Pearls of Wisdom: What to Expect On Your Baby’s First Doctor’s Visit

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Post By. Dr. Pearl Cenon

In my 15 years as a pediatrician, I’ve had the pleasure of being one of the first faces (outside of family) that new babies meet! A baby’s first visit to the pediatrician is always an exciting one: parents are full of questions about their precious little one. Even if it’s not a firstborn, each baby has her own unique personality so parents find themselves seeking new and different advice or trying to remember how things worked the last time around! Whether you are expecting your first or fifth child, this is a basic summary on your newborn’s first visit to the pediatrician.

New moms and dads should expect to see their family pediatrician the most during baby’s first year. Right after the baby is born, an appointment should be made for a visit. It’s a good idea for two people to accompany baby so that one parent can focus on the discussion with the doctor, while the extra caregiver attends to baby. This will give parents an opportunity to get to know their pediatrician and exchange questions and answers. Questions can range from medical issues to common childcare topics, parental support groups, and any other practical matters.  From this very first visit, a good pediatrician will make parents comfortable and assist them in every possible way.

Initially, your baby’s weight, height and head circumference will be measured and plotted on a growth curve that shows how your baby compares to other babies the same age. These measurements will be taken at all subsequent infant visits because they help track your baby’s growth.  Interesting fact: generally speaking, (though your baby’s milestones may vary; check with your doctor if you have questions), babies will double their birth weight by their sixth month of life and triple it by the age of one. Imagine if we tripled our weight within a year?!

Provincial health department, Bolu, Turkey Photo: Simone D. McCourtie / World Bank

Provincial health department, Bolu, Turkey Photo: Simone D. McCourtie / World Bank

Next comes a thorough, head-to-toe physical examination. In the head exam, the doctor examines the soft spots — called fontanelles – that are normally open and flat in the first few months. The posterior (back) fontanelle usually closes at two to three months while the anterior (front) fontanelle closes before the second birthday.

Though most newborn nurseries perform hearing tests before the baby is discharged, baby’s ears will be examined again during this visit. To assess hearing, the doctor may ask how your baby reacts to your voice or loud sounds. The doctor will use an otoscope that provides a good view of the ear canal and eardrum.

Everything Checks Out!- Lab212

Everything Checks Out!- Lab212

Using a bright light such as an ophthalmoscope, the doctor will examine your baby’s eyes to detect cataracts that sometimes form early in life. He or she will also track eye movements and check the pupil’s response to light.  Next is an exam of the mouth and neck, followed by use of a stethoscope to listen to the heart and lungs. The doctor is listening for murmurs, abnormal heart rhythms, and breath sounds.

The doctor will also gently apply pressure to your baby’s abdomen to check for any abnormal masses or tenderness. If your baby still has the umbilical stump, he or she will show you how to clean and keep the area dry until it falls off.  Genitalia are also checked for abnormal lumps or signs of infections. In baby boys, the doctor will examine the penis (and healing, if a circumcision was performed) and ensure that the testes are both down in the scrotum.

To assess for problems in the hip joints, your doctor will move your baby’s legs to detect any abnormalities such as congenital hip dysplasia; early detection of this condition is critical for correction later in life.

Lastly, your pediatrician will ask about your baby’s feeding, sleep patterns, and bowel/urinary frequency. It is crucial that you learn to recognize developmental milestones that your baby will reach; hence the doctor will discuss when you can expect your baby to smile, roll over, sit up, walk, and how he or she uses her hands and arms. During this visit, your pediatrician will also test the baby’s reflexes and muscle tone.

Prior to baby’s birth, consider asking your family members, friends, and even your ob/gyn for their recommended pediatricians; then make appointments to meet several.  Just as you would interview childcare providers, you will want to ensure that the pediatrician you choose for your baby is someone that you trust and with whom you have a good relationship.  You and your child will be in close contact with the family pediatrician for almost two decades… that’s good reason to be choosy!  A good pediatrician is one whose reputation is excellent, but also someone who can clearly answer your questions, is a good listener, instill confidence in you, and someone who always makes you feel welcomed!

Warm Wishes,

Dr. Pearl

 

All information contained in this blog and on our web site(s) should be independently verified by you by a medical professional of your own choosing and you should always conduct your own research and due diligence before making any decision related to the subject matter of this blog or our web site. 

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Dr. Pearl

 

Dr. Pearl Cenon

A pediatrician in private practice in New Jersey for over 15 years, Dr. Cenon (we like to call her Dr. Pearl) also has two children of her own. Dr. Pearl’s husband, Kevin McDonough is also a pediatrician and they work together. She’ll write basic posts about topics that interest many parents, from skin care and nutrition to seasonal issues, such as allergies and colds. Her kind, approachable tone in each blog post will have you looking forward to the next one.

“Itchy Spots” (or Eczema, as it is Called Elsewhere)

Four years ago, the extent of my knowledge regarding eczema was its existence as some kind of skin rash. Having worked with a person who had psoriasis, I somewhat (incorrectly) equated the two and felt bad for people who dealt with them but didn’t give them much thought myself. So, when my son had a circular patch of red, bumpy skin on his arm, I never considered eczema but thought it was ringworm. Daycare thought the same and the nurse at my son’s clinic confirmed the suspicion and said to use Lotrimin on the area. A few days of Lotrimin, however, brought about no change and my mother, a RN, was visiting, so I asked her opinion. She thought it looked like “contact eczema” and suggested we change laundry detergents.

This change seemed to do the trick at first, but it wasn’t long before what came to be called “itchy spots” in our house started popping up all over my son’s arms and legs and occasionally his back and stomach. All of these spots were circular in nature (similar to ringworm), not like the eczema photos I’d seen on posters in the doctor’s office, and daycare was concerned that this was some type of fungal infection and therefore contagious. So I did some research and saw a pediatrician and it turned out eczema appears in more than one form and the form my son had was Nummular Dermatitis or Nummular Eczema which is often misdiagnosed initially as ring-worm due to its circular appearance. So, no ringworm (phew), but still the unpleasant “itchy spots” remained. Typical eczema remedies – cortisone on the “itchy spots” when they were red and Aveeno when they were not, no use of soap (just Aveeno bath wash), free & clear laundry detergents, and no bubble bath became the routine at our house. Still, for a long time my son would go through periods where he had these horrible “itchy spots” that he would often pick at and worsen. The crease on the inside of his elbow was particularly bad and I had difficulty getting the eczema to clear from that area. Of course, this is also an easily accessible spot to itch, so I took to covering it with Band-aids to keep my son from picking at it.

ScratchingIn the meantime, I kept researching and came across a link between eczema and milk protein allergy. I spoke with the pediatrician about the possible connection between that two, but was told that it was unlikely and there was no proof of a connection (the same thing I was told about my son’s reflux and a possible milk allergy) and so, we just continued our “itchy spot” routine. It wasn’t until this year, as my son’s “itchy spots,” all-but disappeared and then were gone, that my daughter (who is eczema free) was diagnosed with a milk protein allergy. When we saw the specialist regarding this, the conversation with him resulted in the following conclusions:

1. According to the specialist, it was surprising that my daughter did not have eczema given the obvious milk protein allergy.

2. Milk protein allergies are often the cause of night-waking (something my son has always struggled with).

3. My son likely had a milk protein allergy which caused or at least aggravated his reflux and eczema and was no longer struggling with it because he had outgrown the allergy (as most children do by the time they are six) or reduced his milk intake to a level where it was not affecting him.

Having one of those, “if I had only known then” moments, I wished I had just taken my son off dairy a few years ago to see what happened despite the pediatrician’s assurance that a milk allergy was not likely. It certainly would’ve been nice to ascertain a connection between the two four years ago, but hindsight is always 20/20. Still, I would be curious to know how many out there have found an obvious connection between their child’s eczema and a food or other allergy. I also encourage any of you dealing with eczema to explore the possibility of it being caused from a food allergy – and follow your instinct even if your doctor says there is little chance…see a specialist or try eliminating dairy. It might be worth it.

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About the Blogger:

Hi! My name is Shawna. I am a married mother to two adorable children and love being a mom. My children throw me unexpected surprises more often than I can count, but I wouldn’t change that for the world. Thanks for reading!