Timeline of infant health checks

Dr. Sara L Watkin
Specialist Pediatrician & Neonatologist, Optimal Healthcare Ltd.

The American Academy of Pediatrics recommends that all children have regular well-child checks with their doctor, in order to support and monitor normal growth and development, and provide timely and effective intervention where necessary.

These appointments are offered by all the private paediatricians on-island. As well as assessing growth and development, these visits provide the opportunity for paediatricians to address any concerns, advise on expectations, and refer for additional support such as speech and language therapy, if appropriate.

Research shows that failing to adhere reliably to the advised schedule of well-child checks is linked to increased emergency admissions and late diagnosis of conditions that warrant early treatment.

THE SCHEDULE

In the first two years, visits are frequent, matched to a child’s own rapid rate of development. As time progresses, visits become annual. Routine wellchild checks occur at 4 to 7 days, 2 months, 4 months, 6 months, 9 months, 12 months, 18 months, 2 years, and annually thereafter until age 21.

WHAT IS CHECKED?

Many different things are specifically assessed at each visit and the checks are designed to build up a sequential picture, over time. Additionally, at each visit, your paediatrician learns a great deal from observing and examining your child. Here are some highlights from each stage of checks.

TIMELINE OF INFANT HEALTH CHECKS

4 TO 7 DAYS

Your doctor will check your baby has not lost too much weight, which can be a sign of a poor milk supply or other problems. The doctor will look for jaundice, which may need treatment with special light therapy to prevent harm to your baby. There is a big focus on ensuring your baby has successfully transitioned from their cosy intrauterine home to the big wide world.

2 MONTHS

Your doctor is now particularly interested in your child’s very early development and whether they are reaching their first milestones. Direct observations are made, for example early assessment of vision, to ensure vital intervention is provided as early as possible, if necessary.

4 MONTHS

There will be much to discuss at this visit, including teething, moving to solid food at six months and, of course, lots of development. There are some very specific things to assess, such as the presence or absence of strabismus (an eye turning in or out).

6 MONTHS

At this point, your doctor will be checking that your child is not anaemic. They will discuss feeding solids and preventing food allergies, teeth cleaning and more. Safety is an additional focus at this point, important in preventing or addressing a range of common accidents.

9 MONTHS

This is a very important time for your doctor to observe your child’s developmental progress and a time when many more signals can be found through assessment. Your doctor may discuss sleep training, if your child still wakes in the night, as well as other emerging behaviours.

12 MONTHS

This is an important time to review your child’s nutrition and examine growth, as your child enters a new phase of physical development.

18 MONTHS

By this time, behavioural and physical changes allow your doctor to perform a screening test for autism, which, if picked up, allows some particularly important interventions to be provided at the earliest possible point.

24 MONTHS

At this check, your doctor may well repeat the autism screen, as a follow-on from the 18-month check. Your doctor will be carefully observing and assessing your child’s speech and interactions with them, as well as their growth. Your doctor will be able to provide advice on potty training, temper tantrums and the ‘terrible twos’. Thereafter at the annual check, your child’s doctor is assessing both growth and behavioural development, including social development. From age 4 onwards, checks will be made to ensure your child’s spine is growing straight and that their blood pressure is normal. Contact your paediatrician for more information about what they will be assessing at each visit.

Information provided by Dr. Sara L Watkin, specialist paediatrician & neonatologist at Optimal Healthcare Ltd.

To see the HSA’s childhood immunization schedule click here.