Your Child and Blood Work

Reader’s Question

How often should children have a panel of blood work done if they don’t have any health issues? Should it be every year?

Dr. Blum’s Response

Recommendations about how often blood work and other screening tests should be done keeps changing. I can tell you what we do in our office and this follows the most current recommendations. We do our first blood test at either 9 or 12 months old. This includes a complete blood count and a lead test if children are at high risk for lead poisoning. The blood count is primarily to look for anemia, which can develop during the first year of life. We will then check another blood count yearly until 4 or 5 years old and then every other year during the rest of childhood. When girls begin menstruating, we again check every year to make sure they are not becoming anemic. We also check a cholesterol level in all patients at 4 to 5 years old. We find a surprising number of very high cholesterol levels in this young age group and it is a great opening for discussion about proper nutrition and exercise. If the cholesterol level is high we will continue to monitor it every year. If it is normal we will check it every few years. If someone had been at high risk for lead poisoning we will check the lead level a second time at 2 to 3 years old.

It had been our practice to perform yearly urine screening beginning at the time of toilet training but in the last year we greatly reduced that testing. The Academy of Pediatrics and the American College of Urologists no longer recommend routine urine screening. They only recommend checking urine tests if there is suspicion for a urinary problem. We haven’t completely stopped screening but we now do one before kindergarten and one at 11 to 12 years old. The days of peeing in a cup in the doctor’s office seem to be fading but you can still expect a finger poke almost every year.

 

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