No matter what grade your child is entering, there is always a checklist of things to do before school starts. It is a good idea to add an annual wellness visit and sports physical to that list. Annual checkups allow your child’s pediatrician to determine whether there are any problems with your child as he/she develops and progresses. These checkups are especially important for adolescents going through puberty, a time when vital changes are taking place inside your child’s body and mind. Schools may require sports physical forms to be completed before your child can participate in a sport or physical education class. Make sure to bring the form to your child’s wellness exam.
The annual checkup is oftentimes the only visit your child will have with the pediatrician every year. In addition to monitoring heart/blood pressure and testing for diabetes, the pediatrician will also use this visit to discuss diet, exercise options, provide pediatric vision screenings, and test for cholesterol and anemia. If you have any questions about your child’s health, this is a good time to ask them.
During the wellness annual visit, your child’s pediatrician will also want to make sure your child’s vaccinations are up-to-date. Students attending school in California will need the following shots before admission:
- Polio (OPV or IPV)
- Diphtheria, Tetanus, and Pertussis (DTaP, DTP, Tdap, or Td)
- Hepatitis B
- Measles, Mumps, and Rubella (MMR)
- Varicella (Chickenpox)
Check our page here for more information on vaccines.
Source: American Academy of Pediatrics
Diet & Exercise
Your child’s need for calories rises during times of rapid growth, gradually increasing from middle childhood through puberty. It is important to make an effort to provide your child with a well-balanced, nutritious meal. Your child should consume a variety of foods from the five major food groups: vegetables (3-5 servings/day), fruits (2-4 servings/day), bread/cereal/pasta (6-11 servings/day), protein foods (2-3 servings/day), dairy products (2-3 servings/day). Your child should be getting enough (but not too much) of fiber, protein, fat, sugar, and salt. For more detailed information, check this page. Ensuring that your child has a healthy diet can prevent childhood obesity and diabetes. Currently in the U.S., about 20% of adolescents ages 6 to 11 years have obesity. Making even small changes in diet can help those struggling with their weight. For more healthy eating tips, check out the MyPlate Daily Checklist, the NIH Body Weight Planner, or BAM! Body and Mind.
Regular exercise is also extremely important during development. Physically active youth have higher levels of fitness, lower body fat, and stronger bones and muscles. Physical activity also helps stimulate the brain, helping to improve cognition and reduce symptoms of depression. Regular exercise during childhood and adolescence can also promote lifelong health, reducing the risk for heart disease, obesity, and type 2 diabetes. The U.S. Department of Health and Human Services recommends that children and adolescents ages 6-17 years do 60 minutes (1 hour) or more of moderate-to-vigorous physical activity daily.
There is no exact age when everyone experiences puberty. Your child may start hitting puberty between the ages 8 and 18. Girls can expect puberty to hit between the ages 8 and 17, whereas boys can expect puberty to hit between the ages 10 and 18. During puberty, your child’s body will start to change and grow. Physical and mental developments will occur in your child as your child begins to transition into adulthood. Your child needs to understand the changes that will occur during puberty.
Most of the changes that occur will differ between girls and boys, but there are some changes that will happen for both sexes:
- Begin to gain weight
- Grow taller
- Grow more body hair
- Speak with a deeper/stronger voice
- Develop acne
Premature puberty, or precocious puberty, is when children show signs of puberty too early (before age 8 in girls, age 9 in boys). The most common form of precocious puberty is called central precocious puberty (CPP). CPP happens because of an abnormality in the master gland (pituitary) or the portion of the brain that controls the pituitary (hypothalamus). Rarely, puberty occurs early because the glands that make sex hormones start working on their own, earlier than normal. This form of precocious puberty is called peripheral precocious puberty (PPP). In both boys and girls, the adrenal glands can start producing weak hormones called adrenal androgens at an early age, causing pubic/axillary hair and body odor before age 8. This is called premature adrenarche, but generally does not require any treatment. Exposure to estrogen- or androgen-containing creams or medication can lead to early puberty.
CPP can have lasting complications beyond childhood, but timely treatment can prevent those complications. The goal of this treatment is to turn off the pituitary gland’s production of hormones LSH and FSH, which will slow down the appearance of the signs of puberty and delay the onset of periods in girls. If you suspect your child is undergoing premature puberty, speak with your child’s pediatrician to get a diagnosis as soon as possible. For more information on central precocious puberty, check this website.