Well-Child Visits, Vaccinations, and Milestones to Look for as Your Child Grows Up

Watching your child grow up is a wonderful experience. Their mind, body, and personality develop quickly. It may seem as if an entire year passed by in a single day.

Because children have so many developmental milestones in such a short period of time, having regular contact with their health care provider (pediatrician) can ensure your child is healthy and on track.

Pediatric primary care appointments for services like well-child visits and routine vaccinations are an important part of this process. These visits are great opportunities to learn about topics from sleep habits to seatbelt safety to developing healthy relationships with their peers, and to ask them about any questions or concerns.

    5 Benefits Of Having a Regular Pediatrician

  1. Access to the knowledge of a medical professional who specializes in diagnosing and treating illnesses from infancy through adolescence.
  2. Prevention of health issues, such as measles or obesity, with scheduled immunizations and education about nutrition and safety.
  3. Tracking your child’s growth and development, and discussing your child’s milestones, social behaviors, and learning.
  4. Opportunities to raise concerns about development, behavior, sleep, eating, and relationships.
  5. A team approach that forms strong, trustworthy relationships between you, your child, and your child’s pediatrician to benefit your child’s physical, mental, and social health.

How to Choose a Pediatrician for Your Child

Choosing your child’s pediatrician is an important decision. All pediatricians have special training in caring for children from birth to adolescence, but there are many other factors to consider.

Questions to ask yourself include:

  • Is the office conveniently located?
  • Are their office hours convenient for my schedule?
  • Do I sense a genuine interest in my child’s wellbeing, including any specific health concerns my child may have?
  • Do the office staff and pediatricians appear to be kind, compassionate, and patient, or do I feel rushed through my appointment?
  • Do I feel comfortable with the way the pediatrician explains illnesses and treatments, and do I feel as though all my questions were answered?

Questions to ask the pediatrician and office staff include:

  • What medical school, postgraduate, and residency training did you undergo?
  • What hospital would my child go to if it became necessary for them to be hospitalized?
  • What is your policy on taking and receiving phone calls? Is a nurse available to answer routine questions, even after hours?
  • Who covers for you if you are out of the office? Who handles phone calls when the office is closed?
  • How do you handle visits for acute illnesses, such as a sore throat, cold, or ear infection? Can I make an appointment on short notice?
  • What is the office’s policy on processing insurance forms?
  • What fees will I be responsible for when my child has sick visits, routine examinations, and vaccinations?
  • If my child ever develops a complex illness that requires the care of specialists, such as asthma or diabetes, will you coordinate care among other pediatrcians?

Types of Children’s Health Care Providers

Many types of providers specialize in pediatrics.

Health care professionals for children include:

  • Pediatricians, who graduate from medical school, take special courses in caring for children for 3 or more years (called a residency). Pediatricians can provide well-child care and management of some chronic illnesses. They specialize in a broad range of conditions, from mild childhood illnesses, such as colds and the flu, to serious childhood diseases, such as whooping cough and epilepsy. After residency, pediatricians are able to take an exam given by the American Board of Pediatrics. This exam allows them become board certified.
  • Family physicians, who graduate from medical school, complete a 3-year residency, and may also become board certified. They care for people of all ages, not just children from birth through adolescence.
  • Advanced practice providers (APPs), including nurse practitioners (NPs) and physician assistants (PAs):
    • Nurse practitioners have completed a master’s or doctoral program in addition to their registered nurse (RN) training and education. Nurse practitioners who specialize in pediatrics have advanced training in caring for children, and they may work in your pediatrician’s office as a part of a team led by a physician (pediatrcian).
    • Physician assistants have completed a master’s degree and training that includes extensive experience working directly with patients. Physician assistants can specialize in pediatrics and may work in your pediatrician’s office as part of your child’s care team.

If you see the initials “FAAP” after a pediatrician’s name, they’ve passed their board exam and are a Fellow of the American Academy of Pediatrics — the highest status of membership in this professional organization. Physicians who maintain their FAAP designation commit to lifelong education and training in order to treat the children in their care.

What to Expect at a Well-child Visit

A well-child visit is a time for your child’s growth and development to be assessed, in order to find or prevent any issues.

Well-Child Visit Must-Haves

Each child is unique, and your child’s pediatrician will be able to determine the tests and screenings they need. However, there are some “must-haves” that allow pediatricians to provide comprehensive monitoring and care.

At each well-visit, your child’s pediatrician should:

  • Document health history
  • Provide a thorough physical examination
  • Administer scheduled immunizations
  • Measure height and weight
  • Monitor development (make sure they’re meeting important milestones)
  • Assess behavior and social development
  • Provide guidance about future care and wellness

Depending on your child’s age and medical history, a typical well-child visit may also involve:

  • Checking their blood pressure
  • Performing hearing or vision screenings
  • Performing other tests, such as cholesterol and anemia tests
  • Receiving information about wellness topics such as family and relationship issues, school, and access to community services, such as counseling
  • Talking about common adolescent issues, such as drinking, smoking, drugs, sexual activity, and depression

Your child’s pediatrician can establish a long-term relationship with them during these visits, as well as monitor progress and development over time. By remaining familiar with your child’s history, such as past illnesses, injuries, and other concerns, their pediatrician can detect any emerging issues.

This relationship between your child and their pediatrician also allows your child the opportunity to share information and ask important questions in an environment where they feel safe.

Recommended Timeline of Well-Child Visits

Before children are 3 years old, well-child visits are recommended much more frequently than when they are older. Well-child visits should be done at:

  • The first week (3 to 5 days old)
  • 1 month old
  • 2 months old
  • 4 months old
  • 6 months old
  • 9 months old
  • 12 months old
  • 15 months old
  • 18 months old
  • 2 years old
  • 2 ½ years old
  • 3 years old
  • Each year until they are 21 years old

Your child’s pediatrician can recommend an adult primary care provider for them to transition their care to when they get older. While pediatricians can treat patients through age 21, many people like to switch to an adult provider during their later teenage years or when they go to college.

Developmental Milestones to Look For

It’s exciting to watch your child grow. From their first smile to their first step, you’ll be able to witness them hit many important milestones.

While most children meet developmental milestones around a certain age, some children may take longer to reach them. When you read these guidelines — or see your friends posting on social media that their 6-month-old is already forming sentences — don’t panic. All children move at their own pace, and that’s okay. These milestones are general, and if you have any concerns about your child’s progress, discuss them with your child’s pediatrician.

Common developmental milestones include:

  • By 2 months: Pays attention to faces and tries to look at their parent or caregiver
  • By 4 months: Mimics facial expressions and responds to affection
  • By 6 months: Enjoys looking at their reflection in the mirror and can bring objects to their mouth
  • By 9 months: Has favorite toys and uses their thumb and forefinger to pick up small items
  • Around 12 months: Helps with dressing by putting out their arm or leg, and follows simple directions
  • At 18 months: Can identify major body parts by pointing and explores areas alone if a parent or caregiver is nearby
  • By 2 years: Is excited to see other children and starts to sort colors and shapes
  • By 3 years: Can get dressed on their own and complete puzzles with three to four pieces
  • By 4 years: Is able to tell the difference between real and make-believe and predict what will happen next in a book
  • By 5 years: Wants to be like their friends and can draw a person with six body parts

If you feel that your child isn’t hitting the milestones as they should, talk to their pediatrician. Milestones will also be monitored at every well-child visit.

The Who, What, When, and Why of Vaccinations

Before children are born, their mothers provide them with some antibodies (proteins that fight disease) for extra protection. But this protection is only temporary. Vaccinations are an important way to create immunity — or protection — from some diseases.

Vaccines contain a small amount of a killed or weakened germ that causes disease. They can be viruses, such as the measles virus, or bacteria, such as pneumococcus (an infection that can cause pneumonia and other illnesses).

Vaccines make your body think there is a real infection, and the immune system fights off the disease. Your body remembers the germ, which allows it to fight if it enters the body later.

Some vaccinations require more than one dose to be effective. A typical vaccination schedule may include:

Disease Description Recommended Vaccine Schedule
Hepatitis B A liver infection transmitted through blood, semen, and other body fluids  Given at birth, between 1 and 2 months, and between 6 and 18 months
Rotavirus An infection that leads to inflammation of the stomach and intestines, causing severe watery diarrhea, vomiting, fever, abdominal pain, and extreme dehydration Either a 2-dose series given at 2 and 4 months, OR a 3-dose series given at 2, 4, and 6 months
Diphtheria, Tetanus, and Pertussis (DTaP)
  • Diphtheria: Infection that causes a thick coating in the back of the throat that may lead to trouble breathing, heart failure, or paralysis — and can be fatal 
  • Tetanus: Infection that causes painful muscle contractions, especially in the jaw
  • Pertussis (whooping cough): Very contagious respiratory illness that causes uncontrollable, violent coughing which makes it difficult to breathe 
Given at 2, 4, and 6 months, and between 15 and18 months, and between 4 and 6 years
Haemophilus influenzae type b (Hib Disease) A bacteria that leads to infections such as pneumonia (lung infection), bacteremia (blood infection), meningitis (infection in the tissue that covers the brain and spinal cord), and cellulitis (skin infection) Either a 4-dose series given at 2, 4, and 6 months, and between 12 and 15 months, OR 3-dose series given at 2 and 4 months, and between 12 and 15 months
Pneumococcal An infection that can cause other illnesses, such as pneumonia, ear infections, meningitis, or sepsis Given at 2, 4, and 6 months, and between 12 and 15 months
Inactivated Poliovirus A potentially deadly infection that invades a person’s spinal cord and brain, causing symptoms ranging from flu-like symptoms (sore throat, fever, nausea) to paralysis (inability to move parts of the body) Given at 2 and 4 months, between 6 and 18 months, and between 4 and 6 years
Influenza A respiratory system disease that can be mild to severe and may lead to complications such as ear infections, congestive heart failure, and diabetes  1 or 2 doses can be given annually beginning at 6 months, 1 dose annually can be given from age 7 years on
Measles, Mumps, Rubella (MMR)
  • Measles: Infections that cause cold-like symptoms (cough, runny nose, watery eyes), a rash that covers the entire body, and potentially lung infections or, in rare cases, brain damage, or death
  • Mumps: Virus that causes flu-like symptoms (fever, headache, muscle aches) and potentially deafness, swelling of the brain or spinal cord or, very rarely, death
  • Rubella: Virus that causes fever, rash, eye irritation, and potentially arthritis 
Given between 12 and 15 months and between 4 and 6 years
Varicella (chickenpox) A contagious disease that leads to blister-like rashes, itching, tiredness, and fever Given between 12 and 15 months and between 4 and 6 years
Hepatitis A A disease of the liver that causes tiredness, low appetite, stomach pain, and nausea  2-dose series given at least 6 months apart, between 12 and 23 months

Understanding Vaccine Safety

Vaccination Ingredients

Vaccines only contain ingredients that allow them to be safely administered. In fact, the ingredients in vaccines are at doses even smaller than we’re naturally exposed to in the environment.

For example, some vaccines contain thimerosal, a mercury-containing compound used to preserve vaccines — but that’s not as concerning as it may sound. The dose in a vaccine is very low, and there’s no evidence to suggest that this low dose poses any health risks. And, your child is probably already exposed to low doses of mercury — milk, seafood, and contact lens solutions all contain some mercury.

Vaccination Reactions

Vaccines are very safe, and most reactions are minor, such as a fever or sore arm. Vaccines are not linked to autism or sudden infant death syndrome (SIDS). The 1998 study that raised these concerns was retracted and the medical community does not view it as valid.

Viruses in Vaccinations

Getting the disease from a vaccine is extremely unlikely — and usually impossible. Most vaccines contain an inactivated virus — meaning they use a dead version of the germ — which makes it impossible to get the disease. The few vaccines that contain live organisms can lead to a mild case of the disease, such as a rash after the chickenpox vaccine. This isn’t harmful — actually, it shows that the vaccine is working.

Benefits of vaccines greatly outweigh any risks associated with dangerous, preventable diseases.

Why Choose Stormont Vail

Located in Topeka, Kansas, Stormont Vail Health is a community-driven organization. It offers close to home care and with limited travel requirements, it will be easier for you to get the care your child needs from experienced pediatric providers you can trust at Cotton O’Neil Pediatrics.

In 2018, Stormont Vail achieved Magnet designation for a third time. Magnet designation is one of the highest awards in nursing excellence and high-quality patient care. Only 9% of US hospitals have earned this recognition. The Joint Commission — with more than 50 years of accrediting hospitals in high quality standards — has also accredited Stormont Vail Hospital.

With a care team that includes pediatricians, behavioral health specialists, nurses, and other specialists, Cotton O’Neil Pediatrics has an experienced and skilled medical team to help you manage your child’s health.


Next Steps

Make an Appointment

  • To make an appointment at Cotton O’Neil Pediatrics, call (785) 273-8224 (Gage office) or (785) 273-7571 (Urish office).
  • Not a Stormont Vail patient yet? Call (785) 273-8224(Gage office), or (785) 273-7571 (Urish office) to make your child’s first appointment with one of our pediatricians.