PARENTS CONNECTION
Ask the Pediatrician

Well Visits Help Keep your Child Healthy
Before they head back to school, make sure your children have their annual “well visit.” Immunization requirements have changed in Texas, so there’s a good possibility your children are due for one. And well visits are a great way to monitor your children’s health year to year, uncover any illness that may be brewing and build a solid relationship with your physician.

Below, Dr. Sheida Asgari, a pediatrician with Texas Children’s Pediatric Associates, discusses well visits and immunizations:

How often do children need to go to the doctor for a well visit?
The American Academy of Pediatrics recommends 6 well visits in the first year of life, 3 in the second and 1 yearly thereafter until age 21. The timing of the visits in the first 2 years is determined primarily by the immunization schedule. However, it also makes sense with respect to a child’s growth and development, which is lightning-fast in early years, then gradually slows.

What should be expected at a typical well visit?
At each well visit, weight, height and head circumference (for the first 2 years) are measured and plotted on standard curves to monitor growth. The doctor will ask questions regarding:

Sheida Asgari, M.D. Dr. Asgari is a pediatrician with Texas Children's Pediatric Associates - Spring Branch. She is also a member of the American Academy of Pediatrics.

• Developmental milestones
• Eating, sleeping and social behavior
• Recent illnesses, injuries or other health problems
• Changes in the child’s family or social environment

Then a careful physical exam is performed. For older children, this includes checking blood pressure and screening vision and hearing. Lab work may be done, including newborn screening, blood count and blood lead level.

Next, you will usually discuss issues that may be on the horizon. These may include dental hygiene, accident prevention, healthy eating and toilet training. For teenagers, topics might include puberty, driving safety, alcohol, tobacco or drug use and sex.

Finally, there is usually an open-ended inquiry for doctors to answer any questions the child or parent might have.

What are the recent changes in immunization requirements in the State of Texas?
New school immunization requirements take effect August 1, 2009 for students entering kindergarten and seventh grade.

Kindergarteners are now required to have the following:

• 2 doses of Hepatitis A
• 2 doses of Varicella
• 2 doses of MMR

Incoming seventh graders are required to have:

• 1 dose of Meningococcal
• 1 dose of Tdap
• 2 doses of Varicella

If children have been receiving vaccines per the Advisory Committee on Immunization Practices (ACIP) recommendations, they should have already received these vaccines. Click here to see the complete schedule of vaccines.

Can you address the risk of side effects associated with vaccinations and the suggestion of a possible link between autism and vaccinations?
Vaccines are the most rigorously tested pharmaceutical product on the market. Vaccines undergo years of testing before they are licensed and are continually monitored for safety and efficacy after licensure. Despite some public assertions that vaccines cause autism, there is no scientific evidence to support this theory. Rather, there are nearly 20 studies refuting the claim that vaccines, vaccine ingredients or combinations of vaccines cause autism. Earlier this year, a special federal court rejected a claim that vaccines caused autism in the case of several families.

In the case of vaccines, the tremendous medical benefits far outweigh any possible risks. Choosing not to vaccinate leaves your child susceptible to vaccine-preventable diseases that can be devastating or even deadly. For more information, please visit the Texas Children's Hospital Center for Vaccine Awareness and Research or Centers for Disease Control and Prevention Web site.  Or order a copy of Texas Children’s new publication, “Vaccine-Preventable Disease: The Forgotten Story.”

What does Texas Children’s Hospital offer for parents who can’t afford vaccinations or well visits?
Texas Children's Hospital operates 2 mobile clinics that provide free, basic pediatric health care to uninsured children ages 0 to 18. Texas Children’s Pediatric Associates’ Project Medical Homes are another option – these pediatric primary care offices provides convenient, affordable access to top quality primary pediatric health care services for children in medically underserved areas of Houston, regardless of ability to pay. To obtain information on free or low-cost immunizations please call the Texas Children’s Hospital Immunization Project Helpline at 832-824-2061 or visit a Texas Children's Pediatric Association Project Medical Home or mobile clinic.

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