Healthy start: The importance of regular check ups for babies and children

Regular health checks for babies and children are crucial for ensuring their growth and development are on the right track. These check ups monitor physical health and assess developmental milestones, growth, vaccinations and overall wellbeing.

"Early detection of health issues can prevent complications later in life," says Dr Preoshni Moonsamy, a paediatrician at Netcare Waterfall City Hospital. "Regular check ups provide an opportunity to catch potential problems and address them promptly."

Raising a healthy child takes teamwork between an informed parent and a treating doctor, to give the child access to the right health checks, at the right time.

Keep track of your child's growth and development

When your baby is born, the hospital will give you a Road to Health Booklet or something similar. The booklet allows parents and caregivers to record the following development goals of their child in the first five years of life:

• Birth history
• Growth (height, weight and head circumference)
• Development
• Illnesses
• Vaccination history

Ask your child's paediatrician to fill in this essential record at every visit (and scan your child's booklet after every health check so that you have a digital back up). Also use your visits to talk about other important matters, such as:

• Infant feeding, especially the importance of breastfeeding (if you are able to breastfeed) and weaning to solids
• Infant sleep position and patterns
• Car and home safety (as a child becomes more mobile and explorative)
• Certain all-important child health checks that you may overlook.

Let's take a closer look at those health checks.

Important tests for newborn babies

"The first time your child will have a health check is straight after they are born to check their overall health and whether there are signs of any inherited health conditions," says Dr Moonsamy. "Private hospitals offer screening tests as part of the newborn health check."

These checks are:

• Screening for congenital (a condition that exists at birth) hypothyroidism (low levels of thyroid hormones, which are essential for healthy growth and development). Most newborns with this condition show no symptoms at first. Delayed diagnosis can lead to mental and growth retardation, so it is very important to test baby's blood for this condition soon after birth, and, if necessary, to normalise thyroid function as soon as possible.
• A metabolic screening for your baby is especially important if there is a history of uncommon metabolic conditions in your family. The test involves pricking the baby's heel to collect a few drops of blood. There are very few risks associated with this procedure, with minimal discomfort for your baby.
• It is important to test bilirubin (formed when red blood cells break down) levels in the blood. High levels make the skin and the whites of the eyes look yellow and can indicate a problem with baby's liver - a condition called jaundice. Jaundice is common in newborns and premature babies, and may require treatment soon after birth. It's important to test your baby's bilirubin levels before discharge from hospital. If you gave birth at home or you went home from hospital within two days after your baby's birth, you might miss this test. If your newborn has a yellow tinge to the skin, a yellow tinge to the whites of the eyes, is unusually drowsy or floppy, or has difficulty feeding, contact your paediatrician immediately for advice.
• Screening for congenital (a condition that exists at birth) heart disease is done to exclude a group of serious heart defects that are present from birth. The test uses sensors placed on the hands and feet to measure how much oxygen there is in the blood and whether there are significant differences between the hands and feet. Low oxygen levels suggest heart problems, and you should have it further evaluated.

• - Discovery Health Medical Scheme members have access to cover for pregnancy, childbirth and early childhood through their Maternity Benefit. The early childhood benefits are available for up to two years after birth and offer a newborn screening, GP and specialist visits, a breastfeeding consultation with a registered nurse or lactation specialist, and more.

Has your child's hearing been checked?

An audiologist should test your child's hearing shortly after your baby's birth. The audiologist uses special apparatus to determine whether the baby's inner ear or brain responds to sound. It is a painless test and easy to do while the baby is sleeping.

The general recommendation is that newborns should have hearing assessments before they go home from hospital or between the ages of 3 to 5 days and 1 month old. While most children born in private hospitals undergo such a test, it is not compulsory, and you can take your baby for a hearing test in your own time.

It is key to identify any hearing problems by the time a baby is 3 months old so that early intervention or treatment can be underway by the time the baby is 6 months old.

"Hearing loss affects the development of speech, language and social skills. Babies hear sounds before they are born and their hearing system continues to develop after birth. At three months, babies smile when addressed, and by six months they can babble and imitate sounds. If a baby cannot hear, their auditory and cognitive development will be slow. This makes early identification and intervention key."

Children should go for another hearing test around one year of age, and when they start school at around five years old. If you suspect that your child has hearing loss or difficulty hearing, ask your GP or paediatrician for advice or contact an audiologist for an assessment.

Eye tests for kids

The American Optometric Association recommends that children between 3 and 5 years old have a comprehensive eye examination. This assessment will detect whether the child has any conditions that could impact their vision. Once children start formal schooling, they should have their eyes tested by an optometrist every year.

Ensure a healthy environment for your child

"It is important to provide an environment and lifestyle for children that promotes their health and lifelong healthy behaviours," says Dr Moonsamy.

Research shows that high levels of screen time are associated with a variety of health harms (from obesity to depression, poorer diet and quality of life) for children and young people. Your baby shouldn't be exposed to any form of screen time - like watching TV or videos on a phone or tablet until after they are 18 months old. This is according to guidelines set out by the World Health Organization.

"The impacts of screentime on developing brains is starting to become clearer. In my practice I see children with delays in speech and language as a direct result of screentime. I recommend that screentime for children is limited to between 10 - 20 minutes a day and that where screentime happens, it be an interactive family activity."

The WHO recommends that children aged 5 to 17 do at least 60 minutes of moderate to vigorous physical activity each day. Other research shows that children at these ages should sleep at least nine hours a night to reduce their odds of becoming overweight or obese.

"A nutritionally complete diet is also very important for a child. Good nutrition contributes to healthy brain development, physical growth, and overall health."

Stay up to date with vaccinations, including the annual flu jab

The South African national expanded programme on immunisation spans from birth to age 12. Parents can have their children vaccinated at state clinics for free or through private healthcare. Some vaccinations, such as those against MMR (measles, mumps and rubella) and chickenpox, are not available in the public sector.

"Making sure that your child gets their vaccinations on time and is fully vaccinated is absolutely essential," says Dr Moonsamy. "The vaccines protect your child against life-threatening diseases."

A vaccine that parents sometimes overlook is the voluntary, annual flu vaccine. "It is safe to vaccinate children aged 6 months or older against influenza. Children under the age of five fall into the 'high risk' group for being hospitalised due to severe complications from flu."

Join forces with your paediatrician to stay on top of your child's health and development

"Your paediatrician is your partner in staying on top of your child's health and development," says Dr Moonsamy. "During your baby's first two years they should have regular check ups at the paediatrician - at 6 weeks, 3 months, 6 months, 12 months, 18 months, and 24 months. After that your child can visit the paediatrician for annual health checks until they are around 13 years old."

"At health checks, your paediatrician will check on your child's growth, development and overall health. They will discuss any concerns you might have and remind you if you've missed any vaccinations. Your paediatrician will be able to diagnose any inherited conditions like congenital heart diseases, asthma and allergies, congenital hypothyroidism, neuromuscular disorders and inherited metabolic diseases. They can also help to manage any recurrent illnesses that are affecting your child's quality of life."

"And parents, trust your gut. If you feel that something isn't right with your child, seek professional advice. Sometimes getting that extra advice from your healthcare team can make a world of difference!"

Give your child's doctor access to your child's electronic health record

Your relationship with your paediatrician will last for years. To help a doctor fully understand a child's full medical history, you or your child's guardian can give the doctor consent to access your child's electronic health record through Discovery HealthID. It allows the doctor to access past health history, health plan benefits, blood test results, and to write electronic prescriptions and referrals to other healthcare professionals and more. Ultimately, this gives your child the best care possible.