Preventive examination of the newborn

This page describes the preventive examinations for newborns (U1 and U2).
If you are looking for the check-ups U3, U4, U5, U6, U7, U9 and U9, switch to our page: Check-ups for children

Synonyms

U examination, examination by the pediatrician, U1-U9, newborn screening

definition

A large and decisive area of ​​paediatrics is preventive medical checkups, the so-called "U's", which are recommended to be carried out regularly by paediatricians.

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.

They serve to monitor the child's development and health.

The findings of the preventive examinations are in one yellow care booklet notes which will be given to the parents by the midwife or doctor after the child is born.

The doctor carries out a thorough physical examination for all examinations, and the children are measured and weighed at every U and their head circumference is determined.

The preventive check-ups serve to identify diseases and developmental delays that can occur in the child at an early stage so that treatment can be carried out in good time. This is done against the background of wanting to prevent permanent damage to the child (p. E.g. Congenital hypothyroidism).

U 1

The U1 is the initial examination of the newborn in the first few minutes of the child's life. It is carried out by the pediatrician who checks the following aspects of the newborn: breathing, heartbeat, muscle tension, reflexes and skin color.

Info: Apgar index

The findings of the three-part examination are classified in the so-called APGAR classification (= APGAR stands for: breathing, pulse, grimacing, appearance, reflexes). With the help of this classification, the vital condition of the child is assessed.

In the first, fifth and tenth minutes after the birth, the doctor records the child's heart and respiratory rate, checks the muscle tension and reflexes and assesses the child's skin color (assessment of skin color, etc.).

In addition, the newborns receive oral vitamin K prophylaxis to prevent bleeding (this is also done with U2 and U3).

The baby is also measured and weighed.

The doctor also examines the child for possible malformations:
The child's extremities are examined and all body orifices are checked for their correct positioning: When sucking off the amniotic fluid, the pediatrician checks the patency of the esophagus and when taking a rectal temperature, a malformation of the intestinal anus would be noticed.

U 2

The U2 examination is the comprehensive basic examination of the newborn.
The child should be examined by a pediatrician between the 3rd and 10th day of life; This thorough examination of the newborn takes place either in the hospital, if the mother and child have not yet been discharged, or on an outpatient basis at the pediatrician.
During this examination, diseases can be identified or findings can be made that are in need of immediate treatment or require intensive monitoring, e.g. Valve defects or a large head circumference in the baby.
The doctor examines the baby thoroughly (eyes, ears, throat, stomach, heart, lungs, extremities) and checks whether it was injured during the birth process.

The doctor also assesses the severity of neonatal jaundice (= Icterus neonatorum) in babies, which begins between the 2nd and 3rd day of life.
This form of jaundice can be traced back to exchange processes in the child's blood: In the unborn child there is a special type of red blood pigment (= hemoglobin) in the child's red blood cells (= erythrocytes). This dye is gradually broken down after birth and converted into another form of dye that is also present in adults.

Due to the breakdown of the child's blood pigment, the blood contains more bilirubin, which is the breakdown product of hemoglobin. The newborn's liver, which breaks down bilirubin, is not yet fully developed, which is why the bilirubin is transferred from the bloodstream to other body tissues. This explains the yellowing of the skin and the sclera (white part of the eye) in children with newborn jaundice.
Is the severity of jaundice normal, i.e. physiological range, no special treatment is required.

Read more on the subject below Newborn jaundice

In addition, the doctor checks the child's digestion and tests various reflexes that provide information about the child's nerve and brain function.
So-called newborn screening is carried out at U2:
Blood is drawn from the child to check for possible metabolic or hormonal disorders.

Read more on the topic: Phenylketonuria

An ultrasound scan of the hips is carried out and all joints are checked for mobility. If a misalignment of the feet is noticed, physiotherapy or orthopedic therapy (e.g. clubfoot) must be initiated at an early stage.
The doctor also discusses vitamin D, fluoride and iodine prophylaxis with the parents and questions about the child's diet.

Read more on the topic: U2 examination