The 6-8 Week Examination Dr Lesley McDonald Community Paediatrician Achamore Child Development Centre.

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Presentation transcript:

The 6-8 Week Examination Dr Lesley McDonald Community Paediatrician Achamore Child Development Centre

History revision of antenatal and birth histories revision of antenatal and birth histories family history of congenital abnormalities family history of congenital abnormalities parental concern regarding baby parental concern regarding baby general health, feeding, sleeping general health, feeding, sleeping smiling smiling vision – fixing and following vision – fixing and following startle to loud sounds startle to loud sounds Guthrie result Guthrie result

Examination general appearance and facies general appearance and facies skin and nails (jaundice) skin and nails (jaundice) then start at top and work down then start at top and work down

Head and Neck fontanelles fontanelles eyes – cataract (red reflex) eyes – cataract (red reflex) fixing and following fixing and following palatal integrity palatal integrity

Chest respiratory movement – intercostal recession respiratory movement – intercostal recession palpation of apex beat and thrills palpation of apex beat and thrills auscultation of heart sounds and murmurs auscultation of heart sounds and murmurs femoral pulses femoral pulses

Abdomen umbilicus umbilicus –hernia –infection palpation of kidneys, liver, spleen palpation of kidneys, liver, spleen herniae herniae

Genitalia testicular descent testicular descent hypospadias / epispadias hypospadias / epispadias

Back, Hips, Limbs sacral dimple - ? blind ending sacral dimple - ? blind ending buttock crease symmetry buttock crease symmetry hips hips talipes talipes syndactyly syndactyly

Neurodevelopmental assessment alertness alertness tone tone symmetry of movement symmetry of movement head control head control primitive reflexes primitive reflexes milestones of development milestones of development

Growth naked weight naked weight length length head circumference head circumference plot on growth chart plot on growth chart beware OFC +/- 2SD compared to weight and length beware OFC +/- 2SD compared to weight and length

Prematurity correct for growth and development correct for growth and development immunisations at post birth age, not corrected age immunisations at post birth age, not corrected age