By the age of 6 weeks, your baby will be beginning to smile, look at you when you talk and generally respond positively to any form of contact.
Your GP will want to know about his general health, and will review any problems there may have been with your pregnancy, the delivery and in the time since then.
You may also be asked about any family health problems that might possibly affect your baby, such as congenital hearing loss, thalassaemia (an inherited form of anaemia), or genetic disorders.
The results of any blood tests your baby had shortly after the birth will be recorded. These will include the result of the Guthrie test (the heel prick test which checks thyroid function and for phenylketonuria), and sickle cell and thalassaemia, if taken.
How to prepare for your visit to the doctor
- Your health visitor or midwife should have given you a Personal Child Health Record (or ‘red book’) for your baby, which will be used to chart his routine health checks and developmental progress. Remember to bring this along with you.
- Make a note of any questions you have so you can discuss them with your doctor.
- If at all possible, try to plan things so that your baby is not too hungry or too tired for the appointment. This will enable the doctor to do the check-up and talk with you more comfortably than if your baby is miserable and crying.
- Dress him in clothes you can take off and put back on with the minimum of fuss.
What gets checked?
The size and shape of babies’ heads vary enormously, but very large or small heads may, along with other signs, be a cause for concern. Plagiocephaly (lop-sided head) is a common finding and usually not significant.
There are two fontanelles (soft spots). The posterior fontanelle closes by 6 weeks and the anterior fontanelle (towards the front) is generally closed by 18 months.
Your doctor will ask you whether your baby turns to shiny, bright objects or lights and if his eyes follow your face when you move in front of his line of sight. She’ll also check your baby’s tear ducts and look for any sign of cataracts or other abnormalities.
She’ll look at the shape and position of your baby’s ears (some genetic disorders have characteristic appearances, such as the low-set ears associated with Down’s syndrome). She’ll ask you whether your baby seems to respond to noises and check the ear canal looks normal.
Your doctor will check your baby’s nostrils for any abnormal swellings or cysts.
Your baby’s mouth should be pink and moist inside. The doctor will look for any evidence of a cleft palate or lip. She’ll also check for white patches on the tongue and gums, which may indicate thrush. If your baby has any teeth, your doctor will make a note in your baby’s records.
Occasionally a harmless swelling called a sternomastoid tumour may be found in the neck muscle. It can restrict movement and may need physiotherapy.
Chest, heart and lungs
By listening to your baby’s heart rate and observing her breathing, any heart and lung problems can be identified. If you have any worries about your baby’s breathing, respiratory rate or colour while resting, sleeping or feeding, discuss this with the doctor.
The size and position of vital organs (liver, kidneys and spleen) are examined. Your baby’s umbilical stump should have fallen off and healed up by now. Occasionally it may still be moist or have a lump, called a granuloma, that your GP will advise you about. Some babies have small hernias which usually reduce by themselves given time.
Your baby’s hips are examined to detect a condition calleddevelopmental dysplasia of the hip (DDH). This is more likely to occur where there is a family history of the disorder or if your baby was breech.
The elasticity, colour and texture of your baby’s skin are checked and a note is made of any birth marks, including Mongolian spots (blue/ grey birthmarks found near the bottom of the back). Sometimes a strawberry birthmark is present, which grows rapidly as your baby gets bigger. These marks are not usually a problem unless they happen to be close to your baby’s eye, and they usually disappear completely without treatment.
Your baby’s arms and legs should appear symmetrical and have good muscle tone.
Reflexes are automatic, involuntary movements. Testing the prescence of these reflexes helps determine the health of your baby’s central nervous system. The GP may hold your baby to assess muscle tone, movement and responses.
Boys are examined to ensure there’s no evidence of hypospadias, (where the urethra opens on the underside of the penis). Both testes should be descended. If they are not completely down, they will be checked again at between 6-9 months of age.
Girls are checked to ensure that the labia are not fused, or any anatomical abnormality found. Both sexes will have their anus checked.
His height, weight and head circumference are measured and plotted on a chart in his red book. This shows his growth pattern.