Good Pediatrics

APPOINTMENTS: 941-955-7337
1961 Floyd Street, Suite A
Sarasota, FL 34239
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24 Month

HAPPY BIRTHDAY

At this visit your 2 year old will be weighed and their height will be measured. We will also measure head circumference. In addition to all the measurements we have taken, plotted on the growth curve, and discussed with you since they were born, at this visit a new number comes into the picture. The BMI (Body Mass Index). This is a number we get when a child's weight and height are plugged into a mathematical formula. The number itself in children (unlike adults) does not tell us much. This is because the same BMI (number) may indicate a healthy weight in one age group and obesity in another age group. Also, the same BMI (number) may indicate different things depending whether the child is male or female. This is why the BMI (number) that we calculate is then plotted on a boy's chart or a girl's chart at the age of the child on the day the measurements were taken. This gives us a percentile for the child. We then use the percentile to determine if they are underweight, at a healthy weight, overweight, or obese. It is important to know and to communicate to your children from an early age that BMI is about health not beauty. If you asked 3 people from 3 different countries to tell you if the child standing before them was overweight, a healthy weight, or underweight, you might very well get 3 different answers. This also may be a generational issue. If you took the exact same child and put him in a room with 3 generations of his/her own family, parents, grandparents, and great grandparents you may get 3 completely different answers. What we do know without a doubt is beauty truly is in the eye of the beholder. However, your child's risk for Heart disease, Stroke, High Blood Pressure, Diabetes, High Cholesterol, Poor Self-Esteem, Depression, Obstructive Sleep Apnea, Fatty Liver, and Early Puberty goes up dramatically as your child moves from the healthy weight to overweight or obese. This has been proven repeatedly in thousands of studies all over the world. This is supported by the CDC, NIH, AAP, AHA and the ADA to name a few. So it is important to implement good habits early. It is much easier for the parent when the child is young because the older they become the more difficult it is to change bad habits. Your 2 year old doesn't have their own money or car, they don't shop at the grocery store or drive themselves to a fast food restaurant. You, the parent are in almost complete control at this point in time, but this is NOT forever. Be a good example for your children. Do not have junk food, soda etc. in the house. I have had many parents tell me “we try but they stay with grandma/grandpa/aunt etc. during the day and she/he gives them anything they want all day long.” Please, I encourage you to bring the caregiver to the next appointment. I know how difficult it can be to tell a caregiver, especially a relative who loves your child and is doing you a favor by taking care of them, that what they are doing is not in the best interest of the child. When it comes to family, pick your battles carefully, but in some cases you just have to put your foot down. I do not mind being the bad guy if it is in your child's best interest. Also, I have had this conversation many times and it usually goes much smoother than you think it will. If it is not possible for the caregiver to join you, I have written many letters to caregivers in English and Spanish and I am happy to write many more. Once again, you will have completed an online Ages and Stages, Health Risk questionnaire and the M-CHAT prior to your visit . These questionnaires are recommended by the American Academy of Pediatrics. These forms may be completed on a computer, IPAD/tablet or a smart phone by accessing our website goodpediatrics.com and clicking on the link to CHADIS. The forms are accessed electronically by Dr. Good. They are scored and a report is generated for her review prior to your arrival. If you do not have access to this technology or have trouble, we will have computers in the waiting room that you may use for this purpose as well as staff to help you. Please come 30 minutes early in this case to be assured you have time to complete the forms accurately and the doctor has the information for review before she sees your child. If your child is overdue for any of the routine childhood vaccines, those vaccines will be administered at this visit. In addition, if your child's well visit falls between September and March and they are due for the flu vaccine, it will also be recommended at that time as per the CDC and the AAP guidelines. Please see our vaccine section of the website for more details.

An Oral Health Risk Assessment will be performed at this visit. If your child meets the criteria, fluoride varnish will be offered as recommended by the American Academy of Pediatric Dentists to help prevent cavities.

 

 




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