Well Child Visits

Congratulations! Your baby is finally here. Newborns are wonderful, but exhausting! Having friends or family around to provide extra help and support can be very helpful. Make sure all visitors wash their hands well. Your baby’s first visit to our office takes place during his or her first week of life, usually 1-2 days after you are discharged from the hospital.

We do a lot at this visit, including:

• Check your baby’s weight.
• Monitor for signs of jaundice.
• Check to see how your baby is feeding.
• Answer questions about your new baby.

Immunizations: 

• HepB#1 (if not given in hospital)

Tests/Screens/Assessments:

• Review any outstanding labwork or testing from in the hospital.

Helpful Info: 

• Caring for Your Newborn

The 2 Week Visit (sooner if you have concerns!) is a time to talk about how your family is acclimating to the newest addition. Feeding, bowel habits and sleeping are common topics. If you are breastfeeding and need extra support, we can help refer you to a lactation specialist. 

By 2 weeks of age, your baby will likely have regained his or her birth weight. Please remember that it is important to always put your baby to sleep on his or her back in a flat, firm and separate sleep space to reduce the risk of SIDS. As always, we are here to answer questions and offer anticipatory guidance. Here is a great resource to review SIDS prevention.  HealthyChildren.org Safe Sleep Recommendations

We do a lot at this visit, including:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Remind you to give your baby a daily supplement of 400 IU of vitamin D drops if you are breastfeeding.
• If not already completed, we will remind you to get the second newborn screen drawn for your baby.

Immunizations:  

• None

Tests/Screens/Assessments: 

• None

Helpful Info: 

• Back to Sleep, Tummy to Play

Many babies seem more fussy or colicky at this age. Be patient. Colicky babies eventually outgrow their crying phase. Keeping your baby safe is the most important thing you can do. Even if you feel frustrated, handle your baby gently and reach out for help to friends, relatives or your pediatrician if the crying is getting to be too much. If you need a break and no one is available to help you, place your baby on his/her back gently in a safe space, such as a crib or bassinet and take a few minutes to calm down.

We do a lot at this visit, including:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Provide your baby’s first set of immunizations. Immunizations are safe, effective and keep your child and our community healthy. During this visit, you will be able to discuss any questions you may have about immunizations.

Immunizations: 

• Vaxelis#1, Prevnar#1, Rotavirus#1

Helpful Info: 

• Colic
• Crying and Your Baby: How to Calm a Fussy or Colicky Baby

Your baby is becoming more active and verbal. Be careful not to leave your baby unattended, especially on a bed, couch or counter. They move faster than you think! Many babies go through a sleep regression around this time. It usually only lasts a short period of time and will resolve.

Babies need only breast milk or iron fortified formula for the first 4-6 months of life. We will talk at this appointment about the appropriate time to introduce solid foods and what foods to introduce first. One food to be sure to avoid is honey until your baby is at least 12 months old.

At this visit we will:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Provide your baby’s immunizations.
• Discuss when to start feeding your baby solid foods. Some great resources for starting your baby on purees/solids are:  Solid Starts ,  Starting Solid Foods (HealthyChildren.org)

Immunizations: 

• Vaxelis#2, Prevnar#2, Rotavirus#2

Helpful Info: 

• Starting Solid Foods

Your baby will begin to move more and will be able to sit up independently for short periods of time. Now is the time to start baby-proofing your house - if you haven't already done so. You should move the mattress in your baby's crib down to the lowest level.

At this visit we will:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Provide your baby’s immunizations.
• Discuss the introduction of a fluoride supplement to encourage the development of strong and healthy teeth. Some areas around Spokane may have fluoride in their water systems. If you have well water, you should have your water tested for fluoride before offering it to your baby.

Immunizations: 

• Vaxelis#2, Prevnar#3, Rotavirus#3, flu vaccine and COVID vaccine are also available

Helpful Info: 

• Teething

Your baby may be starting to crawl, pulling to a stand and cruising on furniture. Babies will want to touch everything - this is how they learn. This is a messy time! Have fun and be patient.

At this visit we will:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Discuss your baby's upcoming dental care. Your baby should see a dentist at 1 year of age. You should be brushing your child's teeth with an infant toothbrush and a tiny smear of fluoride toothpaste. 

Immunizations: 

•  Flu vaccine and COVID vaccine are available seasonally

Tests/Screens/Assessments: 

• Fluoride Varnish, Hemoglobin Test

Helpful Info: 

• Teething

At this age, your baby can transition from breast milk or formula to cow’s milk. However, it is healthy to continue breast milk, if that is what you prefer, for your baby. Most babies need 3 meals, 2-3 snacks per day, and no more than 16-20 ounces of whole cow's milk per day. Your baby will be able to eat many of the foods you eat, but be careful to avoid small, hard foods that can cause choking.

It is time to wean your child from the bottle and offer all liquids in a sippy cup. It is much easier to wean your child now than if you wait until they are older. Avoid cavities and additional tears and make the change now!

Your baby will be outgrowing the infant carrier car seat. Continue to have your baby in a rear facing car seat until age 2.

At this visit we will:

• Measure your baby’s weight, length, and head size and record on a growth curve.
• Provide your baby’s immunizations.
• Discuss dental health and apply fluoride varnish to your baby’s teeth.
• Screen your baby for vision abnormalities with our ocular photoscreen device.
• Screen your baby for vision abnormalities with our ocular photoscreen device .

Immunizations: 

• HepA#1, MMR#1, VAR#1,  Prevnar20#4, Influenza vaccine (during flu season), COVID vaccine seasonally

Tests/Screens/Assessments: 

• Screen for Lead Exposure, Oral Health Surveillance, Fluoride Varnish, Vision Photoscreen

Helpful Info: 

• Playing Is How Toddlers Learn

Your child may be able to climb and run, so be sure to safety proof your home.

Poison control is available 24 hours a day: 1-800-222-1222 - keep this number handy in your cell phone and on your refrigerator.

At this visit we will:

• Measure your baby’s weight, length and head size and record on a growth curve.
• Check a hemoglobin level to assess for anemia.
• Provide your baby’s immunizations.

Immunizations: 

• DTaP, HIB, Influenza vaccine (during flu season), COVID vaccine seasonally

Tests/Screens/Assessments: 

• Anemia Surveillance, Fluoride Varnish

Helpful Info: 

• Choking Prevention and First Aid for Infants and Children

At 18 months, your child understands much more than he or she can say in words. Use words to describe your child’s feelings and gestures. Read and sing to your child often. When reading, use simple words to talk about the pictures.

At this visit we will:

• Measure your child’s weight, length and head size and record on a growth curve.
• Provide your baby’s immunizations.
• Discuss dental health and apply fluoride varnish to your baby’s teeth.
• Discuss temper tantrums.

Immunizations: 

• Influenza vaccine (during flu season), HepA#2, COVID vaccine seasonally

Tests/Screens/Assessments: 

• MCHAT Questionnaire (Autism Screening), Oral Health Surveillance, Fluoride Varnish

Helpful Info: 

• Is Your Toddler Communicating With You?

At this age, your 2 year old may go from trying to be independent to clinging to you; this is normal. It is better for toddlers to play than to watch TV. Even having television playing in the background interrupts healthy toddler play. Background music is a better choice.

At this visit we will:

• Measure your child’s weight, length, head size and body mass index and record on a growth curve.
• Most of our patients do not have immunizations due at this visit.  Your child may need immunizations if they are behind on their shots.
• Review your child’s development with you using the MCHAT (Autism screening tool) questionnaire.
• Screen your baby for vision abnormalities with our ocular photoscreen device.
• Discuss dental health and apply fluoride varnish to your child's teeth.
• Discuss toilet training and parenting/discipline.

Immunizations: 

• Flu vaccine (during flu season), COVID vaccine seasonally

Tests/Screens/Assessments: 

• MCHAT Questionnaire, Anemia Surveillance, Oral Health Surveillance, Fluoride Varnish, Vision Photoscreen

Helpful Info: 

• Playground Safety

Your baby is not really a baby anymore. They are firmly in the toddler years. One moment they seem so big and the next still very small. This is the "do-it-myself time."

At this visit we will:

• Measure your child’s weight, length, head size and record on a growth curve
• Most of our patients do not have immunizations due at this visit.
• Evaluate your child’s development 
• Discuss dental health  (if they have not yet seen a dentist, they should!)
• Discuss healthy meals/snacks, avoid food pouches and no or little juice

Immunizations: 

• Flu vaccine (during flu season), COVID vaccine seasonally

Helpful Info: 

• Snacks for Toddlers

Your child will likely be moving into a world of make believe that they create with their imagination. Toys for dress up and make believe are important at this age. Read books, sing songs and play rhyming games with your child each day.

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Most of our patients do not have immunizations due at this visit.  Your child may need immunizations if they are behind on their shots or during flu season.
• Discuss dental health and apply fluoride varnish to your child's teeth.

Immunizations: 

• Flu vaccine (during flu season), COVID vaccine seasonally

Tests/Screens/Assessments: 

• Anemia Surveillance, Oral Health Surveillance, Vision Testing, Fluoride Varnish

Helpful Info: 

• Toilet Training.

Four year olds often like to sing, dance and act. They like to tell "tall tales" and make up stories.  Enjoy these fun moments with your little one!  Parents should continue to help with brushing teeth even though your child will want to do it all by themselves.

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Provide your child's immunizations.
• Discuss dental health and apply fluoride varnish to your child's teeth.

Immunizations: 

• MMR#2, VAR#2, Kinrix (DTaP, IPV), Flu vaccine (during flu season), COVID vaccine seasonally

Tests/Screens/Assessments: 

• Anemia Surveillance, Oral Health Surveillance, Vision Testing, Fluoride Varnish

Helpful Info: 

• Encourage Your Child to Be Physically Active

At this age, your child needs more independence. However, you need to set clear limits. A consistent bedtime routine are important. Be a great role model. Show an interest in what they are learning.

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Review your child’s speech and development.
• Discuss exercise and nutrition.
• Discuss kindergarten readiness.
• Discuss dental health and apply fluoride varnish to your child's teeth.

Immunizations: 

• MMR#2, Var#2, Kinrix (DTaP, IPV) (if not received at 4 years), Flu vaccine (during flu season), COVID vaccine seasonally

Tests/Screens/Assessments: 

• Anemia Surveillance, Oral Health Surveillance, Vision Testing, Fluoride Varnish

Encourage good learning by helping your child organize a distraction-free time to do homework and ensuring eleven hours of sleep each night. Teach your child what to do if there is a fire and have practice fire drills. There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

At this visit we will:

• Measure your child’s weight, height and body mass index  and record on a growth curve.
• Screen your child's vision.
• Review your child’s school performance and development.
• Discuss exercise and nutrition.
• Review safety issues.

Immunizations: 

• Flu vaccine (during flu season), COVID vaccine seasonally

Tests/Screens/Assessments: 

• Anemia Surveillance, Oral Health Surveillance, Vision Testing

Continue to encourage good nutrition and exercise for your child. This is the time he or she is building good health habits for a lifetime! There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

At this visit we will:

• Measure your child’s weight, height and body mass index  and record on a growth curve.
• Review your child’s school performance and development.
• Discuss exercise and nutrition.
• Review safety issues.

Immunizations: 

• Flu vaccine (during flu season), COVID vaccine seasonally

Tests/Screens/Assessments: 

• Vision Surveillance,Anemia Surveillance

Helpful Info: 

• Growing Up Healthy: Fat, Cholesterol, and More

Positive self-image is important as your child begins to enter the changes that come with puberty. Empower them to feel good about themselves, their interaction with others and praise their effort more than the outcome.

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve
• Measure your child’s blood pressure and heart rate
• Screen your child's vision and hearing
• Review your child’s school performance and development
• Discuss involvement in activities
• Discuss sleep
• Discuss anticipating pubertal changes
• Discuss exercise and nutrition
• Review safety issues

Immunizations: 

• Flu vaccine (during flu season), COVID vaccine seasonally

Tests/Screens/Assessments: 

• Vision Testing, Anemia Surveillance

Helpful Info: 

• Developing Your Child’s Self-Esteem

Your child be is becoming more responsible and will be able to take on more tasks such as taking care of his/her own room. He or she may also start reading independently for pleasure.

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Review your child’s school performance and development.
• Discuss exercise and nutrition.
• Review safety issues.

Immunizations: 

• Flu vaccine (during flu season), COVID vaccine seasonally, HPV is available starting at age 9 years

Tests/Screens/Assessments: 

• Vision Surveillance, Anemia Surveillance, Lipid Profile testing (completed once between 9-11 years)

Helpful Info: 

• The Importance of Family Routines

Your ten year old still requires adult supervision when you are away. Watching TV with your child allows you to discuss any controversial topics that may come up, but limit screen time to 2 hours per day. Family mealtime is important to keeping communication open and fostering healthy lives.

At this visit we will:

• Measure your child’s weight, height, and body mass index and record on a growth curve
• Measure your child’s blood pressure and heart rate
• Screen your child's vision 
• Provide your child’s immunizations, if needed
• Review your child’s school performance and development
• Discuss involvement in activities and peer relationships
• Discuss sleep
• Discuss exercise and nutrition
• Discuss puberty changes to expect or that may be starting to occur

Immunizations: 

• Flu vaccine (during flu season), COVID vaccine seasonally, HPV is available starting at age 9 years

Tests/Screens/Assessments: 

• Vision Testing, Lipid Profile (completed once between 9-11 years)

Your child may be transitioning to middle school at this age. He or she may be participating in more group activities. Expand your conversations about healthy living practices to include tobacco, drug and alcohol avoidance.

At this visit we will:

• Measure your child’s weight, height, and body mass index and record on a growth curve.
• Provide your child’s immunizations.
• Screen your child for anemia and dysipidemia per AAP recommendations.
• Review your child’s school performance and development.
• Discuss exercise and nutrition.
• Discuss puberty changes to expect or that may be starting to occur.

Immunizations: 

• Tdap#1, MCV#1, ​HPV#1 (series of 2; 11-12 years), Flu vaccine  (during flu season), COVID vaccine seasonally

Tests/Screens/Assessments: 

• Vision Surveillance, Anemia Surveillance, Lipid Profile (completed once between 9-11 years)

Helpful Info: 

• Substance Abuse Prevention

Your child will be in middle school at this age. Continue your conversations about healthy living practices to include tobacco, drug and alcohol avoidance. Your child should be able to assume more responsibility for personal hygiene and chores. There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

At this visit we will:

• Measure your child’s weight, height, and body mass index and record on a growth curve.
• Screen your child's vision.
• Review your child’s school performance and development.
• Complete sports physical forms and discuss sport safety (if your child is participating in sports).
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet.
• Discuss puberty changes to expect or that may be starting to occur.

Immunizations:  

• HPV#2 (if not previously completed; series of 2; 11-12 years), Flu vaccine (during flu season), COVID vaccine seasonally

Tests/Screens/Assessments: 

• Anemia Surveillance, Adolescent Depression Screening, Vision Testing

Even though friends are becoming more important at this age, having a caring adult to provide a listening ear and from which to obtain accurate health information is equally important. Foster open communication with your child. There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

During the teen years, we provide the opportunity for your teen to have at least a portion of this visit with the parent out of the room.

At this visit we will:

• Measure your child’s weight, height, and body mass index and record on a growth curve.
• Review your child’s school performance and development.
• Complete sports physical forms and discuss sport safety (if your child is participating in sports).
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet.
• Discuss puberty changes to expect or that may be starting to occur.

Immunizations: 

• Flu vaccine (during flu season), COVID vaccine seasonally

Tests/Screens/Assessments: 

• Vision Surveillance, Anemia Surveillance, Adolescent Depression Screening

Helpful Info:  

• Teens, Behavior

Your child may be showing an increasing interest in extracurricular activities. Have conversations about risk taking behaviors, driving, alcohol, drug use, family rules and expectations. Discuss media and internet safety. Make certain that they have an adult they can confide in if they are unable to communicate with you. There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

During the teen years, we provide the opportunity for your teen to have at least a portion of this visit with the parent out of the room.

At this visit we will:

• Measure your child’s weight, height, and body mass index and record on a growth curve.
• Complete sports physical forms and discuss sport safety (if your child is participating in sports).
• Review your child’s school performance and development.
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet.

Immunizations: 

• Flu vaccine (during flu season), COVID vaccine seasonally

Tests/Screens/Assessments: 

• Vision Surveillance, Anemia Surveillance, Adolescent Depression Screening

Helpful Info: 

• Teens, Behavior

Your teen may be adjusting to the transition to high school. Development of family relationships continues to be important, but it is also normal for teens to place more and more emphasis on their peer relationships. There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

During the teen years, we provide the opportunity for your teen to have at least a portion of this visit with the parent out of the room.

At this visit we will:

• Measure your child’s weight and length and record on a growth curve.
• Complete sports physical forms and discuss sport safety (if your child is participating in sports).
• Review your child’s school performance.
• Reinforce healthy choices and risk behavior avoidance.
• Perform any recommended yearly screening tests (depending on family history, sexual activity etc.).
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet.

Immunizations: 

• Flu vaccine (during flu season), COVID vaccine seasonally

Tests/Screens/Assessments: 

• Anemia Surveillance, Adolescent Depression Screening, Vision Testing

Helpful Info: 

• Teens, Behavior

Congratulations! You are solidly in the teen years! It is exciting to see the wonderful person your child is becoming. Possible conflict can arise at this time as your teen assesses your family values versus those of culture and peers. Keep the lines of communication open and give them additional responsibility while being present for them when they inevitably make mistakes. Be supportive and allow them to develop resilience and self-pride. During the teen years, we provide the opportunity for your teen to have at least a portion of the visit with the parent out of the room.

At this visit we will:

• Measure your teen’s weight, height and body mass index and record on a growth curve
• Measure your teen’s blood pressure and heart rate
• Complete sports physical forms and discuss sport safety (if your teen is participating in sports, please bring any forms to the appointment)
• Review your teen’s school performance and development
• Discuss involvement in activities and peer relationships/dating
• Discuss sleep
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet
• Reinforce healthy choices and risk behavior avoidance
• Perform any recommended yearly screening tests (depending on family history, sexual activity etc.)

Immunizations: 

• MCV4#2 , MeningitisB vaccine#1  (second dose 6 months after first dose),  Flu vaccine  (during flu season), COVID vaccine seasonally

Tests/Screens/Assessments: 

• Vision Testing, Anemia Surveillance

Helpful Info: 

• A Message to Parents of Teen Drivers

Your child is getting closer to finishing high school and entering the adult world. Making mistakes are a normal part of growing up. Continue to provide emotional support and guidance for them during this time. There are no scheduled immunizations at this visit unless your child is behind and needs to catch up on immunizations.

During the teen years, we provide the opportunity for your teen to have at least a portion of this visit with the parent out of the room.

At this visit we will:

• Measure your child’s weight, height, and body mass index and record on a growth curve.
• Complete sports physical forms and discuss sport safety (if your child is participating in sports).
• Review your child’s school performance.
• Perform any recommended yearly screening tests (depending on family history, sexual activity etc.).
• Reinforce healthy choices and risk behavior avoidance.
• Discuss exercise and nutrition, particularly in association with increased awareness of body image and diet.

Immunizations: 

• MeningitisB #2  (if not already received),  Flu vaccine  (during flu season), COVID vaccine seasonally

Tests/Screens/Assessments: 

• Vision Surveillance, Anemia Surveillance, Adolescent Depression Screening, Lipid Profile

Helpful Info: 

• Teens, Behavior

Congratulations on having an adult! They will still look to you for support and guidance, but will be more on their own when it comes to decision making. 

At this visit we will:

• Measure your child’s weight, height and body mass index and record on a growth curve.
• Screen your child's vision.
• Discuss transitions to life after high school—whether that be work, travel, vocational school or college.
• Discuss importance of responsible decision making and recognizing healthy -vs- unhealthy relationships.
• Complete college physical forms and any required college screening labs/tests.
• Perform any recommended yearly screening tests (depending on family history, sexual activity etc.).
• Reinforce healthy choices and risk behavior avoidance.
• Discuss transitioning to an adult care provider. At Centennial Pediatrics of Spokane, we see patients up until their 22nd birthday.

Tests/Screens/Assessments: 

• Anemia Surveillance, Depression Screening, Vision Testing

Helpful Info: 

• Teens, Behavior