WELL-BABY CLINICS

Well-baby clinics, or well-child clinics as they are commonly known, deal with the total well-being of children and family. As public health clinics, supported by tax dollars, they provide a safety net for the economically disadvantaged by offering low-cost health care. The clinics operate on a slidingfee scale, or they may give free care to families unable to pay.

One of the important services offered by well-baby clinics is the provision of immunizations for childhood diseases such as diphtheria, pertussis, tetanus, polio, Haemophilus influenzae type b, hepatitis B, measles, mumps, rubella, and varicella. The clinics are responsible for tracking immunization rates in the community and notifying families when shots are due.

Families frequently ask why their children need routine health care when they have already received all of their required immunizations. The answer is simply that well-child clinics provide an array of diagnostic and preventative services. Infants are checked for growth and developmental delays. At each visit the staff will check the eyes for vision abnormalities and muscle imbalance, the ears for infection, the heart for murmurs, and the hips for developmental dysplasia. Infants are initially examined at two weeks of age. Subsequent visits are at 2, 4, 6, 9, and 12 months. Toddlers and preschoolers are seen at 15 months, 18 months, and then yearly at 2, 3, 4, 5, and 6 years. Testing is done for anemia and lead poisoning on this age group because early detection and intervention is needed to prevent damage to sensitive developing neurologic tissue. The staff also teaches anemia and lead prevention techniques. Interagency referrals are made to the Women, Infant, and Children WIC Food Program and to housing agencies when needed. These older children receive routine screening of vision, hearing, blood pressure, language, and development. When problems are detected, referrals for early intervention can then be made before school age.

School-age children are routinely examined every one to two years for school and camp physicals. Teenagers are screened for sports participation and work permits. They are also counseled on age-appropriate issues such as drug and alcohol abuse, prevention of sexually transmitted diseases, and the hazards of smoking.

Families are often not aware of available community programs and services. The staff of well-baby clinics provides referrals to other agencies that educate families on parenting skills and financial counseling. Referrals to other health-coverage programs are also often discussed. Most importantly, the staff provides parenting guidance for those with no support system in an effort to help reduce child abuse and neglect.

Maryann C. May

(see also: Child Health Services; Immunizations; Maternal and Child Health; Screening; Women, Infants, and Children Program [WIC] )