A guide to toddler health checks, and signs to look out for to ensure your toddler’s development is normal.
Is your toddler in good health? Follow our handy guide on toddler health checks and how to spot any problems.
No routine tests are offered until your child reaches school entry age.
Dr Susan Blakeney, optometric adviser at The College of Optometrists, says, “Apart from infections, for which your GP can prescribe drops, the main danger is amblyopia, or lazy eye (when one eye works harder than the other). Signs include one eye turning in or out, closing one eye, screwing the eyes up, or problems with hand-eye co-ordination.”
Patching the ‘working’ eye makes the lazy eye work harder. It’s vital lazy eye is detected before 7 years old, as after that any sight loss is likely to be permanent.
Dr Blakeney advises taking your child to an optometrist as soon as you notice something – children don’t have to be able to read to get an eye test and optometrists are trained to examine toddlers. If there’s a problem they can’t deal with they may refer him to a specialist.
Following the MMR injection at 13-15 months, your toddler won’t need anything else until he’s 3 years and 4 months old. Then he’ll be given a booster jab for diphtheria, tetanus, pertussis (whooping cough) and polio (dTaP/IPV or DTaP/ IPV), and an MMR booster.
Between the ages of 1 and 3, your toddler gets one check-up. It’s usually carried out by your health visitor when he’s about 2, although the timing may vary according to your Primary Care Trust. This gives you the chance to discuss any concerns you have about behaviour, development, hearing, vision or feeding.
Arrange a hearing test if your toddler’s speech or behaviour deteriorates, he appears not to hear you, or is less sociable than usual. These can be symptoms of developmental problems, but are more frequently down to glue ear.
Dr Ann Robinson, GP
Following his first hearing check, which can be between birth and 9 months, there’s no screening until school age.
Arrange a hearing test if your child has had repeated ear infections, suffered from bacterial meningitis, been treated with ototoxic drugs (drugs that cause hearing loss, such as some antibiotics) and following head injury.
For glue ear, which seven out of 10 children will have had by the age of 4, your GP may adopt a ‘wait and see’ policy for three months, as glue ear can clear up by itself. If there’s no improvement, grommets (small plastic tubes inserted into the ear drum) may be recommended.
Always see your GP with concerns you have about your child’s hearing: he or she will refer you for further tests if necessary. For good general advice on hearing problems in babies and toddlers, go to NHS Direct.
“There aren’t any standard dental checks for toddlers,” says Janet Clarke, from the British Dental Association. “It’s up to parents to take their children to the dentist, ideally around the age of 2½ when they themselves have a check-up. When your toddler’s ready, she’ll ask to go in the chair herself.”
Problems, such as no teeth coming through, are incredibly rare. Common concerns for parents, however, include their toddlers resisting tooth-cleaning and suffering from dental decay.
“For resistant tooth-cleaners try smearing a little toothpaste over the teeth. The fluoride will help beat cavities,” says Janet.
“Making a game of brushing – mum’s turn, toddler’s turn – is also a good idea. As for pin-pointing decay before it turns into full-blown toothache, try to look in your child’s mouth when he’s happy and relaxed. Any decay will look like a brown hole in the tooth.”
If there is evidence of tooth decay, a filling will be necessary unfortunately.
“One of the best ways to find a good NHS dentist is to ask friends and relatives in your area for recommendations,” says Janet. “NHS Direct has a list of NHS dentists in your area. Always phone ahead and ask if a dentist is happy to see children. Some are more at ease with young children than others.” If you already see a private dentist, check with your practice, as some are happy to treat your children on the NHS.
Aside from your child’s routine check-up (around 2 years), it’s up to you to raise nutrition concerns with your GP or health visitor.
What you see as a problem may well be normal. “Erratic feeding in toddlers is the norm,” says Dr Ann Robinson. “They eat what they need. It’s essential to offer a varied diet, and don’t let them just eat crisps.”
What treatment might he get?
Your child will be weighed and, after a few weeks, weighed again. “If your child sticks to the same growth line, there’s probably no cause for concern,” says Anne. If a problem is suspected, your child may be referred to a nutritionist, or a metabolic disorders specialist.
Ask your GP or health visitor for an assessment. For up-to-date advice on feeding toddlers, visit the Food Standards Agency site.
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