CherylH14 4/3/2014

Question

Is blood work routine for a 9-month-old? Can I refuse it? It was traumatizing for me to hold my baby while she got blood drawn.

Answer

Most pediatricians recommend  some routine blood work to be done between the ages of 9 and 12 months of age. Often these tests include a hemoglobin level and a lead level. Hemoglobin is the part of your blood that carries oxygen throughout the body. Infants and children who do not have enough hemoglobin (a condition known as anemia) can suffer irritability, developmental delays and behavior problems. Young children are especially at risk for a type of anemia called iron-deficiency anemia, which is why it is recommended to check a hemoglobin level at this age. Your doctor may check your child’s hemoglobin as part of a complete blood count (CBC), which looks for other indicators of anemia.

Lead poisoning can cause headaches, constipation, hearing loss, behavioral problems and learning disabilities. Sometimes the symptoms of lead poisoning can be subtle and the only way to catch it is to check a blood lead level. Also, young children tend to put everything into their mouths, which increases their risk of lead exposure. Your pediatrician will likely ask you questions about risk factors and if your child has a lead risk, a blood test may be recommended. In some states and with some insurance it is required to check a lead level between 9 and 12 months. 

It is never easy to watch your child go through a painful procedure. However, before you refuse, make sure you talk to your pediatrician about the risks. Missing lead poisoning or anemia can have long-term consequences for your child.  
 
Bryan Wohlwend, MD, FAAP

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