When should the child see a specialist? Baby and family

In addition to the pediatrician, ear, eye or dentist care for small patients. When does the examination at the specialist make sense??

Even without a referral, parents can go to the specialist with their offspring

The last U-scan was normal. But you shouldn’t go to the eye, ear and dentist with the child?

From what age the child should be a specialist

"As a rule, the pediatrician decides when an additional consultation with the specialist is useful. He is not only responsible for the primary care of the child, but, not to forget, a specialist himself, namely pediatric and adolescent medicine", says Prof. Dr. Ingeborg Krägeloh-Mann, President of the Germans Society for Pediatric and Adolescent Medicine from Tübingen. "It is therefore advisable to check with the pediatrician first and have a referral made to an expert." The pediatrician can recommend specialists who are familiar with the peculiarities of their specialist area and who can respond sensitively to children, which is not guaranteed if you look for an address yourself on the Internet.

"In principle, however, parents insured by law are allowed to refer their child to their specialist without referral choice go", explains Heike Morris, legal director of the Independent Patient Counseling Germany in Berlin. "If necessary, the pediatrician can issue a referral with an urgency note. Then there is a right to prompt treatment", explains Morris.

When to the ear, nose and throat doctor?

One to two out of a thousand children are born with hearing loss. Illnesses in the first years of life can also impair hearing. Detected early, a reduced hearing can usually be treated well. "In newborns, the pediatrician performs hearing screening in the first few days after birth. If there are any abnormalities, an ear, nose and throat doctor should carry out further tests", advises Prof. Dr. Jörg Lindemann, senior physician at the Ulm University Hospital. If the newborn screening was normal, no further control is necessary.

As a standard, the pediatrician checks the hearing during the U examinations, partly using sound signals via headphones. However, the informative value of such tests also depends on how well the child participates and how well the doctor is trained to use and evaluate them.

Lindemann advises parents not to rely on a good test result, but also on child behavior and behavior development Attention: If the child turns the CD player on very loudly, they often ask questions or speak less than their peers? "In the event of any abnormalities, I recommend a prompt consultation with the ear, nose and throat doctor so that the child does not fall behind in its sensory and language development. This also applies to frequent infections in the head and neck area", says Lindemann.

When to the ophthalmologist?

Six percent of six-year-olds suffer from ametropia. A number that according to Prof. Dr. Klaus Rüther, ophthalmologist in Berlin and head of the department of strabology and neuro-ophthalmology of the professional association of ophthalmologists, would be significantly reduced if children were introduced to the specialist earlier. Overall, the spectrum of eye tests at the pediatrician has expanded in recent years.

The Brückner fluoroscopy test has belonged to U 4 to U 7 since 2017. The measurement with infrared light, which is also offered by many paediatricians for children from the age of six months, provides information on the possible need to wear glasses. "Nevertheless, many forms of poor eyesight go undetected, such as an unremarkable squint", says Rüther. He therefore advises that the child’s eyes be checked between 30 and 42 months of age at the latest.

In the case of severe ametropia of the mother, father or siblings and at increased risk (such as premature births), a child between six and twelve months should see an ophthalmologist. This also always applies to abnormalities such as strabismus, cloudy lenses or eye tremors. "In order to make a diagnosis and make the structures of the eye completely visible, special examinations by the eye doctor are necessary", so Rüther. If you arrive without suspicious diagnosis and transfer, costs may arise.

When to the dentist?

Almost 14 percent of three-year-olds suffer from milk tooth caries. "We cannot emphasize the importance of thorough dental care from the first tooth enough", emphasizes children’s dentist Dr. Jacqueline Esch from Munich. The pediatrician advises about oral hygiene and excessive pacification or sucking the thumb.

"Pediatricians sometimes discover malpositions or incipient caries during the examination and then refer them to the dentist", says Esch. The pediatrician recommends visiting the dentist as part of the U 5. "I would recommend that the child be checked every six months from then on, even if the teeth are in an unremarkable state", said the doctor. This is the only way for the little ones to get to know the dentist’s chair and instruments in a relaxed atmosphere.

Fluoride administration, which toothbrush and toothpaste brush and how often – parents can discuss these questions in detail with the specialist. "Beginning caries can often be stopped well", says Esch. Between the sixth and the 34th month of life, the health insurance companies pay for three early diagnosis examinations at the dentist and the application of fluoride varnish twice a calendar half-year. Between the 34th month of life and the completed sixth year of life, three early detection examinations are also paid; there is a right to fluoridation if there is a high risk of caries.

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Christina Cherry
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