The Doctor's Exam

Every day that your baby is in hospital, he will be checked by a doctor. We do the same exam each time because the baby's body is rapidly adapting and changing, and we want to be aware of those changes.

Heart Check

If you watch me, or any other doctor, check your baby, chances are we will start our exam by listening to your baby's heart and lungs. We need a quiet baby to hear well, and often the baby will be crying soon after we start the exam.

Each doctor will do his or her exam a little differently, or in a different order, but we are using a system to help us be complete, and we are all checking the same things. Some doctors choose to wear gloves, but that is just personal preference. We are usually quiet when we do an exam, because we are concentrating and making mental notes.

I will listen for bowel sounds (stomach rumbling) after listening to the heart and lungs.

Mouth Check

After listening, I work from the top down. I check the baby's mouth, palate and gums.

Eye Check

I check the baby's scalp, skull, nose, ears, neck, and eyes. Checking the eyes of a newborn is challenging. Here is a short video of another way to check the pupils of a newborn.

Belly Check

I take the baby's shirt off so I can see every part of his skin.

Then I turn him over so I can see his back, the back of his neck, and all the way to his buttocks. I pay attention to how he responds to this change in position.

Next I check his arms, legs, hands and feet. I am also watching to see how he moves and the way he responds to my exam. His movements tell me a lot about his nervous system.

Belly Check

When I press on his belly, I am feeling for enlargement of his liver, spleen, kidneys or bladder.

Pulses

I check the pulses in each leg crease.

Hip Check

Then I check his hip joints.

Hip Check

Finally, I check his genitals and anus to make sure they are formed properly. (See Inside the Diaper.)

Crying

Chances are, by the time I am done, he is wailing. While I know that it is hard to hear your baby cry so loudly, I am glad he can make this much noise. It tells me his heart and lungs are healthy and strong and that his nervous system is responding appropriately.

How can I possibly check so many things in just a few minutes? A lot of practice! I have done this same exam on thousands of babies over the years. Even a new pediatrician has checked a few hundred babies by the time he has finished his training.

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Thanks to Janelle Aby MD, Stanford School Of Medicine, Newborn Nursery, and Lucille Packard Children's Hospital for the use of occasional photographs.