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The question
I have a 14-month-old daughter. She was delivered by the midwives at a birth centre. Since that time, we have been to the doctor twice for a checkup, once at 12 weeks and once at one year - she is healthy! As we're not getting her vaccinated, how often must I take her for checkups?
The answer
I'm happy you have a healthy baby.
I would suggest that your next checkups be at 18 months and 24 months. These are called well-checks and the purpose is to ensure that the child's growth is continuing on the same percentile curve and that developmentally, there are no subtle changes that need to be addressed. For example, we screen for important milestones, such as making eye contact, pointing and developing a normal vocabulary.
Safety issues become more important at this age. When you see your pediatrician, we review anticipatory guidance regarding her environment. Accident prevention can save you from unplanned visits to an emergency room.
Although you say you have decided to avoid vaccines, I am hopeful that more information regarding vaccine safety may help you change your mind - especially when it comes to serious infections such as meningitis, which may cause life-long neurological damage.
At 14 months, we also focus on making sure her nutrition is balanced: Too much milk can lead to lower iron and subsequently more infections and developmental delays.
Pediatricians tend to see infants before a dentist, and we are trained to look for dental issues. We also screen the eyes to ensure that vision is symmetrical and the eyes do not wander. The latter may be too subtle for a layperson to pick up. If these conditions are missed, valuable time may be lost before we get the right management in place.
The bottom line is that although your baby girl is well now, you will not waste your time (or a doctor's) by having her checked at 18 months and then at 24 months. Better to be safe than sorry.
Send pediatrician Peter Nieman your questions at pediatrician@globeandmail.com. He will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.
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