaviour (“How do I get my toddler to stop hitting his brother?”), as well as other age-appropriate issues. Finally, your child will get the recommended vaccinations. (In some areas, this could also be done by another health professional, such as a public health nurse.)

With so much to cover, throw in a toddler freakout or poopy diaper episode, and it’s easy to see how your questions could go right out the window. Want to plan ahead for the smoothest visit possible? Here’s advice from some leading Canadian physicians.

Before the visit

1. Choose your time carefully

Dr. Rourke suggests you try to schedule the appointment at a time when your child is most likely to be cooperative. “If possible, avoid nap time.”

2. Write your questions down and prioritize them

We all know this, but it’s worth repeating. “It really helps if you write everything down,” says Dr. Catherine Groh, a family doctor in Elliot Lake, Ont. “Then you don’t walk out of the office, thinking you’ve forgotten something.”

If you have a lot of questions, prioritize them. Adds Dr. Groh, “Then at least we can look at it and see what we can deal with today, and come back for the other ones at another visit.”

3. For specific concerns, do a little homework

“It’s always good for the parent to do a little reflection before they come in on the kinds of questions the doctor will ask,” says Dr. Rourke.

At a typical wellness appointment, you can expect questions about family history and community contact. But if your child is exhibiting any unusual symptoms, there might be other questions, such as:
  • How long has it been going on? 
  • Is it getting worse, staying the same or improving? 
  • Is there anything you think is causing it, or anything you’re really afraid it could be? 
  • What have you tried to do to solve it? 

“Sometimes that means also discussing with other caregivers or teachers,” says Dr. Shaw. “You can take a picture or video, if you think that’s helpful, of a behaviour or something you’re concerned about.”

And don’t even think about hiding your online habit. Doctors know, says Dr. Rourke, that parents are researching concerns online before they come in. The key, she says, is getting “proper, reliable, accurate, up-to-date information on the Internet.” So tell your doctor what websites you’ve been reading.

4. Calm your child’s fears

Some kids and babies chuckle through the whole appointment. Others, not so much. If your child is the nervous type, keep a positive attitude, says Dr. Groh.

“Talk about what’s going to happen ahead of time and be honest,” says Dr. Shaw. “Using a toy doctor kit to teach young children about what the doctor is going to do during the visit can be helpful; bring a stuffed animal that they can practise on ahead of time. And the doctor may use the stethoscope first on the bear and then on your toddler.”

5. With older kids, discuss who does the talking, and who stays in the room

“There’s no definite age,” Dr. Shaw says, “but a preschooler can answer some questions and describe some symptoms. And certainly for an elementary school age child, generally I would ask them questions first and then I ask the parents… As you’re getting to 10, 11, 12, and certainly in the teen years, kids should have the opportunity to see the doctor on their own, both so they can discuss issues confidentially and also so that they are taking a role in their own health.”

Dr. Groh says doctors will ask kids about school, and if they have any concerns about bullying. “When they’re even older, you start to talk about smoking, alcohol and drugs, and in the teen years, sexual activity.”

Just before you go

6. Dress your child appropriately

Practicality rules. “It’s not the time to put on your child’s frilliest dress or something with lots of buttons,” says Dr. Shaw. Bringing a blanket to keep your baby warm is good too, she adds. “Often you’ll get them fully undressed to be weighed and measured.”

7. Bring the right stuff

Besides baby blankets, doctors advise parents to bring these items along:
  • Books and toys 
  • Snacks and fluids 
  • Extra diapers 
  • A change of clothes for babies or toddlers 
  • Your child’s health card and immunization record 
  • A list of medications your child takes (include supplements, and alternative or complementary medications) 
  • Any forms you need filled out for daycare, school, camp, etc. (there may be a fee for this) 
  • If possible, bring your partner, or a friend or family member to help you manage baby gear, and/or siblings. “If you need to talk about a sensitive issue with your doctor, it’s helpful if they can bring someone else” to sit with the child, says Dr. Shaw. 

8. Check for refills

If applicable, Dr. Shaw also advises checking to see if your child needs any refills on any product medications that they take. “Then you’re not having to call back after your appointment to deal with that.

During the visit

9. Be honest

“Answer the doctor’s questions as honestly as possible,” says Dr. Shaw. “If your child was prescribed an asthma puffer to take daily and you really only remembered to administer it two times per week, it’s not helpful for anyone if you’re not upfront about that.”

The same applies to your worries. “If your child is coming in for belly pain and the doctor tells you they most likely have constipation, but what you’re really worried about is a liver tumour because that’s what great aunt Melda had, then just be upfront and say that, so you can discuss that during the visit and not be worrying still when you’re leaving the office.”

Just as important, if you’ve been supplementing your child’s treatment – for example, with that homeopathic remedy your friend swears by, or with vitamin supplements or probiotics – share that, too. According to a study published earlier this year in Pediatrics, more than half of respondents said they have given their kids alternative medications alongside prescription drugs. And yet, almost 20 percent of families admitted they hadn’t advised their doctor of this dual treatment. Why come clean at the checkup? Your doctor or homeopath needs the information. In some cases, a combination of treatments could result in adverse reactions.

Connie Jeske Crane is a Toronto-based freelancer and mom who writes frequently on parenting, green living, and health and wellness.

Originally published in ParentsCanada magazine, February/March 2013.

By Connie Jeske Crane| February 19, 2013

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