Preventive Care for Children and Teens
The following is a summary of the preventive health care schedules for children and teenagers. The schedules are mainly for children without symptoms of health problems and who do not have special health risks. If your child has any health problems or you have a family history of certain illnesses, ask your child's health care provider to recommend a schedule of preventive care visits that is appropriate for your child.
Listed with each prevention step is the recommended frequency of performing the step.
Birth to 24 Months
When To Schedule a Visit
Visits are usually scheduled within the first 2 weeks of birth, at 2 months, 4 months, 6 months, 9 months, 12 months, 15 months and 18 months. Each visit includes a physical exam, a height and weight check, developmental assessment and head circumference measurements.
Lab Tests
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Hemoglobin or hematocrit: once during infancy
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Cholesterol: not recommended for healthy children
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Urinalysis: not recommended for healthy children
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Tuberculin skin test: not recommended for healthy children
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Lead screening: recommended for children at high risk
Immunizations
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Hepatitis B: series of three between birth and 18 months
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Polio: 2, 4, and 6 to18 months
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Diphtheria/pertussis/tetanus: 2, 4, 6, and 15 to 18 months
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H. influenza, type B: 2, 4, 6, and 12 to 15 months
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Measles/mumps/rubella: 12 to 15 months
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Varicella (chicken pox): 12 to 18 months
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Pneumococcal: 2, 4, 6, and 12 to 15 months
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Influenza: yearly for healthy children ages 6 to 23 months
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Hepatitis A: 24 and 30 months
Rotavirus Vaccine
In February 2006, the U.S. Food and Drug Administration licensed a rotavirus vaccine (RV) for infants. That same month, the Advisory Committee on Immunization Practices (ACIP) recommended routine immunization of all infants with RV. The provisional ACIP recommendations say that infants should receive three doses of oral vaccine, at 2, 4 and 6 months of age. Talk to your health care provider to find out if your child should have the rotavirus vaccine.
Examinations
Ages 2 to 6
When To Schedule a Visit
Visits usually are scheduled at 2 years, 3 years, 4 years, and 5 years of age. Visits include a physical exam, height and weight check, developmental assessment, and vision, hearing, and blood pressure checks, starting at age 3.
Lab Tests
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Cholesterol: recommended for children at high risk
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Urinalysis: not recommended for healthy children
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Tuberculin skin test: not recommended for healthy children
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Lead screening: recommended for children at high risk
Immunizations
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Measles/mumps/: 4 to 6 years
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Diphtheria/pertussis/tetanus: 4 to 6 years
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Polio: 4 to 6 years
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Second varicella (chicken pox) immunization: 4 to 6 years
Examinations
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Blood pressure: every year, startging at age 3
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Vision exam every year, starting at age 3
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Hearing exam: every year, starting at age 4
Ages 7 to 11
When To Schedule a Visit
Visits should be scheduled at least every other year. It will include a physical exam, height and weight check, developmental assessment and blood pressure check .
Lab Tests
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Cholesterol: recommended for children at high risk
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Urinalysis: not recommended for healthy children
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Tuberculin skin test: not recommended for healthy children
Immunization
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Diphtheria/tetanus/pertussis (Tdap): 11-12 years, with boosters approximately every 10 years therafter
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Second varicella (chicken pox) immunization if not previously given at the recommend age of 4-6 years
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Human papillomavirus vaccine for girls age 9 and older.
Examinations
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Blood pressure: every 2 years
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Vision and hearing exams: every 2 years
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Scoliosis screening: every 1 to 2 years
Ages 12 to 18
When To Schedule a Visit
Visits usually should be scheduled every year, but at least every other year. Visits include a physical exam, and height and weight check; developmental assessment; blood pressure check; counseling about tobacco, alcohol, and drug use and sexual activity; and a Papanicolaou (Pap) test for girls at age 18, or upon becoming sexually active.
Lab Tests
Immunization
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Diphtheria/tetanus/pertussis (Tdap): 11-12 years, with boosters approximately every 10 years therafter
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Hepatitis B vaccine (series of three): before entering seventh grade if not done previously
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Varicella (chicken pox): before entering seventh grade if not done previously
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Second varicella immunization if not previously given at the recommended age of 4-6 years
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Measles/mumps/rubella vaccine: before entering seventh grade if not done previously
History/Counseling
Examinations
Risk Factors
Children suspected of having tuberculosis, children who live in households with cases of tuberculosis, or children who are new immigrants from areas known to have high rates of tuberculosis should be tested.
Vision and hearing tests given at school usually do not need to be repeated by the health care provider. Hearing tests are recommended for all newborns but definitely should be given to children with infections at birth, family history of hearing problems, low birth weight, low Apgar scores, or malformation of the head or neck.
Children older than 2 who have a family history of heart disease before the age of 55 or who have a parent with cholesterol readings of over 300 may need to have their blood cholesterol checked.
Children at high risk for lead poisoning include those who live in—or visit—housing built before 1950, or housing built before 1978 that is run down or undergoing renovation; those who live or play with other children who have high lead exposure; those whose parents work in lead-related occupations; or children who live near hazardous waste sites, busy highways, or lead processing plants.
If the child has a serious or dirty wound, a tetanus booster may be recommended if he or she has not had one in the past five years.
Lifestyle Habits
Make sure that your children receive all the recommended immunizations and that your home is a safe, smoke-free environment. Children also need to use car seats and seat belts, wear bike helmets, eat a variety of nutritious food, and be physically active.