Keeping Track of Health and Growth

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Unless a baby has a specific medical problem, your attention in feeding and frequent cuddling and caressing will assure that he thrives. A newborns tiny body is, however, highly vulnerable to the stress of even a minor illness or other setback. Thus, new parents need to be aware of possible trouble signs or missed milestones (signs of normal development that should be reached by certain ages).

Health and Growth

At first, it may seem hard to balance vigilance with common sense. Its better to err on the side of caution, and call the doctor whenever anything seems unusual. Pediatricians are used to reassuring new parents, and they will understand your concern.

Doctor visits: Why and how often

Routine pediatrician visits are required to maintain your babys health. Regular well-baby visits are essential for giving immunizations and monitoring growth and development.

The first of these checkups is generally performed about two weeks after birth, although the exact timing varies from region to region (as well as from doctor to doctor). A child who had medical problems at birth or in the newborn period may need a checkup sooner. The next routine visits generally come at eight weeks and four months of age.

After the first two weeks, rapid and steady weight gain on average, about an ounce per day, or about two pounds per month is the hallmark of an infants physical development. Birth weight is usually doubled by three to five months. Your babys head also grows, by about a half-inch in circumference each month, and the soft spot near the back of the head (but not the larger one at the front) closes by four months or so. Your doctor will be plotting your babys weight and length on a growth chart such as the one in Volume II, A to Z Encyclopedia of Child Health & Illness. This monitoring will assure that your baby is growing along his own curve and will alert your pediatrician of any possible growth problems.

During these visits, the pediatrician will take note of the babys appearance and development. The doctor will also perform a careful physical exam and measure the babys weight, length, and head size. Blood may be taken using a needle prick in the heel during the two-week visit to check thyroid function and, in some cases, to repeat the screening test for the genetic disorder PKU (phenylketonuria). (The PKU test is generally performed once before the baby leaves the hospital.) Both visits should include a discussion of feeding, daily care, and vitamin supplementation, and the pediatrician should answer any questions you may have.

A babys immunizations should start a day or so after birth with the hepatitis B vaccine, which is now routinely administered in the hospital or at the first visit to the pediatrician. At one to two months of age, a second dose of hepatitis B vaccine is recommended, and at two months, the first doses of oral polio vaccine, DTP (diphtheria, tetanus, and pertussis) vaccine, and Hemophilus influenzae type B vaccine are administered. (For a more detailed discussion of immunizations, see the encyclopedia.)

Many infants barely seem to notice the brief needle prick of an immunization. The baby may startle and cry or simply flinch a bit when he gets the shot (which is given in the upper thigh muscle). At the other extreme, sensitive newborns cry throughout their checkups because they dont like having their clothes removed and being handled by the pediatrician. These babies may cry even harder when they get shots. Whatever your babys response, you can help by staying calm and relaxed.