American Medical Association Family Medical Guide - American Medical Association [156]
Routine Health Care
Your child’s doctor may be a pediatrician (a doctor who is trained to care for infants, children, and adolescents, usually up to age 18) or a family physician (a doctor who is trained to care for both adults and children). During these visits, the doctor will examine your child, make sure that he or she has all the required vaccinations, and treat any disorders. Take advantage of these visits to talk with the doctor about any concerns or questions you have about your child’s health or development.
Examining a Newborn
Immediately after delivery, the doctor and nurses in the delivery room examine a newborn to make sure that he or she is healthy. They use a suction device to remove any mucus from inside the baby’s nose and mouth, put antibiotic drops in his or her eyes to prevent infection, and give him or her an injection of vitamin K to help the blood clot normally. The doctor evaluates the infant’s heart rate and breathing; measures his or her length, weight, and head circumference; and performs a thorough physical examination to look for any physical abnormalities. All babies are given screening tests for some disorders and an evaluation, called the Apgar score, of their general health status.
The Apgar Score
The Apgar score assesses heart rate, breathing and crying, muscle tone, reflex responses, and skin color (examining the inside of the mouth and lips, palms of the hands, and soles of the feet). Each of these five components is given a number from 0 to 2, and then all five are added up. A score between 7 and 10 is a general indication that the infant is healthy. The score does not, however, predict a baby’s development or long-term health.
Physical examination of newborns
A physical examination is performed on newborns immediately after birth to check for birth defects or other abnormalities. In most cases, early detection helps ensure successful treatment. For example, the child’s mouth is examined for cleft lip and cleft palate, and his or her face is examined for features of Down syndrome (top). The infant’s anus is checked to make sure it is open, the genitals are checked to verify the baby’s sex, the navel is examined for swelling (a sign of an umbilical hernia), the feet are examined for clubfoot, and the hips are checked for dislocation (center). The spine is examined for any swelling or opening that could indicate spina bifida (bottom).
Newborn Screening Tests
Every state requires testing of newborns for a variety of disorders 24 hours after birth, before the child is released from the hospital. Some of these disorders cause no symptoms initially but can lead to serious health problems or can be fatal. Testing is done immediately after birth because the risk of complications is reduced significantly when these disorders are diagnosed and treated early. Abnormal results are followed up with more thorough, precise testing.
Newborn testing
From a small sample of blood taken from a newborn’s heel, doctors can diagnose a number of serious but treatable disorders, including sickle cell disease and phenylketonuria (PKU). The sample is examined in a laboratory and the results are sent to the child’s pediatrician.
Vaccinations
Vaccinations, or immunizations, protect against contagious infections, many of which are life-threatening. All children in the United States are required to have vaccinations against a number of infectious diseases, including hepatitis B, measles, mumps, and rubella. Your doctor will tell you when your child needs each vaccination. Keep a record of all your child’s vaccinations