Pediatrics Screening

Newborn Screening

• screening | Technique

• Hypothyroidism

  • For full-term infants (2-7 days), initial (T4) assay, with follow-up [TSH] assay if the blood T4 value is 10th percentile

• Phenylketonuria

  • The AAFP recommends ordering screening test for Phenylketonuria in neonates.

• Critical congenital heart defect

  • ≥ 4 hour of age or before discharge, Pulse oximetry

Infant and Children Screening

• Screening
  • Hip Dysplasia
    • Barlow and Ortolani tests
  • Vision screening
    • 1 mon.- 1.5 years: red reflex
    • 1.5 year – 3 years:
      • Infants and young toddlers: Fixate and follow response

Barlow Test

• Pushing backwards to try to dislocate hip

Ortolani Test

• Abducting the hips to try to relocate hip
• Fingers push femur forwards into acetabulum

Barlow’s Test

• Adduct the hip, then apply a downward pressure over the knee with your thumb. If the hip is unstable, the femoral head will slip out of the acetabulum, producing the palpable sensation of the hip dislocating. If the hip is dislocatable, then Barlow’s test is positive.

The Ortolani Test

• The examiner’s hands are placed over the child’s knees with his/her thumbs on the medial thigh and the fingers placing a gentle upward stress on the lateral thigh and greater trochanter area.
• With slow abduction, a dislocated and reducible hip will reduce with a described palpable “clunk.”

Hearing Screening

• At all health maintenance visits and periodic hearing screening at 4, 5, 6, 7, 8 and 10 years of age.
• Audiometry screening that includes 6000 and 8000 hertz frequencies is recommended once between 11 and 14 years, once between 15 and 17 years, and once between 18 and 21 years.

Behavior Screening

• At 18 and 24 months of age.

IDA

• At four months of age and measurement of hemoglobin or hematocrit at 12 months of age and repeat risk assessment at 15, 18, 24, 30, and 36 months of age and annually thereafter.

Vit D

• Recommends 400 IU of vitamin D daily for all children.