Baby's First Doctor Visit: What Does That Mean?

Pediatricians explain just what they're doing when they examine your baby.

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Now It's Baby's Turn

For you, going to the doctor is old hat. During pregnancy, you visited the ob-gyn so often that you were on a first-name basis with everyone on staff. Now, it's your infant's turn to become a doctor's-office regular. The lineup of well-baby checkups during the first year includes at least a half dozen pediatrician visits: usually at 3 to 5 days, 1 month, 2 months, 4 months, 6 months, 9 months, and 12 months. Before you cry overkill, keep in mind that frequent appointments with your baby's doctor are the best way to get expert answers to your questions and to make sure your child's on track both physically and developmentally. While the star attraction of a well-baby visit is the weigh-in, and the vaccine is the price of admission, there are other parts of the exam that aren't so easy to figure out. We asked pediatricians for the scoop.

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Aimee Herring

Neck and Collarbone Check

What Your Doc Does: Feels along baby's neckline

When It Happens: Your baby's first office visit.

What He's Looking For: A broken collarbone. Some babies fracture their clavicle while squeezing through the birth canal. If your pediatrician finds a small bump, that means a break is starting to heal. It will mend on its own in a few weeks. In the meantime, he may suggest pinning the baby's sleeve across his chest to stabilize his arm so the collarbone doesn't hurt.

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Head Check

What You Doc Does: Palms your baby's head

When It Happens: Every visit for the first one to two years.

What She's Looking For: A still-soft fontanel. Your baby's head should grow about four inches in the first year, and the two soft spots on her skull are designed to accommodate that. But if the soft spots close up too quickly, the tight quarters can curb brain development, and your child may need surgery to fix it.

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Hip Check

What Your Doc Does: Rolls baby's hips.

When It Happens: Every visit until your baby can walk.

What He's Looking For: Signs of developmental hip dysplasia, a congenital malformation of the hip joint that affects one in every 1,000 babies. "The exam looks completely barbaric," says Vinita Seru, M.D., a pediatrician in Seattle. "I tell families what I'm doing so they don't think I'm trying to hurt the baby." If your pediatrician feels a telltale click from the hips, he'll order an ultrasound. Luckily, when dysplasia is found early, treatment is simple: The baby wears a pelvic harness for a few months.

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Reflex Check

What Your Doc Does: Startles you baby.

When It Happens: The first four visits.

What She's Looking For: A Moro reflex. For her first 3 or 4 months, when something catches your infant off-guard she'll fling her arms out as if she's falling; it's one of a host of involuntary responses that show your baby's developing normally--and if it's not there, it could indicate a neurological problem. Other reflexes your doctor might look for: whether your little one grasps a finger or fans her toes when the pediatrician strokes her foot.

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Genitalia Check

What Your Doc Does: Checks your baby's private parts.

When It Happens: Every Visit.

What She's Looking For: Normal genitalia. In up to 4 percent of boys, testicles don't descend into the scrotum before birth. While the problem usually corrects itself by 9 months, your doctor will keep an eye on things to see if your son needs a surgical assist later on. In girls, it's not uncommon to find labial adhesions. Although the labia should open up over time, in some cases adhesions can shrink the vaginal opening and make your baby more prone to urinary-tract infections. "If we know that they're there, when your baby has a high fever we look for a UTI first," says Melissa Kendall, M.D., a pediatrician in Orem, Utah.

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Pulse Check

What Your Doc Does: Presses the skin along the side of baby's groin.

When It Happens: Every Visit.

What She's Looking For: A pulse in the femoral artery, which runs up from your baby's thigh. Your pediatrician wants to see if the pulse is weak on one side, or hard to detect at all, since that may suggest a heart condition. One in 125 babies is diagnosed with a heart defect, and this check is a simple way to screen for problems, says Vinita Seru, M.D., a pediatrician in Seattle. "When a heart condition is caught early it can increase the likelihood of a good recovery."

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Appointment Pointers

Make the most of your baby's doctor visit with tips from Christopher Pohlod, D.O., assistant professor of pediatrics in Michigan state university's college of osteopathic Medicine, in East Lansing.

Come Armed With Questions: When you have a written list of talking points, you won't worry about your mind going blank if your baby starts to fuss.

Give a Thorough Family History: Knowing that your older child has asthma or your parents are obese focuses your pediatrician's attention on likely problems.

Keep Things Cheerful: The happier you are to see the pediatrician, the happier your baby will be too--and the easier it will be for the doc to examine him.

Originally published in the August 2009 issue of Parents magazine.

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