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The question: Does my kid need to get a physical every year? At what age can I start spreading out the visits a bit longer?

The answer: Well-child visits play a vital role in monitoring your child's health status, growth and development. These visits are particularly important in the first two years of life when your infant is changing rapidly and early detection of problems is critical. Although the schedule may vary slightly from physician to physician, expect these visits to occur at one to two weeks of age followed by appointments at one, two, four, six, 12, 18 and 24 months of age. This pattern of appointments conveniently mirrors the Canadian infant immunization schedule.

After two years of age, if your child is otherwise in good health, you can expect the visits to be more spread out. Factors that will determine the frequency of well-child visits include the health needs of your child, the preference of your physician, and your own parental need for visits and reassurance. First-time parents may find annual visits to be very helpful, while for more seasoned parents this may not be as necessary. As a bare minimum, I recommend visits every five years starting at age five. Here's why:

  • Four to five years old: This will be the last opportunity to have your physician review your child’s growth and development prior to school entry. The final preschool vaccines are also administered at this age. There are a number of factors that contribute to your child being ready to succeed in kindergarten including a balanced diet that is rich in fruits and vegetables, healthy sleeping habits, including sleeping soundly through the night, daily play and physical activity, and consistent bowel and bladder control. Don’t hesitate to discuss any of these issues with your physician if you have any concerns. This is also an ideal age to make appointments with an optometrist and audiologist to evaluate your child’ hearing and vision.
  • 10 years old: If your child has been healthy, they may not have seen a physician for several years so this is a good opportunity to review general health, growth, and progress at school. Young girls start to enter puberty around this time so this is an excellent opportunity to discuss anticipated body changes and menstruation. Injuries are common at this age, so your physicians may want to discuss the importance of helmets and protective gear. This can also be an age where some preteens start to develop poor eating and sleeping habits that your physician may also want to address.
  • 15-16 years old: This may be your adolescent’s last doctor’s visit before leaving home and there are many important topics to discuss. This visit is the perfect time to discuss teenage issues including smoking, alcohol and drug use, drinking and driving, sexuality and contraception. Unlike previous well-child appointments, you will probably be excused from the room for at least part of the visit. Teens at this age should be taught the basics of accessing the health care system including the importance of their Medicare card, how to make an appointment with their family physician, and the appropriate use of emergency departments and walk-in clinics.

To be clear, these five year visits are only appropriate for children and teens who are in good physical and mental health. As always, discuss your child's needs with your physician as there may be compelling reasons for more frequent appointments depending on your specific circumstances.

Dr. Michael Dickinson is the head of pediatrics and chief of staff at the Miramichi Regional Hospital in New Brunswick. He's a staunch advocate for children's health in Atlantic Canada through his involvement with the Canadian Paediatric Society.

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