How important are well-child visits for babies?

[Hannah C.]

I have a 4 month old who hasn't been to the pediatrician yet. When I called the doctor's office recommended by the midwife who delivered dd, I was told I had to vaccinate dd either on the normal or on the Dr. Sears schedule. I don't really feel comfortable doing either - I want to be able to evaluate the risks/benefits of vaccines myself, not be tied to a list by the doctor in order to get a well child checkup.

 

Now I have to find a new doctor, which means looking at lists of names. :( This is very disheartening, as I'm sure the problem will probably pop up again. Plus, I'd really rather go to a doctor I know a little bit about instead of picking a name.

 

Anyway, my actual question is - how important are well child visits when one isn't giving vaccinations? If my dd seems happy and healthy, but doesn't see a doctor regularly, is she doomed? Will I be in trouble trying to get her care when she actually is sick if she doesn't go see a doctor regularly? How can I find info on doctors?

 

Bah. This is so complicated. :(

[celticmom]

:lurk5:

[....]

It says you live in Irving... Isn't there a Dr Sears delayed vac/no vac dr in Colleyville? Or is it Coppell? Doesn't Dr Sears' website have a list of recommended drs? It's a lady and I think she practices family medicine... I wish I was more helpful, but it's a start. Insurance makes it hard to pick anyone you'd like to go to. Look on the Dr Sears website...

 

I would still get the baby a check-up, but it's not for me to say. We don't like our pediatrician, either. They rolled their eyes at the homeschooling thing and asked a LOT of questions.

[SweetBean]

I think it is very important to have a relationship with a physician for your children, just in the event that something comes up. Those early visits are also important for height and weight checks. Since I am an RN I know what babies should be doing when. Honestly, I have always been the one who figured out when something was off, and brought it up to the pediatrician. That being said, I don't know if that is true of all parents, and I like the reassurance that someone else is performing a physical and developmental assessment on my child. Ask around, and see if you can get a recommendation from a friend for a physician who is okay with not vaccinating.

[elizabeth]

Are you serious??? There are a multitude of developmental milestones that need to be watched for and physical changes as well. If you want a doctor to permit you to be under a physicians care not a pseudophysician then you might as well stop looking. I do understand staggering the vax schedule or having them administered with a crash cart nearby due to allergy to components or growing medium(eggs) but expecting an MD to rubberstamp your particular mode of thinking is going to be interesting. Neglect is neglect no matter what the intentions. You need to find an MD who is willing to discuss the realistic risks with certain vaccines and have a discussion along with the well baby check up. They check for vision, hearing etc I cannot imagine pretending to live in a third world country medically in order to accomodate my irrational fears.

[Hannah C.]

Are you serious??? There are a multitude of developmental milestones that need to be watched for and physical changes as well. If you want a doctor to permit you to be under a physicians care not a pseudophysician then you might as well stop looking. I do understand staggering the vax schedule or having them administered with a crash cart nearby due to allergy to components or growing medium(eggs) but expecting an MD to rubberstamp your particular mode of thinking is going to be interesting. Neglect is neglect no matter what the intentions. You need to find an MD who is willing to discuss the realistic risks with certain vaccines and have a discussion along with the well baby check up. They check for vision, hearing etc I cannot imagine pretending to live in a third world country medically in order to accomodate my irrational fears.

 

Wow, I guess I wasn't very clear in my original post.

 

I want to research vaccines and decide whether risks outweigh benefits for our specific situation, myself. Turns out that the doctor I had chosen before is not okay with this - they want all kids at their practice to be vaccinated using either the government schedule or the Dr. Sears schedule. Since I don't want to use either at this time, I have to find a doctor that actually WILL discuss benefits and risks and be okay with me making medical decisions for my child - which is part of being a parent. It's not neglect. Being in the US and not vaccinating (or even not doing well child checks on the "normal" schedule) is WORLDS away from being in a third world country medically.

 

If I was ever to leave the US, or even change our lifestyles (e.g. putting dd in daycare), I would reassess this and probably decide to do vaccinations. As the moment, that isn't our situation. I'm not against vaccines, necessarily - I just want to be able to do the research and act according to what I find, NOT have to follow a schedule someone else has set up because that's what the doctor says.

Edited June 9, 2011 by Hannah C.

[Joanne]

There are compelling reasons to take your baby and toddler to the Dr. If not vaccinating, it does not have to be on "well baby" frequency, but I do believe their are a lot of reasons to go:

 

 

1. A medical paper trail, in case someone in you life reports you for what they think is wacky parenting, abuse, or neglect
    
   
2. In case you are not fully trained as a pediatrician
    
   
3. To establish a relationship, rapport and history in the case of medical issues emerging
   

 

 

A dear friend of mine took her step son (11) to the eye doctor. He had some trouble in school, and was a bit clumsy. Within 10 minutes of the exam, the Dr. told her and her DH: take him immediately to the MD Anderson ER.

 

Young man had an aggressive brain cancer. He was in(brain) surgery within 48 hours of crossing the ER threshold.

 

This is not an urban legend, "I know someone who knows" story. This is a child my children have met, played X Box with, and for whom we recently organized and hosted a benefit. (Dad is unemployed, family is uninsured)

 

I used to be fairly anti-vax myself, and, at times, anti-routine well visits. I'm not either of those anymore.

[aggieamy]

A dear friend of mine took her step son (11) to the eye doctor. He had some trouble in school, and was a bit clumsy. Within 10 minutes of the exam, the Dr. told her and her DH: take him immediately to the MD Anderson ER.

 

Young man had an aggressive brain cancer. He was in(brain) surgery within 48 hours of crossing the ER threshold.

 

This is not an urban legend, "I know someone who knows" story. This is a child my children have met, played X Box with, and for whom we recently organized and hosted a benefit. (Dad is unemployed, family is uninsured)

 

I used to be fairly anti-vax myself, and, at times, anti-routine well visits. I'm not either of those anymore.

 

OT: What happened to the boy? Is he okay now?

[Rebecca]

i agree with you about being in the driver's seat regarding procedures, etc. for your child. I also agree that establishing a relationship with a ped. is very, very important. You could also consider a family doctor- one who cares for the entire family from baby on up.

 

It is worth the time, effort, research it will take you to find what you want and need.

 

There are many things I have almost missed as a mom over the years and I have been very , very thankful for my peds. I did start off with a family doctor and when my son was about a year old- we switched to pediatricians and have never looked back.

 

Pediatricians can be amazing, awesome support for parents and there is something so reassuring about having someone you can call when your child is really, really sick on Saturday night- and they know you and they know your child... even if it is a large practice- at least there is the familiarlity with their standards, etc. and they can tell you which E.R. to go to and call ahead to help you before you get there.

 

It is worth it and important. It does not mean you have to do every vaccination that they suggest when they suggest it. They should be willing to work with you.

 

I hope this makes sense,

Rebecca

[jelbe5]

One of the main reasons for well baby check-ups is to administer the vaccines, as well as to observe developmental milestones. If you are delaying vaccines there is no need to go to the ped so frequently.

 

There are ways to find a doctor who will work with you. You may want to contact your local La Leche League as these ladies are experts at finding doctors who will work with them. Any doctor who does homebirths will probably work with you also. Also, there is no need to use a pediatrician . . . consider a DO (Doctor of Osteopathy) or a general practitioner/family doctor. They may be more willing to work with your vaccine schedule as you do research. Most peds are not willing to deviate from the CDC schedule for vaccinating. I hope you find someone who is willing to work with you soon. We use a DO and she stated to me at one visit that since I am the parent, it is my decision how to handle the vaccine issue. It is HER job to give me her medical opinion, but that is all. I truly love my children's doctor as she respects my wishes and concerns.

 

Editing to Add: Feel free to pm me if you have any questions re the vaccine issue that I may be able to answer from my personal experience for you.

Edited June 9, 2011 by jelbe5

[....]

I'm going to pm you. I found a couple of doctors.

 

Also, if the baby got sick before you found a pediatrician, the baby could probably go to Care Now. We go there more than our regular pediatrician. They caught something once that our regular pediatrician didn't catch.

[Rebecca]

Oh- in answer to your title. I think well child visits are very important.

Not because of vaccinations...

 

They really help establish a relationship with your doctor and help you parent your child's health.

 

Having a health record established is helpful as well.

[Alice]

I'm a pediatrician so admittedly biased. I think it's very important. At the very least, it will be more difficult to find someone to see when your kids are sick if they don't already have a regular doctor. There are urgent cares and ERs but in my experience they tend to either give less than ideal care for kids (urgent cares) or be expensive and require lengthy waits (ERs).

 

I also have posted on this multiple times before so those who've seen it before can forgive me but there are many things we can find on a well check. I think people see it as not much being done and if the child is healthy that's what it will look like, but it's not uncommon for us to find things in a baby or child that were not suspected by a parent. A partial list of things I've diagnosed in kids at check-ups: cataracts, vision problems (commonly), polycystic ovarian disease, scoliosis (commonly), autism, developmental delay, craniosynostosis (potentially dangerous issue where the bones in the skull fuse together prematurely), diabetes, hypertension, kidney disease, thyroid disease, growth problems, anorexia, infantile spasms (very serious seizure disorder in babies), heart murmurs of various etiologies. In all those situations the parent was NOT concerned and had not noticed anything wrong. Sometimes this was because we made the diagnosis early, sometimes it's because they had just gotten used to the problem and didn't realize it was a problem. I work in an area with well-educated parents. If anything most of my parents are too worried about things in their kids. I think of myself as a good doctor but not particularly unusual or great. I'm sure all my partners have similar lists. All that to say, I do think well checks are important.

 

I do sympathize with the vaccination issue. Pediatricians are struggling with this issue as we strive to best serve all our patients. We do want to respect parents decisions, but at the same time we also want to protect the most fragile in our practice (infants who can't be vaccinated, children on immunosuppressive therapies, those who can't be vaccinated). For us it would be a disaster if an infant contracted pertussis in our waiting room and died. All over the country we are seeing outbreaks of vaccine-preventable diseases, the most common being measles and pertussis.

 

Every pediatric practice is figuring out for themselves how to handle this. Until recently, we accepted all patients, regardless of their decisions about vaccines. We had them sign a waiver and made it clear that we strongly recommended the standard schedule but we would still see them. Recently, due to the concerns I mentioned above we have decided to ask all our patients to vaccinate and follow a "reasonable schedule". We are intentionally keeping it vague so that we can work with patients individually to figure out what their concerns are. Obviously, they have the choice to decide this doesn't work for them and find another doctor although we hope no one does that.

 

I hope you can find someone in your area who is willing to see your kids and work with you to find a vaccine schedule you are comfortable with.

[LittleIzumi]

Our well visits have consisted of me filling out a long form of everything my kids can & can't do (draw a straight line, talk in sentences of 5 words or more, etc), the pedi asking, "How is ____ doing?", checking eyes & ears, vax or no vax, & we leave. Sometimes they don't even collect the big form, just ask if I noticed any issues. If there's a problem generally I have to come in & tell them so myself, already knowing what it is. It's pretty much been just checking the box of "I went" that is based around a vax, IME. The forms didn't catch dd's sensory issues, for instance, neither did my comments about her behavior at her visits. I finally researched it myself, went in, told the pedi I strongly suspected sensory issues for X reasons (he was visibly startled), he faxed the referral over, and she was in therapy for a year and a half. That's been typical of our experiences here--me having to figure it out myself first. However, this is one of the better pedis in our area, esp on discussing vaxes & allowing alternate schedules, so we go with it. But I haven't seen the value in well child visits personally.

[TracieT]

I REALLY like my pediatrician, but he really doesn't like the fact that we stopped vaxing. He tolerates it, but made it known he doesn't approve. I will most likely keep going for once a year well visits, though. I do like the security of having a dr. who knows my boys, knows their histories and is there if they do get sick.

 

As for the baby well visits, my pediatrician has found things and not other things. I was very confident my oldest had a speech delay and he wanted me to wait until he was 2 to look into it. I'm thankful I didn't take his advice because it took months to get going with the early intervention program and then even at 26 months my son's expressive language was that of a 15 month old.

 

At one well visit he was listing to my oldest's chest, stood up with wide eyes and says "He has pneumonia!" I had no clue and the dr. said he never would have suspected. (my kids have an insanely high pain tolerance and it's really hard to tell if they are sick)

 

He also found my youngest's heart murmur and kept an eye on it over the years. It was back at his 4 yr. visit, so we saw a cardiologist who gave him the all clear.

 

I know he and I won't see eye to eye on everything and I'm thankful he will still see my children regardless of whether we vax. I do like having someone to bounce things off of and to reassure me if I have a concern. I will always maintain that Mom is the one who will know if something is seriously wrong with her child....I would never put that all on a dr. who spends 5 minutes with a child once a year. But I do think it's nice just having that extra set of eyes.

[AvasMom]

It always felt like it was all about the vaccines. That said I do want to have a doctor who knows a little about my children. They are rarely sick so they are never at the doctor's except for the well checkups.

 

I don't know why, but I've done a 360 on my feelings of this over the years. I grew up with a mother who lived at the doctor and took us to the doctor for every little thing. It never felt necessary. So now I often feel like it is a waste of time. The last time I took my kids they did get the vaccines, but they were weighed, height checked, and tapped on the knee. That was about it. It always feels ridiculously pointless.

 

:iagree: I didn't take ds to well-baby visits. We weren't vaxing, I'm an RN so I know the milestones, and my kids are never sick. Like ever. Ds just had his *first* antibiotic at almost 10 years old. Everyone has strong opinions on this but I think my kids are better off for it. We took dd but she was my first, we vax'ed back then and since we had Dr. Sears we went more for parenting advice (I was 2000 miles away from my family) then anything else.

[stripe]

I would go regardless of the vaccines. Find a doctor you're comfortable with.

[Annie Laurie]

In the Sears Vaccine Book, he quotes the AAP's recommendation that parents not be refused service for not vaccinating. I can't find it on the AAP website right now but will link when I do. I would not want to see a pedi who did myself, even though I do vaccinate (on a selective schedule).

[Jenny in Atl]

A dear friend of mine took her step son (11) to the eye doctor. He had some trouble in school, and was a bit clumsy. Within 10 minutes of the exam, the Dr. told her and her DH: take him immediately to the MD Anderson ER.

 

Young man had an aggressive brain cancer. He was in(brain) surgery within 48 hours of crossing the ER threshold.

 

This is not an urban legend, "I know someone who knows" story. This is a child my children have met, played X Box with, and for whom we recently organized and hosted a benefit. (Dad is unemployed, family is uninsured)

 

I used to be fairly anti-vax myself, and, at times, anti-routine well visits. I'm not either of those anymore.

 

And I almost lost my youngest, even though she was under the regular care of a highly thought of pediatrician in our area. She had all the classic signs of type-1, but he shrugged it off, and said she just had a virus. She was in the ER just hours away from death. We left his practice the next day. What do they say? Buyer beware...

 

I'm not anti-doctor, but I do find some of the milestone stuff to be BS. Just a few years ago our current ped said my oldest was underweight. Mac had always been off the charts, so far as height & weight goes. So, when she really shot up in height her weight leveled off, and she was slim, but completely normal (BMI and all). I laughed my ass off, and told her her bell curve was off due to having so many overweight kids in her practice.

 

Fi's Endo often laughs about how little pediatricians know. They are some of the least educated in the medical field, most likely because there's no $$$ in it, compared to urology or plastic surgery.

 

All I can say is, don't give up trying to find a doctor that will support you, that you are comfortable with. I'm not a anti-vax/well baby check-up person, but I am for patients being able to say what kind of care they and their wish to receive, not to just sit passive and have the doctor do all the driving. Just make sure you do the research and don't get caught up in the emotional tug of war.

[AvasMom]

I don't care because my kids are vaccinated, but if my children had some sort of reason why they could not be vaccinated, I think I'd be afraid to bring them to a doctor that didn't care. Every time I go I worry my kids will get sick because they aren't sick often and it seems crazy that I bring them into this place that could be filled with sick germs (to have them weighed and their knee tapped). So having a kid with some sort of fragile condition, yeah I'd be more worried and picky.

 

I think there can be other ways of dealing with this than just banning unvaxed kids. I'm thinking along the lines of when an unvaxed kid has a fever or rash or other suspicious symptom that they need to be brought in after hours or in the back door or something to avoid contact with the more fragile kids. But then if I had a medically fragile child I'd want that done with *any* child with symptoms of illness.

[katilac]

Extremely important. As Alice noted, there are numerous issues that can be caught at well visits. Catching them early can make the difference between successful treatment or devestating consequences.

 

Also, your dd is surely going to get sick at some point. This usually happens late Friday afternoon :D. Do you really want to take your sick infant to some random urgent care? Wouldn't it be better to make those phone calls and consults now, rather than being forced into taking whatever care is available, right when it matters the most?

 

You've only spoken to one doctor. I understand that you want a doctor who is "on the same page" and willing to work with you; that's pretty much what we all want, right? But getting there takes some legwork. You need to ask around for recommendations, make a list, call that list and ask initial questions, and then visit your top one or two choices. I wasn't charged for any of my "just want to meet you" visits - - it's just a few minutes to meet face-to-face and verify the info you got on your phone calls. Just say, "It sounds like this practice might be what we are looking for. Would it be possible to just stop by and meet Dr. X before I decide?"

 

If she hasn't been to the ped yet, I'm assuming she didn't have a "heel stick" done, correct? You really need to get her in for that reason alone. It's a simple test that screens for various conditions, and early treatment can make an extreme difference for many of them. Cystic fibrosis, PKU, hypothroidism, and metabolic disorders, to name a few. These tests exist b/c a baby can "seem" happy and healthy while having a condition that will worsen each day it is left untreated.

[Annie Laurie]

I don't care because my kids are vaccinated, but if my children had some sort of reason why they could not be vaccinated, I think I'd be afraid to bring them to a doctor that didn't care. Every time I go I worry my kids will get sick because they aren't sick often and it seems crazy that I bring them into this place that could be filled with sick germs (to have them weighed and their knee tapped). So having a kid with some sort of fragile condition, yeah I'd be more worried and picky.

 

I think all doctors care, but I think it does a disservice to those children who are turned away because their parents don't vaccinate.

 

I see what you're saying. But if my child couldn't be vaccinated and I was worried about them contracting a disease, I'd probably be just as worried out in crowds, at stores, etc. Our pedi has a separate sick and well waiting area, I know that won't eliminate all exposure, but it seems less likely to me than the close contact we experience at public drinking fountains, touching shopping carts, etc.

[Annie Laurie]

If she hasn't been to the ped yet, I'm assuming she didn't have a "heel stick" done, correct? You really need to get her in for that reason alone. It's a simple test that screens for various conditions, and early treatment can make an extreme difference for many of them. Cystic fibrosis, PKU, hypothroidism, and metabolic disorders, to name a few. These tests exist b/c a baby can "seem" happy and healthy while having a condition that will worsen each day it is left untreated.

 

My son had this before we went to the pediatrician- actually, my pediatrician won't do it. They said it's always taken care of at the hospital by the OB. I had a homebirth, so my midwife did it both times.

[happypamama]

If she hasn't been to the ped yet, I'm assuming she didn't have a "heel stick" done, correct? You really need to get her in for that reason alone. It's a simple test that screens for various conditions, and early treatment can make an extreme difference for many of them. Cystic fibrosis, PKU, hypothroidism, and metabolic disorders, to name a few. These tests exist b/c a baby can "seem" happy and healthy while having a condition that will worsen each day it is left untreated.

 

While I agree that it is important to get the heel stick done, it's not necessarily true that you can't have it done without seeing a doctor. For two of my children, my midwives drew the blood for the metabolic screens, no pediatrician needed at all.

[SailorMom]

Not going to try to debate, but I do think well-visits are important - if anything to establish a relationship with a practice.

I also - from the bottom of my heart - ask you to please vaccinate for pertusis as soon as you can. There are flare ups all over, some are adults who weren't vaxed giving it to their own children... tragic. We recently had large group of kids in the school system where we live out for it - there were no percentages given, but it was reported that many were not vaccinated. Thankfully - no one died from it.

[Stages]

My daughter is vaccinated on the "typical" schedule, but I wanted to say that her doctor told us it would be ok to skip the well baby visits after she turned 2. We switched insurance and we simply couldn't afford $72 every few months for 5 minutes of their time. Granted, DD has always been in perfect health and we can still go if she gets sick.

[TracieT]

And I almost lost my youngest, even though she was under the regular care of a highly thought of pediatrician in our area. She had all the classic signs of type-1, but he shrugged it off, and said she just had a virus. She was in the ER just hours away from death. We left his practice the next day. What do they say? Buyer beware...

 

I'm not anti-doctor, but I do find some of the milestone stuff to be BS. Just a few years ago our current ped said my oldest was underweight. Mac had always been off the charts, so far as height & weight goes. So, when she really shot up in height her weight leveled off, and she was slim, but completely normal (BMI and all). I laughed my ass off, and told her her bell curve was off due to having so many overweight kids in her practice.

 

Fi's Endo often laughs about how little pediatricians know. They are some of the least educated in the medical field, most likely because there's no $$$ in it, compared to urology or plastic surgery.

 

All I can say is, don't give up trying to find a doctor that will support you, that you are comfortable with. I'm not a anti-vax/well baby check-up person, but I am for patients being able to say what kind of care they and their wish to receive, not to just sit passive and have the doctor do all the driving. Just make sure you do the research and don't get caught up in the emotional tug of war.

 

My children are adopted and I've been involved in a lot of adoption message boards and things like that. I've noticed many doctors do not take ethnicity into account when it comes to charts and milestones. My ped. was concerned about the size of my oldest's head when he was a baby. He had me SO worried. He told me they might have to send him for a cat scan to make sure nothing was wrong. Well, my son is part Mexican and I've noticed since then that Mexican babies tend to have larger heads. That was never taken into account. I've heard other moms talk about their children from other countries being off the charts small, but it was completely normal for that ethnicity. I think that's something that really needs to change seeing how the world is shrinking.

[Aelwydd]

Wow, I guess I wasn't very clear in my original post.

 

I want to research vaccines and decide whether risks outweigh benefits for our specific situation, myself. Turns out that the doctor I had chosen before is not okay with this - they want all kids at their practice to be vaccinated using either the government schedule or the Dr. Sears schedule. Since I don't want to use either at this time, I have to find a doctor that actually WILL discuss benefits and risks and be okay with me making medical decisions for my child - which is part of being a parent. It's not neglect. Being in the US and not vaccinating (or even not doing well child checks on the "normal" schedule) is WORLDS away from being in a third world country medically.

 

If I was ever to leave the US, or even change our lifestyles (e.g. putting dd in daycare), I would reassess this and probably decide to do vaccinations. As the moment, that isn't our situation. I'm not against vaccines, necessarily - I just want to be able to do the research and act according to what I find, NOT have to follow a schedule someone else has set up because that's what the doctor says.

 

 

Hey Hannah, we live in the same area (I promise I say this in a non-creepy manner!). My sister was also very unsure about vaccinations and so delayed them until her ds was 2 years old. She saw a pediatrician in Arlington, who did not push vacs and leaves it up to the parent. If you like, I can get the name and number for the practice.

 

I think that it is important for your dd to be seen regularly in the first two years. Many, many disorders and problems are much more treatable if caught early. Also, if your child requires hospital care at any point, it is much easier if you have an established relationship with a ped. Hospital personnel can be quite hostile toward those parents they deem as being irresponsible or lax in regards to medical check ups. Your pediatrician not only gives you "credibility," but they know your child's history, and are better positioned to be an advocate for you and your family.

 

When my son had his first asthma attack at 10 months old, it was very severe and required hospitalization. When I got a couple of sarcastic comments from a nurse about overreacting about ds' wheezing by bringing to the E.R., it was our pediatrician who stepped in and basically told her to shut up, and we probably saved ds' life.

 

Finally, I'm very much understanding in regards to delaying vacs. However, I would caution you about avoiding or delaying the pertussis vaccination in this area. Cooks Children's hospital in Fort Worth lost several infants last winter due to "whooping cough," and there is an increasing incidence rate among children in this region. It is due to the decreasing protection of "herd immunity" as more and more adults have their own immunity wear off, in addition to more and more children not being vaccinated. Pertussis is a high-risk disease for a baby to catch, and one I would seriously consider vaccinating against.

[Alice]

 

Fi's Endo often laughs about how little pediatricians know. They are some of the least educated in the medical field, most likely because there's no $$$ in it, compared to urology or plastic surgery.

 

 

 

I'm not even sure what to say to this it's so wrong and offensive. Suffice to say that almost every medical specialty thinks they know more than every other. In my experience doctors who think they know the most and are the most insulting of others are usually the ones who should be practicing a little humility.

 

If you don't want to do well checks or you've had bad experiences with pediatricians, fine, but it would be nice to stay civil.

 

I think there can be other ways of dealing with this than just banning unvaxed kids. I'm thinking along the lines of when an unvaxed kid has a fever or rash or other suspicious symptom that they need to be brought in after hours or in the back door or something to avoid contact with the more fragile kids. But then if I had a medically fragile child I'd want that done with *any* child with symptoms of illness.

 

We deal with this by having our most medically fragile kids (post-transplant for example) come at separate times. The reality is though that most parents who don't vaccinate take offense at being treated differently. Maybe some here wouldn't, but it has been my experience that many do. For example, if we have a baby who has received no vaccines and has a fever we are much more likely to recommend bloodwork and possibly other tests that we wouldn't in a child who was vaccinated. I've had parents get very angry at me about that.

 

Many of the kids at risk are simply the ones who haven't yet been vaccinated (newborns, kids under a certain age). I don't see it as feasible to ask all unvaccinated kids coming in for a sick visit to sneak in the back to avoid possibly meeting a baby.

 

I

 

Our pedi has a separate sick and well waiting area, I know that won't eliminate all exposure, but it seems less likely to me than the close contact we experience at public drinking fountains, touching shopping carts, etc.

 

Unless the ventilation systems are separate and things like all doorknobs/door/examining rooms are separate these separate waiting areas are mostly for show. It looks nice but doesn't really do all that much.

 

Yes, it's true that you can be exposed anywhere (an argument for vaccination perhaps). But it's also true that as a pediatrician I'm only really responsible (and able) to protect my patients in my own office. I can advise parents on how to limit their 2 day old infant's exposure to illnesses but I can't do much about it if they decide to go to a mall. However, if I'm asking them to bring their baby in to see me for a weight check I do have the abiltiy (and some would argue the responsibility) to limit their exposure in my office as much as possible.

 

The recent measles epidemic in California was partly spread through contact in a pediatrician's waiting room (it was Dr. Sear's office, in fact).

 

Here is part of the mother's account from the CDC website:

 

"We spent 3 days in the hospital fearing we might lose our baby boy. He couldn’t drink or eat, so he was on an IV, and for a while he seemed to be wasting away. When he began to be able to drink again we got to take him home. But the doctors told us to expect the disease to continue to run its course, including high fever—which did spike as high as 106 degrees. We spent a week waking at all hours to stay on schedule with fever reducing medications and soothing him with damp wash cloths. Also, as instructed, we watched closely for signs of lethargy or non-responsiveness. If we’d seen that, we’d have gone back to the hospital immediately."

 

In their case they were lucky and the baby survived.

 

I know this got off topic, and I apologize to the OP.

 

But since the thread was going in that direction I just wanted to give a little idea of why some pediatricians choose to not see patients who don't vaccinate. It's a difficult decision and not one made lightly.

[Karen in CO]

 

Anyway, my actual question is - how important are well child visits when one isn't giving vaccinations? If my dd seems happy and healthy, but doesn't see a doctor regularly, is she doomed? Will I be in trouble trying to get her care when she actually is sick if she doesn't go see a doctor regularly? How can I find info on doctors?

 

Bah. This is so complicated. :(

 

The well-child visits establish a relationship and help your doctor to know you and your child. It helps so that when something is wrong, your doctor can compare that to what is normal for your child. My doc was the one to suggest delaying vaccines for my youngest. He knew me, and he knew her. It is not unreasonable to expect to find a doctor that respects you and helps you to make informed decisions. It just sometimes takes a lot of persistence to find one.

 

Asking for recommendations from the local hs community might be a good place to start. I know I've recommended my terrific doc to a few fellow homeschoolers.

Edited June 9, 2011 by Karen in CO

[PinkInTheBlue]

I took my oldest to all the visits he was scheduled to have and they were useless. I tried and tried to tell them something was wrong and they completely ignored me. I finally switched practices and she found the problem immediately without me really even getting the opportunity to tell her. A few months later my 6 month old developed a rash and they just knew what it is. Well the rash grew and grew and didn't respond to anything they told me to do or prescribed. He was miserable and pitiful. I told them "that's not what it is. This is ridiculous." after 3 months of torture. Again I changed peds and they knew immediately what it was and, of course, it was what I had already suspected it was.

 

Needless to say, I haven't found any of the peds in my area to be worth the bother. There is NO "relationship" built. They don't remember me or my children from time to time. There's been no benefit to developing some relationship. They are barely aware of us outside of a visit that consists of "Hi, how are you? Check mark, take a temp, weigh...see you later" Around here it's a waste of time, money and whatever cold or such someone ends up catching from the waiting room.

 

I wish I could have some of the experiences you all seem to have had. We are nothing but a chart number around here. I stay informed about milestones and measurements and use a general doctor whenever there is the rare illness.

 

That's MY experience. My answer would be "no, they aren't worth it". :)

[....]

Not going to try to debate, but I do think well-visits are important - if anything to establish a relationship with a practice.

I also - from the bottom of my heart - ask you to please vaccinate for pertusis as soon as you can. There are flare ups all over, some are adults who weren't vaxed giving it to their own children... tragic. We recently had large group of kids in the school system where we live out for it - there were no percentages given, but it was reported that many were not vaccinated. Thankfully - no one died from it.

 

I had pertussis a couple of years ago and I've been vaccinated for everything under the sun (I was in the military).

[Aelwydd]

I'm a pediatrician so admittedly biased. I think it's very important. At the very least, it will be more difficult to find someone to see when your kids are sick if they don't already have a regular doctor. There are urgent cares and ERs but in my experience they tend to either give less than ideal care for kids (urgent cares) or be expensive and require lengthy waits (ERs).

 

I also have posted on this multiple times before so those who've seen it before can forgive me but there are many things we can find on a well check. I think people see it as not much being done and if the child is healthy that's what it will look like, but it's not uncommon for us to find things in a baby or child that were not suspected by a parent. A partial list of things I've diagnosed in kids at check-ups: cataracts, vision problems (commonly), polycystic ovarian disease, scoliosis (commonly), autism, developmental delay, craniosynostosis (potentially dangerous issue where the bones in the skull fuse together prematurely), diabetes, hypertension, kidney disease, thyroid disease, growth problems, anorexia, infantile spasms (very serious seizure disorder in babies), heart murmurs of various etiologies. In all those situations the parent was NOT concerned and had not noticed anything wrong. Sometimes this was because we made the diagnosis early, sometimes it's because they had just gotten used to the problem and didn't realize it was a problem.

 

Alice, you reminded of me of something. Our son was born with a sacral dimple, where you could not see the bottom of the pit. I had noticed it soon after we had ds, but the nurse midwife and the RN at the birth center did not mention it, nor notate it on his chart. It was rather small, so they had missed it.

 

When we took ds to his first ped visit at one week old, it was the ped. who notated it, and had referred us to CHOP (we lived near Philly at the time) for an MRI to make sure it was benign. Turned out there was no problem, but had it been open down to his spine, obviously the ramifications for his developing muscle tone and control in his legs would have been very important. We had a great relationship with this ped, and I still find myself thinking of him and the nurses in his practice and missing them. We have a very nice ped now, and I always approach well-child care for my son as a team effort with our doctors.

[sassenach]

I think having a relationship with a ped is important. I think with your first child, the scheduled well checks are also important. After the first couple of kids, I did not do all of the infant well checks. I feel that they are overkill that first year, because they are connected with the vaccination schedule. We vaccinated more slowly with our second 2 (not completely delayed, but not on schedule) and did not go into the ped nearly as much as I did with the first 2. I knew what normal development looked like and was comfortable with less "supervision." However, I still maintained an excellent relationship with our ped. I could call him about anything, and he was very valuable to me (past tense because we moved). Now that my kids are older I do physicals about every other year, but we're in a lot for various other ailments so the relationship is maintained.

 

For you, as a first time mom, I think it is important to find a ped with whom you can build a solid relationship.

[Aelwydd]

I had pertussis a couple of years ago and I've been vaccinated for everything under the sun (I was in the military).

 

No vaccine is 100%, which is why the higher the proportion of a population is vaccinated, the better for that entire population. It's called "herd immunity," and usually the goal is to be >90%. Once you have enough individuals with either waning immunity, or no immunity in your population, than even those who are vaccinated are going to be at more risk. Because there will be more opportunities for them to come in contact with infected individuals, and while most of them will be protected, there will be some whose passively acquired immunity will not be enough to avoid infection.

[Jenny in Atl]

I'm not even sure what to say to this it's so wrong and offensive. Suffice to say that almost every medical specialty thinks they know more than every other. In my experience doctors who think they know the most and are the most insulting of others are usually the ones who should be practicing a little humility.

 

If you don't want to do well checks or you've had bad experiences with pediatricians, fine, but it would be nice to stay civil.

 

 

I never said I don't do well check-ups (we're at the doctor's every three months), but I was adding a caveat that just because you go for well check ups, does not mean you should blindly follow what the doctor says. Yes, we had an awful experience with a well know highly thought of ped, who nearly killed our child. Perhaps my experience colored my choice of words; I apologize. Our Endo is one of the best in the country; I don't believe he intent was to be offensive. However, I can't tell you how many times I've received advice from our ped that contradicts what our endo has advised. I think I'll listen to the specialist.

 

I think there is a real issue with patients not feeling empowered to have an active role in their healthcare. Many go to the doctor for support, and instead feel judged, the whole "white coat" syndrome. The vax debate is not something I have an issue with, as we fully vax. I do feel the OP's issue is in having a doctor who will listen, and work with her. No matter the specialty, I think this is in short supply.

[BatmansWife]

I haven't had time to read all the responses; I kind of just skimmed. But, I did read this:

 

Are you serious??? There are a multitude of developmental milestones that need to be watched for and physical changes as well. If you want a doctor to permit you to be under a physicians care not a pseudophysician then you might as well stop looking. I do understand staggering the vax schedule or having them administered with a crash cart nearby due to allergy to components or growing medium(eggs) but expecting an MD to rubberstamp your particular mode of thinking is going to be interesting. Neglect is neglect no matter what the intentions. You need to find an MD who is willing to discuss the realistic risks with certain vaccines and have a discussion along with the well baby check up. They check for vision, hearing etc I cannot imagine pretending to live in a third world country medically in order to accomodate my irrational fears.

 

This seems a bit harsh. I don't think the OP is neglecting her baby if she is considering if well-child visits are needed or not.

 

Anyway, my actual question is - how important are well child visits when one isn't giving vaccinations? If my dd seems happy and healthy, but doesn't see a doctor regularly, is she doomed? Will I be in trouble trying to get her care when she actually is sick if she doesn't go see a doctor regularly? How can I find info on doctors?

 

Bah. This is so complicated. :(

 

I took my first two children in for every single well-child visit. By baby #3 I didn't feel it was necessary. This child didn't have vaccinations. I knew if she was developing correctly or if there were any problems. Yeah...I'm not an expert, but a mom does know if something isn't right with their child. We had WIC, so she got regular weight and height tracked through them. I just didn't feel it was necessary to possibly expose a healthy baby to germs at the clinic. Over the years, I've just taken her in whenever it was needed but not for well-checks. She's 7 now and very healthy.

 

If she hasn't been to the ped yet, I'm assuming she didn't have a "heel stick" done, correct? You really need to get her in for that reason alone. It's a simple test that screens for various conditions, and early treatment can make an extreme difference for many of them. Cystic fibrosis, PKU, hypothroidism, and metabolic disorders, to name a few. These tests exist b/c a baby can "seem" happy and healthy while having a condition that will worsen each day it is left untreated.

 

My youngest (don't remember about the first two) had this done in the hospital shortly after birth.

Edited June 9, 2011 by ~AprilMay~

[elizabeth]

I haven't had time to read all the responses; I kind of just skimmed. But, I did read this:

 

 

 

This seems a bit harsh. I don't think the OP is neglecting her baby if she is considering if well-child visits are needed or not.

 

 

I took my first two children in for every single well-child visit. By baby #3 I didn't feel it was necessary. This child didn't have vaccinations. I knew if she was developing correctly or if there were any problems. Yeah...I'm not an expert, but a mom does know if something isn't right with their child. We had WIC, so she got regular weight and height tracked through them. I just didn't feel it was necessary to possibly expose a healthy baby to germs at the clinic. Over the years, I've just taken her in whenever it was needed but not for well-checks. She's 7 now and very healthy.

 

 

My youngest (don't remember about the first two) had this done in the hospital shortly after birth.

 

I certainly appreciate a staggered vaccine schedule. That way it is easy to determine which vaccine might have caused undue swelling, or perhaps an allergy to one of the components. But to simply choose not to vaccinate without a scientific reason for doing so violates the very essence of the social contract . In fact , if I were a member of this group I would say it was downright un-Christian. While a child might come through measles, mumps, rotavirus , chicken pox, etc these diseases can be carried before symptoms are apparent and they can kill without mercy those who are immune-suppressed, especially those who are undergoing cancer treatment. It is selfishness and willful blindness to suggest that your choice not to vaccinate at all does not affect other people. It does. The whole theory behind vaccination of heard immunity depends on the social contract. How would you feel knowing that your measles-laden child caused another child to be born deaf? It happens . Measles used to be one of the main causes of women bearing hearing-disabled children . As I said, I get doing a very careful, slow, methodical vax schedule. But to pretend that it is simply a matter of private choice is a moral illusion . Those choices do affect other people and you need to account to other people because they can be affected seriously by your choices.

[TracieT]

I never said I don't do well check-ups (we're at the doctor's every three months), but I was adding a caveat that just because you go for well check ups, does not mean you should blindly follow what the doctor says. Yes, we had an awful experience with a well know highly thought of ped, who nearly killed our child. Perhaps my experience colored my choice of words; I apologize. Our Endo is one of the best in the country; I don't believe he intent was to be offensive. However, I can't tell you how many times I've received advice from our ped that contradicts what our endo has advised. I think I'll listen to the specialist.

 

I think there is a real issue with patients not feeling empowered to have an active role in their healthcare. Many go to the doctor for support, and instead feel judged, the whole "white coat" syndrome. The vax debate is not something I have an issue with, as we fully vax. I do feel the OP's issue is in having a doctor who will listen, and work with her. No matter the specialty, I think this is in short supply.

 

I agree totally. I had an AWFUL experience with our ped. (who I previously praised) putting my son on Pulmicort and not telling me he couldn't be exposed to chicken pox. Three days later he did come down with chicken pox (even though he was vaxed for it) and I found out it could be deadly if they are on Pulmicort. I told him no more of that med and he handed me Singulair and assured me "there are NO side effects." That was the worst drug I've ever experienced...put my two year old through hell. I learned after that to NEVER put something into our mouths without researching it first, regardless of what a doctor tells me.

[TracieT]

I certainly appreciate a staggered vaccine schedule. That way it is easy to determine which vaccine might have caused undue swelling, or perhaps an allergy to one of the components. But to simply choose not to vaccinate without a scientific reason for doing so violates the very essence of the social contract . In fact , if I were a member of this group I would say it was downright un-Christian. While a child might come through measles, mumps, rotavirus , chicken pox, etc these diseases can be carried before symptoms are apparent and they can kill without mercy those who are immune-suppressed, especially those who are undergoing cancer treatment. It is selfishness and willful blindness to suggest that your choice not to vaccinate at all does not affect other people. It does. The whole theory behind vaccination of heard immunity depends on the social contract. How would you feel knowing that your measles-laden child caused another child to be born deaf? It happens . Measles used to be one of the main causes of women bearing hearing-disabled children . As I said, I get doing a very careful, slow, methodical vax schedule. But to pretend that it is simply a matter of private choice is a moral illusion . Those choices do affect other people and you need to account to other people because they can be affected seriously by your choices.

 

This argument is incredibly insulting because it is saying I should put MY child at risk just in case something could possibly happen to another child.

[kchara]

We kept up on our well baby visits just b/c I have a crazy family who hates me, and I want a paper trail in case they try anything stupid. That was until we moved with our youngest, and he really probably should be seen, but he hasn't been yet. I know if something's off, and we don't vax, so there's not been a huge need to. Now, part of that, too, is I haven't found a ped I like yet. There's not a huge selection where we are, and I'm not impressed with the ones I've seen, or I've been warned off of others. And I was rather spoiled by our last, he was AMAZING. I really need to make some more calls, though. I don't like not having a doc, in case something does happened.

[Clover11]

This argument is incredibly insulting because it is saying I should put MY child at risk just in case something could possibly happen to another child.

 

 

:iagree:

[Mama Geek]

I certainly appreciate a staggered vaccine schedule. That way it is easy to determine which vaccine might have caused undue swelling, or perhaps an allergy to one of the components. But to simply choose not to vaccinate without a scientific reason for doing so violates the very essence of the social contract . In fact , if I were a member of this group I would say it was downright un-Christian. While a child might come through measles, mumps, rotavirus , chicken pox, etc these diseases can be carried before symptoms are apparent and they can kill without mercy those who are immune-suppressed, especially those who are undergoing cancer treatment. It is selfishness and willful blindness to suggest that your choice not to vaccinate at all does not affect other people. It does. The whole theory behind vaccination of heard immunity depends on the social contract. How would you feel knowing that your measles-laden child caused another child to be born deaf? It happens . Measles used to be one of the main causes of women bearing hearing-disabled children . As I said, I get doing a very careful, slow, methodical vax schedule. But to pretend that it is simply a matter of private choice is a moral illusion . Those choices do affect other people and you need to account to other people because they can be affected seriously by your choices.

 

You are being extremely harsh and critical. I have known or met 3 people in the last year or 2 who can trace major changes in their kids after having been vaccinated. They have been diagnosed with Autism. I grew up in church with a family that has an autistic son. I do know how hard things are for him. I have watched him grow up. I selectively vaccinate and do so on a slow schedule. I am a very conservative Christian and I do look at the risks of the vaccines versus the disease for my child.

 

A parent in this country still has the right to make medical decisions for their children. Do you really want to take that away?

[Clover11]

As I said, I get doing a very careful, slow, methodical vax schedule.

 

There are those that would say following a delayed schedule is still putting lives at risk. By your argument, a child delaying the measles vaccine could contract it and spread it to another causing serious damage or death. If they would have gotten it "on schedule" this wouldn't have happened. Seems a bit hypocritical to me.

[Embassy]

I think the importance depends on your child's health. Occasional well-child visits rather than the standard schedule may be a good compromise. My kids have gone years without going to the doctor though. They have been very healthy and visits to the doctor for sickness have been extremely rare. Probably the most important well-child visits are the ones in the first several months of life. I wouldn't skip those.

 

As for non-vaxing - many non-vaxing parents also practice extending breastfeeding which helps protect the infant/child from diseases.

[Clover11]

You are being extremely harsh and critical. I have known or met 3 people in the last year or 2 who can trace major changes in their kids after having been vaccinated. They have been diagnosed with Autism. I grew up in church with a family that has an autistic son. I do know how hard things are for him. I have watched him grow up. I selectively vaccinate and do so on a slow schedule. I am a very conservative Christian and I do look at the risks of the vaccines versus the disease for my child.

 

A parent in this country still has the right to make medical decisions for their children. Do you really want to take that away?

 

 

We know someone who lost a child after being vaccinated. It caused seizures and brain swelling which led to complications and the baby died.

 

There are too many stories like this. Parents have the right to choose, and to not put their child at risk just because it might affect another.

[Guest momk2000]

Getting the child to a Pediatician for regular well baby visits is extremely important. I would not put it off. I understand there may be some risks involved when vaccinating our children (as there are risks in life with just about everything we do on a daily basis). Imo, when it comes to vaccinating my children, the benefits far outweigh the risks. Were you able to do any reseach on vaccines during your pregnancy? If you take the baby to see the doc., would you be able to discuss which vaccines you want your child to have and which ones you would like to delay? If your ped. will not work with you, then find one that will, just don't delay your child's well visits they are for more that just giving vaccines.

[elizabeth]

This argument is incredibly insulting because it is saying I should put MY child at risk just in case something could possibly happen to another child.

 

I am merely pointing out it is not a morally neutral choice in that it does have effects on the health of unknown persons. I guess that implying selfishness as not a desirable virtue is another taboo. Absent an allergy there is no scientifically verified risk. However, that is not the issue. The study about an alleged tie to MMR vax and autism was totally false and its author said so. To suggest that your choices are not morally neutral is not insulting in the least and I cannot see how it would be insulting. The fact that it feels like hypocrisy to claim to believe X and live or conduct oneself in accord with something in opposition to X at tthe same time, might give one pause . Maybe there is merit to my proposal that there are moral choices being made and there are consequences.

Edited June 9, 2011 by elizabeth
clarity

[Ester Maria]

If my dd seems happy and healthy, but doesn't see a doctor regularly, is she doomed?

Maybe.

Maybe not.

Your key word is "seems", which is also the reason why I would absolutely urge you not to raise a child, particularly a small one, without some form of a regular medical oversight with check-ups. Generally, with small children, better safe than sorry and better to prevent eventual problems than put up with them when they take off.

 

Regarding vaccines, I am with Elizabeth.

[Halcyon]

I'm not even sure what to say to this it's so wrong and offensive.

 

:iagree::iagree: On so many levels.