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Baby's First Checkup
Your baby starts changes over the first days after the birth, both in the way he looks and the way he behaves. • Over the first week, you'll observe your baby's skin seems to smooth out a little, his head becomes rounder, and the whitish coating of vernix he may have been born with vanish. • Some babies sleep quite a lot in the first two or three days; others are already quite alert. Later, though, most babies become more wakeful, restless and start needing more feeds and more attention and care in general. The midwife or doctor must carry out a few checks on your baby, to rule out any health or progress issues. Baby checkups, starting a few weeks after birth, help examine your baby's well-being. Most babies have their first medical checkup within the first few weeks after birth. Even when things are going well, regular checkups during the first year are essential for monitoring your baby's state. If the checkup will double as your baby's first outing, leave yourself plenty of time to stock the diaper bag and fastener your baby into the car seat. You may be surprised how long it takes to get your new family out the door! Measurements Most well-baby checkups begin with measurements of your baby's length, weight and head circumference. Keep a blanket handy to undress your baby. The measurements will be produced on a growth chart. You can see how your baby's size compares with other babies of the same age, but the comparison isn't what matters. The doctor will use these measurements to make sure your baby's growth is on mark from one visit to the next. Remember that many factors can affect a baby's position on the growth charts. Babies born several weeks early are likely to be smaller than those born closer to their due dates. Babies who were overdue may top the charts. Head-to-toe physical exam A thorough physical exam can help the doctor discover issues from diaper rash to breathing difficulties. Here are the basics: • Head. The doctor will check the size and softness of the fontanels, the soft spots on your baby's head. These gaps between the skull's bones give your baby's brain plenty of room to grow. They're safe to touch and typically disappear within 12 to 18 months, when the skull bones combine together. The doctor can propose varying your baby's head position to help your baby's head remain an even shape. Place your baby on his or her back to sleep, but alternate the direction your baby faces. When your baby's able to hold up his or her head, try supervised tummy time. • Ears. The doctor will check for fluid or infection in your baby's ears with an instrument called an otoscope. The doctor may check the shape of your baby's ears as well. • Eyes. The doctor will look for blocked tear ducts and eye discharge, may examine the inside of your baby's eyes with an instrument called an ophthalmoscope. The doctor will look for crossing of the eyes (strabismus) and ask if you've ever noticed your baby's eyes crossing at home. By the end of the first month, most babies can focus on objects about 8 to 12 inches away - about the distance to your eyes during a feeding. • Mouth. The doctor may check your baby's sucking reflex by placing a fingertip or pacifier in your baby's mouth. A look inside your baby's mouth may reveal signs of oral thrush, an easily treated yeast infection common in babies this age. • Skin. The doctor will look for various skin conditions, including birthmarks, rashes and jaundice - a yellowish discoloration of the skin and eyes. Mild jaundice that develops soon after birth often vanishes on its own within a week or two, but more severe cases may need simple therapy or other treatments. The doctor will also make sure the area around your baby's bellybutton is beginning to heal. • Heart and lungs. The doctor will listen to your baby's heart and lungs with a stethoscope to detect any abnormal heart rhythms, sounds or breathing difficulties. Heart murmurs are common in infants and are rarely a concern. • Abdomen. By gently pressing your baby's abdomen, the doctor can detect softness, enlarged organs or an umbilical hernia. (A hernia is the protrusion of an organ through the structure that normally surrounds or contains it. With an umbilical hernia, a bit of intestine or fatty tissue near the navel breaks through the muscular wall of the abdomen. Most umbilical hernias resolve on their own by age 2.) • Hips and legs. The doctor will move your baby's legs to check the hip ligaments and joints and all the muscle tone as well. • Genitalia. The doctor will inspect your baby's genitalia for tenderness, lumps or other signs of infection. He or she will also check for an inguinal hernia, which results from a weakness in the abdominal wall. For boys, the doctor will look for descended testicles and a hydrocele, a fluid-filled sac around the testes in the scrotum. If your son was circumcised, the doctor will make sure the area is beginning to heal. General development It may seem as if your baby does little more than wiggling in your arms, but even limited head, arm and leg movements can help the doctor assess muscle strength and tone. Your baby's reflexes and overall responsiveness will be checked as well. Asking the Doctor During the appointment, the doctor will ask how things are going. How are you adjusting to life with a newborn? How is the rest of the family adjusting? How much does the baby cry? Is he or she easy to soothe? Who helps you care for the baby? Have you and your partner had any time to yourselves? Be ready to describe a typical day with your baby. How much does the baby sleep? If you're breast-feeding, how's it going? How often do you feed the baby during the day? At night? How active is the baby? How many diapers does your baby go through a day? This is also your opportunity to ask questions to your doctor. Maybe you wonder when your baby's umbilical cord stump will fall off or if you should try a pacifier. Be sure to bring up whatever's on your mind. Nothing is too trivial when it comes to caring for your baby. Your well-being is important, too. If you're feeling depressed, stressed out or exhausted, explain what's happening. Your baby's doctor can offer suggestions to help you get through this challenging time. Immunizations Many babies are given a hepatitis B vaccine in the hospital nursery shortly after birth. If your baby's had this vaccine, he or she is off the hook for this visit. If not, the hepatitis B vaccine may be given now. Other vaccinations will be given at the next checkup. Heading home Make sure you know when to plan your baby's next appointment - probably at 2 months - and how to reach the doctor in the meantime. Ask if your doctor's office or clinic offers a 24-hour nurse information service. There may be no way to guarantee a good night's sleep when you have a newborn, but knowing help is available when you need it can present precious peace of mind.
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