Children's preventive health guidelines

Children grow by baby steps and then leaps and bounds. We make it easy for you to keep up with their checkups, immunizations, and screenings.

For children ages 0 to 2

Topics you may want to discuss with your doctor

Safety     

• Use a checklist to "baby-proof" your home. 
• Check your home for the presence of lead paint. 
   

Nutrition

• Breast-feeding and iron-enriched formula and food for infants.
   

Dental health

• Do not put your baby or toddler to bed with a bottle containing juice, milk, or other sugary liquid. Do not prop a bottle in a baby’s or toddler’s mouth. Clean your baby’s gums and teeth daily.
• Use a clean, moist washcloth to wipe gums. Use a soft toothbrush with water only, beginning with eruption of first tooth.
• Age 6 months to preschool: Discuss with your dentist about taking an oral fluoride supplement if water is deficient in fluoride.
• Age 2: Begin brushing child’s teeth with pea-size amount of fluoride toothpaste.

Injury prevention for Infants and young children

Decrease risk of SIDS

Sudden infant death syndrome (SIDS) is a leading cause of death for infants. Put infants to sleep on their backs to decrease the risk of SIDS. 

Protect your children with car seats

Use the right car seat for your vehicle and for your child’s weight. Read the car seat and vehicle manufacturer’s instructions about installation and use. Use a rear-facing car seat until your child is at least 40 inches tall or weighs at least 40 pounds.

Baby-proof your home

Take these steps to give your child a safe home environment: 

• Keep medicines, cleaning solutions, and other dangerous substances in childproof containers, locked up and out of reach of children.
• Use safety gates across stairways (top and bottom) and guards on windows above the first floor. 
• Keep hot water heater temperatures below 120° F. 
• Keep unused electrical outlets covered with plastic guards. 
• Consider not placing your baby in a baby walker. If you do, provide constant supervision. Block the access to stairways and to objects that can fall (such as lamps) or cause burns (such as stoves or electric heaters).
• Keep objects and foods that can cause choking away from your child. This includes things like coins, balloons, small toy parts, hot dogs (whole or small bites), peanuts, and hard candy. 
• Use fences that go all the way around pools, and keep gates to pools locked. 

For children ages 3 to 10 

Be aware of your child’s recommended weight: Use our online tools to calculate your child’s body mass index (BMI) by logging in to blueshieldca.com and searching for BMI.
 

Topics you may want to discuss with your doctor

Safety 

• Use a checklist to "child-proof" your home.
• Check your home for the presence of lead paint.
   

Exercise

• Participate in physical activity as a family, such as taking walks or playing at the playground.
• Limit screen time (such as mobile devices, computers, and television) to less than two hours a day. 
   

Nutrition

• Eat a healthy diet. Limit fat and calories. Eat fruits, vegetables, beans, and whole grains every day. 
   

Dental health

• Ask your dentist when and how to floss child's teeth. 
• Age 5: Talk to your dentist about dental sealants. 
   

Other topics for discussion

• Well-child visits are a good time to talk to your doctor about any concerns you have with your child's health, growth, or behavior. 

Injury prevention 
 

For older children

• Children under 8 years old must ride in a car seat or booster seat in the back seat. Children who are 8 years old or are at least 4’9” tall may ride in a booster seat, but at minimum must wear a safety belt.
• Older children should use car seat belts and sit in the back seat at all times. 
• Teach your child traffic safety. Children under 9 years old need supervision when crossing streets.
• Make sure your child wears a helmet while rollerblading or riding a bicycle. Make sure your child uses protective equipment for rollerblading and skateboarding (helmet, wrist, and knee pads). 
• Warn your child about the risks of using alcohol and drugs. Many driving and sports-related injuries are caused by the use of alcohol and drugs. 
   

For all ages

• Use smoke and carbon monoxide alarms/detectors in your home. Change the batteries every year, and check once a month to see that they work.
• If you have a gun in your home, make sure that the gun and ammunition are locked up separately and kept out of children’s reach.
• Never drive after drinking alcohol or after marijuana use. 
• Use car seat belts at all times. 
• Post the number for the Poison Control Center - (800)-222-1222 - near your phone. Also, add the Poison Control Center number to your home "Important Information" list. The number is the same in every U.S. location. Do not try to treat poisoning until you have called the Poison Control Center.

   

  For children ages 11 to 19

   

  Immunizations

  COVID-19	Recommended for everyone ages 6 months and older.29
  Dengue	Three-dose series for children ages 9-16 living in dengue endemic areas and have laboratory confirmation of previous dengue infection.6
  Flu, annual	Recommended.2
  Hepatitis A	Two-dose series for individuals not previously vaccinated and risk factors are present.
  Hepatitis B	Two-dose series for individuals not previously vaccinated; for individuals with risk factors seeking protection.4
  HPV (human papillomavirus)	Two- or three-dose series depending on age at initial vaccination. Recommended for all adolescents 11-12 years and through 18 years of age.

  IPV (inactivated poliovirus vaccine)	For individuals not previously vaccinated. Not recommended for individuals 18 years and older.
  Meningococcal	Routine vaccination two-dose series. First dose at ages 11-12, second dose at age 16.
  MMR (measles, mumps, rubella)	Two-dose series for children under 12 previously unvaccinated

  Pneumococcal (pneumonia)	For children with risk factors.6
  Tdap booster (tetanus, diphtheria, pertussis)	For children ages 11-12 who have completed the recommended DTaP immunization series.17
  Varicella (chicken pox)	Two-dose series for children previously unvaccinated.

   

  Screenings/counseling/services
  Alcohol misuse	Screening for unhealthy alcohol use and behavioral counseling as needed for individuals 12 years and older.
  Annual exam	Includes height, weight, body mass index (BMI), blood pressure, age appropriate exam and history and coordination of preventive services.
  Chlamydia and gonorrhea	Screening for all sexually active women 24 years or younger and in women 25 years and or older who are at increased risk for infection.
  Contraception	FDA-approved contraceptive methods, education and counseling.32
  Depression/Anxiety	Screening for all adolescents for major depressive disorder (MDD) and anxiety.
  Domestic violence and abuse	Screening for intimate partner violence (IPV) in women of reproductive age and provide or refer women to ongoing support services.34
  Drug misuse	Screening for unhealthy drug use for individuals 12 years and older.25
  Healthy diet and physical activity	Behavioral counseling interventions to promote a healthy diet and physical activity for individuals 18 years and older with risk of cardiovascular disease or a diagnosis of hypertension, dyslipidemia, metabolic syndrome, etc.27
  Hepatitis C	Screening for HCV infection in persons at high risk of infection.30
  HIV	Screening for HIV infection for all adolescents and adults ages 15 to 65. Younger adolescents and older adults who are at increased risk of infection should also be screened. Recommend preexposure prophylaxis (PrEP) using effective antiretroviral therapy to persons at high risk of HIV acquisition.16
  Hypertension	Screening for hypertension in adults 18 years and older with office blood pressure measurement (OBPM). Blood pressure monitoring outside the clinical setting is recommended to confirm diagnosis.
  Latent tuberculosis infection (LTBI)	Screening for individuals at increased risk of infection.33
  Obesity	Screening, counseling, and behavioral interventions and offer or refer to comprehensive intensive behavioral intervention to promote improvements in weight status.
  Sexually transmitted infections	Behavioral counseling for all sexually active adolescents and for adults who are at increased risk for sexually transmitted infections (STIs).6
  Skin cancer	Behavioral counseling for minimizing exposure to ultraviolet radiation for adolescents at high risk.
  Syphilis	Screening for individuals at increased risk for infection.12
  Tobacco use and cessation	Provide education or brief counseling to prevent initiation of tobacco use among school-aged children and adolescents.

   

  Promoting your preteen's and adolescent's social and emotional development

  Parents need to offer open, positive communication while providing clear and fair rules and consistent guidance. Let your child find her or his own path while staying within the boundaries you have set. 
  

  • Be a good role model for handling disagreements – for example, talkcalmly while disagreeing. 
  • Praise him or her for successfully avoiding a confrontation – for example, say "I'm proud of you for staying calm." 
  • Supervise the websites and computer games that your child uses. 
  • Set limits on use of computers, telephones, texting, and TV after a set evening hour to help your child get regular sleep. 
  • Talk to your child about healthy relationships. Dating abuse does occur among preteens and teens. 
  • Be a role model for healthy eating and regular physical exercise. 

   

  Topics you may want to discuss with your doctor

  Exercise

  • Regular physical activity (at least 30 minutes per day starting at age 11) can reduce the risks of coronary heart disease, osteoporosis, obesity, and diabetes. 
     

  Nutrition

  • Eat a healthy diet. Limit fat and calories. Eat fruits, vegetables, beans, and whole grains every day. 
  • Optimal calcium intake for adolescents and young adults is estimated to be 1,200 to 1,500 mg/day. 
     

  Sexual health

  • Sexually transmitted infection (STI)/HIV prevention,¹⁶ practice safe sex (use condoms), or abstinence. 
  • Avoid unintended pregnancy; use contraception. 
  • Prior to beginning PrEP, the following tests are recommended: HIV testing, serologic testing for hepatitis viruses B and C, periodic serum creatinine testing, periodic pregnancy testing, periodic screening for sexually transmitted bacterial infections. 
  • Ongoing follow-up counseling and monitoring every 3 months is covered without cost- sharing.
     

  Mental health and substance use disorder 

  • Use of alcohol, tobacco (cigarettes, vaping, or chewing), inhalants, and other drugs among adolescents is a major concern for parents. Let the doctor know if you have any concerns about your child. 
  • Mental health and substance use disorders is defined as those conditions listed in the most recent edition of the World Health Organization (WHO) International Classification of Diseases or in the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders.
     

  Dental health

  • Floss and brush with fluoride toothpaste daily. Seek dental care regularly. 
     

  Other topics for discussion

  • It is a good idea to let your teenager have private time with the doctor to ask any questions he or she may not feel comfortable asking you. 

  Download the complete preventive health guidelines

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