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Visiting the Pediatrician
Visiting the Pediatrician

CARING FOR YOUR BABY AND YOUNG CHILD
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You probably will see more of your pediatrician in your baby's first year than at any other time. The baby's first examination will take place immediately after birth.

Ideally, both parents should attend these early visits to the doctor. These appointments give you and your pediatrician a chance to get to know each other and exchange questions and answers. Don't restrict yourself to medical questions; your pediatrician also is an expert on general child-care issues and a valuable resource if you're looking for child-care help, parent support groups or other outside assistance. Many pediatricians hand out information sheets that cover the most common concerns, but it's a good idea to make a list of the questions you have before each visit so you don't forget any important ones.

If only one parent can attend, try to get a friend or a relative to join the parent who does. It's much easier to concentrate on your discussions with the doctor if you have a little help dressing and undressing the baby and gathering all of her things. While you're getting used to outings with your newborn, an extra adult can help carry the diaper bag and hold doors.

Growth

You will be asked to undress your baby, and then she'll be weighed on an infant scale. Her length may be measured lying on a flat table with her legs stretched straight. A special tape is used to measure the size of her head. All of these measurements should be plotted on a graph in order to determine her growth curve from one visit to the next. This is the most reliable way to judge whether she's growing normally and will show you her position on the growth curve in relation to other children her age.

Head

The soft spots should be open and flat for the first few months. By 2 months to 3 months of age, the spot at the back should be closed. The front soft spot should close before your child's second birthday (around 18 months of age).

Ears

The doctor will look inside both ears with an otoscope, an instrument that provides a view of the ear canal and eardrum. This tells him whether there is any evidence of fluid or infection in the ear. You'll also be asked if the child responds normally to sounds. Formal hearing tests are rarely given to an infant unless there is suspicion that a problem exists.

Eyes

The doctor will use a bright object or flashlight to catch your baby's attention and track her eye movements. He may look inside the baby's eyes with a lighted instrument called an ophthalmoscope, repeating the internal eye examination that was first done in the hospital nursery. This is particularly helpful in detecting cataracts (clouding of the lens of the eye).

Mouth

The mouth is checked for signs of infection and, later, for teething progress.

Heart and Lungs

The pediatrician will use a stethoscope on the front and back of the chest to listen to your child's heart and lungs. This examination determines whether there are any abnormal heart rhythms, sounds or breathing difficulties.

Abdomen

By placing his hand on the child's abdomen and gently pressing, the doctor makes sure that none of the organs is enlarged and there are no unusual masses or tenderness.

Genitalia

The genitalia are examined at each visit for any unusual lumps, tenderness or signs of infection. In the first exam or two, the doctor pays special attention to a circumcised boy's penis to make sure it's healing properly. He checks all baby boys to make certain both testes are down in the scrotum.

Hips and Legs

The pediatrician will move your baby's legs to check for dislocations or other problems with the hip joints. Later, after the baby starts to walk, the doctor will watch her take a few steps to make sure the legs and feet are properly aligned and move normally.

General Development

The pediatrician will ask about the baby's general development. Among other things, he'll observe and discuss when the baby starts to smile, roll over, sit up and walk, and how she uses her hands and arms. During the exam he will test reflexes and general muscle tone.

Excerpted from Caring for Baby and Young Child: Birth to Age 5, Bantam 1999


© Copyright 2000 American Academy of Pediatrics

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