1. Introduction to Newborn Checkups

This guide will explain each check-up and how to prepare for them, discuss steps for a productive relationship with your providers, and answer many of the questions or fears that you and your family may have as your baby grows and changes over this first very eventful year of life.

A good relationship with your baby’s healthcare providers is important because you will be working with them over the next year to come up with a plan to keep your child’s body growing properly. They will treat your child over the course of their childhood and beyond. They will provide invaluable medical care, counseling, and education: your providers’ job is not only to answer your questions, but to make sure that you feel comfortable and a part of your child’s healthcare team. In turn, you play a major role in the care of your baby.

The first year of your child’s life is a flurry of checkups: the baby’s new little body grows and squirms with energy that will need to be carefully monitored. Your baby is tiny, yet spirited and full of life that the thought of checkups with doctors can feel very intimidating – many new parents put this thought of frequent newborn checkups out of their minds. You can never fully prepare to become a parent, but you can take steps and learn about the checkups to make the experience less overwhelming, and to develop a relationship with your baby’s healthcare providers.

1.1. Purpose and Importance

When parents take their babies to the pediatrician’s office for a newborn well-baby check, they become active participants in the effort to ensure their child’s overall long-term health and well-being. At each such appointment, parents’ watchful eyes, firsthand knowledge, and daily experiences are important contributors to the important work of a pediatrician, medical provider, or other healthcare professional who regularly monitors the health and diet of the newborn, and tracks the baby’s growth and development across time. In a general sense, the purpose of newborn well checks has, over longstanding traditions, been relatively straightforward. By asking important questions, conducting thorough physical examinations, and providing answers to the best of their knowledge and training, members of the medical community educate new parents, strive to ensure that children are meeting important developmental markers, and consult with parents about the optimal diet, nutrition, and health practices for the baby in the days, weeks, and months ahead.

1.2. Frequency and Timing

It is important to make these visits easy on yourself, your baby, and your partner. Your baby will be growing by leaps and bounds and these postnatal follow-up appointments will help ease the first-time parenting jitters through direct communication of realistic health and development expectations, and reinforcement of what steps have been mastered so far. Don’t mistake pediatric emphasis on frequent baby health checks as intrusive, nagging, or judgmental of the care you provide your baby. The pediatrician has your baby, and you, as his or her top priority and is required to monitor growth and development progress to ensure your baby’s health and safe growth. Don’t underestimate the need for frequent reassurance and confident encouragement, which is even more important if breastfeeding challenges of ensuring maternal milk transition from colostrum to mature milk at around day three to four, as well as latching on or regaining birth weight, are experienced.

The timing and frequency of well-child visits in the first 2 to 3 weeks after your baby’s birth varies depending upon the number of other newborns requiring pediatric care and how often your pediatrician needs to observe your baby’s growth and monitor your wellbeing. Your first visit will probably be when your baby is 24 to 48 hours old or 2 to 3 days postdelivery. After that, your baby may need to be seen again several times in the first week or two of life in order to ensure sound physical health and ongoing support for both you and your newborn. Your baby’s usual pediatric well-child visit schedule will begin when both you and your baby are old enough to safely leave the confines of your home. Typically, your baby will start on his/her regular pediatric schedule when you and your baby are healthy, your baby’s jaundice resolves, and your weight loss postdelivery is no longer considered an issue.

2. Preparing for the Appointment

Many new parents are often surprised when they are given an appointment for their baby just a few days or up to a week after they are born. The purpose is to check that they are feeding well, are healthy, and to help you get to grips with this new job you have undertaken. When it’s your first baby, it can be a bit bewildering to be given an appointment with a healthcare professional for the baby when he or she has just been home for a couple of days. What is the appointment for? What do they check? What should I take with me? Also, getting out of the house with a newborn can be a bit of a palaver and maybe a bit daunting, particularly in the first week, so in this article, I want to both reassure you about the appointment and give you a heads up as to what’s likely to happen. If your baby was born at home or will be discharged from the hospital earlier, you will have to take your baby to the hospital’s outpatient clinic, polyclinic, or health center between 24 and 72 hours after the birth for a newborn check.

At the end of the first week, and depending on how the next few days go, there is usually a satisfactory weight gain which will mean he has achieved and surpassed his birth weight, and so feeding at this stage is going well. As first-time parents, it is not uncommon to be a little wary about whether a breastfed baby is getting enough milk, and so this first-week weight check can make all the difference to you. There is also another smelly, dirty job that you get to grips with in these early days as well: baby poo. Recent research has shown that the number of dirty nappies in the first few weeks is indicative of good breastfeeding or formula eating – Luca, who is having 6 wet nappies and 2 dirty (but can be up to 8 a day) a day, or Jessica, who is having 1 wet and up to 8 dirty nappies a day?

2.1. Gathering Necessary Documents

Before bringing your baby to the pediatrician for their newborn check, you’ll need to gather some important documents. First, if your baby is covered under a private health insurance plan, be sure to contact your insurer and add your new baby to your plan. The HR department at the hospital where you deliver should give you instructions on how to do this, but if it doesn’t, you can also call within a week of birth to make sure your baby has coverage from his or her date of birth. You’ll need to bring along your health insurance card on the day of your baby’s newborn check. Additionally, if your baby is enrolled in Medicaid or another government health insurance plan, be sure to bring your Medicaid identification card as well.

As part of the required newborn screenings, you’ll also need to make sure that your baby has a Social Security number. You can fill out a form for this at the hospital, or you can apply in person at a Social Security Administration office in your location. Many parents choose to get a Social Security number at birth in order to claim their child as a dependent on their income tax return, as well as to qualify for benefits like those offered by the Child Tax Credit, health benefits, survivor benefits, and more. Be sure to look into the process early and leave yourself enough time to meet any deadlines. Finally, you may be asked for information on your pediatrician at the check-in process. If you’ve already selected one, a name and address will be very helpful. If not, most hospitals will assign one for you and send the report to his or her office on your behalf.

2.2. Packing Essentials for the Visit

Regardless of the time of your baby’s appointment, keep in mind that his or her routine may still be affected. Here is a shortlist of items that you may need to pack before leaving home for your appointment. First, bring extra diapers and wipes, a reliable source of milk for hunger fussiness, and snacks for siblings. In case the baby spits up during the check-up, you may also want to bring extra outfits or a t-shirt for yourself. Furthermore, you may also want to pack travel-friendly activities for children, sunscreen, and warm or cool layers. Don’t forget to bring your car seat. If you are not sure about a particular item, you may want to contact the office before the visit to double-check. This list is non-exhaustive but is a good start.

Remember also to schedule the baby’s newborn check within one week of the birth in order to allow the doctors to oversee you and your baby to start your life together in the best manner possible. If the visit occurs later than one week following birth, keep in mind that it is possible to detect and treat potential newborn health problems as well as to make any adjustments necessary to meet the specific needs of the newborn and of your family. As you will be anxious to maximize the mental and physical health of your baby, be sure to come prepared to ask any questions that you need to in order to make the best possible decisions for the future care of your little one.

3. Understanding the Examination Process

So, you know what to expect during your newborn’s examination. But why is this check necessary? Why must it be done so quickly, within the first couple of weeks of your little one’s life? The newborn check, newborn examination or ‘newborn’ medical, is a thorough examination of your newborn. It helps to ensure the health and wellbeing of your baby. It provides reassurance that your newborn has been born without any major health concerns. If there are concerns or problems, they are quickly picked up. This means that any problems are managed early, and conditions that could cause long-term health or developmental problems for your baby are detected. Most health problems present during the newborn period are manageable if quickly picked up and treated.

This is to ensure your baby looks as expected. The doctor or midwife will examine the head to ensure your baby’s skull shape is round and measure the circumference of the head using a measuring tape. The doctor or midwife will also check the fontanelles (soft spots between the cranial bones of the baby). They will check the eyes to ensure the eyeballs are symmetric and pink on exposure to bright light. They check the following muscles to ascertain normal development and the absence of paralysis: the back, neck, chest, shoulders, and hips. While examining the baby, we observe their behavior and tone, look at their crying and listen to it. Furthermore, the baby’s undercarriage will be checked. Finally, the doctor or midwife will explore the baby’s liver and spleen, by attempting to feel if the area underneath the baby’s ribcage is soft.

3.1. Typical Procedures and Tests

Newborn checks can differ depending on where they are carried out. If your baby was delivered in a hospital or by a midwife at home with a hospital booking, your baby’s first check will be within 72 hours but may be on the day of discharge, but within 72 hours, if discharge is before 24 hours for a vaginal birth or before 48 hours after a vaginal birth. It may be during the parent education class. If your baby is delivering in a hospital without a booking (not requiring a hospital booking, e.g., hospital without entry criteria), it is common for you to be asked to wait for your baby’s first routine check. Attending the check with your baby, you will be informed by your baby’s obstetrician or pediatrician. If your baby was delivered in a community establishment, such as by a GP or midwife, at home, your baby’s first check should be carried out when he/she is 5–7 days old. When the booking of children for their newborn check is enabled by home birth, this is usually an automatic feature.

Anthropometry; you will have anthropometry done at this appointment unless your baby is going home before that time. In this case, anthropometry and the appointment will be done on your way home. Unless there is a contentious vision about examination findings, your baby will usually only have his/her height measured on this occasion. You will be asked to take your baby for his/her hearing test before you are discharged. This may be requested by the pediatrician at your baby’s first examination unless done in the baby’s room prior to the appointment with the pediatrician. You will be informed if your baby is not available for examination. If the examination threshold for GBS assignment is not reached, anthropometry will be carried out at the time your baby is well enough in other respects to allow it.

4. Questions to Ask the Healthcare Provider

What should I be asking at my baby’s check? Here are some questions you may wish to ask your healthcare provider:

– How’s my baby’s weight and height compared to other babies? Is my baby growing properly? – Does my baby have hip dysplasia? – Is my baby’s head shape okay? – Is my baby’s fontanelle okay? – Is it normal for my baby to be spewing milk? – Does a forceful vomit mean my baby has reflux in the stomach? – Does a large vomit mean that my baby has a problem with the bowel? – Is it dangerous if my baby spews while they are lying on their back? – Can spewing damage my baby’s teeth? – Could my baby’s milk make him sick? – Is it worrying if my baby eats and then vomits some milk after each feed? – I have been told that if my baby vomits a few centimeters from her mouth, it is okay, but dangerous if it comes from deep in her stomach. Is this true? – What are signs of distress after my baby vomits which I should be aware of?

If you require your baby to be weighed, you may need to return to the baby health centre if they don’t have the scales at any other nearby clinic. If you are visiting a GP or pediatrician on an ongoing basis, both can perform weighing and height checks.

4.1. About Baby’s Health and Development

Your baby’s health and development will be assessed at birth and then a number of times throughout the first 12 months. Tests will be done during the newborn period, and at 6-8 weeks your baby’s doctor will visit you at home. Your baby will need to have a number of health, hearing, and development checks during his or her first 12 months. The checks are there to make sure that your baby is growing and developing as well as possible, and that any problems are picked up and treated as early as they can be. Babies’ growth and development are extremely rapid. All babies need routine checks to monitor their growth and development in the first few weeks after birth. Well-baby” checks are performed by your baby’s doctor or early childhood nurse. Your baby’s brain and nervous system, physical condition, hearing, circulation, breathing, and their weight, length, and head size will be considered.

You can then keep track of your baby’s growth and development at home by using the Personal Health Record, which is the red book you’ll be given in the hospital when your baby’s born. It’s an important resource that you and your baby’s doctor can use to ensure your baby’s health and development is as good as possible. You can expect questions about your baby’s feeding, sleep, and settling behavior, whether he or she is achieving developmental milestones, if you have any concerns, and information on your mood. It’s important that you ask questions and share your concerns with the doctor or nurse – your baby’s health and development is their core business. Your baby’s doctor or nurse will give you more information on what to expect during these checks.

5. Post-Checkup Care and Follow-Up

If your baby had blood taken, a dressing may have been applied. This is nearly always removed that day when you return to the Maternity Unit for your own postnatal check, or by the midwife if you have had your baby at home. Occasionally, a little bruise may appear at the site of the puncture; this is normal. Be guided by your midwife and seek advice if you are concerned by the way in which the heel puncture place has settled.

Most babies are settled after the test. Occasionally, a baby may be upset by the event. Fussiness, interrupted feeding, and abnormal sleep patterns can occur in any baby, unrelated to the test, the disease being detected, or the need for a repeat test. If there is any unusual fear, dislike, or distress associated with minor events, such as having clothes changed or baby’s position adjusted, take note of your baby’s behavior and discuss this with the midwife or health visitor, as this observation forms part of the test for your baby’s hearing as well as the reserve screening test to which your baby may be offered a second appointment.

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