Your baby's vital six-week check-up
Don't feel nervous about your baby's very first check-up.
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This check-up can be done by a paediatrician, your family doctor, midwife, pharmacy nurse or well-baby clinic. All findings and immunisations are recorded in your baby's Road to Health booklet that is provided free by the Department of Health.

Remember to follow up on any recommendations should your healthcare professional be concerned about anything. You will be asked about your baby's sleeping and feeding patterns, which will correlate with his growth chart. A few babies will have established their diurnal (or daytime/ night-time) sleeping pattern, others may take a few weeks longer.

Overall appearance

Your six-weeker should be healthy and active- freely waving his arms and kicking his legs in all directions. He should not be floppy or rigid; babies who persistently hold their arms, legs, hands and feet in one position may have temporary nerve damage that needs physiotherapy. Most babies smile at familiar faces by six weeks. His size and weight should correlate woth his birth records and follow the curve on the weight-for-age graph on his card.

Skin

Baby's skin tone, colour and texture should be smooth and healthy without rashes or sores. He should feel warm with good circulation to the feet anf fingers. Newborn acne and birthmarks like strawberry haemangioma, storkbite or nevus simplex, port wine stains, Mongolian spots and congenital pigmented nevi don't require treatment. Most will heal in time.

Head

Your baby's head will be bigger than his chest until the age of two and will be regularly measured. Any change from the normal size can indicate a possible problem. The two fontanelles can still be felt. Birth injuries such as foreceps bruises and bumps that are called cephalhaematoma should have healed by now. Your baby's neck should be strong enough to support his head, and he should turn to sounds and follow an obect with both eyes.

Shoulders, arms and chest

Birth injuries that cause temporary paralysis (for example, erb-duchenne paralysis) should have healed or be improved by now, otherwise physiotherapy will be recommended. At six weeks, babies still move their arms randomly and put their fists in their mouth. Swollen breasts at birth may be caused by an oversupply of mom's hormones during the pregnancy. This will have subsided by now. Baby's breathing and heart-rate will be listened to with a stethoscope. 

Abdomen

Your baby will still have a round tummy because his liver is its biggest organ. His belly-button should not pop outwards- this could be a hernia that may need surgery if it hasn't retracted by one year, but usually sorts itself out with time.

Genitals

The scrotum of premature boys will be checked to ensure that both testicles have descended. You will be asked about wet nappies and stool patterns. The foreskin in uncircumcised boys will still be tight, but not too tight that it prevents urinating.

Legs and feet

Babies can be "folded" into their foetal position for up to six months after birth- especially breech babies. Gentle massage and physiotherapy may be recommended to encourage your baby to straighten his legs and feet though. When your baby lies on his tummy, the natural thigh and knee creases should line up. If these don't, it could indicate congenital his dislocation that should be corrected as early as possible. Your healthcare professional will alert you to any issues.

TIP!

You may be kept waiting for your appointment longer than you expected to, so take everything you will need for changing and feeding. You may feel overwhelmed with everything you have to remember, so write a list of questions and pack your nappy bag the evening before. 

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