Selected Podcast
The Importance of Child Well-Check Visits
Well-check visits are an important part of care to ensure the health and wellbeing of your child. Dr. Brad Scoggins with San Juan Health Partners Pediatrics talks about what to expect during your child's visit.
Featuring:
Brad Scoggins, DO
Dr. Scoggins received his undergraduate degree in forensic science from Baylor University in Waco, Texas, and his doctor of osteopathic medicine from Kirksville College of Osteopathic Medicine in Kirksville, Missouri. He completed a pediatric residency at the University of Texas Health Science Center in San Antonio, Texas. Dr. Scoggins’ background also includes pre-hospital emergency medicine, life support training, and field work as a paramedic, including his most recent employment with Adair County Ambulance in Kirksville. Transcription:
Joey Wahler (Host): Parents know to take their sick children to the doctor, but seeing a pediatrician is just as important for healthy kids. So we're discussing what well-check visits are and why they're beneficial to you and your child.
This is Celebrate Health, a podcast sponsored by San Juan Regional Medical Center. Thanks for listening. I'm Joey Wahler. Our guest, Dr. Brad Scoggins, a pediatrician at San Juan Health Partners Pediatrics. Dr. Scoggins, thanks for joining us.
Brad Scoggins, MD: Hey, my pleasure to be here. Thanks, Joey.
Joey Wahler (Host): Same here. So what is a well-check or, as it's sometimes referred to, a well-child visit in a nutshell?
Brad Scoggins, MD: Yes. Wonderful question. I think a lot of people have this question. A lot of parents, I think, wonder about why they need to bring their child to come in to see us every couple of months, particularly in the first few years of life. I've heard it joked about on another podcast I listen to that they have to come in and help the pediatrician make his Porche payments. I assure you, none of us drive Porsches.
Joey Wahler (Host): I heard it was a boat payment actually. Now, I'm just kidding.
Brad Scoggins, MD: Boat payment? Oh, fair enough. Yeah. Yeah. I don't know if any of us have boats either. No, but a well-check, it really is an important check to look at a few key areas. Number one, we always look at growth. So your pediatrician should sit down with a growth curve or growth chart that look at your child's advancement in both height, weight, head circumference and then later on body mass index, just kind of as indicators of adequate growth, making sure that there's nothing pathologic that we need to go looking for reasons why a child is not growing or growing excessively, which is considerably more rare.
The second reason well-child checks are really important is to look at development and we look at development across five different domains, including, you know, motor, both gross and fine; speech, personal, social. So there's a whole bevy of things that we'll look at it on these well-child visits.
And of course, I can't leave out vaccinations. Kind of one of the hallmarks of pediatric care in the last several decades has been vaccination against preventable illnesses.
Joey Wahler (Host): I'm going to ask you about vaccinations in a little more detail in a moment. First, you touched on it there, there are various things that might bring a child to you for a regular checkup. How often is that needed and what age range are we talking about?
Brad Scoggins, MD: Oh, sure. In the first couple of years of life, you see your pediatrician a lot. If we see on the nursery, there's one extra visit there, but we'll certainly see you at 48 to 72 hours of life, so from discharge from the nursery. We'll see you at two weeks of age. We'll see you at 2, 4, 6, 9, 12, 15, 18 and 24 months in most cases. After the age of two years, once we're satisfied that your growth and development have been what we expect, then we'll usually space those visits out to once a year.
You know, as kids get older and they're healthy and vaccinations are up-to-date, you know, a regular visit to the pediatrician and can be a useful resource to track growth, check things like blood pressures and see if there's any other screenings that need to take place.
Joey Wahler (Host): And you mentioned their growth and development, and that includes or can include dietary or weight issues, right?
Brad Scoggins, MD: Oh, very much so. Very much so. And, you know, I knew when you take as long to get into, you know, problems that came up during the pandemic, and certainly one of them was a significant exacerbation of childhood obesity, even above what we had seen previously. Unfortunately, kids were not getting outside to be active and play with their friends and, you know, they certainly weren't benefiting from, you know, the carefully selected diets they might receive at public schools. So we saw a tremendous jump in our childhood obesity rates. And yeah, being able to recognize that ealy before kids get too far off course is really important.
Joey Wahler (Host): Well, you mentioned that being one example of something that worsened during the pandemic. Also, you mentioned a little bit earlier vaccination. So speaking of which, we've heard so much, of course, during the pandemic about COVID vaccinations, but you alluded earlier to other vaccinations, as in let's not forget about those. So how important are those more traditional vaccines for kids?
Brad Scoggins, MD: Oh, tremendously important. In fact, you know, as time has gone on here, I know nationwide COVID has presented some significant morbidity and mortality among pediatrics. We have not had a similar experience here. We've had only a few cases of the multi-system inflammatory syndrome in children, and we've had probably less than 30, I'm going to say close to right about two dozen hospital admissions for COVID over the entire pandemic here in our community. And we had a tremendous burden among our adult population, a very full hospital census, lots of patients in the ICU and on ventilators, but we didn't see that reflected in our population for our pediatric population for whatever reason.
However, we did worry significantly about people not coming in to get their routine childhood vaccines, because we knew that as a pandemic started to wind down, those other vaccine-preventable illnesses may resurface as they did in the infamous Disneyland case from a few years before the pandemic and then in other pockets throughout the country of unvaccinated children.
Now nationwide, we know that there was a considerable drop of vaccinations, routine childhood vaccinations being given during the pandemic. We made a commitment here early on as our governor mandated only mandatory office visits, we felt so strongly that those routine childhood vaccines were mandatory healthcare, that we did continue to see particularly babies under the age of 12 months here to get those vaccines. And I'm proud of the fact that we gave so much vaccination of the routine variety during the pandemic and the shutdowns.
Joey Wahler (Host): Very nice. Now, switching gears just a little bit. How about for slightly older kids involved in sports? Do you see them for sports physicals?
Brad Scoggins, MD: Yes, we do. And we appreciate seeing those kids. You know, we do catch an occasional heart murmur that should have disappeared long ago. Most heart murmurs are physiologic and they're just a sound. But as kids get into their teenage years, if they still have murmurs or if they have new murmurs, those need to be addressed. It's also a good opportunity for us to catch up on kids with a history of asthma and make sure that gets addressed properly. So we certainly welcome and encourage people to come here to their primary pediatrician to get those sports physicals done. And to, sort of piggyback on the obesity discussion, getting those kids back out on the field is tremendously important to their overall health.
Joey Wahler (Host): Maybe talk about that a little bit more, please, doc, because especially for younger kids that are just starting to kind of grow into their bodies and be who they are physically, how important is it to get out there. I mean, you mentioned it's important. Why is it so important for kids to get out there and be active, doing something, whether it's sports or exercising or, you know, running, walking, whatever? Playing, right? Just going out to play like so many of us did as young kids.
Brad Scoggins, MD: Yes, absolutely. Well, I mean, honestly, I'll put it this way, to play is a child's job. So that's how they explore the world. That's how they learn what boundaries exist and what the consequences of certain actions will be. And I do worry as we substitute cell phones and laptops and tablets for playgrounds and trees and big grassy fields. I do worry that it's going to have significant impact in several areas. Not the least of which is getting out in the sunlight, which will help prevent things like, you know, depression and anxiety. Just being outside seems to help with that. Also reduces at least the burden of ADHD, even among those diagnosed with it.
Of course eyesight, if you're spending all day long looking at screens, that's not going to be good for your eyesight long-term. And then if to say nothing of your cardiovascular and pulmonary health you know, you need to get outside, you need to breathe hard and your heart rate needs to get elevated. Then, the list really goes on much beyond that, those are just the ones that come immediately to mind. But yeah, you're absolutely right. Tremendously important. And the kid's job is to play.
Joey Wahler (Host): Is that your own quote? That's great.
Brad Scoggins, MD: Oh, sure. I'll claim it.
Joey Wahler (Host): Why not? If nobody else will, take it as your own.
Brad Scoggins, MD: There we go. I love it.
Joey Wahler (Host): Sure. A kid's job is to play. I like it. I think I might tweet that and attribute it to you.
Brad Scoggins, MD: Oh, awesome.
Joey Wahler (Host): A couple more things. What generally is the biggest concern if there is one that parents have when they bring her younger kid to their pediatrician, such as yourself? Even if it's maybe a concern that's often unwarranted because everything's fine.
Brad Scoggins, MD: Well, that's kind of a moving target, Joey. It kind of depends. Are we talking a first-time parent? Are we talking one with five kids? Because the worries certainly do vary significantly based on your level of experience and sort of based on the, you know, just the constitution of the parents' personality, if you will. Obviously, you know, more anxious parents are going to tend to fixate on the smallest things. And on the other hand, parents like me tend to downplay things and hopefully not to the detriment of our children, but yeah, there's a pretty wide range. First time parents tend to worry about everything. More experienced parents maybe brush things off. But thankfully kids are resilient.
Joey Wahler (Host): Gotcha. And when you say you tend more to downplay things, easy for you, doc, because you went to medical school, right?
Brad Scoggins, MD: Yes. Although I'm aware of plenty of colleagues that have the opposite reaction to their training. You know, you may have heard of the stereotypical medical student syndrome. You know what it could be and so, imagine the worst possible differential diagnosis that runny nose could turn into. But I don't know that it's universal to people who've been to medical school. I think just as often it goes the other way.
Joey Wahler (Host): Understood. Finally, in closing, what general advice do you have for parents listening about keeping kids healthy, especially during spring and summer when they're typically more active?
Brad Scoggins, MD: Yeah, keeping them healthy in these months. Spring where I'm at here in Northwest New Mexico and in many other parts of the country. And there's a lot of wind this time of year. There's a lot of dust. There's a lot of pollen. Allergies are a pretty significant problem. And I want to follow that up with one other thought that maybe a little tangential to your question, but we have to really take our kids' immune systems pretty seriously. In our sort of modern culture where we can keep things really clean and sterile, that's almost the exact opposite of the things of the thing we want to do. You know, so often we clean everything with bleach. We Lysol the air. We keep all those nasty, scary germs away from our kids. When it turns out that most of the germs we encounter in our day-to-day lives are beneficial. So I would encourage people not to overly sterilize their environments.
There's a hypothesis called the hygiene hypothesis that looks at kids raised in sterile environments up to the age of about two have a significant increase in the burden of autoimmune diseases like lupus and rheumatoid arthritis. They also have a big increase in incidents of allergic rhinitis. So nasal allergies, asthma and eczema conditions. So I always like to put it this way, I like to keep the immune system busy. It turns out having a pet dog that comes in and out of the house and brings all that pollen and dirt and things from outside into the house, we see a decrease of those aforementioned conditions, we see a decrease in the disease burden of those things. And some of the things that help with that are attending daycare. That's obviously not a very sterile environment, no matter how hard they try, so those kids tend to have fewer issues later in life also. So that's a big one.
And then of course, in the summer months, the thing I always like to talk about is making sure parents are acutely aware of bodies of water. We have way too many drowning deaths every year. And you know, about the age of five, one of my questions to all of my well checks is do you know how to swim? And if not, I assign that as homework for the summer.
Joey Wahler (Host): That's certainly something to think about at the end. In fact, that entire last answer, certainly good things for parents to kind of go over in their minds as kind of a mental checklist of safety going forward, I would say. Well, folks, we trust you're now more familiar with child well-check visits and keeping your kids healthy, whether there's an issue or not. Dr. Brad Scoggins, thanks again so much.
Brad Scoggins, MD: Hey, absolutely. Thank you, Joey.
Joey Wahler (Host): And to schedule an appointment for your child, please call San Juan Health Partners Pediatrics, 505-609-6700. If you found this podcast helpful, please share it on your social media. And thanks again for listening to Celebrate Health, the podcast sponsored by San Juan Regional Medical Center.
Hoping your health is good health, I am Joey Waller.
Joey Wahler (Host): Parents know to take their sick children to the doctor, but seeing a pediatrician is just as important for healthy kids. So we're discussing what well-check visits are and why they're beneficial to you and your child.
This is Celebrate Health, a podcast sponsored by San Juan Regional Medical Center. Thanks for listening. I'm Joey Wahler. Our guest, Dr. Brad Scoggins, a pediatrician at San Juan Health Partners Pediatrics. Dr. Scoggins, thanks for joining us.
Brad Scoggins, MD: Hey, my pleasure to be here. Thanks, Joey.
Joey Wahler (Host): Same here. So what is a well-check or, as it's sometimes referred to, a well-child visit in a nutshell?
Brad Scoggins, MD: Yes. Wonderful question. I think a lot of people have this question. A lot of parents, I think, wonder about why they need to bring their child to come in to see us every couple of months, particularly in the first few years of life. I've heard it joked about on another podcast I listen to that they have to come in and help the pediatrician make his Porche payments. I assure you, none of us drive Porsches.
Joey Wahler (Host): I heard it was a boat payment actually. Now, I'm just kidding.
Brad Scoggins, MD: Boat payment? Oh, fair enough. Yeah. Yeah. I don't know if any of us have boats either. No, but a well-check, it really is an important check to look at a few key areas. Number one, we always look at growth. So your pediatrician should sit down with a growth curve or growth chart that look at your child's advancement in both height, weight, head circumference and then later on body mass index, just kind of as indicators of adequate growth, making sure that there's nothing pathologic that we need to go looking for reasons why a child is not growing or growing excessively, which is considerably more rare.
The second reason well-child checks are really important is to look at development and we look at development across five different domains, including, you know, motor, both gross and fine; speech, personal, social. So there's a whole bevy of things that we'll look at it on these well-child visits.
And of course, I can't leave out vaccinations. Kind of one of the hallmarks of pediatric care in the last several decades has been vaccination against preventable illnesses.
Joey Wahler (Host): I'm going to ask you about vaccinations in a little more detail in a moment. First, you touched on it there, there are various things that might bring a child to you for a regular checkup. How often is that needed and what age range are we talking about?
Brad Scoggins, MD: Oh, sure. In the first couple of years of life, you see your pediatrician a lot. If we see on the nursery, there's one extra visit there, but we'll certainly see you at 48 to 72 hours of life, so from discharge from the nursery. We'll see you at two weeks of age. We'll see you at 2, 4, 6, 9, 12, 15, 18 and 24 months in most cases. After the age of two years, once we're satisfied that your growth and development have been what we expect, then we'll usually space those visits out to once a year.
You know, as kids get older and they're healthy and vaccinations are up-to-date, you know, a regular visit to the pediatrician and can be a useful resource to track growth, check things like blood pressures and see if there's any other screenings that need to take place.
Joey Wahler (Host): And you mentioned their growth and development, and that includes or can include dietary or weight issues, right?
Brad Scoggins, MD: Oh, very much so. Very much so. And, you know, I knew when you take as long to get into, you know, problems that came up during the pandemic, and certainly one of them was a significant exacerbation of childhood obesity, even above what we had seen previously. Unfortunately, kids were not getting outside to be active and play with their friends and, you know, they certainly weren't benefiting from, you know, the carefully selected diets they might receive at public schools. So we saw a tremendous jump in our childhood obesity rates. And yeah, being able to recognize that ealy before kids get too far off course is really important.
Joey Wahler (Host): Well, you mentioned that being one example of something that worsened during the pandemic. Also, you mentioned a little bit earlier vaccination. So speaking of which, we've heard so much, of course, during the pandemic about COVID vaccinations, but you alluded earlier to other vaccinations, as in let's not forget about those. So how important are those more traditional vaccines for kids?
Brad Scoggins, MD: Oh, tremendously important. In fact, you know, as time has gone on here, I know nationwide COVID has presented some significant morbidity and mortality among pediatrics. We have not had a similar experience here. We've had only a few cases of the multi-system inflammatory syndrome in children, and we've had probably less than 30, I'm going to say close to right about two dozen hospital admissions for COVID over the entire pandemic here in our community. And we had a tremendous burden among our adult population, a very full hospital census, lots of patients in the ICU and on ventilators, but we didn't see that reflected in our population for our pediatric population for whatever reason.
However, we did worry significantly about people not coming in to get their routine childhood vaccines, because we knew that as a pandemic started to wind down, those other vaccine-preventable illnesses may resurface as they did in the infamous Disneyland case from a few years before the pandemic and then in other pockets throughout the country of unvaccinated children.
Now nationwide, we know that there was a considerable drop of vaccinations, routine childhood vaccinations being given during the pandemic. We made a commitment here early on as our governor mandated only mandatory office visits, we felt so strongly that those routine childhood vaccines were mandatory healthcare, that we did continue to see particularly babies under the age of 12 months here to get those vaccines. And I'm proud of the fact that we gave so much vaccination of the routine variety during the pandemic and the shutdowns.
Joey Wahler (Host): Very nice. Now, switching gears just a little bit. How about for slightly older kids involved in sports? Do you see them for sports physicals?
Brad Scoggins, MD: Yes, we do. And we appreciate seeing those kids. You know, we do catch an occasional heart murmur that should have disappeared long ago. Most heart murmurs are physiologic and they're just a sound. But as kids get into their teenage years, if they still have murmurs or if they have new murmurs, those need to be addressed. It's also a good opportunity for us to catch up on kids with a history of asthma and make sure that gets addressed properly. So we certainly welcome and encourage people to come here to their primary pediatrician to get those sports physicals done. And to, sort of piggyback on the obesity discussion, getting those kids back out on the field is tremendously important to their overall health.
Joey Wahler (Host): Maybe talk about that a little bit more, please, doc, because especially for younger kids that are just starting to kind of grow into their bodies and be who they are physically, how important is it to get out there. I mean, you mentioned it's important. Why is it so important for kids to get out there and be active, doing something, whether it's sports or exercising or, you know, running, walking, whatever? Playing, right? Just going out to play like so many of us did as young kids.
Brad Scoggins, MD: Yes, absolutely. Well, I mean, honestly, I'll put it this way, to play is a child's job. So that's how they explore the world. That's how they learn what boundaries exist and what the consequences of certain actions will be. And I do worry as we substitute cell phones and laptops and tablets for playgrounds and trees and big grassy fields. I do worry that it's going to have significant impact in several areas. Not the least of which is getting out in the sunlight, which will help prevent things like, you know, depression and anxiety. Just being outside seems to help with that. Also reduces at least the burden of ADHD, even among those diagnosed with it.
Of course eyesight, if you're spending all day long looking at screens, that's not going to be good for your eyesight long-term. And then if to say nothing of your cardiovascular and pulmonary health you know, you need to get outside, you need to breathe hard and your heart rate needs to get elevated. Then, the list really goes on much beyond that, those are just the ones that come immediately to mind. But yeah, you're absolutely right. Tremendously important. And the kid's job is to play.
Joey Wahler (Host): Is that your own quote? That's great.
Brad Scoggins, MD: Oh, sure. I'll claim it.
Joey Wahler (Host): Why not? If nobody else will, take it as your own.
Brad Scoggins, MD: There we go. I love it.
Joey Wahler (Host): Sure. A kid's job is to play. I like it. I think I might tweet that and attribute it to you.
Brad Scoggins, MD: Oh, awesome.
Joey Wahler (Host): A couple more things. What generally is the biggest concern if there is one that parents have when they bring her younger kid to their pediatrician, such as yourself? Even if it's maybe a concern that's often unwarranted because everything's fine.
Brad Scoggins, MD: Well, that's kind of a moving target, Joey. It kind of depends. Are we talking a first-time parent? Are we talking one with five kids? Because the worries certainly do vary significantly based on your level of experience and sort of based on the, you know, just the constitution of the parents' personality, if you will. Obviously, you know, more anxious parents are going to tend to fixate on the smallest things. And on the other hand, parents like me tend to downplay things and hopefully not to the detriment of our children, but yeah, there's a pretty wide range. First time parents tend to worry about everything. More experienced parents maybe brush things off. But thankfully kids are resilient.
Joey Wahler (Host): Gotcha. And when you say you tend more to downplay things, easy for you, doc, because you went to medical school, right?
Brad Scoggins, MD: Yes. Although I'm aware of plenty of colleagues that have the opposite reaction to their training. You know, you may have heard of the stereotypical medical student syndrome. You know what it could be and so, imagine the worst possible differential diagnosis that runny nose could turn into. But I don't know that it's universal to people who've been to medical school. I think just as often it goes the other way.
Joey Wahler (Host): Understood. Finally, in closing, what general advice do you have for parents listening about keeping kids healthy, especially during spring and summer when they're typically more active?
Brad Scoggins, MD: Yeah, keeping them healthy in these months. Spring where I'm at here in Northwest New Mexico and in many other parts of the country. And there's a lot of wind this time of year. There's a lot of dust. There's a lot of pollen. Allergies are a pretty significant problem. And I want to follow that up with one other thought that maybe a little tangential to your question, but we have to really take our kids' immune systems pretty seriously. In our sort of modern culture where we can keep things really clean and sterile, that's almost the exact opposite of the things of the thing we want to do. You know, so often we clean everything with bleach. We Lysol the air. We keep all those nasty, scary germs away from our kids. When it turns out that most of the germs we encounter in our day-to-day lives are beneficial. So I would encourage people not to overly sterilize their environments.
There's a hypothesis called the hygiene hypothesis that looks at kids raised in sterile environments up to the age of about two have a significant increase in the burden of autoimmune diseases like lupus and rheumatoid arthritis. They also have a big increase in incidents of allergic rhinitis. So nasal allergies, asthma and eczema conditions. So I always like to put it this way, I like to keep the immune system busy. It turns out having a pet dog that comes in and out of the house and brings all that pollen and dirt and things from outside into the house, we see a decrease of those aforementioned conditions, we see a decrease in the disease burden of those things. And some of the things that help with that are attending daycare. That's obviously not a very sterile environment, no matter how hard they try, so those kids tend to have fewer issues later in life also. So that's a big one.
And then of course, in the summer months, the thing I always like to talk about is making sure parents are acutely aware of bodies of water. We have way too many drowning deaths every year. And you know, about the age of five, one of my questions to all of my well checks is do you know how to swim? And if not, I assign that as homework for the summer.
Joey Wahler (Host): That's certainly something to think about at the end. In fact, that entire last answer, certainly good things for parents to kind of go over in their minds as kind of a mental checklist of safety going forward, I would say. Well, folks, we trust you're now more familiar with child well-check visits and keeping your kids healthy, whether there's an issue or not. Dr. Brad Scoggins, thanks again so much.
Brad Scoggins, MD: Hey, absolutely. Thank you, Joey.
Joey Wahler (Host): And to schedule an appointment for your child, please call San Juan Health Partners Pediatrics, 505-609-6700. If you found this podcast helpful, please share it on your social media. And thanks again for listening to Celebrate Health, the podcast sponsored by San Juan Regional Medical Center.
Hoping your health is good health, I am Joey Waller.