The 6-8 Week ExaminationThe 6-8 Week Examination

Dr Lesley McDonaldDr Lesley McDonald

Community PaediatricianCommunity Paediatrician

Achamore Child Development Achamore Child Development CentreCentre

HistoryHistory

• revision of antenatal and birth historiesrevision of antenatal and birth histories

• family history of congenital abnormalitiesfamily history of congenital abnormalities

• parental concern regarding babyparental concern regarding baby

• general health, feeding, sleepinggeneral health, feeding, sleeping

• smilingsmiling

• vision – fixing and followingvision – fixing and following

• startle to loud soundsstartle to loud sounds

• Guthrie resultGuthrie result

ExaminationExamination

• general appearance and faciesgeneral appearance and facies

• skin and nails (jaundice)skin and nails (jaundice)

• then start at top and work downthen start at top and work down

Head and NeckHead and Neck

• fontanellesfontanelles

• eyes – cataract (red reflex)eyes – cataract (red reflex)

• fixing and followingfixing and following

• palatal integritypalatal integrity

ChestChest

• respiratory movement – intercostal respiratory movement – intercostal recessionrecession

• palpation of apex beat and thrillspalpation of apex beat and thrills

• auscultation of heart sounds and auscultation of heart sounds and murmursmurmurs

• femoral pulsesfemoral pulses

AbdomenAbdomen

• umbilicusumbilicus– herniahernia– infectioninfection

• palpation of kidneys, liver, spleenpalpation of kidneys, liver, spleen

• herniaeherniae

GenitaliaGenitalia

• testicular descent testicular descent

• hypospadias / epispadiashypospadias / epispadias

Back, Hips, LimbsBack, Hips, Limbs

• sacral dimple - ? blind endingsacral dimple - ? blind ending

• buttock crease symmetrybuttock crease symmetry

• hipships

• talipestalipes

• syndactylysyndactyly

Neurodevelopmental Neurodevelopmental assessmentassessment

• alertnessalertness

• tonetone

• symmetry of movementsymmetry of movement

• head controlhead control

• primitive reflexesprimitive reflexes

• milestones of developmentmilestones of development

GrowthGrowth

• naked weightnaked weight

• lengthlength

• head circumferencehead circumference

• plot on growth chartplot on growth chart

• beware OFC +/- 2SD compared to beware OFC +/- 2SD compared to weight and lengthweight and length

PrematurityPrematurity

• correct for growth and developmentcorrect for growth and development

• immunisations at post birth age, not immunisations at post birth age, not corrected agecorrected age