Blood tests are not needed at every checkup

BloodtestsinchildrenChildren are encouraged to get regular checkups. In addition to answering a parent’s questions, these visits are meant to reinforce a healthy lifestyle and to screen for certain conditions based on the child’s age. For babies and toddlers, screening questions focus on nutrition, growth and development, and safety. For school-aged children, this focus is broadened to include exercise, academic readiness, and the management of common childhood problems. Adolescents need more independence and should spend some time alone with the doctor.

Every checkup includes a physical examination where the doctor ensures the child is growing well and does not have any problems that could interfere with his health. Checkups are also accompanied by vaccinations to prevent the large number of serious diseases that children are at risk for.

Each question or test a doctor does has a purpose. For example, screen vision and hearing is screened yearly for two reasons:

  • Children may not notice if they are not seeing or hearing well.
  • Research has shown that vision and hearing can change over a span of six to twelve months.

The reason most pediatricians do not do blood tests every year is because the situation is different when it comes to blood work. Doctors routinely check for anemia (low blood count) at nine months and two years of age because the rapid growth of early childhood is a risk factor for developing iron-deficiency. However, if a child is healthy and has a healthy diet, the likelihood of developing anemia in elementary school is very low. This does not mean a doctor will not do blood work throughout this time period, however. But research does not support doing yearly blood counts on most children. Adolescent girls need blood counts more frequently because menstruation puts them at increased risk for iron-deficiency.

Other blood tests you may have heard of include:

  • Cholesterol levels
  • Liver and kidney tests
  • Lead tests
  • Vitamin D levels

While each of these tests is important, there is no reason to do them on a yearly basis. Each doctor will decide when to do them based on the child’s age and certain risk factors, which include family history, if the child has an underlying medical problem, and where the child lives.

Tag-Team Shots: Making Shots Less Painful

Tag Team Shots For most children, immunizations are the most stressful part of an annual checkup. We have a policy in my office that helps reduce the anxiety associated with this necessary evil. Whenever a child needs two vaccinations, we administer the shots simultaneously. This works for a couple of reasons. First, having two nurses in the room helps to distract the child. Second, receiving both shots at once reduces the pain, possibly because the child perceives them as one injection instead of two.

Make doctor’s visits easier for young children

I have an article on helping children cope with doctor’s visits and shots elsewhere on the website. (Link: Today, I wanted to mention a simple technique that can improve the way medical visits go for toddlers and young children. For this to work, you need three things.

  • An older child who likes seeing the doctor.
  • A schedule that allows you to bring the older child to the toddler’s visit.
  • A doctor who is willing to “examine” the older child first.

It’s common for children to bring a “lovey” to doctor’s appointments to make the visits less stressful. Over the years, I have examined hundreds of stuffed animals from dogs to sharks to giraffes. The purpose of this fake exam is twofold. First, it shows the child you like to play. Second, it empowers the child so the visit is less threatening.

During my 30 years in pediatric practice, I have noticed that an older brother or sister can do an even better job reassuring toddlers that a medical checkup isn’t the worst thing in the world. A cooperative sibling can help in situations where a stuffed animal cannot. Here’s why.

  • Toddlers know stuffed animals aren’t real. However, if an older sibling says the ear exam doesn’t hurt, it may carry more weight.
  • Younger siblings generally look up to their brothers and sisters and want to be like them. This encourages the toddler to overcome his fear of the examination.
  • The presence of the older child may act as a distraction making it easier for the toddler to stay still during the examination.

Although older siblings can help with the medical exam, they are less effective when it comes to blood tests or shots. Consequently, unless you have remarkable kids, I wouldn’t ask the older one to tackle that task.