Contents
Checkups,
Tests, and
Immunizations
Keeping Track
of Your Child's
Health
2. Checkups, Tests, and Immunizations
I remember how nervous I was when I had to get shots when I was a kid. Now I know how serious many childhood diseases can be and how lucky I was not to have them. I'm going to make sure that my daughter gets all of her vaccinations on schedule so she'll be protected.
—Alice R.
Regular Checkups
Checkups allow your doctor to review your child's growth and development, perform tests, or give shots. To help your doctor get a full picture of your child's health, bring this booklet with you to each visit and keep the forms in the Keeping Track of Your Child's Health section up to date.
Checkups also are a good time for parents to ask questions. Make a list of your questions and concerns and bring it with you. The doctor will have answers to many questions about your child, such as whether your child is eating too much or too little, whether he or she seems uncoordinated, or what to do if your child isn't sleeping well.
Some authorities recommend checkups at ages 2-4 weeks; 2, 4, 6, 9, 12, 15, and 18 months; and 2, 3, 4, 5, 6, 8, 10, 12, 14, 16, and 18 years.
Some children may need to be seen more often, others less.
Newborn Screening
Certain blood tests should be done before your baby is 7 days old. They are usually done just before your baby leaves the hospital. If the blood tests were done earlier than 24 hours after birth, a repeat test at 1 to 2 weeks of age is recommended. Common newborn screening tests include those for phenylketonuria (PKU), thyroid, and sickle cell disease.
Immunizations
Immunizations (shots) protect your child from many serious diseases. Below is a list of immunizations and when most children should receive them. Some children, for example those with chronic illnesses or those in certain areas of the country, may need to follow a different schedule. Your child's doctor can help you decide which immunizations your child needs and when. Be sure to talk with the doctor or nurse about possible reactions and what you should do if your child has one.
- Hepatitis B: At birth, 1-4 months, and 6-18 months.
- Diphtheria, Tetanus, Pertussis: At 2 months, 4 months, 6 months, 15-18 months, and 4-6 years.
- Tetanus-Diphtheria: At 11-12 years.
- Haemophilus Influenzae Type B: At 2 months, 4 months, 6 months, and 12-15 months. Depending on the type of vaccine your doctor uses, the 6-month dose may not be needed.
- Inactivated Poliovirus: At 2 months, 4 months, 6-18 months, and 4-6 years.
- Measles, Mumps, Rubella: At 12-15 months and 4-6 years. Children who have not previously received the second dose should receive it by 11-12 years.
- Chickenpox (Varicella): At 12-18 months if your child lacks a reliable history of chickenpox.
- Pneumococcal disease (PCV vaccine): At 2 months, 4 months, 6 months, and 12-15 months.
- Pneumococcal disease (PPV vaccine): Recommended in addition to PCV for certain high-risk groups. Ask your doctor.
- Hepatitis A: For children in selected areas or in certain high risk groups. At 2 years or older, two doses at least 6 months apart. Ask your doctor.
- Influenza: Yearly for children 6 months or older with risk factors such as asthma, cardiac disease, sickle cell disease, HIV, and diabetes; and household members of persons in groups at high risk. Government experts recently recommended that all children aged 6 to 23 months receive annual influenza vaccine starting in the fall of 2004. Immunization schedules for influenza may change. For the latest information, check with your doctor or go to: www.cdc.gov/flu/.
From time to time, other immunization schedules may change, too. Check with your doctor or go to: www.cdc.gov/nip.
Vision and Hearing
Your child's vision should be tested by the age of 5. Your child may also need vision tests as he or she grows. Some experts also recommend hearing testing beginning at 3 to 4 years of age.
If at any age your child has any of the vision or hearing warning signs listed below, be sure to talk with your child's doctor.
Vision Warning Signs
- Eyes turning inward (crossing) or outward.
- Squinting.
- Headaches.
- Not doing as well in school work as before.
- Blurred or double vision.
Hearing Warning Signs
- Poor response to noise or voice.
- Slow language and speech development.
- Abnormal-sounding speech.
Warning: Listening to very loud music, especially with earphones, can permanently damage your child's hearing.
Lead
Lead can harm your child, slowing physical and mental growth and damaging many parts of the body. The most common way children get lead poisoning is by being around old house paint that is chipping or peeling. Some authorities recommend lead tests at 1 and 2 years of age.
Look at the questions below. If you answer "yes" to any of them, it may mean that your child needs lead tests earlier and more often than other children.
Has your child:
- Lived in or regularly visited a house built before 1950? (This could include a day care center, a preschool, the home of a babysitter or relative, etc.)
- Lived in or regularly visited a house built before 1978 (the year lead-based paint was banned for residential use) with recent, ongoing, or planned renovation or remodeling?
- Had a brother or sister, housemate, or playmate been followed or treated for lead poisoning?
Tuberculosis
Children may need a tuberculosis skin test if they have had close contact with a person who has tuberculosis (TB), live in an area where TB is more common than average (such as a Native American reservation, a homeless shelter, or an institution), or have recently moved from Asia, Africa, Central America, South America, the Caribbean, or the Pacific Islands.
