Visits benefit parents, children

Jak Mortensen's favorable cancer prognosis reinforces an argument pediatrician Dr. Lynn Dykstra makes for parents to keep up a child's wellness visits.

"A lot of problems, if caught early, are more easily corrected," she said.

Dykstra, who practices in Kalispell with Dr. Wallace Wilder, said the visits allow physicians to provide safety and educational information to parents as well as thoroughly examine the child.

She points out that physicians do more than check a baby or child for signs of disease.

"At every well-child visit, we check for normal development," she said. "This is especially important in babies up to 2 years old."

Dykstra, a mother of two young boys, said she relies on parents to fill out questionnaires that form parts of the development assessments.

"They spend so much time with the child," she said. "They are the best gauge of development."

As with patients of all ages, children don't always behave typically or on cue under the scrutiny of a medical professional. Dykstra considers communication with parents crucial.

"The majority of the time, I think parents' instincts are excellent," she said.

Well-child visits are recommended every few months during the first two years of life, then annually into adulthood. Along with growth and development measures, Dykstra said, each visit includes a physical exam, discussion of nutrition and routine immunizations.

She said the physical includes literally a head-to-toe examination. Dykstra records head circumference along with height and weight.

An abnormally large head might signal an endocrine problem that needs more investigation.

"Every so often we see a child rapidly change head size," she said. "But most often, the family just has big heads."

Pediatricians check babies' heads for closure of the fontanels: soft, open areas of the skull that allow the brain to grow in the first year or more of life. Premature closure could present a problem, as could failure to close.

Brain-development discussions with parents allow Dykstra to learn about the child's activities at home. She recalled one parent telling her that the baby loved television so the family just left the child in front of it most of the day.

"I tell people to minimize TV," she said.

Dykstra also checks head shape, using that opportunity to educate the parents about avoiding flat heads, a problem with babies placed on their backs to avoid sudden infant death syndrome.

"We talk a lot about head positions," she said.

The pediatrician said well-child exams include checks for hearing and vision problems - such as strabismus, or lazy eye - that require referrals to specialists. These corrections have an impact on a child's quality of life as well as health.

Dykstra continues the physical through a complex list of checks including listening to the lungs and heart, palpating the abdomen to check for abnormal masses, lifting the arms and legs to look for equal range of movement.

By moving the arms, Dykstra has discovered broken clavicles, which occasionally occur in childbirth.

Well-child visits continue through high school. Dykstra said pediatricians identify conditions including attention-deficit disorder to types I and II diabetes. When it comes to sports physicals, simple questions might make a life-saving discovery.

"We screen for sudden death in the family," she said.

Dykstra encourages parents to use the visits to get their questions answered. Parents should schedule these visits from two to three weeks in advance.

Reporter Candace Chase may be reached at 758-4436 or by e-mail at cchase@dailyinterlake.com.