There is not a lot of research data regarding HDL in very young children and their future risk. The government does recommend screening children for cholesterol issues at age 2 if one of the parents has a history of heart disease. However, some studies show that low HDL in young children is more common than previously thought, and that link to future heart disease is not clear. You're right that this is likely genetic, but there is not much data to suggest that trying to raise the HDL will have any impact on the child's future cardiovascular health. My best advice is to stay in close contact with your physician and, if you feel more comfortable, visit a pediatric cardiologist who specializes in lipid disorders.