Purpose The purpose of this paper is to explore the meaning of child health as applied by school doctors in the Netherlands and the way it was adapted to the rapidly improving standard of living and the increasing importance of mental health after the Second World War. The extension of the concept beyond physical health into emotional and social well-being is particularly interesting as the school medical inspection was the only public child-hygienic service in a country where religious groups opposed the extension of public hygienic care into parenting and the family. Design/methodology/approach On the basis of secondary literature, the paper discusses the early development of Dutch school medical inspection from a comparative perspective. Changes in the national authority’s and the school doctors’ concepts of what a “healthy” child was between the 1930s and 1970 are examined using a variety of primary sources. These concern both the national discourse and sources that shed light on the daily practice of school medical inspection from the single province for which these are available. Findings Although they adopted a new and more inclusive concept of health in theory, school doctors in the Netherlands were reluctant to actually take up issues of mental health in their daily practice. This reluctance was inspired by the fear of losing their pivotal role in child hygiene and their status as public servants. Originality/value Studies in the history of school medical services have focussed mainly on their establishment and development as an institution. They seldom extend into the post-war era and do not discuss the extension of the inspection into mental health.