Calvin goes to the Barnavårdscentral!

I took Calvin to our pediatrician in Atlanta prior to the move so he was up to date on all of his vaccinations for his 9 month check up.  However, they didn't measure his length, head circumference or weight during that visit so I was eager to find out how my little man was growing.

In Sweden, children are taken to the Barnavårdscentral (BVC) and see children's nurses during their regular wellness visits.  The schedule is a little different in Sweden than in the US so Calvin ended up being right on time for his Swedish 10 month check in at the BVC.  I was told beforehand that he wouldn't be seeing a pediatrician during this visit -- totally fine.  In Sweden, your child only sees a pediatrician during emergency visits.  This makes sense since it is an all-access healthcare plan and pediatrician costs are quite high.  I never understood why we would wait 45 minutes to see our US pediatrician for a sum total of 7 minutes and then the nurses would administer the measurements and vaccinations.  It makes sense to cut out the doctor all together unless there is some pressing need or emergency.  Regardless, it's a different system and I found it to be quite nice.

I found the BVC no problem and maneuvered Calvin's stroller into the elevator.  There was convenient stroller parking outside the BVC entrance, so I stripped Calvin of his warm down snowsuit and hovered outside of the BVC entrance door.  Umm... it was seriously locked.  It looked really welcoming and all but there was a keypad and a series of people's (phone?) numbers outside the door but it didn't look like there would be anyway for me to actually call someone.  Hmm... ok.  Fortunately, a mom was leaving the BVC and held the door open for me.  I slipped inside and looked for the reception desk to "check in."  There wasn't any reception desk, waiting nurse, or central location where I could let someone know that I was there for our appointment.  I continue wandering and manage to find a woman sitting on a chair, apparently waiting for her appointment.  I can only guess really.  I put on my best I'm-totally-lost-and-confused-since-I'm-new-here-and-don't-speak-Swedish look and told her that we were here for our appointment.  There was a room full of nurses just chatting and lounging on couches -- waiting for their patients to arrive.  A nice nurse bounced off the couch and said, "Oooh! I think you must be looking for me!"  Perfect!  Yes!

Stroller parking

She takes me to her room/office and it's a comfortable combination of typical doctor's office but with a couch on one wall and her computer desk across from the examining table.   The room has all of the same features as our old pediatrician's office but its somewhat more comfortable and personal.  There is a mobile hanging above the changing table, weighing scale and measurement area and a smattering of children's toys throughout the office.  I sit on the couch with Calvin and begin to give her our family history, details of my problem-free pregnancy and delivery, etc when Calvin starts getting "chatty" and dives for the floor.  She immediately gets on the floor and asks if he wants to play with some toys.  Of course he does!  She pulls out a box of toys and Calvin happily plays on the floor while we continue to chat.

toys, toys, toys! 

trucks, trucks, trucks

When it comes time to measuring his head, she lets him inspect the measuring tape and asks if she can put it around his head.  She has to do this 4 times since he keeps grabbing the tape, thinking its a game. She stayed patient and gave him a toy to distract him while she tried repeatedly to get a good measurement.

For the weight measurement, Calvin weighs in at a featherweight 7.9kg/17 lbs, 6 oz -- a slight decline from his weight in November.  I look at her worriedly and she reassures me that this is normal as babies start crawling and becoming more active and that I should continue to feed him as much as he wants -- adding a generous tablespoon of olive oil into everything he eats.  She entered his previous height/weight measurements into her computer and set up a custom growth curve for him.  He's currently -3standard deviations below the mean in weight so we'll definitely need to beef him up a bit!  We don't want him getting pushed around by these vikings!

We discuss his vaccination schedule and I shockingly (I don't know why) discover that they do not vaccinate for half of the things that the US does.  She was floored that he already had his MMR shots as they do not vaccinate for that until 18 months. We set up an appointment in late March for a visit with the pediatrician to discuss vaccines and any other questions I may have at that point.  Calvin and I head for the stroller and we're on our way!  All BVC visits are free of cost so we didn't need to check out.  This also explains why there was no central check in/reception desk.  She also gave me the door code so that I could get in again without having to slip in behind someone.

My initial feelings post-visit was that it was a great experience.  I was made to feel very comfortable and was adequately reassured that Calvin's weight plateau was not my fault (of course I blame myself). The visit was pleasant and Calvin didn't cry at any point during the entire visit.  As the nurse was asking Calvin if she could measure his head, I thought back to all of the previous times in Atlanta that we were asked to hold him down while a nurse struggled to get the measuring tape around his head while he kicked and cried.  Or the fact that the wonderful bucket of toys that kept Calvin occupied would be seen as unsanitary and an unnecessary health risk in a US pediatrician's office. Here it was just normal.  I also think that their varying vaccination schedule has a lot to do with their 18 month maternity/parental leave.  Babies don't enter daycare at 3 months like they do in the US, so the number and scope of vaccines that are required are much less.  If your child is being exposed to other children at 18 months, then many of the vaccines can be delayed.  Also, Sweden has a very high vaccination rate amongst their entire population so they have adequate herd immunity.

In the end, I was very pleased with Calvin's first experience with the Swedish children's healthcare system.  In all respects, it seems to be geared towards children which should be the focus of all pediatric practices.