Baby health checks, sometimes called well-baby examinations, are an important way to monitor your baby’s growth and development and promptly identify any issues or areas of concern. Routine checks also provide an opportunity to have questions about your baby’s health and development answered, and help your practitioner develop a rapport with you and your baby. Baby checks can help you make informed choices about parenting issues and your baby’s health care.

If your baby was born in a hospital, your doctor or midwife will likely recommend the first baby health check shortly after discharge from hospital. If your baby was born at home under the care of a Private Midwife, he or she will likely have already explained the schedule of baby health checks they will conduct as part of your antenatal care. In either case, additional examinations generally occur every two to four months.

Measurements

A baby health check generally begins with measurements of your baby’s length, weight and head circumference. Your practitioner will usually ask you to take your baby’s clothes off in order to ensure accurate measurements. These measurements are plotted on a growth chart to determine how your baby’s size compares to their age-related peers, as well as to observe your baby’s growth over time. What’s most important here is that your baby shows steady growth, rather than which percentile they are in. Some baby growth charts are based on bottle fed babies making it difficult to accurately gauge the usual growth of a breastfeed baby. The World Health Organisation has developed baby growth charts based on breastfeeding babies. You can download the girls growth record and boys growth record to compare your breastfed baby’s growth against accurate charts.

Physical exam

Next your practitioner will perform a thorough head-to-toe physical exam. This generally includes:

• Head – Checking the shape of your baby’s head and their fontanels (soft spots)
• Ears – Checking for fluid or infection in your baby’s ears and observing your baby’s response to sounds, including your voice
• Eyes – Checking for blocked tear ducts and eye discharge and, as your baby gets older, tracking your baby’s eye movements
• Mouth – Checking for tongue ties, oral thrush (a common and easily treated yeast infection) and signs of the development of teeth.
• Skin – Checking colour, texture and condition of your baby’s skin, as well as any birthmarks
• Heart and Lungs – Checking for abnormal heart sounds or rhythms, including heart murmurs and breathing difficulties or congestion
• Abdomen – Checking for tenderness, enlarged organs or an umbilical hernia by gently pressing your baby’s abdomen
• Hips and Legs – Checking for any leg problems and for dislocation of the hip
• Genitalia – Checking for tenderness, lumps or other signs of infection, and for boys ensuring both testes have descended into the scrotum

Development

Your practitioner will also ask questions to determine your baby’s motor skills and development. Depending on your baby’s age, these questions may explore:

• Your baby’s ability to control his or her head
• Imitation of your facial expressions and sounds
• Babbling early on and first words later on
• Reaching for and mouthing objects
• Grow motor ability, including rolling over, sitting unaided, crawling, pulling up into a standing position and finally walking
• Fine motor ability, including using the thumb and first finger (pincer grip) to pick up objects (including every tiny piece of fluff they can find!)

What if my baby becomes distressed?

Baby health checks can be stressful for young babies. Being naked and handled by a stranger in a strange environment can leave babies feeling highly vulnerable. It is important to stay close to your baby, maintain eye contact and speak gently and reassuringly during the examination. Don’t be afraid to temporarily stop the examination to cuddle and reassure your baby if they are becoming highly distressed. This supports and respects your baby’s emotional development and assists them to develop trust in you and your practitioner.

Your practitioner’s response to this distress is a good gauge of their understanding, respect and compassion for infants. Ideally your practitioner should identify this distress and work to support your infant to feel more secure.

Where can I go to have baby health checks?

Baby health checks can be performed by private midwives, general practitioners, government-run baby health centres, private clinics or paediatricians. Your choice of provider may be based on a range of factors, including reputation, location, cost and opportunity for government rebates.

How do I choose a practitioner?

Choosing a practitioner to complete your baby’s health checks is just as important as choosing a practitioner for yourself and should largely be based on the same reasons. Beyond the logistic and financial issues mentioned above, when selecting a practitioner consider questions like:

• Does the practitioner demonstrate respect and compassion for you and your baby?
• Do they listen to and respond to your questions in a manner that makes you feel willing to ask more?
• Are they patient in explaining complex or contentious issues?
• Do you feel at ease in your practitioner’s presence and trust their medical judgement?
• Do they respect and support your personal, religious and cultural choices in regards to child caring and rearing practices?