Well-child visits: why they matter

Even if your child isn’t sick, routine visits to the paediatrician are important. During a wellness check, the paediatrician can track their developmental milestones. Even if they’re not sick.

The value of assessing a child’s development and growth in the first few years of life can’t be emphasised enough. The same goes for regular annual checks in older children up to adolescence.

Any signs of underlying health issues can be detected early. They’re also an opportunity to discuss preventative health measures and any parental concerns; this can include feeding, sleep problems, behavioural issues and more.

Schedule an appointment with our resident paediatrician, Dr Shermela Appan, here for a wellness check for your child.

Well checks for babies start soon after the first newborn examination in the nursery. Visits to the paediatrician are scheduled between three to five days after birth. This is followed by visits at one, two, four, six, nine, 12, 18, 24 and 30 months.

Initially, the paediatrician will likely focus on feeding and sleep patterns, and the baby’s social and behavioural responses.

Your baby’s growth is monitored closely. Any problems with poor or excessive weight gain can be addressed and managed as early as possible.

Apart from physical examination, the paediatrician will check on the baby’s cognition, communication, behaviour, social interaction, motor and sensory abilities. Making sure that age-appropriate developmental milestones are met.

Starting at the age of three, a well-child visit to the paediatrician is usually scheduled yearly. However, some parents tend to slip up on yearly assessments after the second year of vaccinations. In doing so, they run the risk of delayed diagnosis of certain conditions, which may present later in childhood.

Apart from assessing the appropriate developmental milestones, the paediatrician may check for certain conditions, you may have otherwise missed, at the right time.

Some conditions don’t present with any symptoms until later in childhood. So, during a wellness check or annual examination, your paediatrician may look for:

Congenital heart defects

• While most congenital heart defects are detected before birth during ultrasounds or soon after birth, some children aren’t diagnosed until they’re older with consequent complications

Eye problems

• Eye problems can be easily overlooked by many parents, particularly with young children. Squints may sometimes present with a compensatory head tilt or face turn. I once encountered a three-year-old patient whose squint was masked by her head tilt. Her parents assumed it was just a habit and ignored it. However, the problem was picked up incidentally when she was seen for another health complaint subsequently. Late diagnosis can lead to a lazy eye, which can affect visual development and, consequently, result in partial or total blindness.

Walking abnormalities

• In-toeing or out-toeing gaits are common gait abnormalities seen in toddlers. While they may self-correct as children grow up, a follow-up is advisable, as the problem can persist.

Hearing problems

• I had a patient who experienced moderate hearing loss in mid-childhood that went undiagnosed until she was in Primary 1. Although her newborn hearing test was normal and her speech development wasn’t delayed, her hearing test at age seven revealed hearing loss in both ears. Her parents had noticed that she didn’t socialise much and spoke very little, yet they simply attributed this to shyness with strangers. It wasn’t until she had trouble academically that she was checked. Luckily, this problem was easily corrected with the use of hearing aids, and her academic performance and social interaction have since improved.

Obesity

• Mistakenly, some parents overlook excessive weight gain under the assumption that it’s acceptable for kids to be overweight and that the problem will resolve as they get older. However, obese children have a higher risk of developing Type 2 Diabetes Mellitus, high blood pressure, high cholesterol, obstructive sleep apnoea (OSA) and joint problems.

Scoliosis

• Scoliosis (curved spine) occurs most often between the ages of 10 to 15 years old in both boys and girls. This is the period of active pubertal growth spurt. Mild curves will often initially go unnoticed because they do not usually cause pain. Luckily, paediatricians can detect these types of abnormalities.

Dr Shermela Appan has been a Singapore Ministry of Health-accredited paediatrician for 39 years, with special interests in child development, puberty, asthma and allergies. She also has 29 years of private paediatric experience as a partner at The Children’s Medical Centre in Bishan, prior to joining HMI.