Child waiting: avoid hyperdiagnosis and polypharmacy

Child check-up is an important part of preventive care for the child's health, which allows timely detection of possible problems and prevention of the development of diseases. However, parents often face such phenomena as hyperdiagnosis and polypharmacy — excessive examination and treatment, which can lead to unnecessary interventions in the child's health. In this article, we will consider why it is important to avoid these mistakes and how to ensure an effective and balanced approach to child check-up in order to ensure optimal health for your child without unnecessary risks.

What do parents need to know in order not to do unnecessary or even unnecessary tests, not to be treated pointlessly and at the same time not to miss the onset of the disease and to disrupt the child's development? Maria Kindzerskaya, a pediatrician at the Oxford Medical clinic with 15 years of experience, tells about it.

Maria Kindzerskaya

Pediatrician of the "Oxford Medical" clinic

If you enter the request "children's waiting", a lot of offers will immediately appear, and the examined packages will be different. Some clinics, for example, immediately recommend that a baby before the age of one year undergo an echocardiogram, ultrasound of the abdomen, kidneys, hip joints, and neurosonography. You yourself understand what the check will turn out to be.

The second basic studies for children under 14 include screening for parasitic infections and glucose level analysis. Others add ECG and narrow specialists: neurologist, ophthalmologist, ENT, surgeon. But is such a volume examined annually?According to Maria Kindzerskaya, the list of really necessary analyzes and consultations of narrow specialists should be determined not by a clinic, but by a pediatrician or a family doctor based on complaints and collected history.

What is the children's waiting room for?

The purpose of scheduled medical examinations, carried out with a certain frequency:

• assess the child's health condition;
• to prevent the disease, revealed the ego at the initial stage;
• find weak areas in the body or developmental disorders in order to correct it with the help of certain measures.

Source: freepik

What are the requirements for children's vocational examinations put forward by the state

There are several normative documents of the Ministry of Health on professional examinations, according to which the scope of medical services, their periodicity and goals are established.

In particular, these are:

• order No. 1351 dated 25.07.2023/XNUMX/XNUMX "On the organization of medical examinations of children and other persons for their enrollment in educational institutions, children's health and recreation facilities";
• order No. 2003 dated 03.12.2024 "On approval of the Procedures and periodicity of preventive medical examinations of certain categories of children";
• Order No. 2146 dated December 25.12.2024, 3 "On Amendments to Order No. 2024 of the Ministry of Health of Ukraine dated December 2003, XNUMX".

According to them, waiting is provided taking an anamnesis, a complete physical examination, checking whether there are signs of an acute illness or chronic conditions, measuring height and body weight, examining visual acuity, hearing (whispered speech), posture and feet, and other examinations.

If necessary, the doctor refers the child to narrow specialists, as well as to clinical and laboratory studies. Depending on the age of the patient and the purpose of the professional examination, for example, before admission to a preschool or school, the examinations may differ - then the overall package includes a stool analysis for infestations (for worm eggs), blood for sugar, a mandatory visit to an ophthalmologist, etc. This is understandable, because the child goes to the team, will study, ask questions in the canteen, engage in physical education, so you need to know the peculiarities of the ego organism.

Source: freepik

How often to wait and why

The frequency of checks according to regulatory requirements depends on age. Up to a year, babies are examined monthly, because they grow and develop quickly. Further, the frequency of visits to the pediatrician decreases to once an hour.

Such professional examinations are aimed at preserving and strengthening health. In addition to medical care, they also provide psychosocial care depending on the needs of the child's developmental period. Thus, the doctor at the reception advises parents on breastfeeding and rational nutrition, prevention of diseases and injuries, early detection of developmental disorders or the risk of their occurrence, formation of healthy lifestyle skills, prevention of bad habits (smoking, use of alcohol and drugs, Internet addiction). This is done in order to create optimal conditions for the harmonious growth of the child in a safe and favorable environment.

So, the main specialist who takes care of the child is a pediatrician or a family doctor. It is he who determines the length of the waiting period, monitors the calendar of vaccinations and appoints the frequency of visits if a small patient has developmental characteristics.

Source: freepik

Moderation and professionalism in diagnostics

Everyone should do their own thing, according to our expert. Parents are to raise children and create proper living conditions for them, and doctors are to monitor the health of patients. There is no need to invent and make diagnoses on your own, look for solutions on the Internet, study medical encyclopedias, pass a bunch of tests that do not carry information for a specialist, or take your child to narrow specialists at your own discretion. This directly concerns checks. A baby should be supervised by a pediatrician from birth, who will know all the nuances of his health and development.

Unfortunately, medical institutions now make a lot of appointments and examinations that are not necessary at all. And all because they have new modern equipment and want to receive funds from the NSZU. In particular, she noted this in an interview with an online publication Natalya Husak, head of the National Health Service.

Pediatrician Maria Kindzerskaya directly says:«It is necessary to fight against hyperdiagnosis and polypharmacy. Parents fall under the influence of advertising about extended waiting packages and lead their children to take tests for ferritin, check vitamins in the blood, calcium

Polypragmasy manifests itself in the fact that the child goes through different narrow specialists, they give him one diagnosis, the second, the third and each specialist gives his appointments, as a result there may be eight!

The expert notes that there are cases when the child has a headache and the parents undertake to examine him on their own. They do a blood test for hemoglobin, X-ray of the cervical spine, neurosonography, electroencephalography, ultrasound of the vessels of the head... And then at the pediatrician's appointment, it turns out that it was enough to measure the young patient's blood pressure - the cause of the pain is low blood pressure. Or the doctor finds out that the child spends half the night sitting on gadgets, and then half the day he does not eat anything until the mother comes.

If any symptoms appear, you should first of all consult a pediatrician - he will better understand what's going on, you should not self-prescribe a spectrum of diagnostics. And the sooner you come to the doctor, the better. So the temptation to try all the drugs recommended by friends or pharmacists will disappear. All the same, as a result, the child will go to the pediatrician, but already in a worse condition.

Separately, Maria notes the need for a direct appointment with a specialist:«If you have questions about health, do not look for answers on the Internet, do not listen to media doctors. The pediatrician must see the child personally, and what the showmen advise is only general information - they are not responsible for their words, they do not observe the patient's condition in dynamics."

Source: freepik

Therefore, the expert concludes that the pediatric waiting list is determined by the pediatrician. Up to a year, there will be visits to the clinic, in addition, the doctor comes home to give recommendations on breastfeeding and safe conditions for the growth of the baby. Further, you should come to the pediatrician every hour for a preventive appointment. He will examine the child and, if necessary, prescribe laboratory tests and examinations by narrow specialists, for example, a dentist, ophthalmologist or orthopedist.

"It's not worth doing either worm tests or blood sugar tests just like that. In the European Union, for example, no one takes a preventive blood test. Even during illness, it is not always necessary. We are not vampires to take blood for every certificate. This is an invasive research method and emotionally traumatic for children." Maria Kindzerskaya explains.

So the task of parents is to be both responsible and moderate in their care: undergo check-ups according to the recommendations of the Ministry of Health, actively communicate with the pediatrician and not succumb to the influence of the current trend of hyperdiagnosis and polypharmacy.