Editor’s note: This is the first of two articles on the importance of wellness visits for children from birth through 18 years of age.

Health care providers want parents to know that wellness visits are not just for babies and toddlers, but are equally important as children head into elementary school.

“I recommend parents bring in their kids every year for wellness checks,” said Dr. Addie Smith, a pediatrician in Steamboat Springs and a member of the medical staff at UCHealth Yampa Valley Medical Center. “While we have specific developmental milestones we watch closely in a child’s first few years, as children grow, they have a whole host of physical needs that we follow, in addition to emotional and psychological ones. These visits are also important for relationship building between providers, parents and children.”

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Smith said medical visits typically fall into three categories: acute when a child is sick; chronic to treat conditions such as asthma or depression or anxiety, and wellness visits that cover issues specific to ensuring optimum health as a child grows.

How can parents make the most out of a well-child visit?

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Birth to three years of age

For children birth to three years of age, providers focus on physical growth and developmental milestones, such as height, weight and head circumference, as well as motor, psychosocial and communication skills.

“There’s a big emphasis on the first 1,000 days to create a good foundation for healthy development as children continue to grow,” said Smith. “We look at where they are at on the growth chart and what factors might be affecting that.”

Other important milestones and topics include:

• Immunizations and vaccinations
• Nutrition
• Sleep challenges
• Temper tantrums
• Safety and accident prevention
• Dental health
• Hearing and vision
• Literacy promotion

Smith said it is never too early to talk about screen time. She recommends none for children under two and limited to no more than two hours per day for older children. With dental health, children should start brushing and seeing a dentist as soon as they have teeth.  

Three to five years of age

As children enter the preschool years from three to five years of age, they have different health benchmarks, although growth and development are still closely monitored. Some conversations parents often bring to health care providers with children this age include problems with sleep, picky eating, potty training and adjusting to preschool. Safety remains a primary focus as children become increasingly independent and physically capable.

Pediatricians continue to closely monitor intellectual and social development, as signs of autism spectrum disorder and learning disabilities may emerge during this period.

“We will help with screening and getting the necessary support for children who are experiencing any challenges,” said Smith.

Elementary years

When children reach elementary-school age, topics often shift to include social and academic aspects, such as making and keeping friends and succeeding at school.

As children are asked to deal with more difficult classroom tasks, concerns such as attention deficit hyperactivity disorder and learning disabilities may emerge, according to Smith.

Also, parents may notice issues such as food selection and screen time can turn into major arguments. She recommends promoting good nutrition and exercise habits, spending time outdoors and with family and friends, and putting limits on electronics.

She and her colleagues can counsel families on ways to cope with strife, so children manage their emotions, make good choices and learn self-discipline and boundaries.

“It can be challenging. When I give parenting advice, I am very circumspect,” said Smith. “We offer suggestions as to what’s shown to be effective, but ultimately, it comes down to parents processing decisions through the lens of their own values.”

Mary Gay Broderick writes for UCHealth. She can be reached at marygaybroderick@comcast.net.