What are the recommendations for a 12-month well-child check?

From the Guidelines

A 12-month well child check is a crucial healthcare visit that assesses a child's growth, development, and overall health, and it is recommended to include a developmental screening using a standardized tool, as well as vaccinations such as MMR, varicella, and hepatitis A, as per the guidelines from the American Academy of Pediatrics 1. During this visit, the pediatrician will measure the child's height, weight, and head circumference to ensure they're growing appropriately. They'll perform a complete physical examination and assess developmental milestones such as:

• Walking or attempting to walk
• Saying a few words
• Following simple commands
• Using gestures like waving The doctor will also discuss nutrition, including:
• Transition to whole milk from formula or continued breastfeeding
• Introduction of a variety of solid foods
• Possibly weaning from bottles to cups Safety topics like:
• Car seats
• Childproofing your home
• Water safety
• Preventing falls will be addressed. This visit also provides an opportunity to discuss sleep patterns, behavior, and any concerns you may have about your child's development. Some of the key recommendations for this visit include:
• Using a standardized developmental screening tool to assess developmental delay, as recommended by the American Academy of Pediatrics 1
• Administering vaccinations such as MMR, varicella, and hepatitis A, as per the recommended schedule 1
• Discussing nutrition and safety topics to promote healthy growth and development Regular well-child visits are essential for preventive care and early identification of potential health or developmental issues, and it is recommended to follow the guidelines from the American Academy of Pediatrics for these visits 1.

From the Research

12-Month Well-Child Check

• The 12-month well-child check is a crucial visit that allows for comprehensive assessment of a child's growth and development, as well as the opportunity for further evaluation if abnormalities are detected 2.
• During this visit, a complete history should be taken, including information about birth history, prior screenings, diet, sleep, dental care, and medical, surgical, family, and social histories.
• A head-to-toe examination should be performed, including a review of growth, and immunizations should be reviewed and updated as appropriate 2.
• The American Academy of Pediatrics recommends developmental surveillance at each visit, with formal developmental screening at nine, 18, and 30 months, and autism-specific screening at 18 and 24 months 2.
• Additionally, the visit provides an opportunity to answer parents' or caregivers' questions and to provide age-appropriate guidance on topics such as car seat safety, dental health, and screen time 2.

Immunizations and Screenings

• The measles, mumps, rubella, and varicella vaccines are recommended for children, with two doses of the MMR vaccine and one dose of the varicella vaccine typically given before the age of two 3.
• The effectiveness of the MMR vaccine in preventing measles is 95% after one dose and 96% after two doses, while the effectiveness of the varicella vaccine in preventing varicella is 95% after two doses 3.
• The 12-month well-child check is also an opportunity to review and update immunizations, as well as to perform screenings for postpartum depression in mothers and to assess the child's vision and hearing 2, 4.

Guidance and Education

• The 12-month well-child check provides an opportunity for healthcare professionals to provide guidance and education to parents or caregivers on topics such as:

• Car seat safety: rear-facing car seats should be used until the child is two years old or reaches the height or weight limit for the seat 2.
• Dental health: fluoride use, limiting or avoiding juice, and weaning to a cup by 12 months of age may improve dental health 2.
• Screen time: screen time should be avoided in children younger than 18 months, with the exception of video chatting, and limited to one hour per day for children two to five years old 2.
• Nutrition and feeding: cessation of breastfeeding before six months and transition to solid foods before six months are associated with childhood obesity, and juice and sugar-sweetened beverages should be avoided before one year of age 2.