Medical check-up in children

This page describes the preventive medical check-ups for children (U3, U4, U5, U6, U7, U8 and U9). They are an important yardstick for assessing the level of child development.

If you are looking for preventive medical checkups for newborns (U1 and U2), switch to our page: Medical checkups for newborns

Synonyms

U-examination, examination at the pediatrician, U1- U9, youth health advice, development guidelines, preschool examination, one-year examination, four-year examination

Percentiles / development guidelines

In paediatrics, there are so-called percentile curves or somatograms for the male and female sex, which enable the doctor to compare the child's level of development and growth with a reference group of children of the same age.

This comparison is used to evaluate the child's level of development by relating it to a comparison group: The percentile curve is available for weight and height as well as for head circumference.

Curves (= percentile curves) in diagrams show how tall and how heavy the children of the same age are on average (so-called 50th percentile).
If the examined child lies on this curve with its height and weight in the diagram, then 50% of the children of the same age are heavier and larger and 50% of the children of the same age are smaller and lighter than themselves.

The third and 97th percentiles are also given in the somatogram:
The statement "The child is in the third percentile with its body size" means that 3% of the children of the same age are smaller and lighter than the examined baby. So the baby is relatively small and light.

If the baby fulfills the criteria of the 97th percentile, only 3% of the same-age, same-sex children are bigger and heavier than themselves, so the baby is bigger and heavier than the average.

The curves are a guide for observing the development of the baby. They are to be viewed together, i.e. if the baby is well and continuously above or below the 50th percentile, intervention is necessary. If there are individual "outliers" in the course of the curve or in the child's development, this is not a cause for concern.

The percentile curves can be found on the last pages of the yellow child care booklet.

General information

These 9 free examinations extend over a period of 5 years: U1 takes place on the child's first day of life, U9 is carried out as a pre-school examination at the age of 5.

Read about the tasks of the preventive medical check-up and the preventive medical check-up for newborns at: Preventive examination of the newborn.

U 3

At the age of 6 weeks or between the 4th and 6th week of the child's life, the U3. The established pediatrician in the practice thoroughly examines the baby and assesses its development. As with every examination, the child is measured and weighed, its head circumference is determined and the pediatrician also checks the child's reactions and reflexes.

Parents are asked about their child's sleep, food intake and digestion. Important points to be asked are how much the baby is drinking, the frequency of meals and whether the child spits or even vomits after meals.

The ultrasound examination of the hip may be repeated or a check of the findings in the event of an abnormal ultrasound in the U2 is carried out. Often the first ultrasound examination of the hip joints is only carried out during U3.

U 4

The fourth investigation (U4) takes place at the age of 3-4. Month of life.

During this examination, the child's internal organs are checked Ultrasonic thoroughly examined and checked the baby's age-appropriate reflexes.

Children of this age can usually lift their heads and look straight ahead when they are prone. In the supine position you can turn your head back and forth. The babies make moaning or sighing noises, especially when they are satisfied or full. You can follow (= fixate) objects or people who are moving in your field of vision.

A visual and hearing screening is carried out at U3, during which visual and hearing difficulties can be identified:
The baby should be able to fix people or objects and react to acoustic stimuli such as clapping or clicking noises.

As with any examination, the child is also weighed and measured.
The determined data is noted in the so-called percentile curve (see under percentiles / development guidelines) in the yellow booklet.

The child's first vaccinations are carried out at this age.

U 5

The U5 is the examination in the 6th to 7th month of life.

The main focus of this investigation is on the
Range and urge of movement of the child as well as the examination of his mental development.

At this age, children purposefully reach for objects that are in their field of vision and pass them from one hand to the other to look at them from all sides.
The children's head posture is perfect, i.e. they can hold and control the head securely in all postures. It is possible to sit upright with help and the children pull themselves up to sit if two fingers are held out to them.

The baby turns from the supine to the prone position and can usually support itself with open hands and look straight ahead while lying on its stomach.
Speech development should be advanced enough for the children to respond with sounds when spoken to.
This examination can be difficult, as the children often strangers at this age, so the doctor depends on careful observation of the parents.

Additional vaccinations may be given as part of this examination, provided the baby is healthy.

Fall to the Pediatrician Visual (Squint) or hearing defects, he will be referred to a specialist immediately so that a detailed examination and possible treatment steps can take place.

U 6

The U6 takes place as a first year examination between the 10th and 12th month of life of the child.

The development of language and senses of perception is examined closely in this investigation: If the child can speak in double syllables (e.g. wawawa, lalala) and imitate speech sounds, it reacts to quiet noises and can concentrate on a certain object while playing, which it intensely and persistently looked at and felt?
The children make their first attempts to stand and walk (see: When does my child start to walk?).
Gripping takes place with the so-called tweezer grip: Objects are taken between the index finger and the thumb.

The older the children get, the more they differ in their individual developmental progress. Parents should therefore not be concerned if their own child is not yet standing or walking compared to other peers.

Hearing and vision disorders

Existing hearing or visual disorders should be recorded and treated at the latest by the end of the first year of life.

Read more about this under Recognizing poor eyesight in children - does my child see correctly?

U 7

In the case of U7 between the 21st and 24th month of life, the doctor checks the further sensory and physical development of the child.
The child should be able to use at least 20 words sensibly, form one- or two-word sentences and be able to name everyday situations in their own words, e.g. sleeping is referred to as "doing Hey".

The children can go forwards and backwards freely, they run, they can climb stairs alone, they can bend down and get up from a crouch, hands-free. The children imitate everyday actions and situations in simple role play and want to assert themselves in contact with others.

The doctor pays attention to possible misalignments of the extremities, the pelvis and the spine. He asks the parents about behavior problems, febrile convulsions or other noticeable events in the child's development.

Vitamin D prophylaxis comes to an end after the first year of life, but sufficient iodine and fluoride administration should still be ensured.

Read more about this under: U7 investigation - you should know that!

U 8

Between the ages of 43 and 48 months, the U8 as a four-year investigation.

The age-appropriate behavior of the child is asked:
Is it dry or wet and defecates, does it have massive defiant reactions, can play with concentration, does it have speech disorders (stammering, stutterDoes it have strong defiant reactions and outbursts of anger, does it play with other children and can it integrate into a group while playing?
An eye test is carried out on the children, either with a vision device or eye charts, which show objects and symbols in different sizes that are easily identifiable for children, so that the child's visual acuity can be determined.

A hearing test is also carried out.

The subsequent physical examination serves in particular to assess the child's muscle tension, to discover coordination disorders or tremors.
Routinely becomes a Urinalysis performed to rule out a urinary tract infection.

U 9

The U9 is the pre-school examination, which is carried out at the age of 5 and is intended to reveal possible undesirable developments in the child, which can be remedied or improved before starting school.
The children's vision and hearing are checked and their motor skills are assessed:
The children have to hop, run and jump on one leg. Muscle strength, posture and fine motor skills of the child are also considered (see also Coordinative skills).
The coordination between hand and eyes is checked by the child drawing simple symbols (e.g. a circle or a rectangle). The child's language skills are tested by naming certain images.

The doctor can have the child count to 10 and ask them about their spatial orientation, such as where they are and how they got to the doctor.

Youth health advice

The so-called J1 is the youth health counseling from 13 to 14 years of age.

The doctor will perform a thorough physical examination of the adolescent to assess the development of puberty.
In addition, the young people are asked about chronic illnesses, disabilities or limitations, school development, family situation and mental problems: The doctor finds out about the young person's diet and personal hygiene, about their social contacts with friends, their range of motion and sporting activities as well as their sex life. In addition, the topics alcohol and nicotine are addressed, for which the doctor gives the young person appropriate advice.
The examination and taking of the medical history (= anamnesis) can take place in the absence of the parents if the young people so wish.

Read more about our new topics: U11 preventive medical check-up and U12 check-up - you should know that!

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