If average LDL cholesterol ≥ 250 mg per dL,† consult lipid specialist

If average LDL cholesterol ≥ 130 to 250 mg per dL, or non-HDL cholesterol ≥ 145 mg per dL, refer to dietitian for medical nutrition therapy with CHILD-1‡ then CHILD-2–LDL§ for 6 months; repeat fasting lipid profile

LDL cholesterol < 130 mg per dL, continue CHILD-2–LDL,§ reevaluate in 12 months

LDL cholesterol ≥ 190 mg per dL,|| consider initiation of statin therapy

LDL cholesterol ≥ 130 to 189 mg per dL, negative family history, no other risk factor or risk condition, continue CHILD-2–LDL,§ reevaluate every 6 months

LDL cholesterol is 160 to 189 mg per dL with a positive family history or at least one high-level risk factor/condition or at least two moderate-level risk factors/conditions, consider statin therapy

LDL cholesterol ≥ 130 to 159 mg per dL and at least two high-level risk factors/conditions, or one high-level risk factor and two moderate-level risk factors/conditions, consider statin therapy

Children on statin therapy should be counseled and carefully monitored

If average triglycerides ≥ 500 mg per dL, consult lipid specialist

If average triglycerides ≥ 100 mg per dL in a child younger than 10 years, ≥ 130 mg per dL in a child 10 to 19 years of age, or < 500 mg per dL, refer to dietitian for medical nutrition therapy with CHILD-1,‡ then CHILD-2–TG** for 6 months

Triglycerides < 100 (130) mg per dL, continue CHILD-2–TG,** monitor every 6 to 12 months

Triglycerides > 100 (130) mg per dL, reconsult dietitian for intensified CHILD-2–TG** counseling

Triglycerides ≥ 200 to 499 mg per dL, non-HDL cholesterol ≥ 145 mg per dL, consider fish oil and/or consult lipid specialist

Children at least 10 years of age with non-HDL cholesterol ≥ 145 mg per dL after LDL cholesterol goal is achieved may be considered for additional treatment with statins, fibrates, or niacin in conjunction with a lipid specialist consultation