Maggie McKay (Host): Welcome to the Parent-ish Podcast, where experts at Children's Mercy, Kansas City talk about the little everyday things parents experience with their babies, teens, and in-betweens. Joining us today is Dr. Chelsea Wolfe, general pediatrician, to discuss building your child's care circle beyond the pediatrician. Thank you so much for being here.

Dr. Chelsea Wolfe: Thank you so much for having me.

Host: Well, let's dive right in. Why is it important for parents to think beyond just the pediatrician when it comes to their child's healthcare?

Dr. Chelsea Wolfe: Sure. So, a child's pediatrician is their primary care provider, so they're in charge of monitoring the child's growth, development, behavior and providing vaccinations, screenings, guidance on nutrition, sleep, safety. But with all that being said, pediatricians are generalists. So, we are not specialists. So, we care for the general health, but I think two big examples of more specialty areas would be like your child's vision or your child's dental care, teeth care. We really rely on our colleagues who are more specialized in those areas to help us treat the whole child.

Host: And what are the most common signs that a child might need to see a specialist like an ENT or a dermatologist earlier than expected?

Dr. Chelsea Wolfe: So specifically, with regards to ENT, they are treating kind of chronic or recurrent ear infections; chronic ear effusions that are affecting hearing; ear wax that's getting stuck in the ear and affecting hearing; tonsils, frequent strep infections, or snoring and breathing issues. So specifically, for a child who's having four or more ear infections within six months, or one ear infection that is requiring multiple rounds of antibiotics to clear it, then an ENT may be required for evaluation of whether ear tubes would be indicated.

Another example would be a child who's snoring loudly, maybe not getting the most restful sleep or waking in their sleep, or pausing in their breathing in their sleep, then an ENT physician can help diagnose that and help treat the tonsils to improve that.

Another example would be dermatologist. They specialize in treatment of the skin. They're very helpful for kids who are going through puberty and having acne. Educating them on their skincare routines, sun protection, but also monitoring birthmarks or moles for concerning or abnormal changes. Early visits in adolescents can help prevent scarring, also boost self-esteem in those kids. In terms of earlier for kids, younger kids, they mostly are seen for weird chronic rash, moderate to severe eczema or other skin conditions that the pediatrician has had trouble treating with our first and second line in the office.

Host: Dr. Wolfe, can you walk us through the ideal timeline for routine visits, like when to see a dentist or an eye doctor, or an orthodontist?

Dr. Chelsea Wolfe: Sure. So, first stop would be the pediatrician. We typically see babies for a newborn visit, and then well visits at two, four, six, nine and 12 months. After about a year, we start seeing toddlers every three to six months, and then yearly after kids turn about three. And these serve as a way for us to evaluate if a specialist visit is needed and also to refer to appropriate specialists.

In terms of dental care, parents should plan to schedule the first visit for their kids about a year of age, or within six months of their first tooth appearing, which can be anywhere from four to eight months up to a year of age when that first tooth comes in. Early dental visits help prevent cavities, monitor tooth development, and establish good oral hygiene habits. Pediatric dentists also educate parents and children on brushing, flossing, nutrition. And after that first visit, they should expect to see their dentist about every six months.

In regards to seeing an eye doctor, children usually have their first formal screening around age five with an eye doctor. Pediatricians do ask about vision concerns at well visits and do yearly vision screenings and may refer earlier if needed. Children who fail their vision screen at their pediatrician will usually be evaluated by an optometrist. For children with more specific concerns such as an eye that's crossing or maybe turning out abnormally, then we recommend seeing an ophthalmologist.

Host: You touched on this a little bit, but how can parents know whether a concern is something to bring up with their pediatrician or if it warrants a direct visit to a specialist?

Dr. Chelsea Wolfe: So as your child's pediatrician, I am your partner in getting your child to be their best self and have their best health. So, I think your child's pediatrician is always a great place to start. Keeping a list of concerns that you want to ask your child's doctor at their well visit is really helpful.

Getting signed up for your child's patient portal and being able to send a message to your pediatrician to ask, if you have questions, is also a great place. We love pictures and videos that can also help us tell you if something is normal or if it warrants further evaluation. I think if you have specific concerns about your child's vision or their eyes or specific concerns about a tooth or how that tooth is going in, then we generally recommend going ahead and seeing the eye doctor or the dentist for those concerns first before seeing your pediatrician. But we're always willing and hopeful in directing those.

Host: And what role do early screenings and evaluations play in preventing long-term health issues?

Dr. Chelsea Wolfe: Early screenings and evaluations play a really critical role in preventing long-term health issues. They're important for identifying potential problems during the most important stages of a child's physical, cognitive, emotional, and social development. Delays or learning difficulties that are caught earlier are much easier to treat, especially when we can get them connected to the right services and therapies. And catching them early helps children succeed best in the classroom, and also prevents them from falling behind their peers. For more specific health conditions, catching them early on and treating them prevents more serious complications or need for emergency care.

Host: Are there any specialists that parents often overlook, but could be really helpful in supporting their child's development?

Dr. Chelsea Wolfe: I think audiologists, who are specialists in hearing can be really helpful. If your child is a little bit delayed in their speech or using jargon for a little bit longer than we expect, then checking their hearing with an audiologist in a more formal hearing test is really helpful for identifying if a hearing issue or difficulty may be causing that delay.

In regards to the kind of same vein, therapist, occupational, speech, physical therapist are very helpful in identifying and treating developmental delays early on so that we can get those kids back on track and help them catch up to their peers. Speech therapists are also really important for testing or diagnosing certain learning disorders like dyslexia in school-aged children.

Host: What advice do you have for parents who feel overwhelmed by the number of appointments or unsure where to start? Because, you know, as a first time parent, you want to do everything right, but it is overwhelming.

Dr. Chelsea Wolfe: Yeah. So, I think starting with your pediatrician is the best place. Again, we're kind of that primary care physician for your child. So, we are there to direct all questions, really help you figure out if you need help with a specialist's care. Our well child visits are great place for parents to discuss concerns that they've been having. So, keeping track of questions that you have for your pediatrician, tracking symptoms like frequent infections, concerns for developmental delays or behavioral changes that your child is having. Using those well visits is a great place to start.

And then, I always recommend for parents as soon as you schedule a visit, put that in your calendar or phones so that you don't miss that visit. And if you need to reschedule, calling as soon as you're able helps with getting your child's care as quickly as possible, but also not getting any kind of fees for any missed appointments.

Host: Absolutely. I've been there. In closing, is there anything else you'd like to add or you want parents to know?

Dr. Chelsea Wolfe: I think just knowing that pediatricians are there to support you and your child's development, and there is no dumb question or thing that we're going to judge you for asking. We're there to really support you and help you, so don't be afraid to ask your pediatrician anytime you have any questions regarding your child or their development.

Host: Thank you so much for sharing your expertise. This has been so informative and helpful. We really appreciate it.

Dr. Chelsea Wolfe: No, thank you so much for having me.

Host: Of course. Again, that's Dr. Chelsea Wolfe. To learn more, please visit childrensmercy.org/parent-ish. That concludes this episode of the Parent-ish Podcast. I'm Maggie McKay. For more parenting tips and tricks, visit us at parentish.org where we help you celebrate the craziness and challenges of parenthood.