WHAT YOU NEED TO KNOW:

What is a well child visit? A well child visit is when your child sees a healthcare provider to prevent health problems. It is a different type of visit than when your child sees a healthcare provider because he is sick. Well child visits are used to track your child's growth and development. It is also a time for you to ask questions and to get information on how to keep your child safe. Write down your questions so you remember to ask them. Your child should have regular well child visits from birth to 17 years.

What development milestones may my child reach at 11 to 14 years? Each child develops at his own pace. Your child might have already reached the following milestones, or he may reach them later:

• Breast development (girls), testicle and penis enlargement (boys), and armpit or pubic hair
  
  
• Menstruation (monthly periods) in girls
  
  
• Skin changes, such as oily skin and acne
  
  
• Not understanding that actions may have negative effects
  
  
• Focus on appearance and need to be accepted by others his own age

What can I do to help my child get the right nutrition?

• Teach your child about a healthy meal plan by setting a good example. Your child still learns from your eating habits. Buy healthy foods for your family. Eat healthy meals together as a family as often as possible. Talk with your child about why it is important to choose healthy foods.
  
  
• Encourage your child to eat regular meals and snacks, even if he is busy. He should eat 3 meals and 2 snacks each day to help meet his calorie needs. He should also eat a variety of healthy foods to get the nutrients he needs, and to maintain a healthy weight. You may need to help your child plan his meals and snacks. Suggest healthy food choices that your child can make when he eats out. He could order a chicken sandwich instead of a large burger or choose a side salad instead of French fries. Praise your child's good food choices whenever you can.
  
  
• Provide a variety of fruits and vegetables. Half of your child's plate should contain fruits and vegetables. He should eat about 5 servings of fruits and vegetables each day. Buy fresh, canned, or dried fruit instead of fruit juice as often as possible. Offer more dark green, red, and orange vegetables. Dark green vegetables include broccoli, spinach, romaine lettuce, and collard greens. Examples of orange and red vegetables are carrots, sweet potatoes, winter squash, and red peppers.
  
  
• Provide whole grain foods. Half of the grains your child eats each day should be whole grains. Whole grains include brown rice, whole wheat pasta, and whole grain cereals and breads.
  
  
• Provide low-fat dairy foods. Dairy foods are a good source of calcium. Your child needs 1300 milligrams (mg) of calcium each day. Dairy foods include milk, cheese, cottage cheese, and yogurt.
  
  
• Provide lean meats, poultry, fish, and other healthy protein foods. Other healthy protein foods include legumes (such as beans), soy foods (such as tofu), and peanut butter. Bake, broil, and grill meat instead of frying it to reduce the amount of fat.
  
  
• Use healthy fats to prepare your child's food. Unsaturated fat is a healthy fat. It is found in foods such as soybean, canola, olive, and sunflower oils. It is also found in soft tub margarine that is made with liquid vegetable oil. Limit unhealthy fats such as saturated fat, trans fat, and cholesterol. These are found in shortening, butter, margarine, and animal fat.
  
  
• Help your child limit his intake of fat, sugar, and caffeine. Foods high in fat and sugar include snack foods (potato chips, candy, and other sweets), juice, fruit drinks, and soda. If your child eats these foods too often, he may eat fewer healthy foods during mealtimes. He may also gain too much weight. Caffeine is found in soft drinks, energy drinks, tea, coffee, and some over-the-counter medicines. Your child should limit his intake of caffeine to 100 mg or less each day. Caffeine can cause your child to feel jittery, anxious, or dizzy. It can also cause headaches and trouble sleeping.
  
  
• Encourage your child to talk to you or a healthcare provider about safe weight loss, if needed. Adolescents may want to follow a fad diet if they see their friends or famous people following such a diet. Fad diets usually do not have all the nutrients your child needs to grow and stay healthy. Diets may also lead to eating disorders such as anorexia and bulimia. Anorexia is refusal to eat. Bulimia is binge eating followed by vomiting, using laxative medicine, not eating at all, or heavy exercise.

How can I help my child care for his teeth?

• Remind your child to brush his teeth 2 times each day. Mouth care prevents infection, plaque, bleeding gums, mouth sores, and cavities. It also freshens breath and improves appetite. Brush, floss, and use mouthwash. Ask your child's dentist which mouthwash is best for you to use.
  
  
• Take your child to the dentist at least 2 times each year. A dentist can check for problems with his teeth or gums, and provide treatments to protect his teeth.
  
  
• Encourage your child to wear a mouth guard during sports. This will protect his teeth from injury. Make sure the mouth guard fits correctly. Ask your child's healthcare provider for more information on mouth guards.

What can I do to keep my child safe?

• Remind your child to always wear his seatbelt. Make sure everyone in your car wears a seatbelt.
  
  
• Encourage your child to do safe and healthy activities. Encourage your child to play sports or join an after school program.
  
  
• Store and lock all weapons. Lock ammunition in a separate place. Do not show or tell your child where you keep the key. Make sure all guns are unloaded before you store them.
  
  
• Encourage your child to use safety equipment. Encourage him to wear helmets, protective sports gear, and life jackets.

What can I do to support my child?

• Talk to your child about puberty. Puberty usually starts between ages 8 to 13 in girls, but it may start earlier or later. Puberty usually ends by about age 14 in girls. Puberty usually starts between ages 10 to 14 in boys, but it may start earlier or later. Puberty usually ends by about age 15 or 16 in boys. Ask your child's healthcare provider for information about how to talk to your child about puberty, if needed.
  
  
• Encourage your child to get 1 hour of physical activity each day. Examples of physical activities include sports, running, walking, swimming, and riding bikes. The hour of physical activity does not need to be done all at once. It can be done in shorter blocks of time. Your child can fit in more physical activity by limiting screen time. Screen time is the amount of time he spends watching television or on the computer playing games. Limit your child's screen time to 2 hours a day.
  
  
• Praise your child for good behavior. Do this any time he does well in school or makes safe and healthy choices.
  
  
• Monitor your child's progress at school. Go to parent-teacher conferences. Ask your child to let you see his report card.
  
  
• Help your child solve problems and make decisions. Ask your child about any problems or concerns that he has. Make time to listen to your child's hopes and concerns. Find ways to help him work through problems and make healthy decisions.
  
  
• Help your child find healthy ways to deal with stress. Be a good example of how to handle stress. Help your child find activities that help him manage stress. Examples include exercising, reading, or listening to music. Encourage your child to talk to you when he is feeling stressed, sad, angry, hopeless, or depressed.
  
  
• Encourage your child to create healthy relationships. Know your child's friends and their parents. Know where your child is and what he is doing at all times. Encourage your child to tell you if he thinks he is being bullied. Talk with your child about healthy dating relationships. Tell them it is okay to say "no" and to respect when someone else tells him "no."
  
  
• Encourage your child not to use drugs or tobacco, or drink alcohol. Explain that these substances are dangerous and that you care about their health. Also explain that drugs and alcohol are illegal.
  
  
• Be prepared to talk your child about sex. Read about these subjects so you can answer your child's questions. Ask your child's healthcare provider where you can get more information.

What do I need to know about my child's next well child visit? Your child's healthcare provider will tell you when to bring your child in again. The next well child visit is usually at 15 to 17 years. Your child may need catch-up doses of the hepatitis B, hepatitis A, Tdap, MMR, chickenpox, or HPV vaccine. He may need a catch-up or booster dose of the meningococcal vaccine. Remember to take your child in for a yearly flu vaccine.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.