BVC, the child health clinic every family in Sweden is enrolled in, follows your child from the first week at home until school starts, with frequent visits during the first six months and fewer after that: at around eighteen months, three, four and five years. At each visit your child is weighed and measured, development is followed up, you get advice on food, sleep and everything else, and the vaccinations in the Swedish programme are given at roughly three, five, twelve and eighteen months and at five years. Everything is free of charge, and you choose your BVC yourself.
Day four at home with a newborn in a flat in Sundbyberg, and a BVC nurse rings to ask whether she can come round on Thursday. It is the start of a relationship that will last five years, and for most parents it is the most important contact with healthcare during the early years. Many people do not really know what BVC is for until they are in the middle of it. Here is what happens at the visits, what is checked and how to use BVC the way it is meant to be used.
What BVC does
Child health services have three jobs: to follow your child's health and development, to give vaccinations, and to support you as parents. The last one matters as much as the first two. The BVC nurse is the person who asks how you are doing, not just how the baby is doing, and who picks up on it if breastfeeding is not working, if sleep has become unsustainable or if a parent is struggling. BVC is not an emergency clinic. It is the place for the ordinary and everyday, and that is why it works. Check your child's BVC schedule with the nurse, because it varies a little between regions and clinics.
The visits, roughly
| When | What happens |
|---|---|
| First week at home | Home visit. Weight, the umbilical stump, breast or bottle, how you are feeling. Questions about sleep and safety at home. |
| Two to four weeks | Weight and length. Feeding, jaundice, colic, how the nights are going. |
| Six to eight weeks | Doctor's examination. Hips, heart, reflexes, a rough check of sight and hearing. A conversation with the mother about how she is feeling. The first rotavirus drops are given at around six weeks. |
| Three months | Weight, length, head circumference. The first injections in the programme. |
| Four to six months | Development: head control, grasping, smiling, babbling. A chat about starting tastes of solid food. Vaccination at five months. |
| Eight to ten months | Sitting, crawling, pincer grip. Food and sleep. Childproofing once the baby starts moving around. |
| Twelve months | Doctor's examination. Walking or standing, saying a few words. Vaccination. |
| Eighteen months | Vaccination. Language, motor skills, play. A conversation about boundaries, tantrums and sleep. |
| Two and a half to three years | Language assessment, often with a simple screening. Weight and length. Nappies, food, förskola (municipal preschool, from age one). |
| Four years | Sight and hearing test, language, motor skills, weight and length. Often a longer visit. |
| Five years | The last BVC visit, with a vaccination. Preparation for förskoleklass (the preschool year that starts school), after which the school health service takes over. |
What is checked, and why
- Weight, length and head circumference are plotted on a growth curve. It is the shape of the curve that matters, not individual numbers. A child who follows their own curve is usually fine, even when that curve sits high or low.
- Motor skills: head control, rolling over, sitting, crawling, walking. The range is wide, and BVC knows where the limits of normal lie.
- Language and contact: smiling, babbling, words, pointing, understanding simple instructions. The language screening at around three catches children who may need a speech therapist early.
- Sight and hearing, roughly in the early months and more carefully at four years.
- Hips and heart at the doctor's examinations.
- How you are doing. A structured conversation about low mood with the mother a few weeks after the birth, and questions to both parents over the years.
The vaccination schedule
The Swedish childhood vaccination programme is run by BVC and protects against a number of serious diseases, including whooping cough, measles, mumps, rubella, polio and pneumococcal infection. The vaccinations are given at around six weeks as drops against rotavirus, and then as injections at three, five, twelve and eighteen months and at five years. After that the school health service continues with a few doses during the school years. The programme is voluntary, free of charge and recommended, and it has made diseases that were common two generations ago rare today. At every visit BVC tells you exactly what is being given, which side effects are common, such as a mild fever and soreness, and what to do if your child is ill that day. Folkhälsomyndigheten (the Public Health Agency of Sweden) has the full programme on its website, and the vaccination card or your child's BVC record shows what your child has had.
How to get more out of BVC
- Write your questions down between visits. You will forget them in the waiting room.
- Use the telephone hours for anything that is not urgent: rashes, food, sleep, dummies, the fact that you are exhausted. That is what BVC is there for.
- Go together when you can, especially to the longer visits. Otherwise the parent who is not at home during the day gets everything second hand.
- Say so if you are not doing well. BVC can put you in touch with a psychologist or counsellor, and nobody judges.
- Change BVC if it is not working. You have the right to choose, and it is not rude.
- The parent groups during the first year are often worth the time, not for the information but for the other parents a few streets away with children the same age.
BVC, 1177 or 112?
| Call BVC | Call 1177 | Call 112 |
|---|---|---|
| Questions about food, sleep, feeding, rashes, development | Your child is ill and you are wondering whether to seek care | Your child is struggling to breathe, is unconscious or hard to wake |
| Booking or moving visits and vaccinations | Evenings, nights and weekends when BVC is closed | Seizures, a serious accident, suspected poisoning in a child who is affected |
| Worries about how you yourselves are doing | Fever in a baby under three months | A severe allergic reaction |
How we do it with our families
Our nannies do not come along to BVC. That is your visit. What we often do instead is stay at home with the older sibling in the meantime, or take the afternoon after a vaccination when a grumpy, feverish one-year-old needs extra patience. At the first meeting before we start, we always ask where your BVC is and which times tend to clash with the sessions, so that the schedule holds. And the nanny who is with you every week is often the one who notices the same things BVC asks about: how your child walks, points and talks.
This text is general information and does not replace advice from BVC, your vårdcentral (local health centre) or 1177. If you are worried about your child, call 1177. In an emergency, call 112.
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Frequently asked questions
What is BVC and does it cost anything?
The child health clinic follows your child's health and development from birth until school starts. The visits, vaccinations and advice are free of charge. You choose your BVC yourself, and it does not have to be the nearest one. Change if you are not happy there. It is simple and common, and your child's records move with them.
How often are the visits?
Frequent during the first six months, then more spread out. Roughly: a home visit in the first week, visits at two, four and six to eight weeks, then at around three, four, five, six, eight, ten and twelve months, and after that at eighteen months, around three years, four years and five years. The exact schedule varies a little between regions and clinics.
What happens if we miss a visit?
Ring and book a new time. Missed vaccinations are caught up. The programme is built for that. BVC does not think you are bad parents because you forgot the four-month check. They have seen it all. If you have been given an appointment you cannot make, ring and move it rather than not turning up.
Which vaccines are given at BVC?
The ones in the Swedish childhood vaccination programme, which protects against whooping cough, measles and pneumococcal infection among others. The vaccinations are given at around three, five, twelve and eighteen months and at five years, with the first rotavirus drops as early as six weeks. BVC explains at each visit what is being given and why.
Can we call BVC about things other than the visits?
Yes, that is the idea. The BVC nurse is the person to ring about feeding, sleep, food, rashes, colds and the fact that you are running on empty. Many clinics have telephone hours every day, and some also answer messages through the 1177 e-services. If it is urgent and outside telephone hours, call 1177. In an emergency, call 112.