AAP PARENTING CORNER Q & A: VISITING THE PEDIATRICIAN

Visiting the Pediatrician

Why does my baby need to see the pediatrician so often?

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. After that, your child will have "well baby" checkups every few months.

The purpose of these early checkups is to make sure your child is growing and developing properly and has no serious abnormalities. These appointments also 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 is also 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 questions before each visit so you don’t forget any important ones.

Specifically, the doctor will check the following areas.

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

Head. The soft spots (fontanelles) should be open (normal skin covered openings in the skull) and flat for the first few months. By two to three months of age, the spot at the back should be closed. The front soft spot should close before your child’s second birthday (around eighteen 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 her 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 done in the newborn nursery and later if 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 his eye movements. She also 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 her 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. She 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.

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

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.