When it comes to taking charge of your child’s health, the job begins at birth — literally.


One of the first decisions parents will make is whether to choose a pediatrician or family medicine provider as their child's primary care provider. Some families prefer to have one family medicine team that can treat the family as a whole, with access to everyone's medical history. Others prefer to have their child treated by a provider who specializes in childhood illnesses and development until they reach young adulthood.


It’s never too soon for wellness visits: Deborah R. Hansen, pediatrician at Cheshire Medical Center, conducts the first new patient appointment at the hospital before parents bring their newborn home.


The second is two to three days after discharge, and from there it’s at two weeks and every few months — 10 visits total before age 2.


During this time at wellness visits, the pediatrician monitor’s the child’s growth, development, and general health, addressing parents’ questions about sleep, feeding, et cetera.


Between age 2 and 3, the once every few months visits are recommended, and once a year after that.


By ages 4 and 5, children receive any needed immunizations at their pediatrician’s office during wellness visits. By age 11, they receive annual flu vaccines (sometimes provided by Cheshire Medical Center nurses are area schools). Meningococcal conjugate vaccine is first given at 11 to 12 years; a second dose is given at 16 years.


“We encourage (parents) to come in regularly for (their child’s) checkups,” said Hansen.


During adolescence, a pediatrician may see patients for additional vaccines, such as that for the human papillomavirus (HPV). Parents can bring in their children for the vaccine as early as age 9 but should have the complete vaccination series by age 13. If a patient receives the vaccine before age 15, two separate doses are necessary and after 15 it’s three doses.


“Vaccines are very important,” said Hansen. “There’s a lot of misinformation about them.”


Cheshire Medical Center’s pediatrics department follows the CDC’s Advisory Committee on Immunization Practices and the American Academy of Pediatrics annual vaccination schedules, explained Hansen, and the state immunization program provides vaccines for children in New Hampshire by supplying hospitals and clinics.


A sample schedule of recommended immunizations is listed on Cheshire Medical Center’s website. Parents can stay on top of their child’s records, prescriptions, and upcoming immunizations through Cheshire Medical Center’s online patient portal and the MyChart app, where they can also connect with all of their child’s providers within the Dartmouth-Hitchcock Health system, schedule appointments and view test results.


Your child’s actual immunization schedule may vary depending on their individual needs, so it’s suggested parents follow their primary care providers’ recommendations. Some of these vaccines may be given as part of a combination vaccine so your child gets fewer shots.


Most are administered by age 4, including vaccines for measles, mumps and rubella, chicken pox and Hepatitis A as well as a lead and iron check.


As outlined on the CMC website, in a few instances, certain vaccines/immunizations follow a different schedule or may change depending on circumstances. The vaccine for tetanus, diphtheria and pertussis is given at age 10, then a booster is given every 10 years unless there is an injury. If an injury occurs, then a booster is needed if it’s been more than five years since the last vaccination.


What Hansen sees in her young patients is high rates of obesity, sleep disorders and overuse of electronic devices, and mental health or behavioral problems.


“It’s not necessarily related to parenting; it’s more societal too,” she said.


So what can parents do?


First, she recommends visiting the American Academy of Pediatrics parenting website, healthychildren.org, for parenting information from the prenatal stage through young adulthood.


The site contains all kinds of good resources in regard to such topics as nutrition, good sleep habits and COVID-19.


The other method to ensure your child’s good health involves a lot of hard work.


“It’s role modeling,” said Beatty. “Enjoying physical activity, instilling healthy habits, going back to basics. Placing an important role in trying to stay healthy, get enough sleep and not abuse drugs and alcohol. Most of these problems are related.”