Cessation of breastfeeding before six months and transition to solid foods before six months are associated with childhood obesity. The American Academy of Pediatrics guideline based on expert opinion recommends that screen time be avoided, with the exception of video chatting, in children younger than 18 months and limited to one hour per day for children two to five years of age. Preventive Services Task Force to detect amblyopia. A one-time vision screening between three and five years of age is recommended by the U.S. Fluoride use, limiting or avoiding juice, and weaning to a cup by 12 months of age may improve dental health. Car seats should remain rear facing until two years of age or until the height or weight limit for the seat is reached. Well-child visits provide the opportunity to answer parents' or caregivers' questions and to provide age-appropriate guidance. Preventive Services Task Force found insufficient evidence to make a recommendation. Based on expert opinion, the American Academy of Pediatrics recommends developmental surveillance at each visit, with formal developmental screening at nine, 18, and 30 months and autism-specific screening at 18 and 24 months the U.S. Screening for postpartum depression in mothers of infants up to six months of age is recommended. Immunizations should be reviewed and updated as appropriate. A head-to-toe examination should be performed, including a review of growth. A complete history during the well-child visit includes information about birth history prior screenings diet sleep dental care and medical, surgical, family, and social histories. 24 The Children's Depression Inventory and Reynolds Child Depression Scale are appropriate screening tools for school-aged children.The well-child visit allows for comprehensive assessment of a child and the opportunity for further evaluation if abnormalities are detected. 8 Younger children may not be able to communicate a depressed mood therefore, physicians should consider a depression diagnosis in children presenting with vague somatic symptoms, irritability, or impaired attention. 8 Less data are available regarding children seven to 11 years of age, and the USPSTF has concluded that there is insufficient evidence to recommend for or against routine depression screening in this age group. 22, 23 There is good evidence to support screening adolescents 12 to 18 years of age for depression when systems are in place to ensure accurate diagnosis, psychotherapy, and follow-up. 21 Children and adolescents with major depressive disorder have increased risk of poor school performance and social functioning, early pregnancy, physical illness, and substance abuse. The prevalence of current or recent depression is 3 percent in children and increases to 6 percent in adolescents. Major depressive disorder can be a debilitating mental health condition in children and adolescents. Age-appropriate immunizations should be given, as well as any missed immunizations. Children who live in areas with inadequate fluoride in the water (less than 0.6 ppm) should receive a daily fluoride supplement. ![]() All children should receive at least 400 IU of vitamin D daily, with higher doses indicated in children with vitamin D deficiency. ![]() There is insufficient evidence to recommend screening for dyslipidemia in children of any age, or screening for depression before 12 years of age. The American Academy of Pediatrics recommends vision and hearing screening annually or every two years in school-aged children. Although the evidence is mixed regarding screening for hypertension before 18 years of age, many experts recommend checking blood pressure annually beginning at three years of age. Children should be screened for obesity, which is defined as a body mass index at or above the 95th percentile for age and sex, and resources for comprehensive, intensive behavioral interventions should be provided to children with obesity. Preventive Services Task Force recommends against routine scoliosis screening and testicular examination. A full physical examination should be performed however, the U.S. School performance can be used for developmental surveillance. A complete history should address any concerns from the patient and family and screen for lifestyle habits, including diet, physical activity, daily screen time (e.g., television, computer, video games), hours of sleep per night, dental care, and safety habits. The goals of the well-child examination in school-aged children (kindergarten through early adolescence) are promoting health, detecting disease, and counseling to prevent injury and future health problems.
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