Maggie McKay (Host): Welcome to the Peds Pod by Le Bonheur Children's Hospital. I'm your host, Maggie McKay. Joining us today is pediatrician, Dr. Steven Bauch, to discuss the importance of the well-child checkup. Thank you so much for being here today.

Stephen Bauch, MD: Thank you for having me. It's an honor to be here.

Host: I'm excited to learn more about this. Let's just start with why are well-child checkups so important for a child's overall health and development?

Stephen Bauch, MD: Well, the well-child exam birth through even 18 years of age, we focus on prevention, the development. Continuing to make sure growth and nutrition's fine in terms of mental health questions. Early on, it's more about feeding and nutrition. So, it kind of handles several key areas to follow along the growth of your child through birth through 18.

Host: And at what ages should children have these checkups? Why are those intervals recommended?

Stephen Bauch, MD: Well, the intervals are tighter in the early stages. Usually, after your baby comes home from the hospital, you're followed up in two or three days unless there's any problems. And then, at the two week checkup, two month, four month, six month, nine month, 12 month. And so, what we're checking for in those times, because the baby's growing so rapidly and brain development is so crucial, we're following up quickly to access that growth and development.

And then, it starts spreading out a little bit in the second year as we're going more into social, language development, motor skills. Usually at 15, 18, and two Years of age, two and a half. And then, after three years of age, it's yearly. And then, we break them up yearly until they are young adults.

Host: I remember when my son was born, I thought, "Oh my gosh, how am I going to keep track of all these different appointments?" But you know what? Luckily the doctor's office was on top of it and reminds you.

Stephen Bauch, MD: We try to give them a kind of a handout or timeline to begin with. In every visit we end with, "This will be the next time we see you."

Host: Yeah. You got to have those. Dr. Bauch, how did these visits differ from sick visits?

Stephen Bauch, MD: Well, I kind of look at it like sick visits are like putting out a fire or something emergent. Well-child exams are preventing that fire from even happening. So, we're going over several things that we look to to make sure that we avoid complications instead of trying to treat the complications. And that's probably the main difference.

And the well childs are a little bit different than they used to be. It used to be that parents would come with no information and come to the old man or woman on the hill, and they would be given knowledge and answer questions. And now, parents come with their own kind of backpack of information that they gather from sources, some good, some not so good internet, social media, AI. And it's our job now to kind of not give them a backpack, but take theirs and go through it and interpret what they have so that they have the right tools in place. So, I would say that's kind of a way of looking at it.

Host: What key developmental milestones do doctors look for during these visits?

Stephen Bauch, MD: It depends on what age they are, but early on we're looking, of course, at development of motor skills, such as starting to move and grab things with the arms and like crawling, pulling to stand, walking. And then, social cues like that, you know, social smile when they're two months old and the paparazzi starts, because they start smiling all the time.

And then, language starting early on in babbling. And then, mothers always get upset because the baby says dada first. It's phonetically easier, but depends on who's in the room with me to encourage them or say, "Oh, it's okay," going on to language skills. And then, well, for autism backing up, autism is something we start checking for at 18 months. And then, as they get older, we start looking at cognition and further development of that kind of thinking skill.

Host: How do well-child checkups help identify potential developmental delays early on?

Stephen Bauch, MD: Well, there are several streams we look at. There's motor, fine motor and gross motor. There's a social cognitive. And then, there's language whether you can speak it or understand it. So, each baby grows, just like a plant in a garden. And at the certain stages, we expect to see certain things happening.

And if they don't, that's what keys us off and there may be a problem. And again, that's why checkups are so important because we can detect any problems early and act early, which is way better than trying to treat it later, and get resources that the parents and families need to help.

Host: How do these checkups help prevent future health issues, Dr. Bauch.

Stephen Bauch, MD: Well, we know kind of what the health issues may be coming up. So, we tackle risk factors that we see. And some of these are very Mid-South specific that we, you know, deal with. For instance, obesity. We tend to follow their growth early and see how they are doing with their height and their weight, so that we can kind of anticipate problems that obesity may be related. Of course, I think one in four teenagers in the Mid-South are obese, and that's above the national average.

In terms of social determinants of health, poverty, we have a lot of poverty, of course, for our children nationwide, but also in the Mid-South. So, we address what their home life is like, what access to nutrition they have. Asthma. We have a high incidence of asthma. So, we try to assess if they're wheezing, having trouble with activities.

And then, you know, the development is a big thing about possible issues with mental health, and development that can occur later. We ask these questions early on and have screening toolsz to identify them.

Host: And what would you say are the most common questions or concerns that parents bring up during these visits?

Stephen Bauch, MD: Again, it depends on the age, but I would say the top three are vaccines; two would be mental health. We're seeing a lot more mental health issues in our young. You know, we're seeing a lot more anxiety, depression. And this has to do with a lot with also more social media, Google, internet. We're starting to deal with these kind of influences as well and pressures, So, that's another question parents have.

And then, early on for babies, it's like, how to feed or how are we feeding, how are we growing? And then, you know, those kind of issues are predominant. We see a lot as well.

Host: And I guess the big question is how can parents best prepare for a well-child appointment?

Stephen Bauch, MD: Come with questions. And it's important that they realize that they're no longer just showing up for a physical where we give them information, reams of information, and declare them healthy. It's interactive. We want and we crave their questions so that we can address what's bothering them. I think the first question, you know, I try to go in with the checkup is, what do I need to do for you today? What questions do you have? So, come with questions.

Also, if you have information or if you have questions about something you read online or heard, talk to us. We'd love to go through that with you. And it's interactive. It's more interactive than I think it's ever been. So, you know, it's okay to bring what other things you want to talk about.

Host: I always wrote them down because once I got in there, I forgot half of them.

Stephen Bauch, MD: Oh yeah. Usually, I would say at the end of the visit, now you think about half of the ones you didn't ask, message us in the portal or call back. We're happy to talk about it.

Host: Exactly. Well, thank you so much for sharing your expertise. This is such useful information. We so appreciate it.

Stephen Bauch, MD: Oh my pleasure. And thank you for having me on.

Host: Absolutely. Again, that's Dr. Steven Bauch. To learn more, please visit lebonheur.org. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library. For topics of interest to you, I'm Maggie McKay. Thanks for listening to the Peds Pod by Le Bonheur Children's Hospital.