As we have already mentioned, revisions of the healthy child are necessary to prevent and detect possible diseases that the child may have. Without them, there are problems that would be overlooked and could affect their development.
After the birth of the baby and the first check-ups in the hospital, it is the first review at the health center, which is performed between the fifth and tenth day after birth. We tell you what doctors check in newborns.
Clinic history
The medical history opens with:
- Obstetric data of the mother: pregnancy, abortions, etc.
- Pregnancy history: desired, unwanted, single fetus or multiple pregnancy, diseases, controls, etc.
- Perinatal data: weeks of gestation, presentation of the baby, type of delivery, weight, size and head circumference of the baby at birth, weight at hospital discharge, blood group, emission of meconium, etc.
- Family history: diseases, malformations, etc.
- Psychosocial factors: single-parent family or not, employment status, drug addiction, etc.
Physical exploration
The most important part of the review is the newborn's physical examination, where a check is made very similar to the one made at 48 hours after birth.
- Baby measurements and weight: weight, height and head circumference with percentiles and registration in growth curves.
- Skin: If you look at the color of the skin (if there is jaundice, paleness, grayish tone, etc.), it is checked if there are spots on the skin such as angiomas, nevi, etc.
- Skull shape: the shape of the skull is assessed and the fontanelles are controlled.
- Eyes: malformations of the lens, iris, cornea and eyelids are sought. Eye motility, pupil reaction and retinal red reflex are assessed.
- Ears: hearing tests are performed (if the mother's voice follows, if she reacts to blows), the ears are explored and the shape of the ears is assessed.
- Neck: the shape of the neck and clavicles is assessed, if there are lumps, mobility ...
- Chest: the shape of the thorax, of the moms is explored and cardiopulmonary auscultation is performed
- Abdomen: the form is explored and a palpation is performed to rule out hernias, the navel is inspected
- Genitals: in boys the penis (size, shape), urethral meatus and scrotum is examined, while in girls, the hymen, vulva and clitoris to detect possible malformations.
- Musculoskeletal system: assessment of extremities and hips (hip dysplasia is one of the most common lower limb malformations in newborns)
- Neurological state: muscle tone and neurological responses of the newborn
Heel test
The second heel test is performed between the fourth and seventh day of life, which coincides with the first review of the newborn at the health center. The first test is performed 48 hours after the baby is born.
In Spain it is routinely practiced and consists of a puncture in the heel to take a few drops of blood. That blood sample is sent to the laboratory at approximately three weeks by mail the results.
It serves to detect up to 19 congenital metabolic disorders that still do not show symptoms, but that can affect the development of the baby such as hypothyroidism, adrenal hyperplasia, hemoglobinopathies, hyperphenylalaninemia and phenylketonurias.
Breastfeeding, urination, care, etc ...
After the physical examination come the questions to parents about feeding, baby hygiene, sleep and clarifying any concerns they may have.
He wonders if breastfeeding or artificial feeding occurs, if there are problems with the technique or pain in the mother; it is advised on the bath, the cleaning of the navel, of the genitals, it is asked about the urination and the depositions of the baby; how do you sleep, if with parents or in your crib, sleeping position (face up position is advised), etc ...
Advice to parents
During the visit, parents receive or should receive advice from the pediatrician or nurse about good practices for the health and development of the baby, such as:
- Exclusive breastfeeding is recommended up to six months
- Avoid using the pacifier until breastfeeding is not established
- Take daily walks so that the baby receives vitamin D from the sun
- Prevent accidents: monitor the baby in the changing table, in bed, control the temperature of the bath water, always take it in a restraint system in the car, do not drink hot liquids with the child in arms, etc.
- Daily bath
- Vaccine information (if not given in the hospital, the hepatitis B vaccine is applied)
- Clarification of any questions that may arise.
In general, this first review is done by the pediatrician together with the nurse, and if either of them considers it or the parents ask for it, another optional visit at 15 days of life.
As I said, the healthy child reviews They are essential to prevent any problem, especially when the baby is so small. Know that doctors check in newborns It will help you prepare for the first visit you make to the pediatrician.
Photos | erikhuiberts and Monica Arellano-Ongpin on Flickr In Babies and more | Reviews of the healthy child: what they are for, The first visit of the baby in the health center
