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There should be a 15-month, 18-month and 24- month physical scheduled during the second year. If your pediatrician suspects that there may be some form of growth delay, then he/she may advise more frequent follow-up visits to check height, weight, and head circumference. As children enter their second year, their growth rate slows down quite a bit. You instead see acceleration of social, motor, and verbal skills development. Typically, the three visits are adequate, but if there's any suspicion of any form of delay, then the child should be re-evaluated sooner. I've attached the url for the CDC's growth charts that we use in our offices. If you use them, you need to take into account family history and environmental factors as well. Also we use these to look for trends and not any one point in time.

http://www.cdc.gov/nchs/about/major/nhanes/growthcharts/clinical_charts.htm

Hope this helps,

Dr. Bill

This is a frequently asked question asked by many parents. First thing to talk about is that there are two types of ear infections: middle ear infections and swimmer's ears. The first, which is what I assume your daughter has had are not caused or made worse by being in the pool. Unless she has ear tubes or a perferation, that should not be a problem. Middle ear infections are brought about by secretions that collect in the middle ear and then become infected. Children with persistent or multiple middle ear infections may need to see an ear specialist at some time.

Swimmer's ear is an infection of the ear canal and is caused by water or humidity in the ear canal. They can be quite painful and can require special drops and/or oral antibiotics to treat. You usually see these infections during warm weather. Some people try using ear plugs to prevent them, but these rarely work well since it's hard to get them form a perfect seal to keep water out, not to mention that most small children hate having object put in their ears by someone else ( note I said someone else, they have no problem putting things in there on their own... another discussion...) . I reccomend to my parents to use a mixture of white vinegar and alcohol in a one to one ratio. Mix up a small amount and put about a dropperful in each ear canal and let it drain out. If your children have never had swimmer's ear, I would just watch and see how they do. But if they've had this in the past or have a family history of this, then the alcohol/vinegar mix will help. Please note you should not use this if the child has an ear tube or perferation in the ear drum. In that case your only recourse is to buy a really good pair of earplugs and don't let them go very deep under the water.

In addition to the ear concerns. The pool's chlorination may irritate skin and eyes. And don't forget to bring plenty of SPF 50 or better sunblock that won't rinse off in the pool.

Hope this was helpful. Let me know if there are any other specific questions relating to this topic.

Dr. Bill