Section 2 - Child health checks

Health check recommendations

• All children from birth to < 15 years at each scheduled health check

1. Procedure

• Ask the questions as per Table 1. Be prepared to explore answers
• Provide brief intervention if required
• Determine if the child requires a referral and place on a follow-up and recall register

2. Results

1. Physical activity ^1,2
   • Characterised by activity that makes breathing and heart beat faster
   • Moderate intensity activity requires some effort where children can still speak easily while doing it e.g. fast walking, riding a bike or scooter and active play
   • Vigorous intensity activity requires effort and makes children breathe hard and fast (‘huff and puff’) e.g. running, chasing or organised sports e.g. football, netball
2. Sedentary behaviour ^1,2
   • Characterised by sitting or laying down (except for when sleeping)
   • Electronic devices are the primary contributors to sedentary behaviour

3. Brief intervention

• Parents are the role models to encourage and provide their children with opportunities for Physical activity and sleep which:
  • creates opportunities for fun with friends
  • reduces anti-social behaviour, including aggressive and disruptive behaviour
  • develops skills such as co-operation and teamwork
  • improves self-esteem, confidence and concentration
  • manages anxiety and stress
  • reduces the risk of developing chronic conditions in adulthood
  • improves physical fitness, co-ordination and movement skills
  • builds muscle and bone strength
  • improves healthy growth and development and reduced weight gain
• Children should not be restrained or be sedentary for > 1 hour at a time e.g. stroller, car seat, high chair, electronic devices or screen time
• If sedentary, encourage parents to engage their child e.g. read, sing, play
• Sedentary behaviour can counteract the benefits of physical activity
  1. Infants 0–1 year ^1,2
     • Encourage floor based play, plus 30 minutes of tummy time, in a safe and supervised environment
     • Encourage 14–17 hours of good quality sleep (including naps) for < 3 month olds and 12–16 hours for 4–11 month olds. Provide Resource 1.
  2. Toddlers 1–2 years ^1,2
     • Should be physically active every day for > 3 hours; more is better
     • Encourage 11–14 hours of good quality sleep (including naps) with routine sleep and wake times. Provide Resource 1.
  3. Preschoolers 3–5 years ^1,2
     • Should be physically active every day > 3 hours with > 1 hour of vigorous play; more is better
     • Restrict daily electronic device or screen time to < 1 hour; less is better
     • Encourage 10–13 hours of good quality sleep (may include a nap) with routine sleep and wake times. Provide Resource 1.
  4. Children and young people 6–17 years ^1,2
     • Should accumulate > 1 hour of moderate to vigorous intensity activity every day including:
     • a variety of aerobic activities that makes their heart beat faster
     • activities that strengthen muscle and bone at least 3 days per week
     • Limit daily screen time to < 2 hours, excluding for educational purposes
       • discuss boundaries, time limits and age appropriate content
       • avoid before sleep, and keep electronic devices out of the bedroom
     • 5–13 year olds should have 9–11 hours of uninterrupted sleep per night
     • 14–17 year olds should have 8–10 hours of uninterrupted sleep per night
     • Provide Resource 2.

4. Referral

• Refer to the MO/NP for concerns of Overweight and obesity (child) despite brief interventions

5. Follow-up

• Place the child on a recall register if required
• Ensure all referrals are actioned
• Provide the parent with details of the next scheduled follow-up appointment

6. References

• All Chronic Conditions Manual references are available via the downloadable References PDF

7. Resources

1. 24-hour movement guidelines – birth to 5 years
2. 24-hour movement guidelines – children and young people (5 to 17 years)