Iowa FFP: Why are physicals for kids so important, and what are providers looking for during the exams?
Dr. Boonstra: During a physical, a doctor makes sure the child is growing appropriately and there aren't red flags for any health conditions. In a standard physical, a pediatrician will check vital signs, such as temperature, pulse, respiratory rate and blood pressure. Height and weight will also be measured, and a doctor will listen to the heart and lungs.
A lot of what we do at a physical is examining how the child is doing developmentally and checking for stressors. This time with the child allows for an opportunity to determine if there are community or school resources that might be beneficial for the child and family. If we can identify these things early, we can help before a potential situation becomes an emergency.
Iowa FFP: When should kids be getting physicals?
Dr. Boonstra: Our protocol for physicals starts soon after birth because we're checking on growth and development and focusing on the health of newborns and infants. I spend time discussing how to raise healthy babies, safety and preventative care, and tips for preventing detrimental health concerns from happening down the line. Immunizations according to the schedule provided by the U.S. Department of Health and Human Services Center for Disease Control and Prevention (CDC) are essential. Many people don't realize that delaying immunizations opens a window of possible exposure to some of these diseases.
We want school-aged kids and teens to get a yearly physical regardless of participating in sports. We're looking at the same standard health markers regardless of whether the child will participate in sports.
Iowa FFP: Is it OK for kids to get physicals during the early summer months or should parents wait until back-to-school time?
Dr. Boonstra: It's really never too soon to get a child’s physical done for school. Schools are generally going to accept a physical if it's been done within a year of when the child is scheduled to start an activity. At the end of the summer, there is always a big rush, and it can be difficult for the child to get in for an appointment. Therefore, we recommend scheduling physicals earlier in the summer to ensure they can be completed before a school year or activities start.
Iowa FFP: What information do you share with young people during the physical?
Dr. Boonstra: In general, we want to promote healthy habits in childhood, so they grow into them as adults. That's the goal for pediatricians when we talk to kids and teens – less focus on specific numbers and more on the positive things we want children to be doing. I discuss why it’s essential to exercise and get adequate sleep every day and the benefits of a healthy diet. I also emphasize drinking water vs. sugary drinks and the overall impacts. Talking about healthy habits is provided at every visit because we want these habits to stick for the long term and children to be healthy as they grow.
Iowa FFP: Why do you feel it's essential for children to receive vaccines?
Dr. Boonstra: Immunization continues to be one of the easiest and most reliable ways to protect children from dangerous diseases. We strongly recommend following the CDC vaccine schedule.
Iowa FFP: Why are most vaccines given in a series of two or more doses?
Dr. Boonstra: Getting vaccines is a bit like studying for a test. Your immune system learns how to fight off disease better if it reviews the material several times. So, we give vaccines as a series, which gives a much better immune response than just one shot. Thanks to vaccines, many of the diseases on the list above have either been eliminated from the country or their numbers are very low. In addition, although all the diseases children are being vaccinated against can cause hospitalization and death, vaccines have helped reduce the severity of sickness if a child does get sick.
No vaccine prevents infection 100%, just like seatbelts don’t prevent automobile injuries 100% of the time. But both keep you much safer than going without the protection.
Iowa FFP: Should parents coach their children to behave a certain way during an office visit?
Dr. Boonstra: I always want families to know that it's OK for your child to be themselves at their visit. Sometimes I feel like families want their child to sit very still and not act like a kid. Certainly, if you have rules about being courteous and polite, we want kids to follow those rules. But it's also great if the child's personality comes through during the exam or physical. As doctors, we learn a lot about a child by watching their natural behavior, understanding their curiosities and learning about their interests. We need this interaction to provide the best possible care to the child.
When I'm meeting with patients, I spend the first several minutes having a conversation with the child. I ask a lot of questions, such as: What games do you like to play? What books are you reading? What shows do you watch? Just chatting about these things is one of the reasons that I'm in this job. Having the opportunity to let kids be kids in my clinic is something that brings me a lot of joy. Hopefully, it helps the kids be comfortable as well.
If you have questions or concerns regarding your child’s school physicals or vaccinations, be sure to speak to your child’s pediatrician.