what does a well child visit consist of

Family Life

AAP Schedule of Well-Child Care Visits

Parents know who they should go to when their child is sick. But pediatrician visits are just as important for healthy children.

The Bright Futures /American Academy of Pediatrics (AAP) developed a set of comprehensive health guidelines for well-child care, known as the " periodicity schedule ." It is a schedule of screenings and assessments recommended at each well-child visit from infancy through adolescence.

Schedule of well-child visits

• The first week visit (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 (24 months)
• 2 ½ years old (30 months)
• 3 years old
• 4 years old
• 5 years old
• 6 years old
• 7 years old
• 8 years old
• 9 years old
• 10 years old
• 11 years old
• 12 years old
• 13 years old
• 14 years old
• 15 years old
• 16 years old
• 17 years old
• 18 years old
• 19 years old
• 20 years old
• 21 years old

The benefits of well-child visits

Prevention . Your child gets scheduled immunizations to prevent illness. You also can ask your pediatrician about nutrition and safety in the home and at school.

Tracking growth & development . See how much your child has grown in the time since your last visit, and talk with your doctor about your child's development. You can discuss your child's milestones, social behaviors and learning.

Raising any concerns . Make a list of topics you want to talk about with your child's pediatrician such as development, behavior, sleep, eating or getting along with other family members. Bring your top three to five questions or concerns with you to talk with your pediatrician at the start of the visit.

Team approach . Regular visits create strong, trustworthy relationships among pediatrician, parent and child. The AAP recommends well-child visits as a way for pediatricians and parents to serve the needs of children. This team approach helps develop optimal physical, mental and social health of a child.

More information

Back to School, Back to Doctor

Recommended Immunization Schedules

Milestones Matter: 10 to Watch for by Age 5

Your Child's Checkups

• Bright Futures/AAP Recommendations for Preventive Pediatric Health Care (periodicity schedule)

Select Your Interests

Customize your JAMA Network experience by selecting one or more topics from the list below.

• Academic Medicine
• Acid Base, Electrolytes, Fluids
• Allergy and Clinical Immunology
• American Indian or Alaska Natives
• Anesthesiology
• Anticoagulation
• Art and Images in Psychiatry
• Artificial Intelligence
• Assisted Reproduction
• Bleeding and Transfusion
• Caring for the Critically Ill Patient
• Challenges in Clinical Electrocardiography
• Climate and Health
• Climate Change
• Clinical Challenge
• Clinical Decision Support
• Clinical Implications of Basic Neuroscience
• Clinical Pharmacy and Pharmacology
• Complementary and Alternative Medicine
• Consensus Statements
• Coronavirus (COVID-19)
• Critical Care Medicine
• Cultural Competency
• Dental Medicine
• Dermatology
• Diabetes and Endocrinology
• Diagnostic Test Interpretation
• Drug Development
• Electronic Health Records
• Emergency Medicine
• End of Life, Hospice, Palliative Care
• Environmental Health
• Equity, Diversity, and Inclusion
• Facial Plastic Surgery
• Gastroenterology and Hepatology
• Genetics and Genomics
• Genomics and Precision Health
• Global Health
• Guide to Statistics and Methods
• Hair Disorders
• Health Care Delivery Models
• Health Care Economics, Insurance, Payment
• Health Care Quality
• Health Care Reform
• Health Care Safety
• Health Care Workforce
• Health Disparities
• Health Inequities
• Health Policy
• Health Systems Science
• History of Medicine
• Hypertension
• Images in Neurology
• Implementation Science
• Infectious Diseases
• Innovations in Health Care Delivery
• JAMA Infographic
• Law and Medicine
• Leading Change
• Less is More
• LGBTQIA Medicine
• Lifestyle Behaviors
• Medical Coding
• Medical Devices and Equipment
• Medical Education
• Medical Education and Training
• Medical Journals and Publishing
• Mobile Health and Telemedicine
• Narrative Medicine
• Neuroscience and Psychiatry
• Notable Notes
• Nutrition, Obesity, Exercise
• Obstetrics and Gynecology
• Occupational Health
• Ophthalmology
• Orthopedics
• Otolaryngology
• Pain Medicine
• Palliative Care
• Pathology and Laboratory Medicine
• Patient Care
• Patient Information
• Performance Improvement
• Performance Measures
• Perioperative Care and Consultation
• Pharmacoeconomics
• Pharmacoepidemiology
• Pharmacogenetics
• Pharmacy and Clinical Pharmacology
• Physical Medicine and Rehabilitation
• Physical Therapy
• Physician Leadership
• Population Health
• Primary Care
• Professional Well-being
• Professionalism
• Psychiatry and Behavioral Health
• Public Health
• Pulmonary Medicine
• Regulatory Agencies
• Reproductive Health
• Research, Methods, Statistics
• Resuscitation
• Rheumatology
• Risk Management
• Scientific Discovery and the Future of Medicine
• Shared Decision Making and Communication
• Sleep Medicine
• Sports Medicine
• Stem Cell Transplantation
• Substance Use and Addiction Medicine
• Surgical Innovation
• Surgical Pearls
• Teachable Moment
• Technology and Finance
• The Art of JAMA
• The Arts and Medicine
• The Rational Clinical Examination
• Tobacco and e-Cigarettes
• Translational Medicine
• Trauma and Injury
• Treatment Adherence
• Ultrasonography
• Users' Guide to the Medical Literature
• Vaccination
• Venous Thromboembolism
• Veterans Health
• Women's Health
• Workflow and Process
• Wound Care, Infection, Healing
• Download PDF
• Share X Facebook Email LinkedIn
• Permissions

The Well-Child Visit

• Original Investigation Adolescent Preventive Care and the Affordable Care Act Sally H. Adams, PhD; M. Jane Park, MPH; Lauren Twietmeyer, MPH; Claire D. Brindis, DrPH; Charles E. Irwin Jr, MD JAMA Pediatrics

Whatever name you use—check-up, well-child visit, or health supervision visit—these are important.

The benefits of well-child visits include tracking your child’s growth and development. Your pediatrician will review your child’s growth since the last visit and talk with you about your child’s development. These visits are a time to review and discuss each of the important areas of your child’s development, including physical, cognitive, emotional, and social development. Pediatricians often use a resource called Bright Futures to assess and guide discussions with parents about child development. Parents can access Bright Futures to review information relevant to their child’s age using the website at the bottom of this page.

Another benefit of a well-child visit is the opportunity to talk about prevention. For many children in the United States, the most common cause of harm is a preventable injury or illness. The well-child visit is an opportunity to review critical strategies to protect your child from injury, such as reviewing car seat use and safe firearm storage. The well-child visit is an opportunity to ensure your child is protected from infectious diseases by reviewing and updating his or her immunizations. If there is a family history of a particular illness, parents can discuss strategies to prevent that illness for their child. Healthy behaviors are important to instill at a young age, and the well-child visit is a time to review these important behaviors, such as sleep, nutrition, and physical activity.

During the teenage years, well-child visits offer adolescents an opportunity to take steps toward independence and responsibility over their own health behaviors. Every well-child visit with a teenager should include time spent alone with the pediatrician so that the adolescent has the opportunity to ask and answer questions about their health. Adolescent visits provide an opportunity for teenagers to address important questions, including substance use, sexual behavior, and mental health concerns.

Physical examination and screening tests are also a part of the well-child visit. Your child’s visit may include checking blood pressure level, vision, or hearing. Your pediatrician will do a physical examination, which may include listening to the lungs and feeling the abdomen. Screening tests can include tests for anemia, lead exposure, or tuberculosis. Some screening, such as for depression or anxiety, is done using a paper form or online assessment.

How Parents and Kids Can Get the Most Out of a Well-Child Visit

Ideally, schedule the visit ahead of time so that there is time to complete any required school or sports forms. Some parents schedule these visits to correspond with their children’s birthdays, while others schedule these during summer months to prepare for the start of a new school year.

Make a list of topics you want to discuss with your child’s pediatrician, such as development, behavior, sleep, eating, or prevention. Bring your top 3 to 5 questions with you to the visit. As your child gets older, ask your child to contribute any questions he or she would like to ask.

When going to the visit, it may be helpful to bring your child’s immunization record, a list of questions, or any school or sports forms you need completed.

For More Information

https://www.healthychildren.org/English/family-life/health-management/Pages/Well-Child-Care-A-Check-Up-for-Success.aspx .

Published Online: November 6, 2017. doi:10.1001/jamapediatrics.2017.4041

Conflict of Interest Disclosures: None reported.

See More About

Moreno MA. The Well-Child Visit. JAMA Pediatr. 2018;172(1):104. doi:10.1001/jamapediatrics.2017.4041

Manage citations:

© 2024

Artificial Intelligence Resource Center

Pediatrics in JAMA : Read the Latest

Browse and subscribe to JAMA Network podcasts!

Others Also Liked

• Register for email alerts with links to free full-text articles
• Access PDFs of free articles
• Manage your interests
• Save searches and receive search alerts

KENNETH W. LIN, MD, MPH, Georgetown University School of Medicine, Washington, District of Columbia

Am Fam Physician. 2015;91(6):362-364

More than two-thirds of practicing family physicians report that they provide care for children, 1 and well-child visits provide the best opportunities to deliver evidence-based preventive services. These services include administering immunizations, assessing growth and development, and counseling children and parents about behavioral issues, nutrition, exercise, and prevention of unintentional injury. 2

The American Academy of Pediatrics (AAP) recently updated its recommendations on preventive health care for children, 3 which define a set of services that, under the Affordable Care Act, must be covered by Medicaid and private insurers at no out-of-pocket cost. 4 The current AAP Bright Futures guideline (available at http://www.aap.org/en-us/professional-resources/practice-support/Periodicity/Periodicity%20Schedule_FINAL.pdf ) includes three screening tests that were not recommended for all children in previous versions: autism screening at 18 and 24 months of age, cholesterol screening between nine and 11 years of age, and annual screening for high blood pressure beginning at three years of age.

It should be noted that none of these screening tests are included in the American Academy of Family Physicians' (AAFP's) list of recommended preventive services for children ( Table 1 ) . 5 The AAFP's clinical preventive services recommendations are generally consistent with those of the U.S. Preventive Services Task Force (USPSTF). The USPSTF methods for developing recommendations include performing a systematic evidence review of the benefits and harms of a preventive service, and recommending that the service be provided to the general population only after consistent data from high-quality randomized controlled trials or other prospective studies establish that the benefits exceed the harms. 6 This rigorous approach to the development of clinical practice guidelines has been endorsed by the Institute of Medicine. 7 In contrast, few AAP policy statements on well-child care are supported by direct evidence of net health benefit. 8 , 9

The rationale for the AAP's recommendation to routinely screen toddlers for autism spectrum disorders (ASDs) with ASD-specific screening tools is to advance the time of diagnosis and deliver early interventions. 10 Although a systematic review of 40 studies found that a policy of universal screening for ASD increased rates of diagnosis and referral, the effects of such policies on time of diagnosis or enrollment in services are unclear. 11 The entire body of evidence that intensive behavioral interventions improve language skills and cognitive or functional outcomes in children with ASD consists of a single randomized controlled trial and several prospective cohort studies of varying quality. 12 , 13

The AAP recommends measurement of blood pressure and cholesterol levels in children to identify modifiable risk factors for cardiovascular disease and to provide early interventions to reduce future risk. However, no studies have evaluated whether treating primary hypertension in persons younger than 18 years reduces adverse cardiovascular outcomes in adulthood. 14 , 15 Similarly, evidence is lacking that lowering cholesterol levels with lifestyle changes or medications improves cardiovascular outcomes, and long-term statin use is associated with rare but serious harms. 16 , 17

Time is a precious clinical resource. Clinicians who spend time delivering unproven or ineffective interventions at health maintenance visits risk “crowding out” effective services. For example, a national survey of family and internal medicine physicians regarding adult well-male examination practices found that physicians spent an average of five minutes discussing prostate-specific antigen screening (a service that the AAFP and the USPSTF recommend against because the harms outweigh the benefits 18 ), but one minute or less each on nutrition and smoking cessation counseling. 19 Similarly, family physicians have limited time at well-child visits and therefore should prioritize preventive services that have strong evidence of net benefit.

editor's note: Dr. Lin is associate deputy editor of AFP Online and chair of the Subcommittee on Clinical Practice Guidelines of the AAFP's Commission on the Health of the Public and Science. Because of Dr. Lin's dual roles, two other medical editors independently reviewed this editorial for publication.

Bazemore AW, Makaroff LA, Puffer JC, et al. Declining numbers of family physicians are caring for children. J Am Board Fam Med. 2012;25(2):139-140.

Riley M, Locke AB, Skye EP. Health maintenance in school-aged children: part II. Counseling recommendations. Am Fam Physician. 2011;83(6):689-694.

Simon GR, Baker C, Barden GA, et al. 2014 recommendations for pediatric preventive health care. Pediatrics. 2014;133(3):568-570.

American Academy of Pediatrics. Bright Futures. http://brightfutures.aap.org . Accessed August 20, 2014.

American Academy of Family Physicians. Summary of recommendations for clinical preventive services. July 2014. https://www.aafp.org/dam/AAFP/documents/patient_care/clinical_recommendations/cps-recommendations.pdf . Accessed August 20, 2014.

Melnyk BM, Grossman DC, Chou R, et al. USPSTF perspective on evidence-based preventive recommendations for children. Pediatrics. 2012;130(2):e399-e407.

Graham R, Mancher M, Wolman DM, et al., eds. Clinical Practice Guidelines We Can Trust . Washington, DC: The National Academies Press; 2011.

Moyer VA, Butler M. Gaps in the evidence for well-child care: a challenge to our profession. Pediatrics. 2004;114(6):1511-1521.

Belamarich PF, Gandica R, Stein RE, Racine AD. Drowning in a sea of advice: pediatricians and American Academy of Pediatrics policy statements. Pediatrics. 2006;118(4):e964-e978.

Johnson CP, Myers SM American Academy of Pediatrics Council on Children with Disabilities. Identification and evaluation of children with autism spectrum disorders. Pediatrics. 2007;120(5):1183-1215.

Daniels AM, Halladay AK, Shih A, et al. Approaches to enhancing the early detection of autism spectrum disorders. J Am Acad Child Adolesc Psychiatry. 2014;53(2):141-152.

Warren Z, McPheeters ML, Sathe N, et al. A systematic review of early intensive intervention for autism spectrum disorders. Pediatrics. 2011;127(5):e1303-e1311.

Reichow B, Barton EE, Boyd BA, Hume K. Early intensive behavioral intervention (EBI) for young children with autism spectrum disorders (ASD). Cochrane Database Syst Rev. 2012;10:CD009260.

Chiolero A, Bovet P, Paradis G. Screening for elevated blood pressure in children and adolescents: a critical appraisal. JAMA Pediatr. 2013;167(3):266-273.

Thompson M, Dana T, Bougatsos C, Blazina I, Norris SL. Screening for hypertension in children and adolescents to prevent cardiovascular disease. Pediatrics. 2013;131(3):490-525.

Grossman DC, Moyer VA, Melnyk BM, Chou R, DeWitt TG U.S. Preventive Services Task Force. The anatomy of a U.S. Preventive Services Task Force recommendation: lipid screening for children and adolescents. Arch Pediatr Adolesc Med. 2011;165(3):205-210.

Psaty BM, Rivara FP. Universal screening and drug treatment of dyslipidemia in children and adolescents. JAMA. 2012;307(3):257-258.

Moyer VA U.S. Preventive Services Task Force. Screening for prostate cancer: U.S. Preventive Service Task Force recommendation statement. Ann Intern Med. 2012;157(2):120-134.

Pollack KI, Krause KM, Yarnall KS, Gradison M, Michener JL, Østbye T. Estimated time spent on preventive services by primary care physicians. BMC Health Serv Res. 2008;8:245.

Continue Reading

More in AFP

More in pubmed.

Copyright © 2015 by the American Academy of Family Physicians.

This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.  See permissions  for copyright questions and/or permission requests.

Copyright © 2024 American Academy of Family Physicians. All Rights Reserved.

An official website of the United States government

Here’s how you know

Official websites use .gov A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS A lock ( Lock Locked padlock icon ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

• Health Topics
• Drugs & Supplements
• Medical Tests
• Medical Encyclopedia
• About MedlinePlus
• Customer Support

Well-child visits

Childhood is a time of rapid growth and change. Children have more well-child visits when they are younger. This is because development is faster during these years.

Each visit includes a complete physical exam. At this exam, the health care provider will check the child's growth and development in order to find or prevent problems.

The provider will record your child's height, weight, and other important information. Hearing, vision, and other screening tests will be part of some visits. So will immunizations.

Even if your child is healthy, well-child visits are a good time to focus on your child's wellness. Talking about ways to improve care and prevent problems helps keep your child healthy.

Information

At your well-child visits, you will get information on topics such as:

• Childhood diseases
• What to expect as your child grows

Write down your questions and concerns and bring them with you. This will help you get the most out of the visit.

Your provider will pay special attention to how your child is growing compared to normal developmental milestones. Your child's height, weight, and head circumference are recorded on a growth chart . This chart remains part of your child's medical record. Talking about your child's growth is a good place to begin a discussion about your child's general health. Ask your provider about the body mass index (BMI) curve, which is the most important tool for identifying and preventing obesity.

Your provider will also talk about other wellness topics such as family relationship issues, school, and access to community services.

There are several schedules for routine well-child visits. One schedule, recommended by the American Academy of Pediatrics, is given below.

PREVENTIVE HEALTH CARE SCHEDULE

A visit with a provider before the baby is born can be particularly important for:

• First-time parents.
• Parents with a high-risk pregnancy.
• Any parent who has questions about issues such as feeding, circumcision , and general child health issues.

After the baby is born, the next visit should be 2 to 3 days after bringing the baby home (for breastfed babies) or when the baby is 2 to 4 days old (for all babies who are released from a hospital before they are 2 days old). Some providers will delay the visit until the baby is 1 to 2 weeks old for parents who have had babies before.

After that, it is recommended that visits occur at the following ages (your provider may have you add or skip visits depending on your child's health or your parenting experience):

• 2 1/2 years
• Each year after that until age 21

Also, you should call or visit a provider any time your baby or child seems ill or whenever you are worried about your baby's health or development.

RELATED TOPICS

Elements of the physical exam:

• Auscultation (listening to heart, breath, and stomach sounds)
• Heart sounds
• Infantile reflexes and deep tendon reflexes as the child gets older
• Neonatal jaundice -- first few visits only
• Standard ophthalmic exam
• Temperature measurement (see also normal body temperature )

Immunization information:

• Immunizations -- general overview
• Babies and shots
• Diphtheria immunization (vaccine)
• DPT immunization (vaccine)
• Hepatitis A immunization (vaccine)
• Hepatitis B immunization (vaccine)
• Hib immunization (vaccine)
• Human papilloma virus (vaccine)
• Influenza immunization (vaccine)
• Meningococcal (meningitis) immunization (vaccine)
• MMR immunization (vaccine)
• Pertussis immunization (vaccine)
• Pneumococcal immunization (vaccine)
• Polio immunization (vaccine)
• Rotavirus immunization (vaccine)
• Tetanus immunization (vaccine)
• TdaP immunization (vaccine)
• Varicella (chickenpox) immunization (vaccine)

Nutrition advice:

• Appropriate diet for age -- balanced diet
• Breastfeeding
• Diet and intellectual development
• Fluoride in diet
• Infant formulas
• Obesity in children

Growth and development schedules:

• Infant -- newborn development
• Toddler development
• Preschooler development
• School-age child development
• Adolescent development
• Developmental milestones
• Developmental milestones record -- 2 months
• Developmental milestones record -- 4 months
• Developmental milestones record -- 6 months
• Developmental milestones record -- 9 months
• Developmental milestones record -- 12 months
• Developmental milestones record -- 18 months
• Developmental milestones record -- 2 years
• Developmental milestones record -- 3 years
• Developmental milestones record -- 4 years
• Developmental milestones record -- 5 years

Preparing a child for an office visit is similar to test and procedure preparation.

Preparation steps differ, depending on the child's age:

• Infant test/procedure preparation
• Toddler test/procedure preparation
• Preschooler test/procedure preparation
• School-age test/procedure preparation

Hagan JF Jr, Navsaria D. Maximizing children's health: screening, anticipatory guidance, and counseling. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics . 21st ed. Philadelphia, PA: Elsevier; 2020:chap 12.

Kelly DP, Natale MJ. Neurodevelopmental and executive function and dysfunction. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics . 21st ed. Philadelphia, PA: Elsevier; 2020:chap 48.

Kimmel SR, Ratliff-Schaub K. Growth and development. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine . 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 22.

Review Date 1/24/2023

Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Related MedlinePlus Health Topics

• Baby Health Checkup
• Children's Health
• Health Checkup

Doctor Visits

Make the Most of Your Child’s Visit to the Doctor (Ages 11 to 14 Years)

Take Action

Kids ages 11 to 14 years need to go to the doctor or nurse for a “well-child visit” once a year.

A well-child visit is when you take your child to the doctor to make sure they’re healthy and developing normally. This is different from other visits for sickness or injury.

At a well-child visit, the doctor or nurse can help catch any problems early, when they may be easier to treat.

Learn what to expect so you can make the most of each visit.

Child Development

How do i know if my child is growing and developing on schedule.

Your child’s doctor or nurse can help you identify “developmental milestones,” or signs to look for that show your child is developing normally. This is an important part of the well-child visit.

Some developmental milestones are related to your child’s behavior and learning, and others are about physical changes in your child’s body.

Check out these resources to learn more about developmental milestones:

• Developmental Milestones (Ages 9 to 11 years)
• Developmental Milestones (Ages 12 to 14 years)

Behavior Changes

What are some changes i might see in my child’s feelings, relationships, and behavior.

Developmental milestones for kids ages 11 to 14 years include:

• Wanting more independence and privacy
• Having mood swings (going quickly from happy to sad or sad to happy)
• Showing more concern about what their friends and classmates think
• Developing stronger problem-solving skills
• Developing a clearer sense of right and wrong
• Challenging rules and resisting advice from parents

This is also a time when some kids may start showing signs of depression or eating disorders. Bullying and social media use may also become issues at this age. It’s important to:

• Make sure the doctor screens your child for depression
• Have your child screened for anxiety
• Know the signs of eating disorders
• Teach your kids to use social media safely
• Watch for signs of bullying

Physical Changes

What physical changes will my child go through.

Many kids ages 11 to 14 years are going through puberty. Puberty is when a child’s body develops into an adult’s body.

• For girls, puberty usually starts between ages 9 and 13 years. Get more information about puberty to share with your daughter .
• For boys, it usually starts between ages 10 and 13 years. Get more information about puberty to share with your son .

You can help by giving your child information about what changes to expect during puberty. You can also encourage your child to talk about puberty with the doctor or another trusted adult, like a teacher or school nurse.

Puberty can be a difficult time for gender-diverse children — kids who feel that they’re a different gender than the sex that’s listed on their birth certificate. Encourage your child to talk with you or their doctor if they have questions about their gender. Find tips for parenting a gender-diverse child .

Behavior and Emotions

The doctor or nurse will pay special attention to signs of certain issues. .

The doctor or nurse will offer additional help if your child may:

• Be depressed 
• Have anxiety
• Struggle with an eating disorder
• Use tobacco, alcohol, or drugs 
• Experience any kind of violence 

And if your child may be having sex, the doctor or nurse will talk to your child about preventing STIs (sexually transmitted infections) — also called STDs (sexually transmitted diseases) — and pregnancy. Learn how to talk with your child about preventing STIs .

The doctor or nurse will make sure you and your child have the resources you need.

This may include telling you and your child about:

• Websites or apps that have helpful health information
• Organizations in your community where you can go for help

If needed, the doctor or nurse may also refer your child to a specialist.

Take these steps to help you and your child get the most out of well-child visits.

Gather important information.

Take any medical records you have to the appointment, including a record of vaccines (shots) your child has received.

Make a list of any important changes in your child’s life since the last visit, like a:

• New brother or sister
• Separation or divorce — or a parent spending time in jail or prison
• New school or a move to a new neighborhood
• Serious illness or death of a friend or family member

Use this tool to  keep track of your child’s family health history .

Help your child get more involved in visits to the doctor.

Once your child starts puberty, the doctor will usually ask you to leave the room for a few minutes so your child can ask questions about their health. This lets your child develop a relationship with the doctor or nurse, and it's an important step in helping your child learn about their health care.

Your child can also:

• Call to schedule appointments (if the doctor’s office allows it)
• Help you fill out medical forms
• Write down questions for the doctor or nurse

For more ideas,  check out these tips to help your child take charge of their health care . You can also share this list of questions for the doctor with your child .

What about cost?

Under the Affordable Care Act, insurance plans must cover well-child visits. Depending on your insurance plan, you may be able to get well-child visits at no cost to you. Check with your insurance company to find out more.

Your child may also qualify for free or low-cost health insurance through Medicaid or the Children’s Health Insurance Program (CHIP). Learn about coverage options for your family.

If you don’t have insurance, you may still be able to get free or low-cost well-child visits. Find a health center near you and ask about well-child visits.

To learn more, check out these resources:

• Free preventive care for children covered by the Affordable Care Act
• How the Affordable Care Act protects you and your family
• Understanding your health insurance and how to use it [PDF - 698 KB]

Ask Questions

Make a list of questions you want to ask the doctor..

Before the well-child visit, write down 3 to 5 questions you have — and ask your child if they have any questions to add. This visit is a great time to ask the doctor or nurse any questions about:

• A health condition your child has (like an allergy, asthma, or acne)
• Changes in behavior or mood
• Loss of interest in favorite activities
• Problems at school (like learning challenges or not wanting to go to school)

Here are some questions you may want to ask:

• How can I make sure my child is getting enough physical activity?
• How can I help my child eat healthy?
• Is my child at a healthy weight?
• Is my child's body developing normally?
• Is my child up to date on vaccines?
• How can I help my child succeed at school?

You may also want to ask:

• How can I talk with my child about sex?
• How can I talk with my child about tobacco, alcohol, and drugs?
• How can I teach my child to use the internet safely?
• How can I talk with my child about bullying?

Take a notepad, smartphone, or tablet and write down the answers so you can remember them later.

Get tips to help you:

• Talk with your child about sex
• Talk with your child about tobacco, alcohol, and drugs
• Talk with your child about bullying

Find more tips to talk to your child about a range of tricky topics .

Ask what to do if your child gets sick. 

Make sure you know how to get in touch with a doctor or nurse when the office is closed. Ask how to get hold of the doctor on call, or if there's a nurse information service you can call at night or on the weekend. 

What to Expect

Know what to expect..

During each well-child visit, the doctor or nurse will ask you questions, do a physical exam, and update your child’s medical history. You'll also be able to ask your questions and discuss any problems. 

The doctor or nurse will ask you and your child questions.

The doctor or nurse may ask about:

• Behavior — Does your child have trouble following directions at home or at school?
• Health — Does your child often complain of headaches or other pain? How much sleep does your child get? When was their last visit to the dentist?
• Safety — Does anyone in your home have a gun? If so, is it unloaded and locked in a place where your child can’t get it?
• School and activities — Does your child look forward to going to school? What does your child like to do outside of school?
• Eating habits — What does your child eat on a normal day?
• Family and friends — Have there been any recent changes in your family? How many close friends does your child have? Has your child been bullied at school or online?
• Emotions — Does your child often seem sad, stressed, or bored? Do they seem scared or worried a lot? Does your child have someone to talk to about problems?
• Sexuality — Have you talked with your child about puberty? Is your child dating?

The answers to questions like these will help the doctor or nurse make sure your child is healthy, safe, and developing normally.

Physical Exam

The doctor or nurse will also check your child’s body..

To check your child’s body, the doctor or nurse will:

• Measure height and weight and figure out your child's body mass index (BMI)
• Check your child’s blood pressure
• Check your child’s vision and hearing
• Check your child’s body parts (this is called a physical exam)
• Decide if your child needs any lab tests, like a blood test
• Give your child shots they need

Learn more about your child’s health care:

• Find out how to get your child’s shots on schedule
• Learn about getting your child’s vision checked

Content last updated February 16, 2024

Reviewer Information

This information on well-child visits was adapted from materials from the Centers for Disease Control and Prevention and the National Institutes of Health.

Reviewed by: Sara Kinsman, M.D., Ph.D. Director, Division of Child, Adolescent, and Family Health Maternal and Child Health Bureau Health Resources and Services Administration

Bethany Miller, M.S.W. Chief, Adolescent Health Branch Maternal and Child Health Bureau Health Resources and Services Administration

Diane Pilkey, R.N., M.P.H. Nursing Consultant, Division of Child, Adolescent, and Family Health Maternal and Child Health Bureau Health Resources and Services Administration

October 2021

You may also be interested in:

Talk to Your Kids About Tobacco, Alcohol, and Drugs

Get Your Pre‑teen’s Vaccines on Schedule

Talk to Your Kids About Sex and Healthy Relationships

The office of disease prevention and health promotion (odphp) cannot attest to the accuracy of a non-federal website..

Linking to a non-federal website does not constitute an endorsement by ODPHP or any of its employees of the sponsors or the information and products presented on the website.

You will be subject to the destination website's privacy policy when you follow the link.

Skip to content

Well Visits vs. Sick Visits – Know the Difference

Published on Jan 11, 2024

Primary Care Locations

Thank you for trusting Children’s Hospital of Philadelphia (CHOP) with your child’s care. We know there’s often confusion about the different types of visits we offer and how they are billed. Even if your insurance plan covers your visit to CHOP, you may be responsible for cost-sharing expenses, such as co-pays, co-insurance and deductibles. We hope the information below is helpful.

What is included in a well visit?

A preventive visit — also called a well visit — is a scheduled check-up focused on keeping your child's whole body healthy and safe. These checkups are recommended for infants, children and teens. Kids need one preventive visit every year from age 3 through age 21; babies and young toddlers need them more frequently. These appointments can include preventive care like: 

• A general physical exam – This includes measuring height, weight and blood pressure, and other age-specific growth and development checks.
• Age-specific immunizations (vaccinations) such as chicken-pox, measles, whooping cough, hepatitis, etc.
• Age-specific screenings, such as hearing and vision screenings.

These visits are typically covered by your health insurance, often at no cost to you. Some of the specific tools used during screenings may be billed separately.

What is a sick (office) visit?

This type of visit is made when your child is having a specific health problem, illness or injury, or for management of chronic, ongoing health problems and/or medications. Reasons for this type of visit can include:

• Illness such as the flu, strep throat or an ear infection
• Anxiety/depression
• ADHD management
• Other chronic condition

There is usually a cost for this type of visit. Your insurance provider may pass some or all of the costs to you. You may be responsible for a copay, co-insurance or deductible.

Can I be charged for both types of visits?

Sometimes at a well visit, an issue comes up that's not part of the regular check-up but that needs to be addressed during that visit. Your provider could address a problem to manage a condition or illness and may prescribe medication, order additional tests like lab work or X-rays, or refer you to a specialist.

In these cases, insurance requires us to bill the visit as both a well visit and a sick (office) visit, so you will likely have to pay an additional co-pay or co-insurance, or the cost will be applied to your deductible.

For more information

See a list of insurance plans CHOP accepts.

Sign Up for E-news *

Recommended Wellness Visit Schedule for Children

by Trio Solutions | Sep 29, 2021 | News & Events | 0 comments

From the time your child is born, their health and safety are your highest priorities. Making sure that they receive the necessary medical care at the proper times is important, but it can be hard to keep track of what is needed and when. 

For this reason, many doctors recommend following a set wellness schedule for children to ensure that the child is reaching age-appropriate milestones, receiving necessary vaccinations and benefitting from proper medical support along the way.

At Fetter Health Care Network, we offer a variety of pediatric services , including general well-child visits. To find out more about our recommended wellness visit schedule for children, read on.

What Is a Well-Child Visit?

A child wellness visit refers to a complete physical for a growing child. Well-child visits consist of a number of things, depending on the child’s age. 

Your pediatrician will perform a complete physical examination to make sure that the child is at an appropriate height and weight for their age. They will look for apparent signs of illness or malformation. Your child’s eyesight and hearing may be checked to make sure that there are no concerns. 

At a well-child visit, the doctor will make sure that the child is adequately verbal for their age and that they do not show any signs of trauma or mental health concerns. The doctor may ask the child to perform basic acts, such as touching their toes or walking in a straight line. This helps to determine whether the child is meeting certain milestones for their age.

An important part of wellness visits is immunizations. Your pediatrician will administer any vaccinations or boosters that your child is due for at the time of their visit.

When Should My Child Have Wellness Visits?

As your child grows, it is important to get them the medical care they need at the proper times. Adhering to a wellness schedule will ensure that your child is in good general health, reaching age-appropriate milestones, and receiving all of their necessary immunizations. 

It can be confusing to try to keep track of when your child should have a wellness visit. To make things simpler, here is the recommended schedule for well-child visits that you can follow:

• 2 weeks to 5 days after birth
• 1 month old
• 2 months old
• 4 months old
• 6 months old
• 9 months old
• 12 months old
• 15 months old
• 18 months old
• 24 months old
• 36 months old
• 3 years old
• 4 years old

After the age of 3, it is recommended that your child receive a general wellness visit once yearly to check their growth, behavioral development , and overall health.

Pediatric Services at Fetter Health Care Network

At Fetter Health Care Network, we offer a variety of pediatric services. Our team is committed to making sure that your child is in good health through their most formative years. 

In addition to well-child visits, we provide preventive care, autism and ADHD screenings, asthma screenings, and sports physicals. To schedule a well-child visit or one of our other pediatric services, contact us today .

Well Child Visit at 11 to 14 Years

Medically reviewed by Drugs.com. Last updated on May 6, 2024.

• Español

What is a well child visit?

A well child visit is when your child sees a healthcare provider to prevent health problems. Well child visits are used to track your child's growth and development. It is also a time for you to ask questions and to get information on how to keep your child safe. Write down your questions so you remember to ask them. Your child should have regular well child visits from birth to 18 years.

What development milestones may my child reach at 11 to 14 years?

Each child develops at his or her own pace. Your child might have already reached the following milestones, or he or she may reach them later:

• Breast development (girls), testicle and penis enlargement (boys), and armpit or pubic hair
• Menstruation (monthly periods) in girls
• Skin changes, such as oily skin and acne
• Not understanding that actions may have negative effects
• Focus on appearance and a need to be accepted by others his or her own age

What can I do to help my child get the right nutrition?

• Encourage your child to eat regular meals and snacks, even if he or she is busy. Your child should eat 3 meals and 2 snacks each day to help meet his or her calorie needs. He or she should also eat a variety of healthy foods to get the nutrients he or she needs, and to maintain a healthy weight. You may need to help your child plan meals and snacks. Suggest healthy food choices that your child can make when he or she eats out. Your child could order a chicken sandwich instead of a large burger or choose a side salad instead of French fries. Praise your child's good food choices whenever you can.
• Provide a variety of fruits and vegetables. Half of your child's plate should contain fruits and vegetables. He or she should eat about 5 servings of fruits and vegetables each day. Buy fresh, canned, or dried fruit instead of fruit juice as often as possible. Offer more dark green, red, and orange vegetables. Dark green vegetables include broccoli, spinach, romaine lettuce, and collard greens. Examples of orange and red vegetables are carrots, sweet potatoes, winter squash, and red peppers.
• Provide whole-grain foods. Half of the grains your child eats each day should be whole grains. Whole grains include brown rice, whole-wheat pasta, and whole-grain cereals and breads.
• Provide lean meats, poultry, fish, and other healthy protein foods. Other healthy protein foods include legumes (such as beans), soy foods (such as tofu), and peanut butter. Bake, broil, and grill meat instead of frying it to reduce the amount of fat.
• Use healthy fats to prepare your child's food. Unsaturated fat is a healthy fat. It is found in foods such as soybean, canola, olive, and sunflower oils. It is also found in soft tub margarine that is made with liquid vegetable oil. Limit unhealthy fats such as saturated fat, trans fat, and cholesterol. These are found in shortening, butter, margarine, and animal fat.
• Help your child limit his or her intake of fat, sugar, and caffeine. Foods high in fat and sugar include snack foods (potato chips, candy, and other sweets), juice, fruit drinks, and soda. If your child eats these foods too often, he or she may eat fewer healthy foods during mealtimes. He or she may also gain too much weight. Caffeine is found in soft drinks, energy drinks, tea, coffee, and some over-the-counter medicines. Your child should limit his or her intake of caffeine to 100 mg or less each day. Caffeine can cause your child to feel jittery, anxious, or dizzy. It can also cause headaches and trouble sleeping.
• Encourage your child to talk to you or a healthcare provider about safe weight loss, if needed. Adolescents may want to follow a fad diet they see their friends or famous people following. Fad diets usually do not have all the nutrients your child needs to grow and stay healthy. Diets may also lead to eating disorders such as anorexia and bulimia. Anorexia is refusal to eat. Bulimia is binge eating followed by vomiting, using laxative medicine, not eating at all, or heavy exercise.

How can I help my child care for his or her teeth?

• Remind your child to brush his or her teeth 2 times each day. Mouth care prevents infection, plaque, bleeding gums, mouth sores, and cavities. It also freshens breath and improves appetite.
• Take your child to the dentist at least 2 times each year. A dentist can check for problems with your child's teeth or gums, and provide treatments to protect his or her teeth.
• Encourage your child to wear a mouth guard during sports. This will protect your child's teeth from injury. Make sure the mouth guard fits correctly. Ask your child's healthcare provider for more information on mouth guards.

What can I do to keep my child safe?

• Remind your child to always wear a seatbelt. Make sure everyone in your car wears a seatbelt.
• Encourage your child to do safe and healthy activities. Encourage your child to play sports or join an after school program.
• Store and lock all weapons. Lock ammunition in a separate place. Do not show or tell your child where you keep the key. Make sure all guns are unloaded before you store them.

What are other ways I can care for my child?

• Talk to your child about puberty. Puberty usually starts between ages 8 to 13 in girls, but it may start earlier or later. Puberty usually ends by about age 14 in girls. Puberty usually starts between ages 10 to 14 in boys, but it may start earlier or later. Puberty usually ends by about age 15 or 16 in boys. Ask your child's healthcare provider for information about how to talk to your child about puberty, if needed.
• Limit your child's screen time. Screen time is the amount of television, computer, smart phone, and video game time your child has each day. It is important to limit screen time. This helps your child get enough sleep, physical activity, and social interaction each day. Your child's pediatrician can help you create a screen time plan. The daily limit is usually 1 hour for children 2 to 5 years. The daily limit is usually 2 hours for children 6 years or older. You can also set limits on the kinds of devices your child can use, and where he or she can use them. Keep the plan where your child and anyone who takes care of him or her can see it. Create a plan for each child in your family. You can also go to https://www.healthychildren.org/English/media/Pages/default.aspx#planview for more help creating a plan.
• Praise your child for good behavior. Do this any time he or she does well in school or makes safe and healthy choices.
• Monitor your child's progress at school. Go to parent-teacher conferences. Ask your child to let you see your child's report card.
• Help your child solve problems and make decisions. Ask your child about any problems or concerns he or she has. Make time to listen to your child's hopes and concerns. Find ways to help your child work through problems and make healthy decisions.
• Help your child find healthy ways to deal with stress. Be a good example of how to handle stress. Help your child find activities that help him or her manage stress. Examples include exercising, reading, or listening to music. Encourage your child to talk to you when he or she is feeling stressed, sad, angry, hopeless, or depressed.
• Encourage your child to create healthy relationships. Know your child's friends and their parents. Know where your child is and what he or she is doing at all times. Encourage your child to tell you if he or she thinks he or she is being bullied. Talk with your child about healthy dating relationships. Tell your child it is okay to say "no" and to respect when someone else says "no."
• Encourage your child not to use drugs, tobacco, nicotine, or alcohol. By talking with your child at this age, you can help prepare him or her to make healthy choices as a teenager. Explain that these substances are dangerous and that you care about your child's health. Nicotine and other chemicals in cigarettes, cigars, and e-cigarettes can cause lung damage. Nicotine and alcohol can also affect brain development. This can lead to trouble thinking, learning, or paying attention. Help your teen understand that vaping is not safer than smoking regular cigarettes or cigars. Talk to him or her about the importance of healthy brain and body development during the teen years. Choices during these years can help him or her become a healthy adult.
• Be prepared to talk your child about sex. Answer your child's questions directly. Ask your child's healthcare provider where you can get more information on how to talk to your child about sex.

Which vaccines and screenings may my child get during this well child visit?

What do i need to know about my child's next well child visit.

Your child's healthcare provider will tell you when to bring your child in again. The next well child visit is usually at 15 to 18 years. Your child may be given meningococcal, HPV, MMR, or varicella vaccines. This depends on the vaccines your child was given during this well child visit. He or she may also need lipid or STI screenings if any was not done during this visit. Information about safe sex practices may be given. These practices help prevent pregnancy and STIs. Contact your child's healthcare provider if you have questions or concerns about your child's health or care before the next visit.

Care Agreement

© Copyright Merative 2024 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

Learn more about Well Child Visit at 11 to 14 Years

Care guides.

• Body Image in Adolescents
• Gender Identity in Adolescents
• Gender Identity in your Adolescent
• Hemoglobin A1c
• Hepatitis B in Children
• Hepatitis B Vaccine
• How to Childproof your Home

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

An official website of the United States government

Here's how you know

Official websites use .gov A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS A lock ( ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

Well-baby and well-child visits

• Latest news
• UCL in the media
• Services for media
• Student news
• Tell us your story

Is reading for pleasure the single biggest factor in how well a child does in life?

13 May 2024

Listen: BBC World Service ‘More or Less’ (from 7 min, 4 sec)