PHOENIX - It is just about time to head back to school and along with buying school supplies and new clothes for your children, its also time to book that back to school doctor's appointment.
Our partners at Arizona Parenting Magazine are a great family resource here in the Valley. They have an informative article in this month's magazine about getting the most out of these appointments. We caught up with Dr. Matthew Barcellona, Pediatrician at North Scottsdale Pediatric Associates.
SF: Let's talk health care in our country. Do most children have annual exams? If not, can you share a brief summary of the state of children's health care in our country?
Dr. Barcellona: Younger children and infants are more likely to have the recommended annual exams than older kids. Lack of insurance- either through private coverage, Medicaid or CHIP- has been shown to lead to lack of preventative care (annual visits). Furthermore, there exists a shortage of primary care physicians nationwide, especially in rural areas which includes much of Arizona.
General pediatricians take care of children best by creating a "medical home". Within a child's medical home, a physician manages all aspects of primary care, including annual physicals, acute care visits, and vaccinations. Pediatricians also coordinate care with sub-specialists and advocate for patients with insurance companies, schools and other community agencies.
Approximately 25% of children today have a chronic illness, such as asthma, obesity, diabetes, mental health disorders and developmental delays like language delays or autism. Receiving annual check-ups within a medical home greatly increases the likelihood of early detection of problems. Timely diagnosis and close follow up greatly improve the outcomes for these children
SF: There are certain years when vaccines are vital, can you tell us the most important check-up years?
Dr. Barcellona: Vaccines are paramount in preventing serious illness in infants and children. Infants are at the highest risk of having severe disease should they contract an infection. Therefore, it is extremely important for babies to receive immunizations at the earliest possible age when they are most vulnerable to bad outcomes. The recommended vaccine schedule, supported by the Center for Disease Control and the American Academy of Pediatrics, is the safest and most effective schedule to use when vaccinating your child. Delaying vaccines puts babies at unnecessary risk of contracting a preventable disease when they are most vulnerable.
SF: Let's break down the age groups and the questions we should be asking as parents, things we should be watching out for, and what we need to know as our children grow and develop.
Dr. Barcellona: As pediatricians, we see a wide range of ages from 0-18 years old, and many times into college. Each developmental stage brings its own challenges and rewards for a doctor and a parent. Here are some key items to watch for at certain stages, from an insider perspective:
Newborns: Weight gain is key. Newborns tend to lose up to 10% of their birth weight in the first 3-4 days of life and gain back to their birth weight by 10-14 days. A baby's weight gain (typically ½ -1 oz a day) is an excellent indicator that their overall health is good. If a baby's weight gain is not adequate, it is important to be evaluated by your physician to find the reason.
Toddlers: Monitoring developmental milestones is important for toddlers. Observing development requires patience and an understanding that kids develop at different paces and a wide range of "normal" exists at every age. This is especially true for toddlers. Pediatricians look for worrisome patterns of development and some basic milestones at each age. Early referral to therapies improves the overall outcome for kids with developmental delays. Be sure to ask your pediatrician what milestones they would like to see your child doing by the next visit. Give your child the opportunity to develop: talk, read, and sing to them, encourage them to use their words, walk them around by their fingers, allow them to experience new sights, smells, and textures. If you feel they are behind, have them evaluated.
School Aged Children: It is crucial to prevent obesity. School aged kids are very impressionable and developing healthy eating habits during this influential time can last a lifetime. Overtime, extra weight on the body has detrimental effects to almost every organ system from heart disease to joint pain. Utilize the "5-2-1-0" pneumonic to encourage a healthier lifestyle -5 fruits and veggies servings each day, 2 hours or less time a day in front of a television or computer screen, 1 hour of exercise each day, 0 servings of fruit juice, sports drinks, or soda.
Teenagers: Monitoring interests, mood, and school performance is essential for assessing the health of a teen. Anxiety, depression, and substance use commonly effect teenagers as they learn to engage their environment