New 2014 recommendations are out for improving our prevention efforts for children. Parents can help ensure children get what they deserve at check ups. The updates to recommendations for wellness check-up are written to guide physicians but parents are a key voice in ensuring it all happens!
Updated 2014 Recommendations For Check-Ups
Some relevant changes to prevention/screening for children:
- Infants: All infants need a pulse oximetry screen at or after 1 day of life to screen for heart defects. The test is non-invasive (just requires a technician, nurse, or doctor put an oxygen probe on their arms and legs). More information on the test here. Ideal time for testing is between 24 and 48 hours of life. If your baby is born at home or outside the hospital, go in to see pediatrician for the screen on day 1 or 2! Toddlers should be screened for iron deficiency risk at 15 and 30 months of age.
- Children: All children should be screened for depression every single year starting at age 11 years. Don’t ever shy away from discussions about mood with your pediatrician. In addition, all children are recommended to have cholesterol screening at age 9-11. I reviewed ways to prevent heart disease and cholesterol screening policy statement here.
- Teens: All teens need an annual check-up (a complete check-up will provide some time alone with doctor and nurse; mom or dad will be asked to leave for at least part of the visit). All teens need HIV screening test at age 16-18 (or sooner) and girls get their first pap smear at age 21.
5 Things Parents Need To Know About Check-Ups
- Lots of visits: Babies and toddlers are recommended to see their pediatrician, nurse, or family doctor 11 times in the first 2 years. Then, it’s recommended that children see the doctor every year thereafter. Be sure to check with your insurance provider for what they cover, though. More on that next week (I received a hefty bill recently for my son’s check-ups that surprised me)! Not all children have insurance that reimburses for every visit unfortunately. Many of us learn the hard way.
- Growth: Children must get their growth checked at every single well check-up for their entire childhood. Babies should have a height, weight, and head circumference measured (through age 2) and then weight, height, and blood pressure should be checked at every check-up from age 3 and up.
- Prevention: Routine care is one way to prevent problems at home, at school, with eating, with sleeping, with sports, with mood, with friends, with safety. Your doc or nurse practitioner is going through myriads of lists in their head while talking with you and while examining your child. If you leave the visit with no new prescriptions and no new diagnoses, don’t think it was an unnecessary visit. Think of it as a huge luxurious treasure — you have a healthy child!
- Sleep: Although sleep is a very essential part of a healthy life, health concerns about sleep can get overlooked or forgotten during well check-ups. If your child’s sleep concerns you, don’t hesitate to bring it up, even if doc doesn’t ask. Quick tips: Infants and toddlers are not supposed to snore. And children should wake feeling rested and ready for the day after being able to fall asleep within about 1/2 an hour at night.
- Embarrassing or personal question? Finally, the perfect place to ask an embarrassing or personal question you’ve always wanted the answer to! Those things you Google at 1am, you know? Anything from your concerns about the your toddler’s masturbation, having a lock on your toddler’s door, your 12 year-old’s bad breath, the shape of your child’s genitals, the weird way your 2 year-old requires you to help them go the bathroom, etc. WHATEVER. Pediatricians offer a safe, open, and honest place to advocate for you and your child. Believe me, I trust that any question you have won’t be a first for your doctor or nurse practitioner. If so, encourage them to ask around!
For an overview (and a somewhat overwhelming) visual guide to what children deserve at check-ups:
My 10-year-old sometimes takes over an hour to fall asleep, and it is difficult to wake her up in the morning. She does not snore, but on the other hand, neither do I, and I have sleep apnea. She will have her annual checkup in a couple of months, so I’ll bring it up then. In the mean time, any suggestions?
What is snoring an indication of in a toddler? My little guy has always been a snorer, but I didn’t realize it was something to be concerned about.
Wendy Sue Swanson, MD, MBE says
Snoring can be caused by all sorts of things. Sometimes it doesn’t cause sleep abnormalities but sometimes snoring can be caused by enlarged tonsils or adenoids or a narrow nasal passageway or overweight or obesity. At first glance we worry about snoring because it may mean that your child is at higher risk for obstructive sleep apnea. Talk with your child’s pediatrician if you have concerns about snoring.
Here’s a link to posts on snoring from a sleep expert I really like, Dr Craig Canapari (he’s at Yale) https://drcraigcanapari.com/tag/snoring/
Alexandra Pellissier says
Glad I read this! My almost 7 month old has been snoring now and then, of course I’m over here thinking “aw how cute,” didn’t realize it was something to be concerned about. My little guy is teething–during the day he has major mood swings, and at night has only been sleeping 1-2 hours straight and then waking for several minutes crying, grabbing at his ears, scratching his head, twisting and turning. I took him in to see his pediatrician but they couldn’t find anything wrong with his ears, instead I received some advice for his diaper rash which since then has gotten much better, but still the restless nights. Any advice?
Jean Maxer says
Good information. Really appreciated the check-up guide.
My daughter is 9yrs old her hieght is 127 cms will she become tall