Baby Guide, U Examinations

Newborn physical examination

Table of Contents

U1 – investigation

The U1 is an important part of the close-meshed research network in the context of pregnancy and childbirth. The first few days after birth are considered critical for infants in medicine, as an adaptation to the new environment costs a great deal of energy. Furthermore, the birth often brings with it stressful situations that a baby has to deal with and master. Also, some developmental difficulties can be discovered or clarified more precisely after childbirth despite extensive prenatal care.

The first examination after birth

The U1 takes place after the birth. The subsequent U2 takes place between the third and tenth day of the life of the infant and also serves to detect any adaptation disorders or health problems.

The U1 at a glance

Although the U1 is one of the most important baby-care checkups, it often takes only a few minutes. Depending on the birth situation, the women’s or pediatrician usually checks the condition and bodily functions of the newborn, usually with the help of the midwife or midwife. Targeted observation, as well as thorough scanning, can be used to identify and handle any difficulties quickly.

Depending on the nature and difficulty of childbirth, many doctors and midwives give the baby and his mom time for each other. While newborns were examined in the minutes immediately after birth in the 1980s and partly 1990s, they now have the opportunity to feel their mother’s closeness and arrive in the New World at a normal birth. It is not uncommon for the first breast application to take place before the first examination U1.

The APGAR tests, named after the American anesthesiologist Virginia Apgar, assess the following health features:

investigation feature 0 points1 point 2 points
breathingno flat and irregularregularly
Skin colorpale & blueblue hands and feet whole body rosy
Heartbeatnounder 100 beats / minuteover 100 beats / minute
muscle tensionlimplyslight movementactive movement
reflexesnofacial grimacingstrong screaming

 

This test is repeated after 5 to 10 minutes. The result on a scale of 1 to 10 is entered in the maternity record as well as in the baby’s yellow prescription book. A value of 8 to 10 is considered harmless or confirms the health of the child but can not be made dependent on it alone. This also always the adaptation of the child to the current situation must be evaluated.

 

In addition to the APGAR test:

  • The degree of maturity of the baby, judged, for example, by observing his responsiveness and looking at the skin, body length and height,
  • the pH of the umbilical cord blood is determined. In healthy newborns, it is usually between 7.21 and 7.31. If he was less than 7, the birth stress for the baby was probably very high and possibly associated with lack of oxygen.
  • Examined the airways and sucked up swallowed amniotic fluid,
  • any birth injuries or abnormalities detected,
  • the head circumference documented.

Unless the parents oppose the vitamin K prophylaxis, the newborn receives vitamin K drops dripped into the mouth to reduce the risk of blood clotting disorders greatly. If the lack of vitamin K is too high, it can lead to dangerous cerebral hemorrhage.

The U1 after cesarean and domestic births

For many mothers, the U1 is the only examination of their baby that they are not directly involved with. In a natural delivery in the delivery room, the U1 is often in the birthing room while the mother is mostly in bed and recover from birth. After a cesarean section, the U1 often takes place in another room.

The father may, of course, be present at the U1 and, if desired, also bathe the newborn for the first time. If the birth takes place in one’s own four walls, the midwife initially takes over the initial examination.

Aftercare with the mother

Of course, in addition to the child’s health, maternal health should also be the focus of attention around the birth. For this reason, of course, in addition to the U1 investigations also take place at the mother. These concern:

  • Checking the afterbirth for completeness. The placenta can be viewed on request together with the medical staff and taken for traditional customs.
  • Assessment and treatment of bleeding and birth injuries.
  • The control of the blood pressure and the general condition.

In the case of mothers with a negative Rhesus factor in the blood picture, an additional vaccination is given after birth if the baby has a positive Rhesus factor. This avoids unwanted reactions of the maternal defense system to later offspring with positive Rhesus factor.

TIPS FROM MIDWIFE INA ELMER

  • Discuss with your attending midwife that your presence at the initial exam is important to you. As a rule, it is also possible during cesarean section to perform the U1 only with the presence of the mother in the delivery room.

U2 – investigation

Head circumference, body weight and length, and reflexes – The U2 takes place between the third and tenth day of life of a newborn. Depending on whether  mother and child are still in the hospital or already at home, they are carried out in the maternity clinic or at the pediatrician.

The U2 at a glance

First, U2 also measures head circumference, body weight and length. The results are entered in the yellow U-book of the baby and compared with the statistical “normal values”. In addition, the doctor focuses his attention on:

 

  • the well-being and adaptation of the baby to the new environment,
  • digestion,
  • the heartbeat 
  • the breathing and
  • whether the child has jaundice (jaundice)

In addition, the baby is bled on the heel, back of the hand or head to perform a metabolic test. This is often more painful for many parents than for the baby itself. Therefore, some doctors ask many parents if they want to leave the room for a short time before taking blood from the baby.

Furthermore, they recommend the use of vitamin D fluoride tablets for the prevention of tooth decay and rickets. These tablets are given to the  baby once a day. Since they dissolve very quickly in the mouth, they are also suitable for most newborns. In addition, in the U2, the review of neonatal reflexes.

Among the newborn’s reflexes count

  • the  gripping reflex . Touches on the hands or feet trigger the grasping or clenching reflex that originally served to hold on to the mother, father or siblings. Already premature babies that from the 32nd week of pregnancy were born with that reflex.
  • the  search reflex . A touch on the cheek or at the corners of the mouth causes a head rotation for breast searching. The search reflex is intended to instantly secure food intake and is lost in the third month of life . He is already observable in premature babies born in the 34th week of pregnancy .
  • the  crotch reflex . If a baby is held upright and gets his feet on a firm surface, it will show pawing movements until about 12 weeks of age .
  • the asymmetric tonic neck reflex . As the head turns to the side, the limbs move in the direction of view.
  • the  Mororeflex . Also referred to as clasping reflex, the Mororeflex is to prevent the fall of the caregiver from the point of view of conventional medicine, if this suddenly changes their position. He is also often seen in babies who are startled in their sleep. It is also used to detect asymetries that may indicate a broken collarbone or a nerve injury. The Mororeflex may also be an indication of neurological problems.

In a medical consultation, paediatricians also give advice on the various topics that will come to a young family in the coming weeks. These include, for example:

  • Baby care ,
  • Umbilical care ,
  • Nutrition ( breastfeeding or bottled milk),
  • Safety in the car and at the sleeping place ,
  • Sleeping habits,
  • Clothing as well
  • dealing with bigger siblings .

Ask questions

Especially with the first baby many questions arise after birth for many parents. However, these are often not addressed due to excitement. So you do not forget any of your questions, write down all the questions.

This will also help the pediatrician assist you with the advice you need at the points where you need help. For many paediatricians it is of course also at U2 to take enough time for a detailed consultation.

Since the birth is only a few days ago, it is important to pay attention to the health and well-being of the mother. Breastfeeding often occurs in the nursing mother during the first two to four weeks after birth due to sore nipples or excessive milk production .

In addition, there are often questions about the topic of weekly flow. In addition to the pediatrician, midwife and gynecologist are important contacts for the health of baby and mother.

TIPS FROM MIDWIFE INA ILMER

  • Make it easier for your baby to take blood by allowing him to make skin contact. Many children are also better able to calm down if they are allowed to drink at the breast during blood collection.
  • It is best to administer the tablets dissolved with breast milk and then breast-feed your baby.

U3 – investigation

The check-up in the fourth to fifth week of life – For many babies, who were born in a hospital and where the first days were also treated medically, the U3 is the first major check-up at the pediatrician.

The U3 at a glance

The U3 takes place at the beginning of the second month of life and is used to examine the development of a baby by a doctor and to recognize any health problems or physical impairments. For the U3 you should plan a lot of time, as it includes various individual examinations. These include the verification of:

  • General condition,
  • Growth (body length and head circumference) and weight gain,
  • Eating or drinking behavior,
  • Sleep behavior,
  • Hip joint as well
  • neurological development (control of reflex patterns).

Also, the pediatrician clarifies the parents about the upcoming vaccinations .

The general physical examination

In addition to recording various measurements such as weight, body length and head circumference, the pediatrician also monitors the baby’s breathing and respiratory system using his stethoscope. In addition, he assesses whether your baby is developing according to age by observing the physical condition, reactions, and behavior. He will also ask you questions about your drinking and sleeping habits in order to assess your child’s developmental stages.

Whether a baby develops normally can be compared, among other things, with the average growth of other babies. Based on an extensive, statistical data material will be:

  • the body weight,
  • the body length,
  • the head circumference and
  • the body measurement index

adjusted with so-called percentile values. These indicate in which measuring areas, a baby under or above average or develops on average.

In addition to the optically visible development, the reflex patterns of your baby are also assessed at the U3. Careful assessment of neurological development is a major focus of this important screening.

The pediatrician pays special attention to the following observation points

  • The baby’s eyes can follow an interesting object or a light source sideways.
  • Noises, such as a chime, are perceived by the baby.
  • There is a reaction when the mother says something.

Of course, your baby can only show all these reactions if it feels safe, full and satisfied during the examination. Therefore, try to make sure that your baby does not freeze when it is pulled out. Most medical practices have a heat radiator over the winding tray.

And try to give him a sense of security, even if you are a bit upset yourself. If your baby does not feel ready for the examination and cries or cries, just make a new appointment.

The study of hip joint development

About two percent of all newborns have problematic hip joint development. Much more girls than boys are affected by this. In the event of an incorrect hip development, hip dysplasia can occur, which can make subsequent movements (such as crawling and running) significantly more difficult or severely hampered.

If a  hip dysplasia is  recognized in the first months of life, it can be treated so successfully that  it heals completely without consequences. Depending on the degree of severity, even a wide winding is sufficient. The diagnosis of hip dysplasia is made using a painless ultrasound.

The vaccination consultation within the U3

Many paediatricians also address the current 13 vaccinations recommended in Germany in the U3. The decision as to whether a vaccination should be made or not, lies solely with the parents or guardians of the child. These include:

  • Diphtheria ,
  • Haemophilus influenzae type b,
  • Hepatitis B,
  • Whooping cough ,
  • Polio ,
  • Measles ,
  • meningococcal,
  • Mumps ,
  • pneumococci,
  • rotaviruses,
  • Rubella ,
  • Tetanus,
  • Chickenpox .

Parents can decide for each pending vaccination on whether you want to follow the vaccine recommendation of the doctor or not. The first 7-fold vaccination against pneumococci, hepatitis B, polio, whooping cough, tetanus, diphtheria and Haemophilus influenzae type b takes place from the eighth week.

U4 – investigation

For paediatricians, this check-up is something special. Because in the third month of lifemany babies are already diligently testing the so-called social smile. A large part of the small patients also presents this to the pediatrician who can draw various conclusions about the physical and neurological development of your child. For example, from a doctor ‘s point of view, direct contact with the baby can be used to assess whether vision and hearing are age – appropriate.

Check-up in the third or fourth month of life

If your child does not laugh at the pediatrician at U4, you need not worry as long as it responds in other ways to the often very exciting situation.

If your baby does not feel well during U4 and cries and yells so much that it calms down for the moment, the exam may be postponed or continued at a more appropriate time.

The pediatrician pays attention to this

When examining your baby, the pediatrician makes sure that your baby:

  • can follow a moving object out of the supine position with the eyes and turn the head accordingly,
  • can keep his head in the middle and prone position and already mastered the symmetrical forearm support,
  • both hands symmetrically in the back or middle position when grasping for an interesting toy ,
  • the legs are propelled towards the ground when held upright over a firm base
  • not only varies the volume of his notes, but also produces different sounds, such as laughter and squeaking.

Also, the doctor points out to parents that it makes sense to take a daily vitamin D and fluoride tablet to prevent vitamin D deficiency, tooth decay, and rickets and, at the request of the parent, issue an appropriate prescription. In order to get enough vitamin D even without the tablets, the stay in the fresh air is absolutely necessary, because the sunlight has a decisive influence on the vitamin D intake and production.

7-vaccination

If the first part of the 7-fold vaccination took place during the ninth week of life at the first vaccination date, the second immunization can be taken against:

  • Diptheria ,
  • Haemophilus influenzae type b (Hib),
  • Hepatitis B,
  • Whooping cough ,
  • Polio ,
  • Pneumococci and
  • Tetanus be made.

Furthermore, the doctor will inform you in detail about the forthcoming development steps and vaccination recommendations of your baby and answer your questions. Especially with the first child, parents often have many questions. Since these usually arise in certain everyday situations and are not always present during an exciting for the baby and the parents foresight appointments, you should create a questionnaire. You can easily take this with you to every check-up.

In addition, consultation appointments with the pediatrician can be arranged outside of a regular check-up. Even midwivesbe happy to answer your questions about the development of your baby at your side and can be utilized as needed. As a rule, the costs are borne by the health insurance .

For questions regarding back development and musculoskeletal system, it may also be useful to consult an osteopath. The next check-up U5 takes place between the fifth and sixth month of life .

U5 – investigation

For many parents, the appointment for the fifth check-up in the sixth or seventh month of life seems unbelievable. The birth is not long ago. But the little baby is now over half a year old and clearly shows that it wants to discover the world more and more intensively.

Second part of vaccinations, height, weight & exciting gymnastic exercises

For example, at the time of U5, some babies may not only turn from the abdomen to the back and from the back to the abdomen . They also found out how to reach the desired toy by rolling. Objects and persons are often very interested in watching a baby’s eyes during the sixth / seventh month, and he also reacts very sensitively to noises.

However, every baby masters these different milestones at different times. As part of the U5, the pediatrician can check whether a baby develops in a timely manner and provides parents with advice on all matters relating to baby development.

So big are you! – the routine measurements

Also, the U5 usually begins with the measurement of height, body weight and the circumference of the head. The pediatrician can determine if their child is developing within the general standard readings by comparing them to commonly collected measurements of babies of the same age.

For this purpose, the so-called percentile curves are used, which clearly show whether the measured values are average or above or below average. Strong deviations from the average are no reason to worry about your baby’s development. Since each baby develops individually, there may well be deviations that balance out a few weeks later.

Playtime: testing the reflexes

To enable the pediatrician to examine the age-appropriate development of your baby’s reflexes and abilities, he playfully deals with it. For example, mouth-hand coordination is checked by showing the baby a toy. If you are curious about it and want to put it in your mouth right away , everything is fine. In addition, U5 checks whether:

  • the support reflex is shown (when pulling up the arms, the baby takes the head with it and tries to catch it from the still unstable sitting position with the arms supported laterally),
  • the foot-grip reflex is still present and
  • the warehouse actions are well trained.

When testing the warehouse actions, your little one is allowed to float in the air. In doing so, the pediatrician will check if your baby is trying to look forward in the overhead position and to tilt the head in the vertical position. It also controls how much your baby bumps against a hard surface when it is put on its feet.

To assess the development of vision and hearing, paediatricians use interesting means and methods for the baby. Switching on and off as well as moving a small lamp shows to what extent a baby can already fix and follow things. It is important that both eyes move in parallel.

Using a tweeter rattle or a bell, your little one’s hearing can be judged. If your baby turns spontaneously in the direction of the noise source, it has already passed the test. Unless a detailed hearing test has been carried out, you can make up for it in the U5.

Ultrasound as a voluntary examination

In order to take a closer look at the function of the internal organs, some pediatricians not only touch or hear the body of a baby. They also perform an ultrasound, with which, for example, early urine backflow can be detected and thus urinary tract inflammation can be avoided.

Vaccination and consulting services

If you have not yet, your baby will receive the second part of the recommended multiple vaccine against tetanus, diphtheria ,whooping cough ,polio , Haemophilus influenzae type b, hepatitis B and pneumococcus during U5 . Of course, this will only be the case if you follow the general vaccination recommendations of the STIKO (Standing Vaccination Commission). Questions are answered by the pediatrician.

He will also discuss sleeping and eating habits with you and give you appropriate medical advice. Also, the behavior and sleeping habits of your baby are an important issue during the U5. In addition, many pediatricians recommend continuing fluoride and vitamin D prophylaxis.

TIPS FROM MIDWIFE INA ILMER

Midwife & mother
  • Discuss with your pediatrician also questions about complementary foods. An interesting time begins. If you have any questions about nutrition, you can also ask your follow-up midwife for advice.

U6 – investigation

The overall development of the first, eventful and exciting year of your little one is assessed from a pediatrician perspective with the U6 ( 10th – 12th month ).

The one-year examination at the pediatrician

Your baby’s sixth check-up once again focuses on whether your baby has developed according to age. To assess this as comprehensively as possible, the pediatrician examines the following points:

  • Medical history in the first year of life
  • Measurements and playful tests during the U6
  • questioned findings such as behavior, eating and sleeping habits or possible allergies .

Routine measurements: from body weight to height

Comparing the measured body length, body weight and head circumference values, the physician can use the so-called percentile scores to help determine your baby’s age-appropriate development. At the end of the first year of life, growth is becoming increasingly individualized.

As soon as babies reach the toddler age, the spreads for normal weight and length are larger. This is primarily due to the different hereditary factors. As a result, the measured values are very different between peers or can even fully equalize within a few weeks.

On average, a baby in the first year of life grows 24 inches and triples his birth weight. This rapid growth will subside in the following years. In the second year of life it is about 12 centimeters, in the third about 8 centimeters.

The tests and investigation questions of the U6

The last examination in so-called infancy focuses on different aspects. These include:

  • the ability to crawl ,
  • the supporting reflex (also known as the parachute reflex), in which a baby instinctively rests sideways or forward with one’s arms,
  • the posture and safety in the sitting position ,
  • first running tests (pulling up furniture and trying to walk along it)
  • the fine motor skills (or pincer grip pliers – from 10 months , together knocking lumps)
  • the communication by sound , mostly two-syllable words like Ma-ma, etc,
  • .the understanding of simple prompts, questions or prohibitions,
  • Perception behavior, perception and recognition of objects (touching details with a forefinger or deliberately throwing away toys) as well as
  • the social behavior (clear signs of strangers , joy in hiding games).

While most babies are masters of crawling at the U6 , it may well be that the pulling up of furniture as well as the first attempts at walking still have to wait. The first understandable syllables or even words are sometimes only after the first birthday. To what extent the development of your child is age-appropriate or not, your pediatrician can often assess very well on the basis of the various assessment points and advise you on any funding requirements.

Further advice on the U6

As with the previous check-ups, your pediatrician will ask questions about the different areas of your child’s life and will also be happy to answer them. In the course of caries prophylaxis , many pediatricians point out that sweet bottle or apple juice in the evening are very harmful to the teeth. In addition, a continuation of fluoride prophylaxis is often recommended.

At the end of the first year of life, you must again make a decision regarding the general vaccination recommendations for your baby. From the 11th month advises the STIKO to the so-called live vaccines. These include:

  • Chickenpox ,
  • Rubella ,
  • Measles and
  • Mumps .

These usually take place as a multiple vaccination between the 11th and 14th month of life. In addition, the booster dose is for tetanus, diphtheria ,whooping cough ,polio , Haemophilus influenzae type b, hepatitis B and pneumococci. After the first 12 months of life , a vaccine against meningococci is possible.

If the doctor identifies any possible allergies as part of the parental interview, he will suggest suitable tests for the determination of possible allergens. Some paediatricians routinely do an allergy test .

U7 – investigation

The First Infant Examination – At the time of U7 ( 21 to 24 months of age ), many parents proudly look forward to the upcoming check-up. In the last year of her baby has learned a lot. Experience has shown that it is not always easy for paediatricians to recognize what they have learned at this age.

Scream investigation

Internally, children and adolescents also refer to the U7 as an “anxiety or cry test”, as many children in this phase of their lives are very strangers or in the midst of the first phase of defiance. This makes it difficult for the pediatrician, for example, to assess language development. If the ice between the pediatrician and the little patient can not be broken, the U7 can simply be repeated or continued at a later time.

At the heart of the U7 stand the assessment:

  • physical development,
  • the motor skills,
  • of social behavior and
  • the speech – and hearing development.

What’s the name of your teddy ?: speak, hear and understand

To be able to comprehensively assess the language and hearing development in the context of the U7, the pediatrician asks the parents about their impressions. On the other hand, he performs light listening comprehension and speaking exercises with his little patients.

He checks whether the child already:

  • understand about 250 words and speak at least 20-50 words,
  • used secure two-word combinations,
  • can name known animal pictures,
  • Calls follows and
  • can name his first name.

If this is not the case or your child is too shy to act or respond appropriately, this may not necessarily indicate a developmental delay. For example, some children first show their speaking skills,if they are very sure of their cause. This time can begin well after the second birthday.

Build a tower and play ball

In conjunction with the speech exercises, the pediatrician also controls the fine motor and gross motor skills of your child. For example, it may pour out water from a bottle or paint a vertical line with both hands. Also running backwards, standing back from the squat freehand and playing football are depending on the pediatrician on the plan of the U7.

The social behavior of your little one is also being examined for the first time. To assess this, the pediatrician, for example, asks the following questions:

  • How does your child behave on the move and at home?
  • How is the relationship to siblings ?
  • How does your child react to pets?
  • Does your child help with dressing and undressing?
  • Can your child wash and dry their hands independently?
  • Does your child like to play catch?

These questions are used to assess the independence and interactivity of your child.

When looking at the physical development are still the values: height, body weight and head circumference in the center. Although the measurement results continue to be with the so-called percentile curves (the comparison with age-matchedChildren). However, this comparison is of no greater importance because children develop very individually from the first year of life.

For the time being, vaccinate one last time

If you have opted for the vaccinations recommended by STIKO, your child will receive a booster dose of the U7 for tetanus, diphtheria, whooping cough, polio , Haemophilus influenzae type b, hepatitis B and pneumococci. Depending on when the first vaccine was taken with the live vaccine combination for mumps , measles , rubella and chickenpox , the necessary repeat vaccination can also be given to the U7 and thus all recommended vaccinations can be completed.

U8 – investigation

Preventive examination with preparation – The check-up U8 takes place between the 46th and 48th month of life. At the age of four children already know a lot about visits to the pediatrician and therefore often look forward to the U8 appointment with excitement, excitement and sometimes also with joy. Some parents already have itThoughts about the upcoming school time and are therefore very interested in the findings of the pediatrician.

This awaits your child at the U8

The age-appropriate growth and the corresponding mental and also motor development are in the foreground in the U8. The behavior of your child, conspicuous habits and the ability to interact will also be considered. In addition, the pediatrician examines vision , hearing, perception and speech .

Among other things, the following development milestones are taken into consideration:

  • Your child is able to stand on one leg for a short time (at least 3 seconds).
  • It can jump 20-30 centimeters with its legs closed.
  • It paints circles to and fro.
  • It recognizes the longer of three lines.
  • It paints people, which consist of three parts.
  • It can cut something out with scissors.
  • It has a wide vocabulary and can also understand common adjectives.
  • It forms sentences, can report on experiences and tell jokes.
  • It does not strangle anymore.

In addition, there is also a thorough internal examination, for example, to rule out urinary tract infections, diabetes, heart disease, thyroid and renal dysfunction. For this, the doctor asks the parents various questions, for example, tooDiseases in the immediate family environment. While during the day a large part of the four-year-olds no longer wears diapers , the nightly diaper protection is still considered normal by paediatricians.

How to prepare your child for the U8

During the U8, your child has many tasks to master. In addition to the routine measurements of height, weight and head circumference, it will:

  • Name pictures,
  • complete a visual and hearing test,
  • a little gymnastics
  • answer many questions
  • wait when you answer and ask questions.

On the one hand, this takes a lot of time and on the other hand requires a high degree of concentration. Also, some of the small patients feel overwhelmed or unsettled by the numerous events during the U8. A detailed preparation for the visit to the pediatrician can prevent this. Tell your child what exactly happens with the U8. There are even toddler-friendly children’s books in which you can read together with your child, what is exciting about the U8 on your child and waiting for you.

Some paediatricians ask for U8 filled out a kindergarten questionnaire. This refers primarily to topics related to social behavior. This is difficult for the pediatrician to assess in the U8.

If all recommended vaccinations have been performed, your child will have a check-up without the dreaded beekeeper.

What to do if you have poor test results?

If the results of the hearing or eye test are below the expected standards, the pediatrician will repeat the respective test again at a later time or recommend a visit to the ear, nose and throat specialist or the ophthalmologist. In the case of language development disorders, the help of speech therapists can also be claimed.

Children who frequently otitis suffer and their tonsils and adenoids are greatly enlarged, have more often difficulty hearing. Most of the infectious water or secretion is behind the eardrum, which leads to a sense of hearing as under a cheese bell. If this is the case, the ENT specialist can perform special therapies with your child to restore full hearing. This is very important for the later language development.

U9 – investigation

With the U9 the toddler and kindergarten time slowly progresses from the point of view of development medicine to the phase of life as a preschool and schoolchild. It is regarded as the most comprehensive, pediatric medical check-up, as it also forms an important basis for the upcoming enrollment.

Preventive examination for prospective schoolchildren

It takes place between the 60th and 64th month and examines:

 

  • the general body and organ functions,
  • the physical development,
  • the sight and hearing,
  • the gross and fine motor skills,
  • the language ability ,
  • the social and interaction behavior as well
  • the understanding and the intelligence.

First, at the beginning of the U9, in addition to the general routine measurements: height, body weight and head circumference, blood pressure and urine will also be checked. A look at the medical history of recent years also gives indications of possible obstacles in the development of your child so far.

During the U9, the following major development milestones will be reviewed, including:

  • Your child can safely stand on one leg freehand (at least 8 seconds).
  • Your child  can walk backwards and forwards on their toes and heels.
  • Your child  can paint triangles, crosses, squares.
  • Drawn people now consist of 6 parts.
  • Your child  recognizes different materials.
  • The language flow is undisturbed, logical and in a timely order.
  • Your child  can define words.
  • Your child  can safely call and count amounts up to 5.
  • Your child  can already write his first name.
  • Your child  can tell clearly from their own social behavior and social life and, for example , clearly distinguish between situations in the kindergarten , at home or with their grandparents .

Schedule time

If you have already experienced the U8 as extensive, you should also prepare for the U9 for a longer examination time or prepare your child accordingly. If you have read a children’s book a year before to visit the pediatrician, you can simply take it out of the bookshelf again. It is important that you prepare your child to be able to perform many tasks during this check-up.

Parents should also be prepared for a few questions from the pediatrician. These serve, for example, to better assess the hearing in combination with the hearing test. For example, paediatricians ask if:

  • Your child frequently asks or
  • The concentration on listening to the radio or reading aloud quickly decreases.

The relationship between children and parents is also examined in order to better assess the overall development and to provide further development impulses.

If the visual and hearing test is not satisfactory, it can be repeated again or a referral to the appropriate specialist is made. The visual acuity should be 100 percent trained in the fifth year of life. Both vision and hearing are essential to successful learning at school. Especially the language subjects are auditory-oriented in the first years of school. That is, listening comprehension plays an important role. If there are hearing problems due to developmental reasons, they should therefore be checked and treated by a doctor.

The U9 as an important vaccination date

If your child was able to do without a new vaccine a year ago, the vaccine protection will be refreshed or completed during the U9. If you follow the recommendations of the STIKO, the following vaccinations are on the U9 vaccination schedule:

  • Revaccination against tetanus, diphtheria, whooping cough, polio , Haemophilus influenzae type b, hepatitis B and pneumococci as well
  • second MMR ( measles , mumps , rubella ) and chickenpox vaccination.

TIPS FROM MIDWIFE INA ILMER

  • The pediatrician is a long companion for your child and also the parents. Pay attention to additional qualifications that are important to you, eg natural medicine, anthroposophic knowledge etc.
  • With the pediatrician your child should feel well and fear be a foreign word.

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