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WELL-BABY EXAMS

By Helen Zelon

Incredible as it seems, your baby will probably see his pediatrician more often in his first year of life than you saw your doctor or midwife during your pregnancy. Well-child visits help your doctor monitor baby's growth. They're an opportunity for you, too, to raise questions about your baby's health and development -- and get some answers.

From the minute your baby's born, you step into a role you'll play for a long, long time: You are your child's advocate, her voice in the adult world, and the 'eyes and ears' that know her better than anyone else. "Pediatricians are interested in providing the best possible care," says Lynn Olson, PhD, of the American Academy of Pediatrics. That means both "responding to parents' needs, and making a difference in children's lives." But your doctor can't do it alone. She needs you as an active partner in your child's health.

The better you educate yourself, the better parent you are to your baby. But it's hard to know what to do in a brand-new situation. Here's what you can expect during doctor's visits -- and how to get the most out of the time you spend with your child's pediatrician.

Every well-child visit begins with a few pleasantries and gets down to business, starting with weighing and measuring your baby. Infants might have their head circumference measured, too, as an indicator of your baby's growth. Most doctors plot a child's progress on a standard growth chart. Your doctor can show you how to read it, if you ask. Steady growth over time is a signal of good health.

Early in your relationship, ask your child's pediatrician whether it's better to raise questions during or after the exams. Don't be shy! You have to speak up for your child, even if the doctor's office is intimidating. It's smart to write down your questions ahead of time, especially if you know the visit might be stressful, like when your baby is getting a shot, or is in the throes of major separation anxiety (common around 9 months of age).

Next, the doctor tests your baby's reflexes and muscle tone. She may gently move your newborn's limbs, or ask whether your two-month-old pushes up on his pudgy arms to look around. Does your four-month-old roll over? At six months, does he sit alone? Is she crawling into everything at eight months or 'cruising' the room-with the help of your furniture-at 10 months? Of course, these milestones represent average ages, and all babies mature on their own schedule. Still, this is the progression your doctor anticipates. If your child's pattern of development varies, it's important to mention during an office visit.

As baby grows, so do her vocal abilities and social interests. Many doctors coo and chat with babies as they check heart rate, ears, eyes and tummies, using the time to see how baby engages with an attentive adult, to check eye function (focus and tracking), and to explore a baby's personality. Some doctors do more formal assessments, especially if there's cause for concern, but most often, they use the exam as a chance to relate to your baby, to play a little and get a sense of her emotional and verbal development.

For babies eating cereal or other solid food, the pediatrician may suggest new foods to try, or ask how the last month's foods have been tolerated. If you have questions about food, possible allergies, or if your mother-in-law's urging you to thicken baby's evening bottle with rice cereal, address them at a well-child office visit. This can be tough, if your doctor is in a hurry, but even everyday concerns deserve a response. It's hard to know how and when to feed a baby (especially your first) and both you and your baby can benefit from extra support and guidance.

When the physical exam's done, it's often time for immunizations or other pesky procedures. Doctors dislike making your baby cry as much as you detest hearing it. In fact, many pediatricians schedule a daily 'quota' of infants and toddlers, to be sure their day isn't all screaming babies. Some moms have concerns about immunizations. If you do, be sure to raise them well in advance. Don't wait until you are in the heat of the moment when emotions and apprehension can be running high.

Use the last few minutes of the office visit to review any instructions the doctor has given you. Once you are sure all your questions have been asked -- and that you understand all the answers -- that's it! Stop at the receptionist's desk to schedule your baby's next appointment. Then, head out and enjoy the day.

One final word of comfort: While the office visit is the best time to get answers, it isn't the only opportunity you have to communicate with your pediatrician. Some doctors have call-in hours when they take questions by phone and others are happy to respond to questions via email.

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