Childhood Check-ups – Are they needed, and how often?

This blog is written by our clinicians and aims to keep patients informed with up to date information on medical conditions. The editor of the blog is Dr Cristina Romete.


As the new school term approached, parents desperately were getting things organised, whether that was uniform, lunches, after-school clubs, helping holiday homework etc.  Child health checks and vaccinations are usually the last thing on a parent’s mind. 

However, it is really important to get your child used to the healthcare setting early in life, so that seeing the doctor for their check-up becomes commonplace – just like seeing the dentist regularly, rather than on an as-required basis when symptoms arise.

These regular health checks are the perfect opportunity to:

  • Educate the parents (and the child if old enough) in health and well-being;
  • Identify any current illness in a simple screening examination that might not have been picked up before; 
  • Discuss any family illnesses that could be passed through generations such as high cholesterol or obesity, and to focus preventative strategies early in the child’s life in the hope that they will not develop it in future.

What Health Checks are available for your child through the NHS?

In 2009, the Department of Health introduced The Healthy Child Programme/HCP which was split into 2 documents – Pregnancy and the First 5 Years of Life1; From 5 – 19 Years Old2 both of which aim to set out a framework of preventative services providing families and young people with screening, vaccinations, development reviews etc in order to promote optimal health and wellbeing in our nation’s children.

Through these documents, leaving aside vaccination appointments, the Department of Health recommends the following health checks:

  • Soon after birth: full physical examination; 
  • 10-14 days old: new baby review and hearing test within the first month undertaken by Health Visitor
  • 6-8 weeks old: check done by the GP
  • By 12 months old: health review by the Health Visitor
  • 2-2½ years old: health review by the Health Visitor
  • 4-5 years old: eye sight check
  • School entry (Reception class): height, weight and hearing done at school
  • 10-11 years (school year 6): height and weight done at school

As you can see from above, the only structured NHS general health checks, scheduled with a doctor, are soon after birth and at 6-8 weeks old! 

Your Child’s health record

If your child was born in the UK, you would have been given a Personal Child Health Record book which usually has a red cover so has gained the nickname the “red book”. Ideally you should take the red book with you to every healthcare appointment, as it contains graphs for weight, height and head circumference, as well as recording every vaccination received. 

The “red book” is a great resource for parents and you can annotate the book as much as you like with specific pages to record any illness or accidents your child has, as well as any medicines they take. The developmental milestones section is helpful to check against what your child is doing for their age. 

How often should my child attend a routine health check with a doctor?

In the private sector, we are often asked ‘How often should I bring my child in for a health check?’. 

It is not uncommon that a doctor may identify a significant heart murmur for example during the teenage years, or prior to embarking on a career as a young adult. The question we are posed with then is ‘how come that wasn’t picked up before?’. 

The answer is simple – attending a doctor for a sore throat does not mean your child had a general check up!

Same as with health checks for adults, we recommend annual well child checks too. 

What would an annual health check for my child include?

An annual health check for your child will include basic tests like height, weight, urinalysis, eyes, ear and throat examination, listen to their heart and lungs and feeling their tummy. Unlike adult health checks, it is unusual for routine blood tests to be done. 

However these may be indicated.

We also enquire and update the vaccinations, personalised to your child’s travelling schedule and exposures throughout the year.

Age-appropriate screening that often can’t be done on the NHS may be added, such as:

  • Adolescent depression screening from 12 years of age
  • Dyslipidaemia screening once between ages 9-11 and again at 17-21. 
  • Hearing screening between ages 11-14; 15-17 and lastly between 18-21.

What about my child’s vision tests?

In the UK, only 60% of schools provide eye tests, and out of those that are, it is usually not a full eye test nor carried out by an eye care professional. 

Therefore it is important that you take your child for a full eye test with a registered Optometrist before they start school and start learning to read. 

Children’s eyes are fully developed by the time they are 8 years old so it is very important for any eye problems to be detected before then as some sight defects cannot be corrected if left undetected too late. Visual problems can be incorrectly attributed to special needs or underperformance at school because they cannot see the board. 

What about my child’s oral health?

You should start brushing your child’s teeth as soon as the first milk tooth comes through. You should be using an age-appropriate fluoride toothpaste. 

Children should brush their teeth for 2 minutes, possibly using an egg timer for guidance. They should not rinse after brushing as otherwise the fluoride won’t be effective. 

NHS dental treatment for children is free until the age of 18 and you should take your child to the dentist as soon as their first tooth appears so they can get used to the environment. 

From the age of 3, children should be offered fluoride varnish application at least twice a year to strengthen tooth enamel, making it more resistant to decay. Fissure sealants can be done as soon as the permanent back teeth have started to come through (around ages 6/7) to protect the grooves in the chewing surfaces of the teeth from germs and food particles.

Be Proactive!

In summary, healthy lifestyles and good habits established during childhood, adolescence and young adulthood will influence a person’s health throughout their life. 

A high proportion of obese adolescents remain obese in adulthood, and adolescents who binge drink are more likely to be dependent of alcohol or misusing other substances by the age of 30. 

Therefore, if healthcare professionals can instil a sense of responsibility for the health of a child’s body from a young age through regular health check-ups, hopefully they will continue to make healthy choices once they become adults, preventing chronic diseases of lifestyle such as heart disease, obesity, type 2 diabetes etc.

If you would like to book a routine check-up for your child at ROC, do get in touch!

References 

1https://www.gov.uk/government/publications/healthy-child-programme-pregnancy-and-the-first-5-years-of-life

2https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/492086/HCP_5_to_19.pdf

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