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)

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.

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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

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Why Well-Child Visits Matter

Published on May 02, 2023

Primary Care Locations

Don't fall behind on your child's routine care — a minor issue today could become a major problem tomorrow.

Well-child visits allow your pediatrician to examine your child holistically, assess their physical and emotional needs, support their growth and development, and intervene quickly if any issues arise.

What are the risks of skipping well-child visits?

If your child is healthy, it can be easy to let well visits fall by the wayside. While those annual checkups may seem like just another thing to fit into your family’s hectic schedule, they play a crucial role in preventing future problems.

Find a CHOP Pediatrician

CHOP Primary Care practices, located throughout southeastern Pennsylvania and Southern New Jersey, provide convenient access to primary health and wellness services for children close to home.

Well visits are essential to ensure your child gets the required vaccinations to attend school, go to daycare and participate in sports. Visiting the pediatrician when your child is well also provides you with an opportunity to ask questions – and get expert answers – about your child’s health, development and well-being. Delaying these visits can put your child at greater risk of illness or delay needed interventions. For example, many common developmental delays are discovered during routine checkups with pediatricians – early intervention makes a big difference in getting your child the support they need before something small turns into a bigger issue.

What to expect at a well-child visit

During an annual wellness visit, your child's pediatrician will:

Determine if your child is meeting growth and developmental milestones for their age.
Evaluate your child's vision and hearing for anything out of the ordinary – it's important to catch these issues early.
Ask about sudden changes in your child's usual activities, mood and overall health.
Assess your child's mental health, and ask questions about how they are coping with school, friends, family and any other outside influences.
Provide immunizations for childhood diseases and common conditions that affect children or young adults, such as measles and HPV.
Give sports physicals to children who want to want to participate in competitive sports at school or in the community.
Get to know your child: their diet, sleeping patterns, nutrition, social interactions, behavior and stress levels
Help your child establish healthy habits and provide tips for families to reinforce these at home.
Provide age- and behavior-based counseling for teens on topics such as driver safety, depression and drug or alcohol use.
Check in on how your family is doing and identify any supportive resources or advice related to navigating daily life.

What are the ages for well-child visits?

A standard well-child visit schedule spans from infancy through adolescence, and includes checkups at the following ages:

In your baby’s first year: Newborn visit (3-5 days after birth), at 1 month old, 2 months, 4 months, 6 months, 9 months, and at 12 months
11-14 years
15-17 years
18-21 years

Your pediatrician can be a trusted partner at every age and stage of your child’s development.

Contributed by: Lisa Biggs, MD

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Are you looking for advice to keep your child healthy and happy? Do you have questions about common childhood illnesses and injuries? Subscribe to our Health Tips newsletter to receive health and wellness tips from the pediatric experts at Children's Hospital of Philadelphia, straight to your inbox. Read some recent tips .

With our patient portal you can schedule appointments, access records, see test results, ask your care provider questions, and more.

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A Dose of Prevention

Learn why vaccinations are important for kids and the community, and what to do if you missed a vaccine and need to get back on track.

Preparing for an Annual Well Visit

Being properly prepared for annual well visits is a great way to get the most out of each appointment with your pediatrician.

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How to Have a Productive Video Visit

If your child is scheduled for an online doctor’s appointment, read these tips to get the most out of your visit.

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Your Guide to Well-Child Visits: What To Expect and How To Prepare

Female pediatrician using stethoscope to examine young boy patient during well-child visit

With all the craziness that comes with having a young child, it’s tempting to want to put off any appointments unless your child is feeling sick. However, regular visits to your child’s pediatric provider are just as important when your child is healthy. The first few years of a child’s life can set the stage for their lifelong health and development, so it’s important to stay up to date on routine well-child visits to help them grow into happy, healthy adults. Here’s what you need to know about well-child visits.

What is a well-child visit and why is it important?

Well-child visits are an important way to keep track of your child’s emotional, social, and physical health and development. These appointments provide an opportunity for both you and your healthcare provider to check in on your child’s growth and development, as well as discuss ways to keep your child healthy and safe. Well-child visits also play a significant role in prevention as well. Through regular checkups and screenings , your child’s provider can catch potentially serious issues early on before they cause any complications or severe illness.

At your child’s visit, we’ll address questions you and your child may have, provide support for your child’s overall health and well-being, talk through any pertinent health information and offer healthcare advice. Topics that are covered may include growth, development, behavior and mental health, nutrition, sleep, safety, and guidance on what to expect in the next stage of development. Your healthcare provider will conduct a physical exam, take measurements, update immunizations, and order any applicable lab tests or specialist referrals. This is also a great time to raise any concerns you may have about your child’s health and emotional well-being you may have noticed on your own. Our goal is to form a partnership based on honest communication, trust, and respect for your family’s culture and traditions.

Who should attend the visit with your child?

It is important that a parent or legal guardian comes to the visit with your child to discuss their health history and any concerns and recommendations your provider may have. As your child reaches adolescence, they will have time alone with their provider to discuss sensitive topics.

What are the types of questions I can ask during a well-child visit?

Our providers are trained to address a wide range of concerns, such as:

How can I get my child to eat more fruits and vegetables?
What development milestones should I be looking for?
How much screen time should I let my child have?
How can I keep my child safe online?
How many hours of sleep should my child get?
How much exercise should my child be getting daily?
How can I support my child’s mental health?

We encourage you to ask us anything related to your child’s health and we will do our best to help you get the answers you are looking for.

What is the well-child visit schedule?

Depending on your child’s age, you may have well-child visits every few weeks, months, or yearly. We recommend bringing your child if for a visit according to the following checkup schedule:

Newborn (3-5 days old)
2 weeks 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
2.5 years old
3 years old: Starting at age 3 years, children should have an annual well-child check through young adulthood.

How should I prepare for a well-child visit?

There are things you can do to get the most from your child’s visit. Make a list of questions for your provider ahead of time.For the first newborn visit, bring your baby’s hospital discharge summary. If your child is a new patient, bring their vaccine records. You can request that your child’s medical records be sent to us prior to the first visit. You can prepare toddlers and young children for the visit by letting them know what will happen during their well check, reading storybooks about going to the doctor, and playing with a doctor’s kit. Older children and teens can help prepare a list of questions they may want to ask about their bodies or health.

Your well-child visit isn’t the only time you can talk with your child’s healthcare team. If questions arise after your visit, please message your provider directly, reach out to our virtual medical team , or schedule a follow-up appointment with your provider. Keeping your healthcare team up to date on any updates or changes prepares everyone for your next well-child visit.

The One Medical blog is published by One Medical , a national, modern primary care practice pairing 24/7 virtual care services with inviting and convenient in-person care at over 100 locations across the U.S. One Medical is on a mission to transform health care for all through a human-centered, technology-powered approach to caring for people at every stage of life.

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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.

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.

Health Encyclopedia

December 2020, why well-child visits matter more than you might think.

Taking your baby to see a doctor is important when your little one is sick. But going to regular well-child visits can be just as important.

These visits occur every few weeks or months for the first year and a half. Think of them as checkups for your child’s growth and learning. The pediatrician will look at how your child is developing in several key areas:

The goal is to make sure things are going as expected. You will have a chance to share any concerns you have.

What to expect

Well-child visits from birth to 15 months old include:

Measurements to see how much your child has grown since the last visit

Physical exam to check your child’s health from head to toe

Screenings for hearing and vision problems, lead exposure, and more

Vaccines to protect your child from several serious illnesses

You and your child’s pediatrician might also discuss:

Feeding your child

Keeping your child safe at home and in the car

Supporting your child’s speech and learning

Creating bedtime routines

How you can help

You play a key role at well-child visits. Share information about what your child is doing at home. Go head—brag about the big milestones! Be open about any challenges that come up.

You may want to write down your top three to five questions before the visit. That way, you won’t forget to ask them. Your child’s pediatrician can be a great resource for helpful advice.

Older kids and teens

As your child grows older, well-child visits are spaced further apart. But they’re still very important. One helpful part of the visits is called anticipatory guidance. This involves you, your child, and your child’s pediatrician talking about key issues that may come up soon. The issues are geared to your child’s age. Examples are bike helmets, time limits for electronic devices, and not smoking.

Your child’s pediatrician will suggest tips and tools for dealing with these issues. Feel free to ask questions and talk about your concerns. This helps the pediatrician give the best advice for your family’s needs.

Medical Reviewers:

Ray Turley, BSN, MSN
Rina Lazebnik, MD
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Well-Child Visit: 16 Years

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What to Expect During This Visit

Your doctor and/or nurse will probably:

1. Check your teen's weight and height, calculate body mass index (BMI) , and plot the measurements on a growth chart .

2. Check your teen's blood pressure and possibly hearing .

3. Ask questions, address concerns, and offer advice about your teen's:

Eating. Teens should eat 3 meals a day that include lean protein, whole grains, at least 5 servings of fruits and vegetables, and 3 servings of low-fat or nonfat dairy products or fortified soy milk.

Sleeping. Teens need about 8–10 hours of sleep per night. Poor sleep is common during the teen years and can hurt school and athletic performance. Biological changes make teens want to stay up later, but early school start times can make it hard for them to get enough sleep. Encourage your teen to follow a relaxing bedtime routine. Electronic devices, like smartphones and computers, should be turned off before bed.

Physical activity. Teens should get 60 minutes of physical activity per day. Encourage your teen to balance screen use (TV, video games, smartphones, tablets, and computers) with healthy behaviors, like spending time with others, being physically active, and getting enough sleep. Set a good example by limiting your own screen time and exercising daily.

Growth and development. By age 16, it's common for teens to:

if female, have gotten a first period by now. If your daughter hasn't , talk to your doctor.
if male, show signs of pubertal development (the testicles get bigger, the penis gets longer, and pubic hair grows)
be influenced by their peer group
explore different identities to help them determine where they fit in
have sexual feelings. This includes an interest in dating and relationships, exploring one's sexuality, and becoming aware of sexual orientation and gender identity.
begin to think abstractly and reflect on how to make decisions, but still be impulse-driven and not think about the consequences of their actions
want to engage in risky behaviors

4. Do an exam . The doctor will look at the skin, listen to the heart and lungs, check the back for curvature of the spine, and check for puberty development. A chaperone should be present during the exam.

5. Update immunizations. Immunizations can protect people from serious illnesses, so it's important that your teen get them on time. Immunization schedules can vary from office to office, so talk to your doctor about what to expect.

6. Order tests. Your doctor may check for anemia , high cholesterol , tuberculosis , and sexually transmitted diseases (STDs) and order tests, if needed.

Looking Ahead

Here are some things to keep in mind until your teen's next checkup at 17 years :

Encourage your teen to participate in a variety of activities , such as music, arts, sports , after-school clubs, and other activities of interest.
Encourage your teen to take responsibility for schoolwork. Praise accomplishments and provide support in areas where your teen struggles.
Talk about future college or work plans. If your teen is having trouble in school, find out if bullying, depression , learning or attention problems are to blame.
Spend time with your teen every day. Share mealtimes , be active together, and talk about things that are important to your teen.
Praise good choices , and include your teen in decision-making.
Set rules and explain your expectations. Have fair consequences for rule-breaking.
Encourage your teen to wait until older to engage in sexual activity with others. Explain the risk of sexually transmitted diseases (STDs) and unwanted pregnancy. Discuss the importance of birth control and condom use.
Your teen should brush their teeth twice daily, floss once a day, and see a dentist once every 6 months.
Explain to your teen the dangers of smoking , vaping , alcohol , and drugs . Talk about prescription drug misuse. Praise your teen for saying no to these activities.
Look for signs of depression , which can include irritability, depressed mood, loss of interest in activities, poor grades, and talk of suicide.
Encourage your teen to take charge of medical care by learning to chedule doctor's appointments, renew prescriptions, and care for any ongoing health problems.
Teens should always wear a seatbelt while in a vehicle.
As your teen starts driving , set limits for the number of passengers allowed and what hours they may drive. Tell your teen not to text or use the phone while driving.
Talk about the dangers of drinking and driving and tell your teen to never get in a car with someone who has been drinking or using drugs. Instead, let your teen know to always call you for help.
Teens should apply sunscreen of SPF 30 at least 15 minutes before going outside and reapply about every 2 hours. They should not use tanning beds, as these increase the risk of skin cancer .
Make sure your teen knows about online safety , cyberbullying , and wise use of social media .
Prevent gun injuries by not keeping a gun in the home. If you do have a gun, keep it unloaded and locked away. Ammunition should be locked up separately. Make sure kids can't get to the keys.
Talk to your doctor if you're concerned about your living situation . Do you have enough food , a safe place to live, and health insurance ? Your doctor can tell you about community resources or refer you to a social worker.

These checkup sheets are consistent with the American Academy of Pediatrics (AAP)/Bright Futures guidelines.

Doctor Visits

Make the Most of Your Teen’s Visit to the Doctor (Ages 15 to 17 Years)

Health care provider talking with teen girl

Take Action

Teens ages 15 to 17 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 teen 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 teen is growing and developing on schedule.

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

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

See a complete list of developmental milestones for your teen .

Behavior Changes

What are some changes i might see in my teen’s behavior.

Developmental milestones for teens ages 15 to 17 years include:

Spending less time with family and more time with friends
Worrying more about the future (like going to college or finding a job)
Thinking more about romantic relationships and sex
Trying new things like new sports or hobbies — or possibly experimenting with tobacco, alcohol, or drugs

This is also a time when some teens may start showing signs of depression, anxiety, or eating disorders. That’s why it’s important to:

Make sure the doctor screens your teen for depression
Have your teen screened for anxiety

Physical Changes

What are some physical changes my teen is going through.

Teens ages 15 to 17 years may be nearing the end of puberty. Puberty is when a child’s body develops into an adult’s body.

Get more information about puberty to share with your daughter
Get more information about puberty to share with your son

Teens might not ask you questions about sex, their bodies, or relationships. That’s why it’s a good idea for you to start the conversation. You can also encourage your teen to ask the doctor or nurse any questions they have about body changes or other health concerns.

Learn how to talk with your teen about sex .

Take these steps to help you and your teen 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 teen has received.

Make a list of any important changes in your teen’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 teen’s family health history .

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

The doctor will probably ask you to leave the room during part of the visit, usually the physical exam. This lets your teen develop a relationship with the doctor or nurse and ask questions in private. It’s an important step in teaching your teen to take control of their health care.

Your teen can also:

Call to schedule appointments
Help you fill out medical forms
Write down questions for the doctor or nurse

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

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 teen 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. This visit is a great time to ask the doctor or nurse any questions about:

A health condition your teen has (like acne or asthma)
Changes in your teen’s behavior or mood
Loss of interest in favorite activities
Tobacco, alcohol, or drug use
Problems at school (like learning challenges or not wanting to go to school)

Here are some questions you may want to ask:

Is my teen up to date on vaccines?
How can I make sure my teen is getting enough physical activity?
How can I help my family eat healthy?
How can I help my teen succeed at school?
How can our family set rules more effectively?
How can I help my teen become a safe driver?
How can I talk with my teen about tobacco, alcohol, and drugs?

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

Ask what to do if your teen 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 teen’s medical history. You and your teen will also be able to ask your questions and discuss any problems.

The doctor or nurse will ask your teen questions.

The doctor or nurse may ask about:

Behavior — Do you have trouble following directions at home or at school?
Health — Do you often get headaches or have other kinds of pain?
Safety — Do you always wear a seatbelt in the car? Do you and your friends use tobacco, alcohol, or drugs?
School and activities — Do you look forward to going to school? What do you like to do after school?
Family and friends — Have there been any changes in your family recently? Do you have close friends?
Emotions — Do you often feel sad or bored? Do you often feel scared or very worried? Is there someone you trust who you can talk to about problems?
Sexuality — Do you have any questions about your body? Have you talked with your parents about dating and sex? Are you dating anyone now?
The future — Have you started to think about what you want to do after high school?

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

Physical Exam

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

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

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

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 teen may:

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

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

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

This may include telling you and your teen 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 teen to a specialist.

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 B. Kinsman, M.D., Ph.D. Director, Division of Child, Adolescent and Family Health Maternal and Child Health Bureau Health Resources and Services Administration

You may also be interested in:

Talk to Your Kids About Tobacco, Alcohol, and Drugs

Talk to Your Kids About Sex and Healthy Relationships

Help Your Child Stay at a Healthy Weight

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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.

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Recommended Wellness Visit Schedule for Children

by Fetter Health Care | 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 Apr 2, 2024.

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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

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

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Are ‘Forever Chemicals’ a Forever Problem?

The environmental protection agency says “forever chemicals” must be removed from tap water. but they lurk in much more of what we eat, drink and use..

This transcript was created using speech recognition software. While it has been reviewed by human transcribers, it may contain errors. Please review the episode audio before quoting from this transcript and email [email protected] with any questions.

From “The New York Times,” I’m Sabrina Tavernise. And this is “The Daily.”

[THEME MUSIC]

This month for the first time, the Environmental Protection Agency began to regulate a class of synthetic chemicals, known as forever chemicals, in America’s drinking water. But the chemicals, which have been linked to liver disease and other serious health problems, are in far more than just our water supply. Today, my colleague Kim Tingley explains.

It’s Wednesday, April 17.

So Kim, any time the EPA announces a regulation, I think we all sort of take notice because implicit in it is this idea that we have been exposed to something — something bad, potentially, lead or asbestos. And recently, the EPA is regulating a type of chemical known as PFAS So for those who don’t know, what are PFAS chemicals

Yeah, so PFAS stands for per and polyfluoroalkyl substances. They’re often called forever chemicals just because they persist so long in the environment and they don’t easily break down. And for that reason, we also use them in a ton of consumer products. They’re in makeup. They’re in carpet. They’re in nonstick cookware. They’re in food packaging, all sorts of things.

Yeah, I feel like I’ve been hearing about these chemicals actually for a very long time. I mean, nonstick pans, Teflon — that’s the thing that’s in my mind when I think PFAS.

Absolutely. Yeah, this class of chemicals has been around for decades. And what’s really important about this is that the EPA has decided, for the first time, to regulate them in drinking water. And that’s a ruling that stands to affect tens of millions of people.

So, help me understand where these things came from and how it’s taken so long to get to the point where we’re actually regulating them.

So, they really actually came about a long time ago. In 1938, DuPont, the people who eventually got us to Teflon, they were actually looking for a more stable kind of refrigerant. And they came upon this kind of chemical, PFAS. The thing that all PFAS chemicals have is a really strong bond between carbon atoms and fluorine atoms. This particular pairing is super strong and super durable.

They have water repellent properties. They’re stain resistant. They’re grease resistant. And they found a lot of uses for them initially in World War II. They were using them as part of their uranium enrichment process to do all these kinds of things. And then —

Well, good thing it’s Teflon.

In the 1950s is when they really started to come out as commercial products.

Even burned food won’t stick to Teflon. So it’s always easy to clean.

So, DuPont started using it in Teflon pans.

Cookware never needs scouring if it has DuPont Teflon.

And then another company, 3M also started using a kind of PFAS —

Scotchgard fabric protector. It keeps ordinary spills from becoming extraordinary stains.

— in one of their big products, Scotchgard. So you probably remember spraying that on your shoes if you want to make your shoes waterproof.

Use Scotchgard fabric protector and let your cup runneth over.

Right — miracle product, Scotchgard, Teflon. But of course, we’re talking about these chemicals because they’ve been found to pose health threats. When does that risk start to surface?

Yeah, so it’s pretty early on that DuPont and 3M start finding effects in animals in studies that they’re running in house.

Around the mid ‘60s, they start seeing that PFAS has an effect on rats. It’s increasing the liver and kidney weights of the rats. And so that seems problematic. And they keep running tests over the next decade and a half. And they try different things with different animals.

In one study, they gave monkeys really, really high levels of PFAS. And those monkeys died. And so they have a pretty strong sense that these chemicals could be dangerous. And then in 1979, they start to see that the workers that are in the plants manufacturing, working with these chemicals, that they’re starting to have higher rates of abnormal liver function. And in a Teflon plant, they had some pregnant workers that were working with these chemicals. And one of those workers in 1981 gave birth to a child who had some pretty severe birth defects.

And then by the mid 1980s, DuPont figures out that it’s not just their workers who are being exposed to these chemicals, but communities that are living in areas surrounding their Teflon plant, particularly the one in Parkersburg, West Virginia, that those communities have PFAS in their tap water.

Wow, so based on its own studies, DuPont knows its chemicals are making animals sick. They seem to be making workers sick. And now they found out that the chemicals have made their way into the water supply. What do they do with that information?

As far as we know, they didn’t do much. They certainly didn’t tell the residents of Parkersburg who were drinking that water that there was anything that they needed to be worried about.

How is that possible? I mean, setting aside the fact that DuPont is the one actually studying the health effects of its own chemicals, presumably to make sure they’re safe, we’ve seen these big, regulating agencies like the EPA and the FDA that exist in order to watch out for something exactly like this, a company that is producing something that may be harming Americans. Why weren’t they keeping a closer watch?

Yeah, so it goes kind of back to the way that we regulate chemicals in the US. It goes through an act called the Toxic Substances Control Act that’s administered by the EPA. And basically, it gives companies a lot of room to regulate themselves, in a sense. Under this act they have a responsibility to report to the EPA if they find these kinds of potential issues with a chemical. They have a responsibility to do their due diligence when they’re putting a chemical out into the environment.

But there’s really not a ton of oversight. The enforcement mechanism is that the EPA can find them. But this kind of thing can happen pretty easily where DuPont keeps going with something that they think might really be a problem and then the fine, by the time it plays out, is just a tiny fraction of what DuPont has earned from producing these chemicals. And so really, the incentive is for them to take the punishment at the end, rather than pull it out early.

So it seems like it’s just self-reporting, which is basically self-regulation in a way.

Yeah, I think that is the way a lot of advocacy groups and experts have characterized it to me, is that chemical companies are essentially regulating themselves.

So how did this danger eventually come to light? I mean, if this is in some kind of DuPont vault, what happened?

Well, there’s a couple different things that started to happen in the late ‘90s.

The community around Parkersburg, West Virginia, people had reported seeing really strange symptoms in their animals. Cows were losing their hair. They had lesions. They were behaving strangely. Some of their calves were dying. And a lot of people in the community felt like they were having health problems that just didn’t really have a good answer, mysterious sicknesses, and some cases of cancers.

And so they initiate a class action lawsuit against DuPont. As part of that class action lawsuit, DuPont, at a certain point, is forced to turn over all of their internal documentation. And so what was in the files was all of that research that we mentioned all of the studies about — animals, and workers, the birth defects. It was really the first time that the public saw what DuPont and 3M had already seen, which is the potential health harms of these chemicals.

So that seems pretty damning. I mean, what happened to the company?

So, DuPont and 3M are still able to say these were just a few workers. And they were working with high levels of the chemicals, more than a person would get drinking it in the water. And so there’s still an opportunity for this to be kind of correlation, but not causation. There’s not really a way to use that data to prove for sure that it was PFAS that caused these health problems.

In other words, the company is arguing, look, yes, these two things exist at the same time. But it doesn’t mean that one caused the other.

Exactly. And so one of the things that this class action lawsuit demands in the settlement that they eventually reach with DuPont is they want DuPont to fund a formal independent health study of the communities that are affected by this PFAS in their drinking water. And so they want DuPont to pay to figure out for sure, using the best available science, how many of these health problems are potentially related to their chemicals.

And so they ask them to pay for it. And they get together an independent group of researchers to undertake this study. And it ends up being the first — and it still might be the biggest — epidemiological study of PFAS in a community. They’ve got about 69,000 participants in this study.

Wow, that’s big.

It’s big, yeah. And what they ended up deciding was that they could confidently say that there was what they ended up calling a probable link. And so they were really confident that the chemical exposure that the study participants had experienced was linked to high cholesterol, ulcerative colitis, thyroid disease, testicular cancer, kidney cancer, and pregnancy induced hypertension.

And so those were the conditions that they were able to say, with a good degree of certainty, were related to their chemical exposure. There were others that they just didn’t have the evidence to reach a strong conclusion.

So overall, pretty substantial health effects, and kind of vindicates the communities in West Virginia that were claiming that these chemicals were really affecting their health.

Absolutely. And as the years have gone on, that was sort of just the beginning of researchers starting to understand all the different kinds of health problems that these chemicals could potentially be causing. And so since the big DuPont class action study, there’s really just been like this building and building and building of different researchers coming out with these different pieces of evidence that have accumulated to a pretty alarming picture of what some of the potential health outcomes could be.

OK, so that really kind of brings us to the present moment, when, at last, it seems the EPA is saying enough is enough. We need to regulate these things.

Yeah, it seems like the EPA has been watching this preponderance of evidence accumulate. And they’re sort of deciding that it’s a real health problem, potentially, that they need to regulate.

So the EPA has identified six of these PFAS chemicals that it’s going to regulate. But the concern that I think a lot of experts have is that this particular regulation is not going to keep PFAS out of our bodies.

We’ll be right back.

So, Kim, you just said that these regulations probably won’t keep PFAS chemicals out of our bodies. What did you mean?

Well, the EPA is talking about regulating these six kinds of PFAS. But there are actually more than 10,000 different kinds of PFAS that are already being produced and out there in the environment.

And why those six, exactly? I mean, is it because those are the ones responsible for most of the harm?

Those are the ones that the EPA has seen enough evidence about that they are confident that they are probably causing harm. But it doesn’t mean that the other ones are not also doing something similar. It’s just sort of impossible for researchers to be able to test each individual chemical compound and try to link it to a health outcome.

I talked to a lot of researchers who were involved in this area and they said that they haven’t really seen a PFAS that doesn’t have a harm, but they just don’t have information on the vast majority of these compounds.

So in other words, we just haven’t studied the rest of them enough yet to even know how harmful they actually are, which is kind of alarming.

Yeah, that’s right. And there’s just new ones coming out all the time.

Right. OK, so of the six that the EPA is actually intending to regulate, though, are those new regulations strict enough to keep these chemicals out of our bodies?

So the regulations for those six chemicals really only cover getting them out of the drinking water. And drinking water only really accounts for about 20 percent of a person’s overall PFAS exposure.

So only a fifth of the total exposure.

Yeah. There are lots of other ways that you can come into contact with PFAS. We eat PFAS, we inhale PFAS. We rub it on our skin. It’s in so many different products. And sometimes those products are not ones that you would necessarily think of. They’re in carpets. They’re in furniture. They’re in dental floss, raincoats, vinyl flooring, artificial turf. All kinds of products that you want to be either waterproof or stain resistant or both have these chemicals in them.

So, the cities and towns are going to have to figure out how to test for and monitor for these six kinds of PFAS. And then they’re also going to have to figure out how to filter them out of the water supply. I think a lot of people are concerned that this is going to be just a really expensive endeavor, and it’s also not really going to take care of the entire problem.

Right. And if you step back and really look at the bigger problem, the companies are still making these things, right? I mean, we’re running around trying to regulate this stuff at the end stage. But these things are still being dumped into the environment.

Yeah. I think it’s a huge criticism of our regulatory policy. There’s a lot of onus put on the EPA to prove that a harm has happened once the chemicals are already out there and then to regulate the chemicals. And I think that there’s a criticism that we should do things the other way around, so tougher regulations on the front end before it goes out into the environment.

And that’s what the European Union has been doing. The European Chemicals Agency puts more of the burden on companies to prove that their products and their chemicals are safe. And the European Chemicals Agency is also, right now, considering just a ban on all PFAS products.

So is that a kind of model, perhaps, of what a tough regulation could look like in the US?

There’s two sides to that question. And the first side is that a lot of people feel like it would be better if these chemical companies had to meet a higher standard of proof in terms of demonstrating that their products or their chemicals are going to be safe once they’ve been put out in the environment.

The other side is that doing that kind of upfront research can be really expensive and could potentially limit companies who are trying to innovate in that space. In terms of PFAS, specifically, this is a really important chemical for us. And a lot of the things that we use it in, there’s not necessarily a great placement at the ready that we can just swap in. And so it’s used in all sorts of really important medical devices or renewable energy industries or firefighting foam.

And in some cases, there are alternatives that might be safer that companies can use. But in other cases, they just don’t have that yet. And so PFAS is still really important to our daily lives.

Right. And that kind of leaves us in a pickle because we know these things might be harming us. Yet, we’re kind of stuck with them, at least for now. So, let me just ask you this question, Kim, which I’ve been wanting to ask you since the beginning of this episode, which is, if you’re a person who is concerned about your exposure to PFAS, what do you do?

Yeah. So this is really tricky and I asked everybody this question who I talked to. And everybody has a little bit of a different answer based on their circumstance. For me what I ended up doing was getting rid of the things that I could sort of spot and get rid of. And so I got rid of some carpeting and I checked, when I was buying my son a raincoat, that it was made by a company that didn’t use PFAS.

It’s also expensive. And so if you can afford to get a raincoat from a place that doesn’t manufacture PFAS, it’s going to cost more than if you buy the budget raincoat. And so it’s kind of unfair to put the onus on consumers in that way. And it’s also just not necessarily clear where exactly your exposure is coming from.

So I talk to people who said, well, it’s in dust, so I vacuum a lot. Or it’s in my cleaning products, so I use natural cleaning products. And so I think it’s really sort of a scattershot approach that consumers can take. But I don’t think that there is a magic approach that gets you a PFAS-free life.

So Kim, this is pretty dark, I have to say. And I think what’s frustrating is that it feels like we have these government agencies that are supposed to be protecting our health. But when you drill down here, the guidance is really more like you’re on your own. I mean, it’s hard not to just throw up your hands and say, I give up.

Yeah. I think it’s really tricky to try to know what you do with all of this information as an individual. As much as you can, you can try to limit your individual exposure. But it seems to me as though it’s at a regulatory level that meaningful change would happen, and not so much throwing out your pots and pans and getting new ones.

One thing about PFAS is just that we’re in this stage still of trying to understand exactly what it’s doing inside of us. And so there’s a certain amount of research that has to happen in order to both convince people that there’s a real problem that needs to be solved, and clean up what we’ve put out there. And so I think that we’re sort of in the middle of that arc. And I think that that’s the point at which people start looking for solutions.

Kim, thank you.

Here’s what else you should know today. On Tuesday, in day two of jury selection for the historic hush money case against Donald Trump, lawyers succeeded in selecting 7 jurors out of the 12 that are required for the criminal trial after failing to pick a single juror on Monday.

Lawyers for Trump repeatedly sought to remove potential jurors whom they argued were biased against the president. Among the reasons they cited were social media posts expressing negative views of the former President and, in one case, a video posted by a potential juror of New Yorkers celebrating Trump’s loss in the 2020 election. Once a full jury is seated, which could come as early as Friday, the criminal trial is expected to last about six weeks.

Today’s episode was produced by Clare Toeniskoetter, Shannon Lin, Summer Thomad, Stella Tan, and Jessica Cheung, with help from Sydney Harper. It was edited by Devon Taylor, fact checked by Susan Lee, contains original music by Dan Powell, Elisheba Ittoop, and Marion Lozano, and was engineered by Chris Wood.

Our theme music is by Jim Brunberg and Ben Landsverk of Wonderly.

That’s it for The Daily. I’m Sabrina Tavernise. See you tomorrow.

April 18, 2024 • 30:07 The Opening Days of Trump’s First Criminal Trial
April 17, 2024 • 24:52 Are ‘Forever Chemicals’ a Forever Problem?
April 16, 2024 • 29:29 A.I.’s Original Sin
April 15, 2024 • 24:07 Iran’s Unprecedented Attack on Israel
April 14, 2024 • 46:17 The Sunday Read: ‘What I Saw Working at The National Enquirer During Donald Trump’s Rise’
April 12, 2024 • 34:23 How One Family Lost $900,000 in a Timeshare Scam
April 11, 2024 • 28:39 The Staggering Success of Trump’s Trial Delay Tactics
April 10, 2024 • 22:49 Trump’s Abortion Dilemma
April 9, 2024 • 30:48 How Tesla Planted the Seeds for Its Own Potential Downfall
April 8, 2024 • 30:28 The Eclipse Chaser
April 7, 2024 The Sunday Read: ‘What Deathbed Visions Teach Us About Living’
April 5, 2024 • 29:11 An Engineering Experiment to Cool the Earth

Hosted by Sabrina Tavernise

Featuring Kim Tingley

Produced by Clare Toeniskoetter , Shannon M. Lin , Summer Thomad , Stella Tan and Jessica Cheung

With Sydney Harper

Edited by Devon Taylor

Original music by Dan Powell , Elisheba Ittoop and Marion Lozano

Engineered by Chris Wood

Listen and follow The Daily Apple Podcasts | Spotify | Amazon Music

The Environmental Protection Agency has begun for the first time to regulate a class of synthetic chemicals known as “forever chemicals” in America’s drinking water.

Kim Tingley, a contributing writer for The New York Times Magazine, explains how these chemicals, which have been linked to liver disease and other serious health problems, came to be in the water supply — and in many more places.

On today’s episode

Kim Tingley , a contributing writer for The New York Times Magazine.

A single water drop drips from a faucet.

Background reading

“Forever chemicals” are everywhere. What are they doing to us?

The E.P.A. issued its rule about “forever chemicals” last week.

There are a lot of ways to listen to The Daily. Here’s how.

We aim to make transcripts available the next workday after an episode’s publication. You can find them at the top of the page.

Fact-checking by Susan Lee .

The Daily is made by Rachel Quester, Lynsea Garrison, Clare Toeniskoetter, Paige Cowett, Michael Simon Johnson, Brad Fisher, Chris Wood, Jessica Cheung, Stella Tan, Alexandra Leigh Young, Lisa Chow, Eric Krupke, Marc Georges, Luke Vander Ploeg, M.J. Davis Lin, Dan Powell, Sydney Harper, Mike Benoist, Liz O. Baylen, Asthaa Chaturvedi, Rachelle Bonja, Diana Nguyen, Marion Lozano, Corey Schreppel, Rob Szypko, Elisheba Ittoop, Mooj Zadie, Patricia Willens, Rowan Niemisto, Jody Becker, Rikki Novetsky, John Ketchum, Nina Feldman, Will Reid, Carlos Prieto, Ben Calhoun, Susan Lee, Lexie Diao, Mary Wilson, Alex Stern, Dan Farrell, Sophia Lanman, Shannon Lin, Diane Wong, Devon Taylor, Alyssa Moxley, Summer Thomad, Olivia Natt, Daniel Ramirez and Brendan Klinkenberg.

Our theme music is by Jim Brunberg and Ben Landsverk of Wonderly. Special thanks to Sam Dolnick, Paula Szuchman, Lisa Tobin, Larissa Anderson, Julia Simon, Sofia Milan, Mahima Chablani, Elizabeth Davis-Moorer, Jeffrey Miranda, Renan Borelli, Maddy Masiello, Isabella Anderson and Nina Lassam.

IMAGES

Your Guide to Well-Child Visits: What To Expect and How To Prepare
Well Child Visit Schedule
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The Pediatric Center of Frederick
Well-Child Visits: What to Expect at Your First Appointment: Northeast
Well Child Visits

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Well child visit
Importance of well-child visits which address physical and emotional well-being
Well Child Visit
The Well Visit Planner
WEEKLY VLOG
Infant Well-Child Visit Affinity Group and Expression of Interest Process September 27, 2021

COMMENTS

Well-Child Visit: What's Included and When to Go
Take blood pressure. Measure oxygen levels. Listen to your child's lungs. Look at your child's eyes, ears, and throat. Press on your child's tummy to feel organs. Move your child's hips ...
AAP Schedule of Well-Child Care Visits
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 ...
Well-Child Visits for Infants and Young Children
Immunizations are usually administered at the two-, four-, six-, 12-, and 15- to 18-month well-child visits; the four- to six-year well-child visit; and annually during influenza season ...
What to Expect at Your Child's Well-Child Appointment
Looking at your baby's head, ears, eyes and mouth to ensure normal growth. Checking the skin for birthmarks or rashes. Pressing on your baby's abdomen to detect enlarged organs or an umbilical hernia. Inspecting your baby's genitalia for tenderness, lumps or other signs of infection. When your child reaches the toddler years the doctor ...
What Is a Well-Child Visit?
What Is a Well-Child Visit? At a well-child visit, your child's doctor may: Weigh, measure, and check your child's growth. Give your child shots to prevent disease. Test your child for illnesses. Check your child's sight, hearing, and teeth. Discuss child safety, eating, and development. Answer questions you have about your child's health.
What to Do at Well-Child Visits: The AAFP's Perspective
Tobacco use, counseling to prevent initiation. Children six years and older. Obesity, screening. Children 10 years and older. Skin cancer, counseling to reduce risk. Children 12 years and older ...
The Well-Child Visit
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 ...
Your Stage-by-Stage Guide to Well-Child Visits
Make sure you have plenty of time before and after their checkup to avoid any stress. Write down questions or concerns as soon as they come to mind before your kid's well-child visit to ensure they get the proper care. Prepare for common questions covering your kid's mental and physical health. Verify your insurance coverage and get a price ...
Why Well-Child Visits Matter
Visiting the pediatrician when your child is well also provides you with an opportunity to ask questions - and get expert answers - about your child's health, development and well-being. Delaying these visits can put your child at greater risk of illness or delay needed interventions. For example, many common developmental delays are ...
Your Guide to Well-Child Visits: What To Expect and How To Prepare
Make a list of questions for your provider ahead of time.For the first newborn visit, bring your baby's hospital discharge summary. If your child is a new patient, bring their vaccine records. You can request that your child's medical records be sent to us prior to the first visit. You can prepare toddlers and young children for the visit ...
What you should know about well-child visits
What is a well-child visit? A well-child visit is a preventive appointment, also called a checkup. It's an appointment that you schedule even if your child seems healthy so that a healthcare provider can monitor the child's growth and spot any signs of a medical concern or illness before it becomes serious.
Well-child visits: MedlinePlus Medical Encyclopedia
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 ...
The Benefits of Well-Child Visits
Dan Nicklas, MD, a pediatrician at Children's Hospital Colorado's primary care-focused Child Health Clinic, says well-care visits are important for children of all ages and their families. "Regular visits help us get to know you," he says. "We do a physical check of your child — blood pressure, eyes, ears and all that — to make ...
Why Well-Child Visits Matter More Than You Might Think
Why Well-Child Visits Matter More Than You Might Think. Taking your baby to see a doctor is important when your little one is sick. But going to regular well-child visits can be just as important. These visits occur every few weeks or months for the first year and a half. Think of them as checkups for your child's growth and learning.
Make the Most of Your Child's Visit to the Doctor (Ages 11 to 14
Overview. 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 ...
Well-Child Visit: 12 Years (for Parents)
1. Check your child's weight and height, calculate body mass index (BMI), and plot the measurements on a growth chart. 2. Check your child's blood pressure and vision using standard testing equipment. Hearing may be checked. 3. Do a screening test to check for signs of depression. 3.
Well-Child Checkups and Immunizations
Toddlers and preschoolers: From 15 months to 4 years old, it is recommended to visit at 15 months, 18 months, 2 years, 30 months (2-1/2 years), 3 years and 4 years. Elementary school-age children: An annual well-child visit is recommended for children between 5 and 10 years old. Preteens and teenagers (adolescents): Starting around age 11 ...
Well-Child Visit: 16 Years (for Parents)
Your doctor and/or nurse will probably: 1. Check your teen's weight and height, calculate body mass index (BMI), and plot the measurements on a growth chart. 2. Check your teen's blood pressure and possibly hearing. 3. Ask questions, address concerns, and offer advice about your teen's: Eating. Teens should eat 3 meals a day that include lean ...
Make the Most of Your Teen's Visit to the Doctor (Ages 15 to 17
Overview. Teens ages 15 to 17 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 teen 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 ...
Recommended Wellness Visit Schedule for Children
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.
Well Child Visit at 11 to 14 Years
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.
What happens at a well-child visit or checkup?
Pharmacy Specialist. At a well-child visit to the doctor, your child's pediatrician or family doctor will examine your child from head to toe to make sure that he's healthy, that he's growing properly and that he's developing normally. Your child's doctor (or a nurse) will measure your child's height (or length, if he's not yet standing ...
Are 'Forever Chemicals' a Forever Problem?
Hosted by Sabrina Tavernise. Featuring Kim Tingley. Produced by Clare Toeniskoetter , Shannon M. Lin , Summer Thomad , Stella Tan and Jessica Cheung. With Sydney Harper. Edited by Devon Taylor ...