Well-baby examination

Well-baby examinations are held regularly during the first two years of a baby's life. They allow the pediatrician to monitor and advise on the baby's growth and development. The American Academy of Pediatrics (AAP) recommends thenewborn infant see a doctor for a check-up at birth, one, two, four, six, nine, 12, 15, 18, and 24 months, and annually thereafter. Most pediatricians follow this schedule, or some variation of it, in prescribing a check-up regimenfor their patients. The features of a well-baby examination or "check-up" include: Taking a history. During this stage, the physician or an assistant will ask the parents a number of questions. Topics include developmental milestones, interactions with peers and adults, sleeping patterns, and eating habits. Typical questions include, "Are there any changes or concerns that have come up since the last visit?"; "How is the child functioning in child-care?"; "How is the relationship with peers?" The pediatrician (or an assistant) willobserve the parents and the infant for signs of distress or difficulties withadjustment. In addition, they will be alert for any signs of child abuse. Performing a physical examination. At every visit, the child will be examined by the physician, usually conducted while the child is undressed to his or herdiaper or underwear. Parents should discuss this aspect of the routine withthe older infant and toddler prior to the visit, so that he or she is prepared to remove his or her clothes. The child will be measured, weighed, and havetemperature and blood pressure recorded. Infants will have head circumference measured as well. The pediatrician will also check the eyes, ears, mouth, and throat; heart and lung rates; abdomen for unusual masses or enlargements;genitalia for anything unusual; arm and leg movement; and reflexes. Answeringparents' questions. The pediatrician may solicit questions by asking the parent if they have any concerns. Some parents bring written questions so that they will not forget to ask something they want more information about. Explaining expected developmental pattern to parents. The pediatrician can help parents understand their child's next stage of development by explaining what stages are coming next, and by forewarning parents of difficulties that typically arise. The pediatrician also discusses behavior, nutrition, and safety issues, recommending childproofing strategies and emphasizing car seat use, forexample. Administering developmental and medical tests and immunizations. Many pediatricians order various tests, such as urinalysis, tuberculin test, andblood tests during the first two years. The AAP recommends cholesterol screening of children over age two whose parents have a history of cardiovasculardisease before age 55, or have blood cholesterol levels above 240mg/dl. Because there are a number of controversial factors influencing the value of cholesterol screening, as of the late 1990s the AAP did not recommend universal cholesterol screening.

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