Family & Geriatric Medicine

Head

The physician will look at the overall shape of your child's head. The scalp will be inspected for such things as over-riding sutures, cradle cap and anatomical deformities. The anterior fontanelle (“soft spot”) will be assessed. This should be non-bulging and touched delicately.

Ears, Nose, and Throat

Your child's eyes will be examined with an ohthalmoscope for what is called a red reflex. The red reflex is normal. The eyes will be examined to eliminate the possibility of cataracts or tumor.

The ears will be inspected for symmetry of auricles and appropriate anatomy.

The physician will also inspect the nose and mouth.

Neck

The neck will be inspected. Passive movement of the neck will be done. Clavicles will be palpated which are bones close to the base of the neck. These can be broken in complicated deliveries.

Heart

Your child may have a heart murmur initially after birth. This will soon disappear as your child changes from fetal to newborn circulation. Your child's heart rate will be approximately 130 at birth.

The doctor will also check several pulses on your child to ensure they are present and equal. These will include the femoral pulse found near the groin area. These pulses should be prominent and equal.

Lungs

Your physician will listen to your child's lungs at every visit. Breath sounds should be equal. The doctor will look for retractions or your child's increased work of breathing. Retractions are seen most usually sub-sternal or around the clavicles.

Abdomen

The physician will first listen to your baby's abdomen for bowel sounds. He/She will then inspect the umbilicus to ensure proper healing. The entire abdomen will be felt for possible masses or enlarged organs such as the liver or spleen.

Genetalia

Whether boy or girl, your physician will inspect the child for correct anatomy.

Male - If circumcised, your doctor will inspect the circumcision site. The penis will be examined for appropriate urinary meatus or opening to ensure normal urination. The scrotum should contain the testicles. Your physician will palpate or feel each testicle to ensure that each is in the appropriate place.

Female - Examination should be performed to ensure normal anatomy.

Extremeties

Arms, fingers, legs and toes will be inspected.

Hips will be rotated to eliminate the presence of a “hip click.” This is an abnormality in the hip which should be investigated at the discovery.

Neurological

This area can be difficult to assess in the first year of life. The physician will make sure he/she moves all extremities (arms/legs) well. The baby's suck and Moro reflex will be checked. The doctor will keep an eye on progression of your child as well. When he/she sits, crawls, walks, speaks are all important in determining normal neurological development.