Q: When my kids were little, we were all about the checkups and vaccination schedule. Now that they are older, do we need to schedule a check-up annually? At what age can we stop?
A: The American Academy of Pediatrics recommends yearly well-child checks for ALL children 3 years and older, and we at COPA agree. For older kids and teens, in addition to the physical exam, we talk to them about topics that are important in their lives. We discuss things like stress management, social pressures, body changes, preventing sports injuries, safe driving, among other age-specific topics. It's a great chance to check in with our teens and make sure they are as thriving, happy and healthy as possible. When kids start high school, many need a sports physical assessment, which is also included in the well-child exam.
Q: Recently, my child had an upper respiratory illness. She never had a fever but coughed for a long time. If there is no fever, how long should you wait before seeing a doctor? Additionally, how long should you wait before sending your child back to school?
A: The cough that comes with a viral illness can be really impressive and often lasts longer than the rest of the symptoms like runny nose. Typically, a cough with a viral illness can last about 10-14 days, sometimes longer for certain viruses like Respiratory Syncytial Virus (RSV). Generally, you should see your pediatrician if your child's cough is worsening rather than improving after the rest of the symptoms have started improving, if your child has any increased work of breathing like breathing quickly or using extra muscles to breathe, if your child has new fevers, lethargy, not drinking fluids well or other concerns. For most viruses, we say it's ok to go back to school after there has been no fever for 24 hours and your child is nearing his/her baseline for energy level and eating and drinking.
Q: My second-grader has not mentioned anything about the recent events surrounding gun violence and does not seem to know about it. We do not watch the news around him nor does he have access to social media, but he may hear about it from another child. Is it better to approach it first or wait to see if it is something he is concerned about?
A: This has become such an important topic lately. I think it's better to plan a time where you both sit down and talk about it, and you present the information in a way that allows for healthy discussion about their feelings and concerns, allowing plenty of time for them to share. No matter what age your child is, a good place to start the discussion is ask what they have already heard and what questions they might have.
It's a good idea to share the basics of the information, but avoid the news and graphic images or descriptions. It can be a straightforward statement such as " In ______ (city/state) there was a ______[disaster/tragedy/event/incident/shooting] and many people were hurt. Right now ______ [police/government/fire department] are working hard at their jobs to try to make sure it doesn't happen again."
Make sure you reassure your child that it's ok to be upset by these things, and that you are there for them. If they are showing signs of not coping well, such as sleep problems or nightmares, changes in appetite, new reports of headaches or abdominal pain, or changes in behavior like not wanting to play with friends or increased anxiety, please talk to your child's pediatrician or mental health professional.
There are a few really good resources out there for parents at the websites HealthyChildren.org and ZerotoThree.org.