The 6-8 Week Examination

1
The 6-8 Week Examination

• Dr Lesley McDonald
• Community Paediatrician
• Achamore Child Development Centre

2
History

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

3
Examination

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

4
Head and Neck

• fontanelles
• eyes cataract (red reflex)
• fixing and following
• palatal integrity

5
Chest

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

6
Abdomen

• umbilicus
• hernia
• infection
• palpation of kidneys, liver, spleen
• herniae

7
Genitalia

• testicular descent
• hypospadias / epispadias

8
Back, Hips, Limbs

• sacral dimple - ? blind ending
• buttock crease symmetry
• hips
• talipes
• syndactyly

9
Neurodevelopmental assessment

• alertness
• tone
• symmetry of movement
• head control
• primitive reflexes
• milestones of development

10
Growth

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

11
Prematurity

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