What Is a Well-Child Check?

What Is a Well-Child Check?

  • A routine, check-up visit for a child may be called either:
    • A Well-Child Check (WCC)
    • Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)
    • EPSDT=
      • Early: Identifying problems early
      • Periodic: Checking children's health at periodic intervals
      • Screening: Providing screening tests to detect potential problems
      • Diagnostic: Performing diagnostic tests to follow up when a risk is identified
      • Treatment: Controlling or correcting any problems that may be found
  • A Well-Child Check is a time for the doctor to evaluate the whole child in-depth. Unlike a "sick visit," a Well-Child Check is a time for the doctor to look at all the factors that go into the health and well-being of a child.

Why Are Well-Child Checks Recommended?

  • It is important for children to be seen regularly by their doctor to make sure their growth and development is on track
  • It is equally important for caretakers to be able to ask the doctor questions about childcare, and for caretakers to be prepared for anticipated changes in the child's behavior
  • Pediatricians are experts in children's health and behavior, and parents are experts in their children. It is important for both to work together to make sure that the child can be as healthy as possible.
  • Well-Child Checks are about far more than just immunizations!

When Are Well-Child Checks Recommended?

  • For healthy children, Well-Child Checks are recommended at the following points in the child's life:
    • In the first week of life
    • 1 month
    • 2 months
    • 4 months
    • 6 months
    • 9 months
    • 12 months (1 year old)
    • 15 months
    • 18 months (1½ years old)
    • 24 months (2 years old)
    • 30 months (2½ years old)
    • 36 months (3 years old)
    • At 48 months (4 years old) and yearly thereafter
  • If a child has a medical problem, the pediatrician will want to see the child more frequently

What Is Involved in a Well-Child Check?

  • Measurements to determine if a child is growing appropriately:
    • Weight
    • Height
    • Head circumference (in children less than 3 years old)
    • It is important to recognize early when a child is not growing well. Some children do not grow well because they have a medical problem. Other children do not grow well because their caretaker does not know how feed them. Early recognition can lead to early treatment.
    • Blood pressure (yearly starting when the child is 3 years old)
    • Bloodwork to check for anemia and lead levels (at ages 1 years old and 2 years old)
  • Sensory evaluations to determine if a child can see and hear well:
    • Vision check
    • Hearing check
  • Caretakers' concerns: Caretakers can ask the doctor questions, and find out what is normal, and what deserves more investigation:
    • It is helpful for a caretaker to write down questions prior to the visit
    • There are no silly questions! Questions could be about development, behavior, growth, sleep, toilet training, etc.
  • Development: The doctor evaluates whether the child is meeting his or her developmental milestones. The fact that a child is not meeting his developmental milestones can mean that he has an underlying medical problem and/or needs developmental therapies.
  • Anticipatory guidance: Physicians will explain new behaviors that the child will soon develop so that caretakers can prepare their homes and prep other caretakers for the changes that are going to occur with their child
    • Knowing what to expect makes what is new feel more familiar and less scary

Well-Child Checks: A Summary:

  • A Well-Child Check is a time for a doctor to catch problems before they turn into emergencies
  • Check-ups are much more than just immunizations!
  • Well-Child Checks are designed to promote and improve the health, education, and well-being of infants, children, adolescents, families, and communities

Jennifer E. Wolford, DO, MPH, FAAP
Children's Hospital of Pittsburgh,
Division of Child Advocacy

Rachel P. Berger, MD, MPH
Children's Hospital of Pittsburgh,
Division of Child Advocacy

Adelaide L. Eichman, MD
Children's Hospital of Pittsburgh,
Division of Child Advocacy

Content Sources:
HealthyChildren.org. "Well-Child Care: A Check-Up for Success." www.healthychildren.org
Medicaid.gov. "Early and Periodic Screening, Diagnostic, and Treatment." www.medicaid.gov

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