What to expect at the two-week checkup for your newborn
Approximately two weeks after birth, newborns are scheduled to see their pediatrician in the office. The doctor gets a baseline while examining the baby at birth. A baseline is simply a standard to which the baby will be compared to during future examinations. For example, if the baby’s weight was 7 lbs at birth, then this is the baseline for weight, and if at two weeks of age, the baby weighs significantly less than 7 lbs, then the doctor knows that the baby is not thriving. If the baby weighs more than 7 lbs, this tells the doctor that the baby is receiving adequate nutrition. Other baselines include height and circumference measurements such as the head and chest. Reflexes are also measured. These measurements can be compared on future visits to ensure positive growth or to watch for deficiencies.
During the two-week check-up, the nurse will have the parent remove all clothes from the baby, including the diaper. It is possible to add two ounces to allow for the diaper’s weight, but if the diaper has urine in it, it will weigh more. Hence, the diaper will be removed briefly. The easiest way to get a height on an infant is to lay him on a table with a fixed measuring stick, and stretch his legs gently to full height (or length, since he is lying down). The nurse will measure the circumference of the head and chest. The heart rate and respirations are also counted. All findings are carefully documented. When the nurse is finished, the baby can be partially dressed, and the parents and baby are taken to an exam room to see the doctor.
The doctor will examine the baby thoroughly for irregularities or signs of infection. He will look at his eyes, nose, ears, mouth and throat, checking for anything that is different or unexpected, such as redness. He will also gently feel the fontanels or soft spots on the baby’s head to watch for signs of them closing too early. The doctor will listen to the heartbeat and the lung sounds checking for any irregularities. The abdomen will be gently palpated. The belly should be soft and should not show signs of being in pain. The genital area will be examined to be sure it is intact and not trying to close up. The doctor may also check the legs for hip dysplasia or dislocation.
Even after all this, the doctor is not finished. He still needs to check the baby’s reflexes to make sure all is well. Common reflexes include rooting and the startle reflex. The doctor will ask the parents if they have any questions. It’s a good idea to have questions written down prior to the visit since it’s easy to forget something.
At the end of the visit, the doctor will give the parents a copy of the baby’s growth chart. This documents the baby’s height, weight, and head circumference to be used as a reference for subsequent visits. The doctor will tell the parents what to expect the baby to do in the next few weeks until the next visit. If the baby fails to do any of these, the doctor would like to be informed of this. The doctor will write down any dosages of medication to give the baby if needed, such as acetaminophen or ibuprofen.
Lastly, if any immunizations were not done at birth, and the parents would like to have them done, the doctor and nurse will give any necessary shots. Before leaving, the receptionist will give you the date of the next appointment.