Children's Check-Ups

Posted: June 1, 2004

Check-up visits are important because they allow your health care provider to review your child's growth and development, perform tests, or give shots.

Check-up visits are a time for parents to ask questions. You may want to bring a list of concerns you have.

Some authorities recommend checkup visits at ages 2-4 weeks; 2, 4, 6, 9, 12, 15, and 18 months; 2, 3, 4, 5, 6, 8, 10, 12, 14, 16, and 18 years.

Some children may need to be seen more often, others less. Ask your clinician how often your child will need to be seen.

Health Exams and Tests for Children

Blood Pressure
Your child should have blood pressure measurements regularly, starting at around 3 years of age. High blood pressure in children needs medical attention. It may be a sign of underlying disease and, if not treated, may lead to serious illness.

Check with your child's health care provider about blood pressure measurements.

Lead
Lead can harm your child, slowing physical and mental growth and damaging many parts of the body. The most common way children get lead poisoning is by exposure to old house paint that is chipping or peeling.

Any "yes" answers to the following questions may mean that your child needs to be tested for lead.

Has your child:

• Lived in or regularly visited a house built before 1950? (This could include a day care center, preschool, the home of a babysitter or relative, etc.)
• Lived in or regularly visited a house built before 1978 (the year lead-based paint was banned for residential use) with recent, ongoing, or planned renovation or remodeling?
• Had a brother or sister, housemate, or playmate treated for lead poisoning?

Vision and Hearing
Your child's vision should be tested before starting school, at about 3 or 4 years of age. Your child may also need vision tests as he or she grows. Some authorities also recommend hearing testing beginning at 3 to 4 years of age.

If at any age your child has any of the vision or hearing warning signs listed below, be sure to talk with your health care provider.

Vision warning signs:

• Eyes turning inward (crossing) or outward
• Squinting
• Headaches
• Not doing as well in school work as before
• Blurred or double vision

Hearing warning signs:

• Poor response to noise or voice
• Slow language and speech development
• Abnormal sounding speech

Special warning: Listening to very loud music, especially with earphones, can permanently damage your child's hearing.

Anemia (Blood) Test - Your child may need to be tested for anemia when he or she is still a baby (usually around the first birthday). Children may also need this test as they get older. Some children are more likely to get anemia than others. Ask your health care provider about anemia testing.

Tuberculosis (TB) Skin Test - Children may need this test if they have had close contact with a person who has TB, live in an area where TB is more common than average (such as a Native American reservation, a homeless shelter, or an institution), or have recently moved from Asia, Africa, Central America, South America, the Caribbean, or the Pacific Islands.

Immunizations
Your child needs immunizations. Immunizations (shots) protect your child from many serious diseases. Below is a list of immunizations and the ages when your child should receive them. Recommended ages may change; please check with your doctor.

• Polio (IPV): At 2 months, 4 months, 6-18 months, and 4-6 years.
• Diphtheria-Tetanus-Pertussis (DTaP): At 2 months, 4 months, 6 months, 15-18 months, and 4-6 years.
• Tetanus-Diphtheria (Td) at 11-16 years.
• Measles-Mumps-Rubella (MMR): At 12-15 months and 4-6 years or as soon thereafter as possible.
• Haemophilus influenzae type b (Hib): At 2 months, 4 months, 6 months, and 12-15 months; or 2 months, 4 months and 12-15 months, depending on the vaccine type.
• Hepatitis B: At birth-2 months, 1-4 months, and 6-18 months. If missed, get 3 doses starting at age 11 years.
• Chickenpox (Varicella): At 12-18 months or under 13 years.
• Hepatitis A (in selected areas): At 24 months-18 years; second dose 6-12 months after first dose.
• Pneumococcal disease (Prevnar™): At 2 months, 4 months, 6 months, and 12-15 months. If missed, talk to your health care provider.
• Influenza (children at high risk for chronic diseases): 6 months-18 years. Two doses at least 1 month apart for children aged 6 months-under 9 years who receive influenza vaccine for the first time.

Source: Agency for Healthcare Quality and Research

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