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Six week check up

Six week check up

All babies are invited for a check up at about 6-8 weeks of age. This may be done by your GP at the same time as your post-natal examination, or in a clinic by another doctor who is trained in child-health promotion. If you do not receive an appointment, check with your GP practice or health visitor.

In most areas, parents are given a personal child-health record book when the health visitor visits them at home after the baby is born. This book explains the different examinations and has space for recording growth and developmental milestones. There may be a questionnaire to complete about the baby's progress at 6 or 8 weeks. Remember to complete this and bring the book to the appointment.

At the check-up

Firstly, your baby will be completely undressed and weighed. You will be asked about any difficulties during your pregnancy or delivery or any medical problems since then. You will also be asked about any feeding problems and your method of feeding (breast or bottle, or both). The baby's weight is plotted on the growth chart in your record book. Babies gain about 200 g (6 ounces) a week after the first 2 weeks, but this can vary from week to week and from baby to baby. If the baby is not gaining weight very well, the doctor will ask more detailed questions about the type of milk and number of feeds.

You will be asked about the baby's vision and hearing. Does the baby turn towards the light, fix your face with his eyes and follow you with his eyes when you move around the room? Is he startled when he hears a loud noise such as a door slamming? Is he starting to make cooing noises? At this age many babies are beginning to smile.

You will be asked how well the baby is sleeping and if the baby is sleeping on his back. It is essential that young babies do not sleep on their tummies or side because this is known to increase the risk of cot death. For the same reason, it is vital that parents do not smoke in the same room as their baby and ideally not at all. You may also be asked questions about how you are coping.

For the physical examination, the baby is checked systematically from head to toe as in the newbirth examination. The baby's head circumference is measured with a tape measure so it can be plotted on the growth chart to check for normal growth. The eyes are examined using an ophthalmoscope. If the baby's eyes are closed it can be helpful to put him over your shoulder, because babies often open their eyes in this position. The mouth, ears and neck are also re-examined. The doctor will feel the pulses in the baby's groin and listen carefully to the heart.

After examining the baby's heart your baby's tummy will be felt and his hips will be checked for any signs of instability or dislocation. If in doubt your baby will need referral to a specialist. With a boy, the penis and scrotum are re-examined. Some boys develop fluid round the testicle (a hydrocele), which is painless and usually disappears on its own over a few months. If the testes are not fully descended by the 6 or 8-week check, the baby may either be reviewed or referred for a surgical opinion to a hospital doctor.

The hands and feet will be checked, the baby's head control and limb tone will be tested to look for any neurological problems, and lastly the baby will be turned over to examine the spine and anus.

After the examination is completed the findings are recorded in the child health record. The immunization programme will be discussed with you, which is due to start when the baby is 2 months of age and your healthcare professional may talk about accident prevention. Remember that your GP will be happy to discuss any worries you may have, but may refer you on to the health visitor for further advice and support.

Remember, when you go to the check up there is no reason to be nervous. The 6-week check-up is exactly that, a check-up and it will help ensure that your baby is fit and healthy.