Health Visit

What to Expect During a Wellness Visit

The well-child visits during your child’s second year are similar to those you had when she was younger, though now you can expect to have deeper discussions with your doctor about behavior and habits.

Fevers

Once your child is two, you can take your child’s temperature via the axillary method (underarm) or orally (mouth). To help your child keep a thermometer in long enough to get an accurate temperature, try holding a timer your child can watch or hold a thermometer under your armpit or in your mouth at the same time.

Underarm:

- 96° F to 99° F is a normal temperature;

- 99.6° F and up means a fever is present.

Mouth:

- 96° F to 99° F is a normal temperature;

- 99.4° F and up means a fever is present.

Eighty to ninety percent of all fevers in young children are related to self-limiting infections (these infections get better without treatment).

Unless a fever rises above 102° F, try these methods of treatment:

- Increase fluids: Fevers can occur if your child is dehydrated.
- Cool down: You don’t want to overheat your child, so cool her down by having her wear fewer layers and bring in a fan. Make sure your child is comfortable and not too cold.
- Slow down: Discourage running around or heavy activity that can increase temperature.

Common Colds

Colds are also known as upper respiratory disorders and are usually caused by rhinoviruses, which spread from hand to hand. The duration of a cold is usually seven to ten days, although some symptoms, such as a cough or runny nose, can linger longer.

The average child gets six to eight colds per year.

Symptoms of a cold:

- runny nose
- nasal congestion
- sneezing
- dry cough
- fatigue
- crankiness
- loss of appetite
- a mild fever
- sore, scratchy throat

Treatments for a cold:

- plenty of warm fluids and vitamin C-enriched foods,
- humidifiers to help clear nasal passages,
- saline solutions to soften dry mucus that clogs your child’s nostrils.

To help prevent a cold: wash hands, disinfect toys, and clean surfaces on a regular basis to get rid of germs.

Your child’s checkup will include:

- a complete physical examination

- measurement of your child’s length, weight, and head circumference; growth will be plotted on a growth chart

- a review of your two year old’s development through simple observation. How is she walking: on tiptoes or flat feet? Is she combining two words?

- safety questions such as asking if your child is in an age-appropriate car seat

- a discussion of your child’s eating habits. Is she eating a variety of foods? Using a spoon? Using a cup? Weaned from the pacifier?

- advice on what to expect in the coming year

- immunizations

- discussion between you and the doctor. Talk about any questions or concerns you have, and write down any specific instructions the doctor gives you regarding special care. Keep updating your child’s permanent medical record, listing information on growth and any problems or illnesses.

Immunizations

Most doctors schedule your child’s two-year-old visit on your child’s actual two-year-old birthday. Your doctor will weigh and measure your child as well as ask you questions about your child’s development and overall health.

Your doctor will discuss your child’s eating habits as well as examine your child’s teeth for tooth decay, abnormal tooth development, or other problems and recommend visiting a dentist no later than your child’s third birthday. The two-year-old checkup includes a number of screenings and required immunizations.

Your child will be screened for anemia, lead poisoning, tuberculosis, and high cholesterol. Lastly, your doctor will talk to you about other safety issues such as wearing helmets when riding bikes or scooters or skating and how to stay germ free. The immunization chart on the next page can give you an idea of the ones required early in life.