New well-visit guidelines

The longer list is an effort to catch serious problems sooner

By Jodi Mohrmann - Managing Editor of special projects
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The American Academy of Pediatrics is updating its checklist of things pediatricians should assess at each well-child visit.  The new guidelines include  recommendations on screening for HIV as well as screening for both depression and cholesterol.

Cleveland Clinic Children's pediatrician Dr. Michael Macknin says he expects some parents to question why doctors would check a child's cholesterol level.

"We're really not looking for the child that has a minor elevation of cholesterol," explained Macknin. "We're looking for the children that have a family problem with high cholesterol and about half the people that do have a family problem with high cholesterol don't know it."

The updated guidelines call for cholesterol screening between ages 9 and 11. They also include information about a specific screening tool to assess a teen's drug and alcohol use.

Depression screenings are recommended between ages 11 and 21 and screening for HIV between age 16 and 18 years.

A risk assessment for hemoglobin, a protein in red blood cells that carries oxygen from the lungs to the body's tissues, was added for babies between 15 and 30 months.

There is also a call to screen all newborns for critical congenital heart defects by checking their oxygen level before they leave the hospital.

Macknin says parents should not be alarmed by the changes, they're preventative measures.

"The reason for doing these things is that there are a lot of children with all of these conditions. The high cholesterol, depression, drugs, alcohol, that have these various problems and we don't know about it and in this way we are more likely to detect these problems and help future, more severe issues from occurring," explained Macknin.

The new guidelines push one test back.  Teenage girls should no longer be routinely screened for cervical dysplasia with a pap test until the age of 21.

Download the complete list of guidelines here.

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