Published March 03, 2013
From the moment your child is born, he or she will have a series of tests to make sure everything is healthy and developing normally. Sure, height and weight are no-brainers, but what about all the other health screenings? Find out which ones are really important and what you need to know about them.
1. Newborn screens
The Apgar score, the first test your baby will ever have immediately after birth, evaluates your baby’s color, heart rate, activity, muscle tone and response to stimulation. Named after American pediatric anesthesiologist Dr. Virginia Apgar, this test helps to determine if the baby is depressed, under stress or lacking oxygen—and if intervention is needed.
The metabolic screen—a heel prick test—is another important test that is done within 48 hours after birth. Your baby’s blood will be screened for a host of metabolic and genetic disorders like hypothyroidism and sickle cell disease. “Although these conditions are rare, they can be devastating,” said Dr. J.J. Levenstein, a board certified pediatrician and founder of MDMoms.com, who says picking them up early is key.
A brainstem auditory evoked response (BAER) test, also done in the hospital, evaluates your baby’s hearing from the brain stem level, is non-invasive and can detect congenital deafness early on.
2. Head circumference
Measured at every well visit from birth to 2 years old, your baby’s head circumference is one of the most important tools available to the pediatrician. If your baby’s growth slows, it could mean that the seams of the skull are fusing too early or that he has a congenital infection or a developmental delay.
Rapid head growth, on the other hand, could indicate a serious condition like Hydrocephalus. “That why those regular, frequent visits and us charting those numbers meticulously—despite the baby’s protests – are so important,” Levenstein said.
During infancy and toddlerhood, your pediatrician will ask about key developmental milestones, like eye contact, social interaction and play. At 18 and 24 months old, a questionnaire called the M-CHAT (Modified Checklist for Autism in Toddlers) will screen for autism. As your child gets older, his behavioral and social development will constantly be evaluated as well.
4. Height and Weight
At every well visit, these two measurements will be charted to determine BMI (body mass index), which is the best way to identify a child’s risk for being overweight or obese. On the flip side, BMI can also point to a potential eating disorder. Your doctor will also ask about your child’s diet, eating habits, and exercise. “It’s non-invasive but lets us have a visual representation of how a kid is doing,” Levenstein said.
At 1 year and 2 years old, your child’s hemoglobin will be tested to make sure he’s not deficient in iron. “If you are anemic, your brain doesn’t work well and you can lose IQ points over time,” said Levenstein, who added that anemia can also affect your child’s activity. “It’s a big stressor on the heart, the brain, the cardiovascular system and even on growth.”
Approximately four million homes house kids who are being exposed to lead, according to the CDC. Lead exposure can affect your child’s IQ and high levels can be toxic. At 1 year and 2 years old, your child’s pediatrician will ask about your home environment, toys your child plays with and what your baby puts in his or her mouth. A blood test to determine lead exposure may also be ordered.
The American Academy of Pediatrics recommends children see an eye doctor every year between the ages of 3 and 6 – and then every other year. Starting at 9 months old, your pediatrician might suggest your child be screened with the Visual Evoked Potential machine, which presents a series of images. “It can measure the electrical activity of the brain in the vision center and see if there is equal activity on both sides,” Levenstein said. “It can be a very nice early screening tool to see if a child needs an ophthalmology visit sooner rather than later.”
Scoliosis, an abnormal curvature of the spine, affects approximately five to seven million people in the U.S., according to the American Chiropractic Association. The condition usually shows up between the ages of 10 and 15. As soon as your child can touch her toes, she should be screened for the condition, because it could become more severe later on in life, Levenstein advised.
Questions about your child’s safety are just as important as other health screenings and should be asked at every visit, Levenstein said. Your child’s doctor may ask about pets in the home, medications used by other family members, where your baby’s crib is placed, if you have a pool, and if there are guns in the home.
Your pediatrician may also talk to you about bullying, your child’s sexual behavior, and if you have concerns about drug use and academic performance. “The screening never stops,” Levenstein said.
Screening for diabetes is not routine, but it’s definitely on the minds of physicians, since obese adults are more likely to be pre-diabetic. In fact, kids with both type 1 and type 2 diabetes have increased more than 20 percent since 2001, according to the SEARCH for Diabetes in Youth study.
If your child is losing weight or has excessive urination, your pediatrician may test him or her for type 1 diabetes. Kids with type 2 diabetes usually gain weight, are sluggish and are not active. If your child has acanthosis nigricans – or a darkening and velvety texture of the skin around the neck or under the armpits – he or she should be screened for high levels of insulin, lipids and cortisone.