Why isn't routine blood work always done at a child's yearly physical?
By: Howard J. Bennett, MD, FAAP
Children and adults are both encouraged to get regular checkups from the doctor. In addition to answering a patient's questions, these visits are meant to reinforce a healthy lifestyle and to screen for certain conditions based on the person's age. For babies and toddlers, our screening questions focus on nutrition, growth and development, and safety. With school-aged children, we broaden this focus to include exercise, academic readiness, and the management of common childhood problems.
Every checkup includes a physical examination where we make sure the child is growing well and doesn't have any physical 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, we screen vision and hearing yearly for two important reasons:
- Children may not notice if they are not seeing or hearing well.
- We know from research 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. We 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 reasonable 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. But research does not support doing yearly blood counts on most children.
Other blood tests you may have heard of include:
While these tests are each important, there is no indication 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.
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