Between six to eight weeks your new baby is due a routine health check to see how she’s growing and developing. In some cases this is done at the same time as your six-week post-partum check but often it’s a stand-alone appointment. You’ll need to take along your Personal Child Health Record, the record book you’ve had since your baby’s birth, so that your doctor can fill in the details. You may feel slightly anxious about having your baby measured, poked and prodded, but there’s really no need to be concerned – here’s what you can expect the check to cover.
You’ll be asked to undress your baby down to her nappy so that your doctor or health visitor can conduct a physical examination and get an accurate weight for your baby – you will need to remove the nappy briefly for a couple of the checks. Your doctor may also suggest that this is a good time for your baby’s first set of immunisations (you can read more on scheduled immunisations here).
The physical examination
- Length and weight – Your baby will be weighed and measured and the results plotted on a centile chart to see how she’s growing and putting on weight in comparison with length and weight averages. In the first few days of her life your baby may well have lost as much as 10% of her birth weight, but she’s usually regained this by the time she’s ten days’ old and should then gain weight day-by-day.
- Shape and size of the head and features – The circumference of your baby’s head will be measured and compared with the average. The doctor will also check all your baby’s features (nose, mouth, ears, scalp etc.) for general shape and symmetry.
What is a centile?
What is a centile? Your baby’s centile gives you an idea of how your baby’s growth compares with other babies of her age. If your baby is in the 50th centile then she’s right in the middle of the range of weights and measures, so her growth is average. Centiles over 50 show above average results and centiles below, below average.
A low centile isn’t necessarily a cause for worry, however, as your doctor is probably using a chart based heavily on bottle-fed babies, who tend to put on weight significantly faster than breastfed babies after twelve weeks. The new World Health Organisation’s latest growth chart is based on breastfed babies but the UK government has not yet decided (as of June 2007) whether to adopt these charts as the new UK standard.
- The fontanelles – The fontanelles are the two soft spots on your baby’s skull which allowed your baby to pass through the birth canal: the fontanelle at the back of the head usually closes by about six weeks while the one at the front takes up to 18 months to close fully. At this check the doctor will check how the fontanelles are developing and hardening.
- The eyes – Your doctor will want to see whether your baby can follow movements with her eyes and will also use a special instrument, an ophthalmoscope, to look closely at your baby’s eyes.
- Breathing and circulation- The doctor will check your baby’s colour and pulse, and use a stethoscope to check that your baby’s heart has a normal rhythm and that she’s breathing normally.
- The abdomen – The shape and colour of your baby’s abdomen is checked for any irregularities: using her hands, the doctor will press gently around the abdomen.
- The hips – Your doctor will check the functioning of the hip joints with a couple of quick manoeuvres as well as checking for limb symmetry.
- The genitals and bottom – You’ll need to remove your baby’s nappy so that the doctor can check his or her genitals and bottom for size, shape and condition. One particular check for boy babies is for undescended testes.
- Joints and spine – These are checked for function and formation.
- Skin – Your baby’s skin condition is checked for healthy colour and texture, any rashes or birthmarks and for signs of skin sensitivities.
- Reflexes – Your doctor may check how your baby’s reflexes are developing with several very simple tests.
What you will be asked
Your doctor or health visitor will ask you several questions about how your baby is settling in. These usually include:
- How she’s feeding – How often and how much your baby drinks usually differs according to whether she’s breast- or bottle-fed: A bottle fed baby often feeds less often than a breastfed baby – usually every three to four hours – while a breastfed baby may feed between 6 and 12 times a day.
- How often she pees – You won’t know exactly how often your baby pees, of course, but she should have at least four wet nappies in a day.
- Questions about your baby’s pooh- You’ll most likely be asked how often your baby does a pooh, what consistency the pooh has and whether she seems to have difficulty or discomfort when doing a pooh. Breast-fed babies’ pooh is often quite runny and may be an initially alarming yellow colour, bottle-fed babies’ pooh is usually firmer but it should still be a lot softer than a normal adult stool.
- Abour her vision – You may be asked whether your baby follows your movements with her eyes and whether she yet smiles in response to you, known as ‘the social smile’.
- About how you’re coping – How you are doing is one of the subjects of your own post-partum six-week check, but your doctor may well ask you questions about how you’re coping physically and emotionally during the baby’s check.
- Any other concerns – This is also a good time for you to raise any questions or concerns you have about your baby with the doctor.