What does a neurologist check at 1 month? Examination by a neurologist for a baby - important points. One-year-old baby: surgeon

The skull develops from life
All over the forehead - from temple to temple. . .
O. Mandelstam

Your baby will soon be or has already turned 1 month old!

One of the most difficult periods in a newborn’s life is behind us. After all, the first month of a child’s life becomes for him the first critical period after birth: it is characterized by the intense work of all organs and systems of the body, “responsible” for the adaptation (adaptation) of the newborn to conditions that are fundamentally new for him environment. By the end of this period, all transition processes should be completed, however, under the influence of unfavorable environmental conditions, with aggravated pregnancy and childbirth, the natural adaptation processes for a newborn can take on a pathological direction and lead to a neurological disease of the child.

It is at this time that it is necessary to visit a neurologist for the first time - usually just to make sure that everything is fine with the baby; but if this is not the case, in order to identify and “capture” the pathology at the very beginning, to prevent the disease from developing. To determine the level of development of the child and exclude neurological pathology, it is important not only to assess the formed reactions to light, sound, motor and psycho-emotional activity of the newborn, but also his appearance (in fact, it is this last topic that my article will mainly be devoted to).

So, what will a neurologist first of all pay attention to when examining a one-month-old baby? On the shape and size of his skull, facial expression, posture, appearance skin. Why is this so important? Why are our worries and worries often associated with the presence of deviations in the child’s appearance, especially if this is a change in the shape and size of the skull? This is primarily due to the fact that such changes can be a diagnostic sign of serious diseases - and microcephaly.

Skull shape and size

Deviation from the norm is a possible pathology. . .

Hydrocephalus- this is an excessive increase in the size of the skull and fontanelles, caused by an increase in the amount of cerebrospinal fluid in the cranial cavity. With this disease, the shape of the skull also changes - its cerebral part significantly predominates over the facial part, the frontal part protrudes sharply forward, and a pronounced venous network is observed in the area of the temples and forehead.

Microcephaly- this is a reduction in the size of the skull and early closure of the fontanelles. With congenital microcephaly, the size of the skull is small from birth, the cranial sutures are narrowed, or closed, or small in size. Subsequently, a slow rate of growth in head circumference is noted, so that sometimes a 2-3 year old child’s skull size is almost the same as at birth. With microcephaly, the skull has a specific shape: the cerebral part of the skull is smaller than the facial part, the forehead is small, sloping, the line of the forehead and nose is sloping.

Conditions such as hydro- and microcephaly further lead to mental and mental retardation. physical development and therefore require correction from a very early age!

. . .or a reason for further examinations?

But should every deviation from the norm clearly indicate a pathological condition? Of course not! Clinical observations show that there are many factors that influence the shape and size of the head. Of course, even a slight increase or decrease in the circumference of the skull in a newborn compared to the age norm can be considered a risk factor for the development of hydrocephalus or microcephaly, but you should not panic when you discover that the baby’s head is slightly larger or smaller than normal: this circumstance should first of all, become a signal for the need for additional examinations to exclude pathological conditions. What kind of examinations are these?

An absolutely safe and reliable method is neurosonography (ultrasound examination of the brain through the large fontanel). This study will help not only to see changes in the structure of the brain and signs of increased intracranial pressure, but also to evaluate blood flow through the main vessels of the brain.
An even more reliable method is nuclear magnetic resonance of the brain (NMR), however, this study for children is carried out under general anesthesia, so it is carried out only for sufficiently compelling indications.
IN in this case Consultations with an ophthalmologist and neurosurgeon are also necessary.

"Homework" for parents

In addition, right from birth, you can independently monitor the growth of the child’s head circumference, which is one of the main indicators of normality and pathology. How to do this correctly?

Measure the child's head circumference weekly and record the resulting numbers in a specially kept notebook.
When measuring, place the measuring tape at the most protruding points of the skull (frontal and occipital protuberances).
To avoid misunderstandings, the measurement must be carried out by the same person.

In addition to the increase in head circumference, you can monitor the increase in chest circumference, which is one of the general anthropometric indicators of child development. To do this:

Measure your chest circumference weekly on the same day you measure your head circumference;
Place the measuring tape at the level of the baby's nipple line.

Why is such “amateur activity” needed? By taking these simple measurements, you will help the doctor draw up an objective picture of the child’s development, and you yourself can have peace of mind, excluding the possibility of developing serious diseases (normally, the monthly increase in head circumference in the first three months of a full-term baby should not exceed 2 cm per month; up to a year, the circumference The chest is approximately 1 cm larger than the child’s head circumference).

Well, now a few words about what can and should be normal and what is pathological. I tried to frame the conversation on this topic in the form of answers to questions that most often concern young parents.

What determines the shape of the skull?

Normally, as a child passes through the birth canal, the bones of the skull overlap each other. Features of the course of the birth process affect changes in the shape of the skull. In the event of a complicated birth, a sharp juxtaposition of the skull bones may occur on top of each other, and this will lead to its deformation, which will persist for quite a long time.

A change in the shape of the skull can be expressed in the persistence of swelling of the soft tissues of the head in the place where the child moved forward along the birth canal. The swelling disappears within the first 2-3 days. (hemorrhage under the periosteum) also changes the shape of the skull. It resolves more slowly than swelling, and this process requires the supervision of specialists (neurologist, surgeon).

Changes in the shape of the skull are also associated with age-related characteristics. In a newborn, the skull is elongated in the anteroposterior direction, and after a few months the transverse size of the skull will increase and its shape will change.

Some change in the shape and size of the skull can occur during normal development in premature babies, or when the child is often placed on the same side, or when the child lies on his back for a long time.

How does the head grow?

The average head circumference of a newborn is 35.5 cm (the range of 33.0-37.5 cm is considered normal). The most intensive increase in head circumference in full-term babies is observed in the first 3 months - on average, 1.5 cm for each month. Then the growth decreases slightly, and by the age of one year the child’s head circumference is on average 46.6 cm (normal limits are 44.9-48.9 cm).

The head circumference of a full-term baby increases faster than that of a full-term baby, and the increase is most pronounced during the period of active weight gain, and by the end of the 1st year of life it reaches normal values. The exception is very premature babies.

However, one should always keep in mind that even with normal there may be physiological deviations from the average values, which are often associated with constitutional features or environmental influences.

What are fontanelles?

The fontanelles are located in the area where the bones of the skull meet. The anterior, large, fontanel is located between the frontal and parietal bones. At birth, it measures from 2.5 to 3.5 cm, then gradually decreases by 6 months and closes at 8-16 months. The posterior, small, fontanel is located between the parietal and occipital bones. It is small in size and closes by 2-3 months of life.

In pathological processes accompanied by increased intracranial pressure, the fontanelles close later, and sometimes they open again. Small sizes of the anterior fontanel may be a variant of the norm if they are not accompanied by a decrease in the circumference of the skull, the rate of its growth and a delay in psychomotor development.

The above characteristics do not limit the diversity possible options abnormalities in a young child. However, it should be borne in mind that any unusual appearance of a child requires a thorough examination and monitoring of his growth and development.

When and how should a neurologist examine a child?

The development of a young child is a very sensitive sign of the state of the body. It depends both on hereditary characteristics and on a complex set of social conditions and requires dynamic monitoring by doctors. Don't forget to show your baby to specialists established deadlines— 1, 3, 6, 12 months!

If you invite a specialist to your home, you must consider the following:

the examination of the child should be carried out on a changing table or other soft, but not sagging surface;
the environment should be calm, eliminate distractions if possible;
It is advisable to carry out the examination 1.5-2 hours after feeding;
the air temperature in the room should be about 25°C, the lighting should be bright, but not irritating.

In conclusion of the article, I would like to remind you once again: do not delay your visit to a neurologist, remember - the timeliness of all health-improving, preventive and therapeutic measures aimed at ensuring its normal development depends on the correct assessment of the newborn’s health, and only a specialist can give a correct assessment!

Inna Sharkova, pediatric neurologist
"Guta-Clinic", Moscow

Discussion

Hello! My daughter is 2 months old, the pediatrician recommended that she undergo neurosonography and contact a neurologist. Based on the results of neurosnography, a diagnosis of 6 slight widening of the interhemispheric fissure was made (3.7 compared to the norm of 2.1). The neurologist examined her and revealed: active, smiling, humming, Graefe's symptom periodically, relying on curled fingers. My daughter shudders, her sleep is disturbed, and she spits up periodically. The doctor diagnosed: s/m PNRV, hypertype SDN, s/m LDN.
The diagnoses are not entirely clear, why they are dangerous, and how to decipher these symptoms. Help, I'm very afraid of losing time.

01/16/2008 21:33:04, Natalia

Hello.
My daughter is 3 weeks old. I recently noticed the asymmetry of her skull, i.e. her right temporal cavity is larger/deeper than the left. Tell me, is this dangerous? Is this a pathology or will symmetry be restored over time? And how to contribute to the restoration/formation of the normal shape of the skull?
PS: we alternate the sides of the child’s sleep.

12/21/2007 11:03:55, Stas

zdrastvuyte. u menye docinka 8 let i ona mikrocefaliya .a kak mojna uznat kakie budeshe jdyot emu.u neqo kajdiy nideli spazmi bivayet.ona ne ustayot v meste.pomaqite pojalusta kokoy lekorstva mojet uspokoyet eqo?ya jdu iz vas otveti.

12/07/2007 21:53:24, Ramil

The child is 7.5 months old, boy. Born on time, naturally (without caesarean section). At birth, she was diagnosed with hypoxia. The child is on breastfeeding.
The child has problems sleeping. The child sleeps only in a stroller or with a nipple in the chest (uses a nipple instead of a pacifier). He has not taken and does not take any medications.
For last month The procedure to expand the eye canal was performed 4 times.
The procedure is painful. The first 3 times the child reacted quite calmly and calmed down within 10 minutes after the end of the procedure. The fourth time he began to cry immediately after he was brought to the clinic, and after the end of the procedure he could not calm down for an hour.
According to the ophthalmologist (head of the department of the eye clinic at the Morozov Hospital), the procedure will be repeated until the eye canal can be expanded. Maybe 20 times.
Question:
Can the procedures affect the child’s psyche or will he forget everything and have no mental problems?

08.11.2007 15:00:20, Vadim

Hello doctor
I'm worried about the size of my head
I'm 21 years old, height 180, weight 75
and the diameter of the head is 54 cm.
my chin is almost GONE!
it feels like the head is the neck
only her hair and face grew
please help me tell me why

Hello Doctor!

Rebenku 5 mesyacev, pri podderjanii rebenka on derjit noqi na noskax, normalno lı eto?
Mi ocen bespokoimsya cto on ne smojet xodit. After osmotra doktor skazal cto u neqo porez na noqax i cerepnoe davleniee i naznacıl etı lekarstva:
Mojno li eti lekarstva prinimat pri takom diaqnoze.
Doktor cto bi vi posovetovali cto nam delat?
Zaranee blaqodaryu.
1 Flexital N10

2 Diacarb N6

3 Eufillin N10

4 Gluferal N

5 Mydocalm N10

6 Calcium is a magician

7 Asparkam N10

03.05.2005 10:02:06, S

Tell me, if the child is only a month old and the neurologist said that the fontanelle is 0.5 and whatever that is good! Is this very bad? And how will this affect the baby's development?
[email protected]

04/05/2005 14:11:35, Roman

I'm 16 years old, I have
enlarged frontal and parietal
skull bones maybe
it was passed down by inheritance,
how to solve this problem,

other therapy. Is it possible
make changes to
genetic level.
Write your answer

03/17/2005 06:48:03, Anton

I'm 16 years old, I have
enlarged frontal and parietal
skull bones maybe
it was passed down by inheritance,
how to solve this problem,
maybe you can use laser or some other
other therapy. Is it possible
make changes to
genetic level.
Write your answer

03/17/2005 06:46:26, Anton

My son was about 4 months old when his psychomotor development slowed down. During the examination, the neurologist at the children's clinic said that the child was completely healthy and had no abnormalities. But (thanks to the advice of a medical friend) we turned to a chiropractor. The chiropractor identified at first glance the non-disjunction of the sutures of the skull bones (the reason was due to postmaturity at 3 weeks and rapid labor). After the first massage session, the bones separated and the child began to catch up in development. Therefore, there is no hope for medical examinations. Just my own observations...

07.12.2004 03:12:23, MammothOK

Hello. My daughter is 1.5 months old. Sometimes she looks "surprised". The neurologist directed us to a neurosonogram. On the direction it is written: "s-m LDN?" What does this “surprised” look and LDN mean? Thanks in advance for your answer

11/13/2004 01:02:21, Julia

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Monitoring a child's development in the first year of life is critical to their later well-being. If the baby is healthy and develops “according to plan,” then visits to the neurologist will be preventive. If pathological changes are detected in the baby, then timely correction will prevent serious deviations in physical, cognitive and mental development.

During an examination by a neurologist, the main indicators of the baby’s neuropsychic development are assessed by checking his innate reflexes. The need for early diagnosis is due to the special flexibility of the formation of brain structures and the sensitivity of the infant’s central nervous system to external influences (and negative ones).

An appointment with a neurologist has several goals:

monitoring the baby's development
informing parents about the child's condition, potential hazards for health, methods of treatment or prevention of deviations from the norm, about the principles and techniques of developmental activities for a healthy baby
treatment of identified pathologies

Diagnosis of indicators of developmental delay before the age of 3 months is especially important. With great accuracy, it helps to predict future problems in the development of certain skills in a child up to one year, and sometimes for the entire preschool period of his life.

Pay attention!

At an appointment with a neurologist, you can and should ask all the questions that interest you. Any. In order not to forget important points, think through them at home and write them down. The activity of a parent is an effective aid to the work of a doctor!

It is the family that has an influence on the baby’s first year of life that becomes the basis of his health or pathology in the future. The role of the mother is invaluable - constant interaction between her and the child is the main condition for stimulating development.

The newborn is examined by a neurologist in the maternity hospital. There, the baby undergoes ultrasonography of the brain through the fontanel. Later, when the fontanel is overgrown, it will be impossible to do an ultrasound of the brain - the bones of the skull do not transmit ultrasound rays. The examination is carried out to detect anomalies. Brain cysts are often detected, but today there is no explanation for their appearance. Small formations up to 5 mm go away on their own. If the cyst is larger, it is monitored over time.

The second visit to the neurologist should take place after a month of the baby’s life. You should prepare for it in advance. What should mothers focus on when daily care for the baby? What does the neurologist look for at the first appointment?

The following things should cause concern:

Too short periods of sleep. If the baby is fed, he usually sleeps. Reasons for waking up: hunger, cold, loud noise, abdominal pain. Stomach colic causes the child to cry “through sleep” without waking up. Healthy baby sleeping most of days.
Mental retardation. By the end of the first month of his life, the baby learns to: focus his gaze on his mother’s face, a bright toy. Turn your head towards the sound. If he remains indifferent to external stimuli, then this is a serious cause for alarm.
Trembling (tremor) of the chin and hands, blue discoloration of the nasolabial triangle, convulsions.
Frequent regurgitation, vomiting after feeding. All babies burp frequently. The reason for this is the air entering the stomach with milk. Formula-fed children are especially susceptible to this. The baby belches air in the first minutes after feeding; a little food comes out with the air - this is normal. Excessive regurgitation that is not related in time to feeding should cause alarm.
Fixing the child in a certain position. A healthy baby constantly moves its legs and arms chaotically, without taking a specific position. When laid out on his stomach, he cannot hold his head up for long. Be sure to tell your doctor if your baby has “learned” to hold his head well or prefers a certain position - this indicates hypertonicity of his muscles.

What mom doesn’t need to do is try to test her reflexes on her own. This should only be done by a specialist. The mother should feed the baby at least half an hour before the appointment and tell the doctor as many details as possible about it.

An examination by a neurologist at 1 month begins with a visual assessment of the baby, his posture, and movements.

Then the doctor checks sequentially:

Development of the nervous system. Tests all innate (unconditioned) reflexes, evaluates their integrity and strength.
Physical development. Carries out by assessing the shape and size of the skull, compliance of head growth with standard parameters.

Oral unconditioned reflexes

Sucking. The baby is given a pacifier, which he begins to actively suck. Automaticity fades away by the age of one year. At this time, it is necessary to wean the child off the pacifier and bottle, so as not to transfer the sucking reflex to the category of conditioned (specially formed).
Search. This reflex is well known to attentive parents - any touch to the baby’s mouth or cheeks makes him turn his head in this direction and look for the breast with his open mouth. This is especially pronounced in a hungry baby.
Proboscis. Automaticity is associated with involuntary contraction of the orbicularis oris muscle when a light tap on the lips occurs - the baby immediately stretches out his lips in a tube.
Palm-oral is a complex automatism related to spinal-oral. When pressing on the baby's palms in the area thumb he “groups” forward in the thoracic region, tilts his head and opens his mouth.

Cervical tonic asymmetrical. If you turn a child's head to the side without his participation, then his arms and legs on this side automatically extend, and on the opposite side of the body the limbs bend. The flexor-extensor muscles are activated, and the baby “stands up” in the fencing position.
Labyrinth tonic. When laying the baby on his stomach, he automatically first selects everything for himself (flexors), then makes, as it were, swimming movements. The cycle ends with elements of spontaneous crawling.
Cervical tonic symmetrical. When the child's head passively tilts forward, he straightens his legs and bends both arms. When throwing the head back in the opposite direction, the limbs act in the opposite way - the legs bend, the arms extend.

Pay attention!

Only a specialist knows where and how to press to check the operation of the automation. Self-checking the baby’s reflex reactions will cause him at least discomfort, at most involuntary urination, defecation (Perez, Talent reflexes).

The lower and upper grasp reflexes are the involuntary flexion of the palms and feet when pressing on certain points. The top one is familiar to parents by how tightly the child grasps when an adult’s finger is placed in his palm.
Upper protective reflex. Since all innate reflexes are “given” to the baby for survival, when laid on the stomach the baby turns his head to the side. His goal is not to suffocate. Automaticity passes by one and a half months.
The Perez, Talent and Hug reflexes are tested using manipulations on the back and blows on the changing table.
Support, straightening reflex, walking pattern. When touching the support in a “standing” position, the baby’s legs involuntarily straighten, and the tilt of his body forward provokes automatic pacing. By 3 months, these “skills” fade away and reappear by the age of one year, when the child learns to stand and walk independently. In a child with developmental disabilities, the walking pattern remains for a long time.

Disruption or suppression of spinal reflexes is an alarming symptom that may indicate a malfunction of the spinal cord. It should be understood that the severity of reflexes is significantly influenced by the condition of the baby, how long ago he ate and slept. The mother should inform the doctor about this.

What the pediatric neurologist checks at the appointment is the growth of the baby’s head. Normally, during the first month of life, the head increases in circumference by 1.5 cm. There is variability in size (a girl is smaller than a boy), but too fast head growth, as well as too slow, indicates possible pathologies - hydrocephalus or microcephaly. Both pathologies are fraught with mental retardation and delayed physical development.

A neurologist examines the condition of the fontanelles. U healthy baby The fontanelles close: large (parietal) by 8-10 months, small (occipital) by 2-3. Faster closure of the fontanels prevents the head from growing normally, while slower closure indicates possible intracranial pressure. Not only the size, but also the shape of the head is assessed.

The neurologist assesses the child’s general condition, his mood, emotional reactions, and typical facial expression. The results of the examination are reported to parents.

The next examination by a neurologist is at 3 months and at 6 months. These examinations differ from what the neurologist looks at once.

Visit to a neurologist at 3 months

If no abnormalities are detected at the first appointment, then an examination by a neurologist at 3 months is more of a preventive nature.

The doctor evaluates the baby’s skills that he has developed:

ability to hold one's head
ability to turn onto your back from your stomach
complex of revival in relation to a loved one
reactions to speech, gentle voice

At three months, the baby is more relaxed and quickly focuses on moving objects and passing people. He turns his head towards his mother’s voice, responds to speech with a smile, laughter, and quick movements of his arms and legs. Starts to gurgle.

Pay attention! An important point of this visit is obtaining permission to carry out vaccinations. The doctor either gives permission for this, or the baby receives a medical exemption - a temporary exemption from vaccinations for medical reasons.

Visit to a neurologist at six months

What does a neurologist check at six months? These are skills that are already abundant if parents were involved in their development.

What should a 6 month old baby be able to do:

sit, roll over from stomach to back and back, try to stand up with support, play with legs, arms
independently pick up toys and move them from hand to hand
eat complementary foods from a spoon in the form of a semi-liquid substance
hold a bottle of water, drink on your own
pronounce some syllables, express emotions with facial expressions, gestures, sounds
distinguish “us” from “strangers”, highlight mother or one significant person who provides ongoing care

This visit for the first time may bring difficulties in examining the child, since he has learned to react to the situation and strangers. It is important for the mother to choose a time to visit the doctor so that the child is not sleepy, tired or hungry. Strive to build trust relationship with a doctor, do not ignore even preventative visits to the doctor - this will help to avoid many difficulties in the upbringing and development of the child.

Well, the baby has grown up. The child is 1 year old. What can he do?

Movements

At this time, most children can walk independently. If your baby does not walk yet, do not be discouraged - everything is individual, some children begin to walk at 1 year old. and 3 months.
The baby usually knows how to climb onto a sofa, bed, chair, etc., but he doesn’t always know how to get off there.

Speech 1 year old child

By the age of 1, most children begin to speak simple words: “mom,” “dad,” “give,” etc. On average, at the age of 1 year, children say about 10 words. But here, too, everything is strictly individual.
If your baby does not speak words, but at the same time understands everything: knows names, recognizes loved ones from photographs, fulfills simple requests: “give me a pen”, “wave goodbye”, “bring a ball”, etc. - you shouldn’t be upset either. .
By the age of 1, a child recognizes pictures in a book and can show them on a favorite picture or doll: eyes, nose, mouth, or on a car: wheels, steering wheel, cabin. Your baby doesn’t know how to do this yet, it’s time to learn.

Skills Child 1 year

By the age of 1 year, the child drinks well from a cup, holding it with his hands. This skill very much depends on the parents - whether you taught him to drink from a cup or not. If you haven't taught it yet, it's time to teach it.
By the age of 1 year, the baby can disassemble and assemble a pyramid.
Some children by the age of 1 year know how to ask to go to the potty.

Examination at the clinic Child 1 year old

Examination of a child at the clinic at 1 year of age includes

general blood test,
general urine test,
perianal scraping,
stool test for worm eggs,
Mantoux reaction,

doctor's examinations

pediatrician,
neurologist,
ophthalmologist,
Laura,
surgeon,
dentist,
Some clinics still have a healthy child’s office, where the appointment is led by a nurse who assesses your child’s skills and abilities and tells you how to deal with a child at this age and what to pay attention to. If your clinic does not have such an office, your local medical specialist will handle this. sister.
If you have not yet given your child an ECG (electrocardiogram), this examination is also carried out at 1 year of age.

It’s better to start with tests and examinations by specialist doctors.

Analyzes

General blood test - recommended for all children at 1 year of age. Most often it reveals: a decrease in hemoglobin. A decrease in hemoglobin below 100 g/l is an indication for treatment with iron preparations and a contraindication for vaccinations (the Mantoux river is allowed, the level of hemoglobin does not affect its result).
A general urine test can detect urinary tract diseases. It's very important here
Perianal scraping is performed to identify enterobiasis. Allows you to detect pinworm eggs on the perianal folds of the child. To ensure the reliability of this analysis, the child does not need to be washed in the morning on the day of the examination and in the evening the day before. If helminth eggs are detected, the child is prescribed treatment, then a follow-up examination, and vaccination is carried out after treatment.
Fecal analysis for helminth eggs is carried out to exclude enterobiasis and other helminth infections.

Doctors

teeth after “silvering”

Dentist

By the age of 1 year, a child usually has 8 teeth: 4 upper and 4 lower incisors. To the list that can be detected, by the age of 1, the initial signs of caries are added: stains on the teeth, darkening of the enamel, chips. The enamel of baby teeth is thinner and more sensitive than the enamel of permanent teeth - therefore it is easily damaged.

And in some children it is especially weak. When identifying the initial signs of caries, the doctor may suggest “silvering” the teeth: applying silver compounds to the teeth, as a result of which the teeth are covered with a thin film that protects them from further destruction. The procedure is painless. True, in this case the teeth are painted an unsightly black color, but tooth decay is significantly slowed down and the need for more serious treatment is postponed.

Pediatrician

This is followed by an examination by a pediatrician with weighing, measuring, etc. At 1 year average height child - 75cm. Average weight- 10 kg. The average head circumference is 46cm, chest circumference is 49cm. The large fontanel is most often closed and the child has 8 teeth. But all these are just average indicators - guidelines. If a child does not correspond to them in some way, this does not make him worse or better than others. If the child is healthy, he is then sent to the Mantoux reaction. This is not a vaccination, but a skin test, so it can be allowed when the child has a medical exemption from vaccinations. But there are recommendations regarding it too.().

Repeated examination by a pediatrician. 72 hours after Mantoux (on the third day), the child is again invited to the pediatrician to evaluate the Mantoux results. Next, if everything is fine with the Mantoux River, the pediatrician examines the child and sends him for vaccination (more precisely, 2): against measles + mumps and rubella.

Vaccinations are performed with a live, attenuated vaccine. The reaction to the vaccine is assessed at 10-14 days; there may be weakness, lethargy, a temperature of up to 37.2, which goes away on its own. There are practically no pronounced reactions to this vaccine. More details about this vaccination in one of the following articles.

1 year old child daily routine

At 1 year of age, a child usually sleeps 1 time during the day: 2-3 hours, night sleep lasts 10-12 hours. During the day, the child is awake for approximately 10-12 hours and sleeps for 12-14 hours. At 1 year of age, it is recommended to feed the child at least 5 times a day.

Child 1 year old Sample menu

7.00 - Breakfast: 150-180g, Milk () 70-100g.
10.00- Second breakfast: Juice 80-100g and cookies.
13.00 - Lunch: Soup (with 50g) 150-180 ml, A piece of bread, Compote or jelly 70-100 ml Soup with vegetables in the form of soft pieces (mash with a fork). You can cook for everyone, taking into account the child’s needs: do not overcook vegetables, but simply add them to the soup during the cooking process, use lean meat, do not add hot seasonings and sauces, add light salt.
16.00 - Afternoon snack: 50-70g. or fresh fruit 50-100g. Kefir (milk) 70-100g.
19.00 - Dinner: 150-180g. Bread. Compote 70-100g.
If necessary, before bedtime, you can breastfeed the baby or give him 200g of the formula to which he is accustomed.

The first year of life is very important for a baby, because it is during this period that the formation of all systems and organs of the child’s body occurs.

The baby’s nervous system and its physical parameters are developing rapidly.

These indicators determine the health of the child. Regular visits to the clinic throughout the first year of life are essential, even if your child is absolutely healthy.

Purpose of visit to doctors at 1 month of age

The main tasks of medical examination of children are monitoring their development over time, timely implementation of health-improving and preventive measures.

Until one month you were examined by a pediatrician at home, and now you must make your first visit to his office. But it is even more important that at this age you are consulted by other specialists: a neurologist, an orthopedist, an ophthalmologist, an ENT doctor, a surgeon.

The purpose of these consultations is to identify previously unnoticed abnormalities and diseases. By identifying any abnormalities in the early stages, you can prevent the development of the disease, and if you have an existing disease, you can begin to treat it as early as possible and, accordingly, more effectively.

Neurologist

The neurologist will conduct a comprehensive examination of your child: assess muscle tone, neuropsychic development, development of motor functions, and check innate reflexes. It is at the age of 1 to 2 months that perinatal (arising during pregnancy and childbirth) lesions of the central nervous system (CNS) are most often detected. These include: increased neuro-reflex excitability and central nervous system depression syndrome.

It is very important to diagnose and begin treatment in the first months of life, since at this time the nervous system is still maturing, and its impaired functions can easily be restored. The vast majority of deviations from the neurological norm at the age of one month and a little more are reversible.

A neurologist will definitely give you a referral for neurosonography (ultrasound of the brain). Sometimes such an examination is carried out in the maternity hospital, and it is repeated every month as prescribed by the doctor. Ultrasound allows you to determine possible changes in the structure of the brain: malformations, vascular cysts, enlargement of the ventricles of the brain (hydrocephalus), intracranial hemorrhages, hypertensive syndrome (increased intracranial pressure).

Orthopedist

First of all, an orthopedic specialist should check the baby for hip dysplasia, since their improper development or underdevelopment in children 1–2 months old is by no means a rare phenomenon.

The doctor will examine the symmetry of the gluteal folds and evaluate the parameters of the separation of your child’s legs in the hip joints. If hip dysplasia is detected in such early age, when the joints are still forming, it can be corrected non-surgically.

If this is not done in time, improper formation of joints can lead to dysfunction of the child’s lower extremities.

In addition, the orthopedist excludes the possibility of developing congenital and acquired pathologies such as dislocations, clubfoot, and torticollis.

Surgeon

The purpose of examining a one-month-old baby by a surgeon is to identify diseases such as hemangioma (vascular skin tumor), inguinal or umbilical hernia (protrusion of part of organs or tissues through weak areas on the anterior abdominal wall), in boys - cryptorchidism (undescended testicles into the scrotum) and phimosis ( narrowing of the foreskin).

Very often in clinics the specialties of a surgeon and an orthopedist are combined by one doctor.

Oculist (ophthalmologist)

At the age of one month, the baby should have the skill of focusing his gaze on an object. This ability will be checked by an ophthalmologist. In addition, the specialist will examine the fundus of the small patient to identify pathologies of the retina and check the patency of the nasolacrimal ducts.

Changes in the early stages can be treated conservatively (non-surgically). This allows you to avoid further violations of eye function and the development of complications from the organ of vision.

ENT doctor

In the first or second month of life, a doctor who monitors the proper functioning of children's ears, nose and throat may prescribe special study to identify possible hearing pathologies. After all, already at this age, an ENT specialist may suspect a decrease in the baby’s hearing (hearing loss).

Early diagnosis of this disease is very important, since hearing loss in the future can lead to delays in speech and mental development. Even such young patients are successfully treated and rehabilitated for this disease.

Health groups

Based on the results of an examination by specialized specialists, the pediatrician evaluates the child’s health in its entirety and, based on this assessment, determines the health group.

There are 5 health groups in total:

First- the child is absolutely healthy, physical and neuropsychic development corresponds to age;
Second- children with minor deviations from the norm or at risk of developing pathologies;
Third- children who have chronic diseases in remission, with rare exacerbations;
Fourth- children with chronic diseases or significant deviations from the norm;
Fifth- disabled children or children with chronic diseases (frequent exacerbations and severe course).

Based on this, each child is given a period of observation by the attending physicians, health measures are developed (massage, hardening, physical therapy), individual recommendations are given regarding the daily routine, methods of physical education, etc.

Regular visits to the clinic are mandatory for mother and newborn. The development of a child in the first months of life progresses at such a pace that it is impossible to do without constant monitoring. An examination by a pediatrician helps to identify diseases, if any, at an early stage. The presence of hereditary diseases and the risk of pathologies is checked. If the child is healthy, the doctor determines the baby’s level of development, carries out parametric measurements, and prescribes tests.

If the child is completely healthy, the doctor simply takes anthropometric measurements and records them, prescribes tests

Further scheduled examination (dispensary examination) is aimed at monitoring the dynamics of the child’s development, carrying out the necessary vaccinations and health programs. The pediatrician visits infants up to 1 month at home (at least 3 times). Such examinations are called patronage. It is advisable that the child be examined by an orthopedist, ENT specialist, neurologist, surgeon, or ophthalmologist before the baby is one month old. When the baby turns 1 month old, it’s time for the mother to go with him for his first medical examination at the clinic.

What items should I take to the clinic for examination?

When going to see a pediatrician with a newborn, you need to take certain things and documents with you. Sample list consists of:

two diapers (one for the changing table, the other placed on the scales);
a pacifier (if the baby takes it) and a rattle to keep the baby occupied while waiting for the appointment;
wet baby wipes and extra diaper;
if the doctor's visit takes place in summer time, take a bottle of drink;
a certificate of vaccinations and a certificate of ultrasound and audio screening results;
a notebook or notebook with questions that you had to ask the doctor during this period (start your mother’s diary immediately after the maternity hospital).

If you were not able to have your baby examined by different specialists before your first visit to the clinic, be sure to do this on your first visit. It is very important to detect the development of diseases in time or confirm the complete health of the baby.

We will tell you which specialists you need to see, what tests you need to take, and what they check for the newborn. Our review will help you stop worrying and understand how important these examinations are for your monthly baby.

It is advisable for the mother to prepare questions for the doctor - they should be written down throughout the entire period between visits

Pediatrician

A pediatrician is a doctor whom a mother and her treasure should see once a month until the child is 1 year old. The clinic specifically sets aside one day a week when doctors examine only infants. “Baby day” allows babies to avoid contact with other children, which prevents the risk of disease. By calling the reception, you can find out what day this day falls on, how your local pediatrician receives you, and how to make an appointment with him.

The main activities at each doctor’s appointment are aimed at measuring the baby’s anthropometric indicators. Weight, height, chest and head circumference are measured. The results obtained help the child therapist find out how correctly and successfully your little treasure is developing. The pediatrician must assess the functional state of the organs; he can coordinate the daily routine and give advice on feeding the baby.

If the examination shows no problems and the baby is healthy, a referral is issued for the vaccinations scheduled for each age. The next one after the first, which is done in the maternity hospital, is carried out against viral hepatitis. Negative reactions to this vaccine are extremely rare; children usually tolerate it well.

Prepare for the fact that on the second visit you will need to take a blood and urine test for your baby. Analyzes show the functioning of internal organs and help identify inflammatory processes.

In addition, the doctor will tell you about preventive measures against rickets. Traditionally, newborns are prescribed vitamin D (1 drop – 500 IU) or water-soluble vitamin D3 taken once a day. Perhaps the dose will be calculated by the doctor based on the physical condition of the baby, or he may not need to take additional supplements at all. For bottle-fed babies, the doctor writes a prescription to receive food at the dairy kitchen.

Additional Research

Special studies are also carried out as prescribed by the pediatrician. When the doctor is alarmed by the results of the initial observation infant, he can send the baby for an abdominal ultrasound. Additional diagnostics are necessary to check the functioning of the kidneys, liver, spleen, gallbladder, and pancreas. Allows timely identification of pathological processes in these organs.

Having discovered a murmur in a child’s heart, the pediatrician usually prescribes a cardiogram (ECG) for the baby. Echocardiography is performed if there is a suspicion of heart or vascular disease. If any diagnosis is confirmed, the child is registered with a cardiologist. You can find out the appointment time at the reception; the doctor himself will tell you the frequency of visits. Complex cases are within the competence of the medical commission.

Neurologist

A neurologist checks the functioning of the child’s nervous system. The specialist examines muscle tone, checks the baby’s innate reflexes, sets parameters for neuropsychic development and checks motor skills. The mother must understand that examinations by a neurologist are very important for the child. Some lesions of the central nervous system that occurred during gestation can be detected precisely at 1 month of life.

A neurologist checks the child’s reflexes; the purpose of the examination is to identify central nervous system diseases in the early stages

Special procedures are carried out that can identify the syndrome of central nervous system depression, the syndrome of increased neuro-reflex excitability. Having discovered a pathology, the neurologist prescribes treatment, which is especially important to begin in the first month. The baby’s nervous system continues to develop, so timely correction and elimination of identified disorders will involve a reversibility mechanism. This means that the baby receives the necessary help and continues to develop normally.

Among the examination methods there is also neurosonography (ultrasound of the brain). The first examination should be carried out in the maternity hospital. If it is not done, the neurologist will definitely prescribe it. The procedure is aimed at detecting developmental defects, signs of hydrocephalus, hypertension syndrome, vascular cysts, ventricular dilatations, and intracranial hemorrhages.

Orthopedist

A child needs an orthopedist to examine the musculoskeletal system. The first appointment allows the doctor to determine the presence or absence of hip dysplasia in the baby. By spreading the child’s legs at the hip joint and examining the gluteal folds for symmetry, the specialist is clearly convinced of whether there is a problem or not. The disease, diagnosed at an early age, is well treated by correction. If the disorder starts, the child will need the help of a surgeon, who will have to correct more complex changes. An orthopedist can identify congenital clubfoot, muscular torticollis, and dislocation. An ultrasound of the hip joints is required, which confirms or reveals their dysplasia (we recommend reading:).

Surgeon

The surgeon's studies can detect inguinal or hemangioma (a tumor on the skin of a vascular nature), cryptorchidism (when the testicles have not descended into the scrotum), phimosis (narrowing of the foreskin) (we recommend reading:). The listed diseases are typical for boys. Early diagnosis of pathologies ensures correct and successful treatment of identified ailments.

If disorders are diagnosed so early, the doctor carries out the necessary treatment to prevent the formation of more complex changes. A hernia causes compression of the mass contained in it by the hernial orifice. Untreated phimosis leads to an inflammatory process in the glans penis (balanitis or balanoposthitis). You may be scheduled to visit only a surgeon, since in some clinics the doctor combines two specialties, orthopedist and surgeon.

Oculist

The area of research of the ophthalmologist is the vision of the infant. Naturally, no table is offered to the child at one month of age. The doctor examines the fundus of the eye to exclude retinal pathology, checks the focus of the gaze and the correct patency of the nasolacrimal ducts. Having established that there are violations, the ophthalmologist draws up a conservative treatment plan that helps relieve the baby from dangerous complications in the visual organ.

Early vision testing is necessary to identify possible congenital or acquired disorders

ENT

The task of the ENT specialist is to use audiological screening to check the child’s hearing for any disorders. Having detected deviations, the specialist issues a referral to the audiology center. The center's doctors conduct more in-depth studies on the subject of hearing loss. Hearing is very important for a child because it affects his mental and speech development. Early diagnosis and treatment can prevent more serious problems.

The baby is 2 months old, which doctors should I visit?

Basic examinations have already been completed, so at 2 months you should only visit your pediatrician. The doctor will continue to monitor the overall development of the baby, familiarize you with the ultrasound findings for dysplasia and disturbances in the functioning of internal organs, and with the results of the tests performed. They may be asked to take tests again. What events await you in 2 months:

Parametric measurements of height, weight, chest and head circumference. Calculation of weight gain. If problems were discovered during the first visit, the doctor will prescribe a repeat examination for them.
Testing a child's hand control. Hearing and vision testing. If the child is healthy, the doctor may limit himself to an external examination.
Additionally, they will remind the mother who is breastfeeding breast milk, about the importance of taking your child vitamin D or fluoride if it is found to be deficient. For a bottle-fed baby, the pediatrician may prescribe iron supplements.