Well-Child Visits and the Vaccination Schedule

Why go for a checkup when your child is not sick?

Well-child visits are done to confirm that growth and development are on track for age, to review feeding and sleep routines, to complete vaccines on time and to catch problems early, before they cause symptoms. Most conditions such as iron deficiency, hearing and vision problems, developmental delay, hip dislocation (developmental dysplasia of the hip), scoliosis (a sideways curve of the spine) and stalled growth are found at these visits before the family notices them.

How often are checkups done?

The widely accepted schedule is frequent in the first year and more spaced out after that:

• Newborn period: First checkup within the first 3–5 days after leaving the hospital
• First 6 months: Once a month
• 6–12 months: About every 2 months
• 1–2 years: Every 3–6 months
• After age 2: Once a year

These intervals are made shorter for the individual child in situations such as premature birth, chronic illness, growth problems or feeding difficulties.

What is checked at the visit?

1. Growth. Height, weight and head size are measured and plotted as a percentile on the WHO growth charts. The course of the curve matters more than any single measurement: a child who follows their own line is usually fine, even at a low percentile; a child who drops down across lines should be looked into.
2. Development. Movement, language, social and thinking–learning milestones are reviewed. The American Academy of Pediatrics recommends developmental screening with specific questions at 9, 18 and 30 months, and autism screening at 18 and 24 months.
3. Nutrition. Breastfeeding, starting solid foods, daily milk intake, iron and vitamin D supplements, picky eating.
4. Vaccines. We check whether the schedule is complete and plan a catch-up schedule for any missed doses.
5. Physical examination. Heart, lungs, abdomen, hips and genitals; and, as suited to age, vision, hearing, teeth and posture.
6. Topics specific to your family. Sleep, screens, safety and accident prevention, getting along with siblings, settling into daycare, and whatever else is on the family's mind.

Vaccination schedule

In Türkiye, the Genişletilmiş Bağışıklama Programı (GBP, the Turkish Expanded Programme on Immunization) has been running since 1985, and all vaccines in the Turkish childhood vaccination schedule are free of charge. The schedule protects against 13 diseases: diphtheria, whooping cough (pertussis), tetanus, polio, hepatitis B, hepatitis A, Hib (Haemophilus influenzae type b), tuberculosis, measles, mumps, rubella, chickenpox and pneumococcus.

The schedule is updated from time to time — for example, hepatitis B was added to the five-in-one combined vaccine, and the six-in-one combined vaccine (DTaP-IPV-Hib-HepB) was included in the programme. We recommend always checking the current schedule on the Turkish Ministry of Health Vaccine Portal (Aşı Portalı): asi.saglik.gov.tr.

In addition to the vaccines in the schedule, there are extra vaccines that are considered after discussion with the family (such as rotavirus, meningococcal and seasonal flu vaccines). These are discussed according to the child's age, risk factors and the family's preferences.

Vitamin D and iron supplements

Under the Turkish Ministry of Health (T.C. Sağlık Bakanlığı) programme:

• Vitamin D: For all babies from birth until age 1, 400 IU (3 drops) a day — to prevent rickets (softening of the bones), free of charge.
• Iron: Supplement drops from 4 months until age 1; checked with a blood count at 9 months.