At the Pediatric Health Clinic of Huilongguan District, Beijing Jishuitan Hospital, many parents have the following doubts: "Does the child's physical examination only need to measure the height and weight? If so, should we monitor it at home instead of the hospital physical examination? "The reason for such confusion often stems from parents' lack of understanding of children's physical examinations, and it is difficult to grasp the key points. In fact, different from the usual hospital visits, physical examination is a complicated job.
When seeing a doctor, there are often clear symptoms or diseases. At this time, doctors and parents are concerned about what the symptoms are, how to get them, and how to treat them. The physical examination is different. The physical examination does not focus on a specific problem, but on all aspects of the child from head to toe, from the inside to the outside. The content of the entire consultation process is numerous and detailed. The content of communication between doctors and parents will involve In all aspects, it is easy for parents to miss the focus. So, what is the baby's physical examination looking for, and what aspects should we pay attention to the baby's physical examination results?
Physical Development
Height and weight are a very important part of the physical development assessment, which can roughly evaluate the nutritional status of a child. Of course, physical development is not just about height and weight, and you need to pay attention to the development level of each system during the physical examination. For example, the nervous system should pay attention to the growth rate of head circumference, physiological and pathological reflexes, muscle strength and muscle tone of the limbs, etc.; the respiratory system should pay attention to the frequency and rhythm of breathing, the condition of the pharynx, the breath sounds of the lungs, etc. The digestive system will feel the internal organs through palpation of the abdomen, understand the peristalsis through auscultation, understand the abdominal distension through percussion, and so on.These examinations are all achieved through physical examinations based on the doctor's solid basic skills and rich clinical experience, so don't underestimate the few minutes that the doctor gives the child's physical examination, which is an important means of comprehensive evaluation of the baby.
Of course, in addition to the physical examination, necessary blood tests or instrument testing can better assist doctors in early detection of baby problems, such as routine blood tests to find out whether the baby has iron deficiency anemia problems, such as vision and hearing problems The screening needs to use the corresponding equipment to check the baby every six months to one year.
Psychological and behavioral development
If the physical development is concerned with whether the baby grows tall and strong, then the psychological and behavioral development, in short, is concerned with whether the baby is smart enough. As the old saying goes, "Three turns, six sittings, eight crawling and walking every week" is a simple milestone of behavioral development, and parents can roughly evaluate the baby according to this standard at home. During the medical examination in the hospital, the doctor will conduct a more detailed evaluation of the baby. During the evaluation process, in order to ensure that the baby can cooperate, the doctors may use various interesting toys to interact with the baby. In the eyes of many parents, this is very much like "playing games" with the baby, but in fact, in "playing games" During the process, the doctor will find out whether there is any abnormal or insufficient behavioral development through the baby's behavior and language, such as chatting with the baby to understand his language and thinking development, and assessing the child's fineness from finger movements. sports, etc. In addition, we also recommend that parents conduct a child neuropsychological development assessment for their baby every six months to a year, through the inspection of gross motor, fine motor, adaptability, language ability, social behavior, etc., to show the baby more comprehensively their development.
Disease Screening
Many parents hope to detect abnormalities in their babies at an early stage during physical examinations to prevent the occurrence or progression of diseases, and this is also the direction that child care physicians have been working towards. Of course, the screening of diseases is not able to screen out all the problems through a physical examination.
In the outpatient clinic, parents often say: "My child did not have this problem during the last physical examination, why is there a problem this time? Is it a missed diagnosis?" There are three main reasons for this situation:
1Some diseases appear gradually with age. For example, intestinal allergic diseases represented by lactose intolerance and milk protein intolerance. Not every baby shows the corresponding symptoms and signs immediately after birth. Many babies gradually show signs of intolerance with the increase of age and milk production.
2Some diseases are age-specific. For example, a baby girl may have the problem of adhesion of the labia minora. The high incidence of this problem is after the baby is 3 months old, so it is natural that this problem may not be discovered during the early physical examination.
3There are still babies who discovered the problem at an early stage, but it may not have been necessary to intervene at that time. At this time, the doctor will tell the parents to monitor it regularly. For example, for the hydrocele of a baby boy, in the early stage, if the hydrocele is not serious, the doctor may not give immediate surgical intervention, so it is necessary to regularly go to the physical examination clinic to evaluate whether the hydrocele is progressing or gradually absorbed. This ensures that your baby receives the right treatment at the right time.How often does
need a physical examination?
Doctors recommend that infants under the age of 1 have a physical examination every 3 months, children aged 1-3 have a physical examination every six months to a year, and after the age of 3, they have a physical examination every year. In addition, it is necessary to explain to parents that there is no fixed package for physical examination. Each physical examination is mainly carried out from the first three aspects according to the characteristics of each age group, but the specific content is not constant and may be adjusted according to the situation of each child.
and above is what I want to share with you today. To sum up briefly, children's physical examination is mainly carried out from the three aspects of physical development, psychological and behavioral development, and disease screening. Adjust your parenting style under the guidance of your doctor. Therefore, during the next physical examination, parents can focus on the doctor's evaluation of the baby and the interpretation of the evaluation results from these three aspects, so as to understand the baby more comprehensively, not to miss the growth problems at each stage, to intervene in time, and to let Babies can thrive.
Text丨Pediatric Internal Medicine Zhang Qian
Editor丨Jin Xiaofang Yu Miao
