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Unnecessary Testing in Children



In in recent times it has come to the attention of our pediatricians here at OASIS International Hospital that a trend is occurring with some kindergardens here in China. The Kindergardens are requesting parents to get medical certification that their children’s liver functions are ok. This exam requires drawing blood from the child’s vein, which can be quite an ordeal for small children.

Blood tests, such as these kindergardens are requesting, are quite unnecessary and can be quite a traumatic experience for young children. Below is a guideline for parents written by Dr. Vasili Berdoukas to assist parents in understanding when blood tests are required and how to increase our child’s vitamin intake, reducing the need for many health check tests.

   

 Every child should have regular checkups. Checkups include a physical examination, looking at the child’s development, making sure there aren’t any physical problems and comparing the child’s development to percentile charts to check their progress and whether there is any need for concern.

    Another important step for ensuring your child’s health is vaccinations. Vaccinations prevent against a large number of serious diseases that children are at risk for. Such as, polio, tetanus, diphtheria, whooping cough, hemophilus influenza (causing extremely dangerous epiglottitis) pneumococcal and meningococcal infections and nowadays most children are also vaccinated against Hepatitis A and B. Childhood diseases, such as measles, mumps and chicken pox, have also been greatly reduced. Even though most children get over these readily, these diseases still pose significant health risks and it is important to treat them seriously.

    With all these preventative measures put in place to ensure the healthy growth and development of our children, testing for the presence of problems or diseases without cause, seems highly unnecessary.


When are Blood Tests necessary?

+Routine blood count for children, not done annually unless there is a medical need for it.

Blood tests for lead poisoning. Testing for lead is not a common procedure nowadays, as the cars we drive use unleaded petrol. A doctor will decide based on the child's age, risk factors, including their family history, any underlying medical issues and where the they live, whether this test in required.

In the presence of a fever, doctors will usually take a finger tip blood test to help differentiate whether the child’s fever is a viral or bacterial infection.


+ When a child is on regular medication, blood tests may be required to determine the effectiveness of the medication and the presence of side affects.

+ Blood tests are also required to determine problems related to liver and kidney functions, but this is only done with the presence of symptoms indicating a need for further investigation.

+ Other requirements for blood tests would be: allergies and as a method of excluding conditions as causes for the child’s illness.

When are Blood Tests NOT necessary?

Checking for anemia. For example: Children between the age of 12-24 months that are primarily fed a diet of pure cow’s milk as opposed to iron fortified milk, may need to be checked for anemia. Doctors can look at the inside of a child’s eyelids and their palms to determine if the child is anemic, so blood tests are not required in this instance.

Children who have been immunized against Hepatitis A and B do not require blood tests to check their liver fuctions, unless there are signs indicating the need for further investigation.


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Dr. Vasili Berdoukas would like to caution parents, if anyone other than your doctor asks for a blood test for your child, it is important to seek the reason and not put your child and yourself through unnecessary testing and upset.


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Note on Vitamin Intake for Children

    We are all lacking in Vitamin D, this occurs because we are not getting enough sunlight exposure to produce the amount of vitamin D our body requires. In children, vitamin D is crucial in the laying down of healthy bones. In winter we hide away indoors and see many overcast days without sunshine, then in summer, we use sunscreens and stick to the shade, so it is important not only for adults, but also children, to take vitamin D supplements and increase our vitamin D intake. 

    With an adequate diet, supplementation of calcium is not necessary.  Ensuring children eat enough dairy products and calcium enriched foods is the best way to ensure your child’s healthy growth and development. Calcium supplements can cause constipation and may interfere with iron absorption and cause kidney stones. They can also fill the kidney with calcium, causing a condition called nephrocalcinosis, which can interfere with kidney function, therefore calcium supplements would not be recommended for children.




Dr. Vasili Berdoukas

Dr. Vasili Berdoukas’s strives to ensure patients and parents are 100% informed, involving parents in the decision-making, making it a partnership between doctor and patient. Dr. Berdoukas is a specialized pediatrics physician, with experience working in the field of hemoglobin disorders for almost 40 years, establishing procedures for prenatal diagnosis of thalassaemia and other significant hemoglobin disorders. In addition to co-authoring a book on the Clinical Approach to Thalassaemia, he has at least 50 publications in the field of pediatrics and haematology. 


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