Questions at 6 weeks

We unpack that allimportant six-week doctor’s check-up – a must for your newborn.

Your baby’s six-week check-up is a milestone, and the visit with the paediatrician is precious – you’ll want to find out as much as possible about your baby’s development. It will help to know beforehand what to expect and draw up a list of all the questions you’ve had over the past few weeks.

WHAT THE DOCTOR WILL WANT TO KNOW

• Your family history regarding healthrelated problems.

• How your baby has been doing up to now, at home, and with the family.

• How much and how often she nurses (breast babies can nurse between six and 12 times a day, while bottle babies should be fed every three or four hours).

• If you’ve had any issues with breastfeeding.

• How much and where Baby sleeps.

• How often you need to change nappies and the nature of the contents of those nappies. How often does your child poo, and does it come easily or with effort? What’s the texture and colour like? Breastmilk nappies are much more runny and initially mustard yellow, while bottle nappies are firmer, but much softer than adult poo.

• Anything you might feel is out of the ordinary.

QUESTIONS THAT MIGHT MAKE YOUR LIST

• Is your baby on track in terms of her height, weight and head circumference?

• Which development milestones (laugh, cry, make noises, roll over, reach out, sit, crawl, pull herself up, walk and so forth) should your baby have reached by the next visit?

• Are there any supplementary tests you should do at this stage?

• Why is immunisation necessary, and what are the options? If you’re unclear about anything or are scared about it, you should sort this out now.

• Are there safety concerns that you specifically have to focus on at this stage?

• Is everything in order with the baby’s heart, lungs, eyes and ears?

• How should you prepare for the next visit?

• How do you know when your baby is sick enough to phone the paed?

WHAT’S DOCTOR GOING TO DO WITH MY BABY?

The six-week check-up is very important. Doctors use this visit to understand how your baby’s developing, what her condition is, how your family is doing and if you show any signs of post-partum depression or suffer from exhaustion, explains paediatrician Dr Jeanne Odendaal.

“We usually ask how Mom and Baby are doing, and if the mother can manage her new circumstances. Then we’ll hear if the baby is being breast- or bottle fed, how often she nurses and the volume she drinks, and if there are problems such as reflux, cramps and diarrhoea. In this way, we can distinguish between normal baby ailments and those needing medication. We also listen to how your baby sleeps and give advice when they’re day rather than night sleepers.” Questions the doctor will ask about her development include: Is she smiling yet? Is she making her first baby sounds? Does she lift her neck from your chest, and does it look like she can focus on an object? After that, your baby is examined from head to toe, Dr Odendaal says.

This is what the checklist looks like:

1 GENERAL GROWTH

At six weeks, the paed again checks the same things that were checked in hospital to ensure nothing has been missed. Weight, height and head circumference are important to monitor growth, and the doctor checks again whether there are any signs of dysmorphism (a deviation in body structure that could indicate a genetic syndrome or birth defect). Your baby’s weight and measurements will be indicated on a curve on a growth chart to ensure development is on track – the curve should go upward. Your baby could lose up to 10 percent of her body weight in the first few days after birth, but she should be gaining about a 1g a day at six weeks.

2 HEAD

The size and shape of baby heads vary dramatically, but a head that is too big or too small and falls outside of this spectrum can be an indication of an issue, especially if there are other worrying factors. Bumps occur quite widely, as Baby’s head can form a bump in your pelvis due to the pressure. Sometimes these bumps disappear and sometimes they don’t, but it’s nothing to be worried about. The doctor will also check that the two fontanelles close like they should (one at six weeks, the other at 18 months).

3 NECK

Can your baby lift her head when she’s lying on your chest?

4 EYES

The eyes are tested to eliminate some eye abnormalities. It’s to be expected that your baby still squints a little because her sight is still developing, but she should be able to focus on a fixed object by six weeks. The paediatrician also checks whether your baby’s eyes move as a unit, and if the tear ducts alongside her eyes are normal.

5 EARS

How does your baby react to a loud sound? The shape and position of the ears will also be checked. 6 BELLY This also has to be examined to determine if there are hernias or perhaps a lump. At the same time, the doctor also looks to see if the hips and reproductive organs are normal.

7 MOUTH AND NOSE

The nostrils are checked for any abnormal swellings or tumours. The mouth should be rosy and moist inside. The doctor looks out for signs of a cleft lip and also checks for white spots on the tongue or gums, which could indicate thrush.

8 CHEST, HEART AND LUNGS

The paediatrician will listen up, especially for a heart murmur, something that can usually only be heard clearly by six weeks. 9 SKIN Paediatricians look at the suppleness, colour and texture of your baby’s skin and any signs of birth marks. Some babies have strawberrycoloured birth marks that grow quickly as they grow older. These marks are usually harmless, unless it’s too close to your baby’s eye, and will gradually disappear spontaneously.

10 LIMBS

Your baby’s arms and legs should look symmetrical, and her muscle tone should be acceptable.

11 REFLEXES

These are automatic, random movements. By testing reflexes, the paed can see if your baby’s nervous system functions normally.

12 NEUROLOGICAL

Here, the milestones are considered (has your baby started making noises and smiling?), as well as Baby’s strength and muscle tone.

LASTLY

Your doctor will check all your baby’s body systems.

More things are of course checked and monitored in premmies than in full-term babies, Dr Odendaal says. “But ask your doctor to talk you through the check-up step by step while it’s being done.”