The U-examinations: Paediatric check-ups are important

Paediatric examinations are medical check-ups. They accompany the child from birth until it reaches adolescence. 

Parents want nothing more than for their child to be born healthy. And then to remain healthy and develop in the best possible way. Having this checked by a competent professional at regular intervals is not only good for the parents, but is also the best guarantee that the child's health development can always be optimised. This is why it is so important that all preventive check-ups (also known as "health checks") for babies and children are carried out at the paediatrician's practice! 

At these appointments, the paediatrician checks the child's general state of health and age-appropriate development. At the same time, parents receive paediatric advice on important issues. This gives them a great deal of security and reassurance that "everything is OK". At these recurring appointments, they can also discuss any questions they still have about the child, its development or its behaviour. From a paediatrician's point of view, these may sometimes only be minor issues that can be resolved quickly. From a parental point of view, however, competent clarification is worth its weight in gold, as it dispels fears and worries.    

And if there are any indications of possible abnormalities in the child during a check-up, the doctor can give advice at an early stage, treat the child if necessary or arrange for further help and measures in good time. 

And even when the helpless babies become happy toddlers, active schoolchildren and at some point increasingly independent teenagers, the so-called "Us", i.e. the preventive check-ups from U1 to J2, remain indispensable. 

In the first year of your child's life, which I will focus on here, six paediatric check-ups await your baby: from U1, the "first check-up" directly after birth, to U6 around the first birthday. In the second year of life, the U7 is then due before the second birthday. What is covered by the respective check-up appointments is regulated by the so-called Children's guideline of the Federal Joint Committee of Doctors and Health Insurance Funds (G-BA). Your health insurance will cover the costs of the tests. 

All medical check-ups are carried out by paediatricians. The only exception is the U1 directly after the birth. This is carried out by the midwife in the delivery room, or in the birthing centre and at home. Unfortunately, experience has shown that many paediatric practices are extremely overcrowded and it can therefore be difficult to find one that still has free capacity. 

My tip: I strongly advise you to make appointments for check-ups at your paediatrician's practice as early as possible. This is especially true if you have a  outpatient birth have planned. This is because the second paediatric examination (U2) takes place on an outpatient basis. Ideally, the paediatrician will come to the newborn's home for this. This saves mum and baby a trip to the paediatric practice during the postnatal period.

By the way: Even with a Premature birth the scheduled screening periods also apply to premature babies. However, the paediatrician will of course take the early start in life into account when assessing the examination results. 

The standard paediatric check-up programme

At every "U" your baby is thoroughly examined and its weight, body length and head circumference are noted. The results are entered into the Yellow examination booklet registered. This booklet will be created in the delivery room when your child is born and given to you. From then on, all of your child's examination results will be recorded in it.

In the booklet you will find various diagrams with percentile curves in which the measurements of babies Head circumference and Body length and his Weight are marked. This then results in a child's individual development curve. This shows whether your child is taller or shorter, lighter or heavier compared to other children of the same age or whether they are average. This allows conclusions to be drawn as to whether they are developing in line with their age. 

From the U2 examination, which takes place between the 3rd and 10th day of the baby's life, parents also receive paediatric advice on various topics at the end of each check-up. This includes questions relating to the child's age, such as nutrition, immunisations and child safety.

U0: Advice for expectant parents from the paediatrician

The so-called U0 is a relatively new screening service aimed at pregnant women (from the 28th week of pregnancy) and expectant fathers. It is a free paediatric consultation that some health insurance companies have been offering since the beginning of 2023. At the paediatrician's practice, parents-to-be can receive advice and information on basic questions about baby health. This includes, for example, the following topics Sleeping environment of the baby, vaccinations, advantages of the Breastfeeding or Support options If you are interested, you can ask your health insurance company whether they also offer this free service. 

U1: Paediatric examination immediately after birth

After the newborn baby has first breath Once the baby has been born and has got used to its new surroundings, it has its first check-up. The midwife or doctor will listen to the baby's heart and lungs, measure its height and head circumference and weigh it. The baby is examined for visible malformations and neonatal jaundice. The baby is also given vitamin K drops to prevent internal bleeding. A small amount of blood is taken from the umbilical cord to check that the baby has been supplied with enough oxygen during birth.  

The U1 also includes the APGAR test. Babies are examined at intervals of one, five and 10 minutes after birth. Atmung, Ppulse (i.e. the heartbeat), Ground tone (this refers to muscle tension), Avision (the skin) and Reflexes and scored from 0 to 2 according to a points system. In this way, a maximum of 10 points can be achieved per test run. The overall result then shows how well the newborn has already adapted to its new life outside the womb. Fortunately, most babies achieve (very) good to satisfactory results. 

U2: Paediatric examination between the 3rd and 10th day of life

Once again, your baby will be thoroughly examined and "measured". This also includes repeated checks for any malformations and neonatal jaundice as well as any previously undetected birth injuries in the child. The paediatrician will also check the sensory organs (i.e. eyes, ears, nose, mouth and skin) and the reproductive organs. Your baby will be given vitamin K drops to prevent internal bleeding. 

Your baby can also expect further screening tests within the first few days of life: Pulse oximetry screening, for example, will check for congenital heart defects. It will also be checked for metabolic and hormonal disorders. This so-called extended newborn screening also includes a special cystic fibrosis test. In this congenital metabolic disorder, the body cells gradually become slimy. In the Newborn hearing screening The hearing is tested in turn. 

The counselling for parents during this check-up focuses on preventive measures for Sudden infant death syndrome and how to prevent the bone disease rickets by giving your child vitamin D. Your doctor will also inform you about support options for families, such as the services offered by the Early help. 

U3: Child examination in the 4th to 5th week of life

At this appointment, your baby will not only be physically examined as usual, but their age-appropriate development will also be checked. This includes, for example, asking whether your child can already lift and hold their head in a prone position. Your paediatrician will also ask you various questions about your child in order to better assess their state of health. For example, they will discuss how your baby is generally behaving, whether there are any problems with drinking or sleeping and what the nappy contents look like. Any abnormalities? If you are worried or unclear about anything, don't be afraid to ask questions yourself. And of course this applies to each Examination appointment! It is not uncommon for many parents to be concerned with the topic "My child cries so much". Your doctor can also advise you on this. You are welcome to read more on my blog.

In addition, parents are now also advised about their child's upcoming immunisations and initial caries prophylaxis as well as accident prevention. To the topic Security for children, you can find more information on my blog.

In the workshop on cry babies, you will learn what measures you can take during your pregnancy so that your baby cries less after birth. The workshop will also help you if your baby has already been born and you would like to find out how you can help to ensure that your baby cries less and is well cared for.

U4: Child examination in the 3rd to 4th month of life

At this screening appointment, your doctor will check your child's general state of health as well as their large fontanel. They will check whether the gap between the baby's skull plates is large enough to allow the skull bones to continue to grow as planned. This is the only way the child's brain can continue to grow unhindered. Your child will also be tested for hearing and vision, mobility and reaction time. Parents are also regularly shown a colour chart to determine the colour of their child's stool. This shows whether everything is in order with the baby's bile ducts. 

You will also receive advice on your child's diet, and some children may be about to have their first experience of Complementary food on. And you have no doubt noticed that your baby is now testing his voice with great pleasure. That's why counselling on your child's Language development in addition. 

You can support your child's development and restful sleep with baby massage. The online baby massage course from Notdienshebamme helps you to lovingly nurture your baby. You can do it from the comfort of your own home, at a time that suits your baby best. After all, it is important that your child can relax during the massage.

U5: Child examination between the 6th and 7th month of life

Your child is now six months old and is becoming increasingly mobile. In addition to the general examination, the examination will also focus on testing his mobility and body control. For example, the baby should be able to pull itself up on two fingers that are held out to it. And it should be able to reach for objects that are shown to it. Baby's hearing and vision are also checked again at this screening appointment.

You will also be informed about other recommended vaccinations for your child and about Security advice. You are also advised to visit the dentist with your child for the first time as soon as possible. This is because as soon as the first milk teeth have erupted, it is advisable to familiarise your little one with the dentist's practice.  

U6: Child examination between the 10th and 12th month of life

The first birthday is just around the corner and your baby is slowly turning into a lively toddler. This means it's time for the so-called "big one-year check-up". This is all about the child's mental development, coordination, dexterity and mobility. 

For example, they will now test whether your child can sit freely with free hands, straight legs and a straight back. Your doctor will also need your help and will ask you a few questions about your child. For example, it is now important to know how your child is developing linguistically. Is it already forming double sounds such as "dada"? How the child behaves in general is also important for the overall picture. Does it already respond to its name, does it already understand small requests ("Give me the ball")? The child's eyesight is also tested again. And boys are examined for a possible undescended testicle. 

You will also be informed about other immunisation appointments and reminded about the early detection check-up at your trusted dental practice. 

Outlook for the "U7" paediatric check-up in the second year of life

After the U6, it will now be a year until the next check-up - quite a long time. The U7 is only available between the 21 and 24 months of age on. By then, your child will be even more independent, mobile and curious about the world. That's why this appointment will also focus on their physical and mental development - and especially their language development. For example, the little ones should now be able to form two-word sentences ("Grandma gone") or name simple objects that they know (car, ball, dog). Their vocabulary should include at least 10 words. Your doctor will advise you on how to further promote your child's language development. Many practices now also give families a reading starter set for this purpose.

The next dates after the U7

And these are the other check-up appointments for your child after the U7: 

- the U7a in the 34th to 36th month of life, 

- the U8 before his fourth birthday and 

- the U9 after his fifth birthday.

That is important!

Data protection for the results: As mentioned, the Yellow examination booklet All the results of the child's medical check-ups are entered in the child's diary. However, only the parents decide who they allow to view this confidential information. No one, not even the childminder, crèche, nursery or youth welfare office, may request to see the medical check-up booklet.

Compliance with the examination periods: There is a specific time period for each check-up. It is important and essential for the health and development of your child that you are aware of these periods and that you adhere to them! Therefore, always arrange the next U appointment for your child in good time!

Detailed information for each individual check-up and the associated checks and focal points can also be found in the yellow check-up booklet under the relevant parental information. Find out about this before your upcoming appointment. It is also best to write down what you want to tell the paediatrician. Make a note of anything else you would like to talk about in advance. Do you have any questions? Are you unsure how to handle something with your child? Are you worried about something? Don't be afraid to talk about this or anything else at the respective provision! The yellow examination booklet also provides space for your notes.

Look at your own child: Whether your child is developing according to age is determined in paediatric practice. This assessment is based on scientifically proven comparisons with the majority of children of the same age. 

And yet every child develops individually and at their own pace. One explores the world on his own two feet at eight months, another does so at 16 months. One talks like a waterfall earlier, another later. This is all normal and nothing to worry about - you will also hear this confirmation from the doctor. And also how you can or should support your child in certain developmental tasks.

Otherwise, always realise what Johann Heinrich Pestalozzi, the "inventor" of the kindergarten, advised parents and educators 200 years ago: "Don't compare a child with others, but only with themselves!" This ensures that you always keep a close eye on the individual development of your own child. That's what matters!