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It’s common practice for parents to bring their healthy children to the doctor for check ups. Often called well-baby or well-child visits, these appointments give pediatricians the opportunity to monitor child growth and development. But a Facebook post offered parental advice that goes against the grain. Want a healthy, happy baby? Skip the Well Baby visits. They make your doctor money and make your baby sick, read a March 30 post . The post comes from Jennifer Margulis, author of books that explore alternative health approaches for parents and their children while challenging financial interests of those involved in shaping infant health and care. It was flagged as part of Facebook’s efforts to combat false news and misinformation on its News Feed. (Read more about our partnership with Facebook .) It’s doctors’ jobs to see patients, and so we aren’t questioning whether they make money doing their jobs, though one expert we spoke to said the field would not be supported if physicians didn’t also regularly care for the sick. We wondered, however, if the advice to skip these well-child visits aligns with data. Experts in the field of pediatrics and medicine widely tout well-child visits as key for child health and parent information. Mayo Clinic describes well-baby visits as an important way to monitor your baby's growth and development and check for serious problems. The U.S. Centers for Disease Control and Prevention says seeing a doctor regularly for well-child visits and recommended vaccines is one of the best things you can do to protect your child and community from serious diseases that are easily spread. While there is a possibility that a child could get sick from a visit to the doctor, experts say the benefits of taking a healthy child to a doctor for these preventative visits outweigh the risk. Studies on illness spread in pediatric settings Asked about her post, Margulis pointed us to a Science Daily article about a 2014 study out of the University of Iowa . The study examined data from the Agency for Healthcare Research and Quality’s Medical Expenditure Panel Survey spanning 1996-2008 and involving 84,595 families. It found that there was a 3.17% increase in the probability of a child under 6 getting sick with a flu-like illness two weeks after their well-child visit. Contrary to the point of Margulis’ Facebook post, the authors of that study emphasized the importance of well-child visits and instead said the data undergirded the need for strong infection control precautions. We believe that attendance at well-child visits is critically important for preventing infections through vaccination and that the benefits far outweigh the risks, the researchers wrote. Nonetheless, our results stress the importance of improving compliance with current infection control guidelines for ambulatory settings—not just for well-child visits, but for all office visits. Dr. Philip Polgreen, one of the study’s co-authors, reiterated that point in the Science Daily article and in an interview with NBC’s TODAY Show, calling t he risk of a child getting sick from a well-child visit actually quite modest. The study’s authors also noted several limitations in their findings, including that their analysis didn’t consider flu vaccination habits among the families of the children. They also wrote that by relying on medical coding data rather than microbiological evidence, the study might have misclassified some of the cases. The study also noted that two other, smaller studies examining the question of illness transmission in children found no increased risk of infection. Benefits of well-child visits Dr. Michael Crocetti, associate professor of clinical pediatrics at Johns Hopkins University, said the data in the University of Iowa study is also problematic in that it didn’t break down the findings by patient age or school and day care attendance. You cannot make a cause and effect conclusion that having a well check two weeks prior to a viral illness is the sole cause, Crocetti said. In a two-week span, children can have multiple other exposures to viruses. Crocetti rejected the notion that children are more likely to get sick from well-child visits. Such visits, he said, enable physicians to provide physical exams for children, monitor their behavior and mental health developments, and administer immunizations in alignment with the CDC’s recommended timeline. They also give parents the chance to ask questions related to a child’s safety, diet, growth and development. The American Academy of Pediatrics also recommends physicians use well-child visits to survey for signs of developmental delay. Crocetti said that a child is more likely to get sick from being around their family, in a daycare or a school setting than they would going into the doctor’s office. In healthcare settings, he said, medical staff wash their hands often, wear masks when needed and are vaccinated against viruses like COVID-19 and the flu. Many offices actually separate out a sick and a well waiting room, he said. Indeed, the American Academy of Pediatrics recommends physicians take specific precautions that include diligent hand hygiene, regular surface cleaning and targeted masking. It recommends separate waiting rooms and precautions for patients who may be contagious and are more vulnerable to infection. Dr. Joseph F. Hagan, Jr., fellow of the American Academy of Pediatrics and co-editor of the Bright Futures Guidelines for Health Supervision of Infants, Children and Adolescents, said the benefits of well-child visits are in prevention. You don’t find many very serious diseases in a well visit, thank God. But sometimes you do, Hagan said. More importantly though, you spend a lot of time with disease prevention — healthy nutrition being a good example of that, encouraging breastfeeding being an example of that. Additional claims Margulis made three other points in response to our inquiry to back up her claim that well-child visits make children sick. First, she said that pediatricians at well visits routinely recommend Tylenol, which she said damages the brain, the immune system and can lead to autism. She pointed to a 2017 paper published in the Journal of International Research that called for more research into links between the drug and autism. But Tylenol at the appropriate dose has been found to be safe, and links between acetaminophen, the active ingredient in Tylenol, and autism are in dispute. There is no indication that healthy children attending well-child visits would be urged to take acetaminophen, which is used to treat fevers and minor aches and pains, unless it were recommended to treat short-term side-effects of a vaccination delivered during the visit. Second, Margulis argued that doctors often find problems at these well baby checks that don’t exist. She pointed to a study that found that in cases where well-checks involved routine temperature checks of asymptomatic patients, fever was detected 0.2% of the time. In about half those cases, doctors deferred planned vaccinations and in some instances prescribed an antibiotic. But that study didn’t question the need for well-child visits. Rather, it recommended a closer examination of the use of routine temperature checks during well-child visits. Finally, Margulis said doctors discourage mothers from nursing and instead promote baby formula. But this sweeping claim contradicts data collected by the Centers for Disease Control and Prevention that show an overall upward trend in breastfeeding, from about 70% in 2000 to nearly 84% in 2018. The American Academy of Pediatrics has published articles and statements that support, not discourage, breastfeeding and, in 2012, it adopted a position that discouraged physicians from handing out formula promotions in clinic settings. Our ruling Margulis’ Facebook post advised parents to skip the well baby visits if they want a healthy, happy baby because they make your baby sick. While there is a risk a child could become sick following a visit to a pediatrician’s office, evidence linking these two is not conclusive. A study Margulis cited as evidence did indicate a small increase in the probability of a child under 6 getting sick with a flu-like illness two weeks after their well-child visit. But even the authors of that study emphasized the importance of well-child visits and said the data undergirded the need for strong infection control precautions — not an end to well-child visits. Regular check-ups for healthy babies and children are recommended by the American Academy of Pediatrics, the CDC, the Mayo Clinic and more as a means to monitor growth and development and assist with parent education and communication. We rate this claim False.
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