From infants to teens, kids get big benefits from regular checkups


Dr. Michael Sia sees a patient at his Honolulu offices. Sia says regular pediatric visits are vital for making sure a child’s development is on track.

Has your child had a back-to-school checkup yet?

Being808 reached out to Dr. Michael Sia, chairman of the Department of Pediatrics at Kapiolani Medical Center for Women & Children, to find out why these “well-child” visits are so important — and what doctors are looking for when they see kids.

Sia said the visits give the parent and the doctor a chance to talk about a child’s development, behavior and general well-being.

“It’s also when parents and children can build a relationship with their doctor,” he said.

Visits are timed to coincide with the recommended schedule for vaccinations and key childhood transition points, he said. Immunizations are an especially important component of the well child visits, and protect kids from up to 14 diseases by the time they’re 2 years old. That’s vital because the immune systems of very young children aren’t fully matured, leaving them vulnerable to serious diseases. Also, their stomachs produce less acid, so it’s easier for bacteria and viruses to multiply.

Being808: When should parents be concerned about a child’s development?

Sia: Well, you know, no two babies are the same in how quickly they start crawling or say their first word. Some reach milestones early; others reach them later. It’s important to understand that “normal” limits for development can vary a lot. Even with premature babies, they develop milestones later and others may just regress sometimes.

Pediatricians can help address basic milestones for physical, cognitive, language, and social/emotional development. And parents shouldn’t be afraid to discuss concerns. At the same time, they shouldn’t compare their child with others.

sia5Being808: What’s the harm in skipping some of these well child visits?

Sia: I wouldn’t recommend it. A skipped visit means you missed that chance for your doctor to check your child’s health and developmental progress.

Being808: Any advice on how to keep your children from getting every cold or other type of sickness going around school? And how do you know when to see a pediatrician if your child seems to catch everything?

Sia: The viruses responsible for colds or the flu cause most of the common illnesses in children in child care and schools. Even though children get their shots, they are still at risk for other infectious diseases.

Most children in child care and school settings will have up to 12 colds a year. Diarrhea episodes can occur once or twice a year. To prevent this, keep a contagious child home from school or daycare until they can no longer spread the illness. This means they are fever free for 24 hours and their behavior is back to normal. Children are contagious a day or more before symptoms, so it’s important for everybody to wash your hands frequently.

The good news is that most of these illnesses are not emergencies and don’t warrant a visit to the pediatrician. Stomach flu, fussiness, colds and minor diarrhea are usually resolved in a few days. But sometimes these symptoms can be signs of something else. I advise worried parents to call the doctor. Trust your instincts. It’s better to be cautious and monitor your child’s energy level.

Being808: Are there any vaccine side effects that I should be concerned about?

Sia: There can be side effects from vaccines, but most of them are minor. The most common side effects are:

• Soreness, redness or swelling at the site of injection. To treat, use ice packs and an antihistamine like Benadryl or Zyrtec.

• Fever, fussiness for infants, muscle aches and fatigue within 6 to 12 hours after the shot. To treat, give the child Tylenol (acetaminophen) or Advil/Motrin (ibuprofen) for children.

Some parents are hesitant about vaccinating their children. Maybe they don’t trust the pharmaceutical companies, or they see stories in the media. I would tell people that a lot of thought and science goes into determining the current recommended vaccine schedule. Doctors and health experts select what vaccines to give at what times based on the amount of risk a child has to a particular disease. For instance, young babies need vaccinations because they are the most vulnerable at that age.

Additionally, there is no medical benefit in spreading out vaccines. In fact, research shows that delaying the measles vaccine until after a child is 15 months old might raise seizure risk. When a child is vaccinated, that child will have immunity to over 14 diseases by the age of 2.

sia4Being808: How do I know if my child has a vision or hearing problem?

Sia: Regular vision and hearing screening is an integral part of your child’s checkups. Experts recommend eye tests from birth and at all routine well child care visits.

Hearing loss in infants and children is known to negatively affect key developmental aspects of life, such as speech, performance in school, and emotional management. Since the introduction of the Universal Newborn Hearing Screening Program, most children born with congenital hearing loss are identified when they’re newborns.

However, some congenital hearing loss may not become evident until later. Infectious diseases like meningitis, trauma, damaging noise levels and certain drugs have been known to cause hearing loss. The American Academy of Pediatrics recommends periodic objective hearing screening for newborns and at various ages between four and 18.

For more information about signs of hearing loss in children, read this fact sheet from the Centers for Disease Control and Prevention. To learn more about the signs of eye and vision problems in children, visit the American Optometric Association’s website.

Being808: Lots of parents struggle to make sure their children exercise. How much daily exercise does a child need?

Sia: Children and adolescents should do at least one hour of physical activity daily. Be sure to include three types of exercise: aerobic activity, muscle strengthening, and bone strengthening. Aerobic activity, like brisk walking or running, should make up most of your child’s 60 or more minutes of daily physical activity. Be sure to include vigorous-intensity aerobic activity, like running, on at least 3 days per week.

Kids should do muscle strengthening activities (climbing trees, playing on the jungle gym) at least three days per week as part of your child’s 60 or more minutes.

Bone strengthening activities (jumping rope or running) should be done at least three days per week as part of your child’s 60 or more minutes.

Being808: Finally, what advice do you have for helping kids who are picky eaters?

Sia: Forcing your child to eat or drink something will never work. Respect your child’s appetite and offer the food or drink instead. Don’t get into a power struggle with your child over food. That’s a no-win situation and can create anxiety for the child and frustration for the parent. Serve small portions and try to make it fun.

Routines are also important, so serve meals and snacks at the same time every day. Limit beverages like milk or juice because this will dampen your child’s appetite for food.

Most of all, be patient. Maybe make a rule that they have to try a new food before passing judgment. Allow them to touch, smell and put tiny bits into their mouths. You can also try to pair a new food with something they already like.

It’s also important to set the example by eating a variety of healthy foods yourself. Try different ways to cook and prepare the foods you serve. Keep meal times interactive; turn off the TV and ban electronic gadgets or other distractions from the dinner table. Make a rule that if your child refuses to eat they can stay at the table without whining. Don’t engage in any bargaining or rewarding.

Of course, if you’re concerned that picky eating is affecting your child’s growth and development, ask your doctor for advice.


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