The lowdown on toddler health checks

Toddler health checks - what tests are available to keep track of your child’s development?

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Is your toddler in good health? Follow our handy guide on toddler health checks and how to spot any problems.

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HEALTH CHECK 1: Eyes

What your toddler gets

No routine tests are offered until your child reaches school entry age.

What to look out for

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.”

What’s the treatment?

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.

Where do you start?

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.

HEALTH CHECK 2: Vaccinations and check-ups

What jabs should your toddler get?

When your toddler is between 12 and 13 months old, they will have a booster injection for Hib/Men C, and the MMR (measles, mumps and rubella) vaccine as a single jab. They will also have the third dose of the Pneumococcal (PCV) vaccine. When they are around 3 years and 4 months they will have their second dose of measles, mumps and rubella (MMR) vaccine, and the 4-in-1 (DTaP/IPV) pre-school booster. This is a single injection and protects your child against diphtheria, tetanus, whooping cough (pertussis) and polio.

From autumn 2014, all children aged 2, 3 and 4 will be offered an annual flue vaccine in the form of a nasal spray.

And check-ups?

Between the ages of 1 and 3, your toddler gets one check-up. It’s usually carried out by your health visitor when your child is 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.

Many health visiting teams will send out an invitation around your child’s second birthday. But don’t depend on it, and don’t be afraid to chase it up if nothing turns up! You’re also entitled to book further appointments with your health visitor if, at any point, you have concerns about any aspect of his development.

HEALTH CHECK 3: Ears

What your toddler gets

Following his first hearing check, which can be between birth and 9 months, there’s no screening until school age.

What to look out for

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.

What’s the treatment?

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.

Where do you start?

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.

HEALTH CHECK 4: Teeth

What your toddler gets

“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.”

What to look out for

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.

What’s the treatment?

“For toddlers who resist teeth-cleaning 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.

Where do you start?

“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.

HEALTH CHECK 5: Diet

What your toddler gets

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 to look out for

What you think is 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.”

If you suspect your child has a feeding problem, get an objective assessment. “Don’t just ask your mum or a friend their opinion,” says Ann. “Take him to your GP or health visitor.”

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 Ann. If a problem is suspected, your child may be referred to a nutritionist, or a metabolic disorders specialist.

Where do you start?

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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When are the health tests and checks done?

  • Eyes: No routine tests until school age.
  • Ears: Hearing test between birth and 9 months, then none until school age.
  • General: Health visitor check-up between 1 and 3 years, usually around 2nd birthday.
  • Vaccinations: MMR injection at 13-15 months. At 3 years and 4 months old, a booster jab for diphtheria, tetanus, pertussis (whooping cough) and polio and MMR. From autumn 2014, flu vaccine at 2,3 and 4 years.
  • Teeth: No standard tests. Experts suggest taking your child to the dentist at 2½.

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