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The first medical examination of babies
The medical examination is carried out by the pediatrician in your room, on the 2nd or 3rd day after birth. Ideally planned just after feeding or bathing to facilitate auscultation, it is the least invasive possible and lasts about twenty minutes. Small detail review.
Heartbeat
Using a stethoscope, the doctor listens to the heartbeat of the newborn baby to screen for a heart murmur. He palpates the femoral pulses in the groin, at the top of the thighs: they should be clear and of the same intensity. If in doubt, he takes the pulses in the hollow of the wrists to check that there is no difference.
Breathing
The pediatrician checks the regularity of inspirations and expirations which must be done effortlessly.
Palpation of the abdomen
It gently touches the infant’s tummy to monitor the size of different organs : the liver in the upper right part, the spleen in the upper left part and the kidneys in the lower back.
Verification of the genitals
In boys, he makes sure that the testicles are in place and that the urinary meatus is not positioned too low. In case of abnormality, an intervention can be considered from 9 months. In girls, he looks at the aspect and proportions of the labia majora and labia minora, and of the clitoris. Also check that the hymen, the small membrane which partially closes the vagina, is not completely blocked to allow the flow of natural vaginal secretions.
Hip dislocation screening
Alternatively on either side, the pediatrician tests the hip joint for instability or limitation in the opening of the baby’s thighs.
Mobility of arms and legs
The doctor observes the gesticulation of the four limbs, the position of the feet, the opening of the hands… No worries if the feet are turned a little inwards. ” There are a lot of bad positions in the newborn that snap back into place in a matter of days », Reassures Dr Elisabeth Gault. On the other hand, an abnormal position must be detected, such as a “varus” foot, forming a more or less fixed angle with the leg, requiring treatment by an orthopedist. He checks the absence of torticollis, palpates the collarbones, which can fracture during birth, especially if the baby is large. They always consolidate spontaneously and without sequelae.
Back inspection
In the lower back, there should be no swelling in the spine, which could be a sign of a neural tube closure abnormality (spina bifida). Likewise, the anus should be in the correct position, permeable and without cracks.
The skin under a magnifying glass
Be aware that newborns have a lot of small spots that, most of the time, are harmless and resolve on their own, such as flat angiomas – or wine spots – in the neck, lower back, eyelids or root. of the nose. On the other hand, it is necessary to be more vigilant with the more extensive angiomas, or on a limb or the face. Finally, jaundice can occur more or less quickly after birth: the skin and the whites of his eyes turn yellow. If you’ve already been home and jaundice starts, your baby will need to be brought back to the hospital for treatment.
Neurological examination
The doctor tests the baby’s tone thanks to various maneuvers: the pull-sit, straightening on the lower limbs… He must also check his so-called “archaic” reflexes like automatic walking.
The appearance of the skull
By palpating the child’s head, the pediatrician may find a lump related to the supports during childbirth. It gradually subsides and is of no consequence. Fontanelles and sutures should be flexible. The professional looks for any abnormalities in the face and palate, by sliding a finger into the baby’s mouth to check that there is no cleft palate. He also makes sure that the frenulum of the tongue is not too short, which can interfere with sucking.
Guthrie’s test
Carried out 72 hours after birth, this examination is not compulsory but strongly recommended for screen for five rare diseases (especially cystic fibrosis and hypothyroidism). Prompt medical treatment avoids complications, which are sometimes permanent. Simply get a drop of blood from your hand or heel. If you have already returned home, the sample will be taken by the midwife who is monitoring the baby.
Vision and hearing
We check the good quality of the baby’s vision. The pediatrician inspects the eyelids, the iris … And if the toddler can follow an object, or catch the eye. Deafness screening is also performed. In practice, headphones are put on the child’s ears so that he can listen to different sounds, and his reactions are tested.