Breaking News: Expect These New Health Screenings for Your Child

Blog Toddler Doc Web

Dorota Szczepaniak, M.D., pediatrician at Indiana University Health, outlines the newer screenings you should expect for your child at these ages.

In an effort to make sure children get the preventative care they need, the American Academy of Pediatrics (AAP) has revised some of their health screening recommendations. The updated guidelines call for additional testing for a range of conditions in newborns through adolescents. The reasoning: the earlier any health issues are detected, the faster families and physicians can take action. Dorota Szczepaniak, M.D., pediatrician at Indiana University Health, outlines the newer screenings you should expect for your child at these ages.

Newborns will be screened for congenital heart disease.

After 24 hours of birth—and before discharge from the hospital—all babies will be screened for heart disease with a simple, non-invasive device called a pulse oximeter. The clip-on monitor is usually placed on the hand, finger, foot, and/or a toe in order to measure the oxygen level of the blood as it pulses. If the pulse oximeter shows that not enough oxygen is being pumped from the heart to a person’s extremities, that’s a sign there is a potential problem, and would be reason for further testing. “It’s important to note that babies who are born at home are not going to get that screening, among other tests, so they should be seen by a physician within 48 hours of life,” says Dr. Szczepaniak.

Children ages 6 months to 5 years old may now receive fluoride at the pediatrician’s office.

“We recommend that all children go to the dentist at one year of age, where they will be screened and given fluoride treatments,” says Dr. Szczepaniak. “But many children don’t visit the dentist regularly, especially in communities that do not have adequate health insurance coverage, so this new guideline allows pediatricians to offer the simple fluoride varnish right there in the doctor’s office.” This gives children an extra opportunity to benefit from a fluoride treatment, which has been shown to effectively prevent cavities. “About 25 percent of children 2 to 4 years old have cavities, and about 53 percent of children 6 to 8 years old have cavities,” says Dr. Szczepaniak. “With fluoride varnish now available in the pediatrician’s office, it reinforces the importance of the pediatrician’s role in dental health.”

Toddlers will be screened more extensively for anemia.

Previously, the AAP recommended a blood draw to screen for iron-deficiency anemia in children ages 1 year to 18 months, says Dr. Szczepaniak. “The AAP still recommends a blood draw but also added further risk assessment screening for anemia between ages 15 months and 30 months that can be done by gathering a patient’s history.” So at the pediatrician’s office, parents might expect more questions about a child’s diet and vitamin intake, among other things, to help clinicians assess if iron may be lacking.

Children between 9 and 11 years old will be screened for high cholesterol.

In the past, cholesterol screens in this age group were left up to the pediatrician’s assessment of each patient’s risk for high cholesterol (aka hyperlipidemia). “Now, all children ages 9 to 11 years of age should get a blood draw to measure the baseline lipid profile,” says Dr. Szczepaniak. “This allows us to earlier identify children who have increased cholesterol.” For children who are identified as having elevated LDL (bad) cholesterol and low HDL (good) cholesterol, the physician can refer them to a nutritionist to manage the issue with diet modification.

Adolescents will be screened annually for depression.

“The prevalence of depression in adolescents is 20 percent at any given time,” says Dr. Szczepaniak. So, the AAP is making mental health screening more of a priority by requiring an annual screening for depression in all adolescents ages 11 through 21. Children should expect clinicians to ask them some simple questions about their emotions. If the initial screen reveals signs of depression, children will then answer a longer questionnaire on a piece of paper or a tablet.

Adolescents ages 14 through 21 years old will be screened for alcohol and drug issues annually.

Estimates show that by the 12th grade, 80 percent of students report having used alcohol. And of those, 38 to 62 percent report having had problems related to drinking, such as emotional or health problems, addiction, or the drinking has interfered with work or school. “The new guidelines recommend that we screen every child ages 14 through 21 for alcohol and drug use with a CRAFFT screening tool, which involves a series of six questions,” says Dr. Szczepaniak. This can help pediatricians identify children who may need help.

Adolescents will no longer automatically need a Pap test before age 21.

“We used to recommend a Pap smear, which screens for cervical dysplasia, for females at age 18 or when they became sexually active,” says Dr. Szczepaniak. But because of recent evidence, this is no longer necessary for all females. “If there is a specific indication or symptom, an adolescent will be screened, but it won’t happen routinely.” There will, however, be an HIV screening (a blood test) for all adolescents between ages 16 and 18 years old.

-- By Rachel Rabkin Peachman

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