Postnatal care for the period from birth to six weeks is called

Postnatal care for the period from birth to six weeks is called the puerperium.Immediately after birth, the first examination of the baby takes place. The doctor or the midwife or the maternity nurse make sure that the baby has survived the birth well.Above all, this first examination, is about recognizing conditions and external malformations that are in need of immediate treatment. Thus, necessary emergency measures can be initiated and complications avoided.With the so-called Apgar score, a simple, painless and effective check, the doctor or midwife are assessing the newborn’s health.One minute after birth and again after five minutes they are evaluating the baby’s wellbeing, by examining the following signs:the skin colour of the baby (checking the appearance from blue to white over pink)the heartbeat (checking the pulse from absent to slow over fast)the reflexes (evaluating the grimace)the muscle tension (looking at the activity if limb, some bending or active movement)the breathing (from absent to weak or irregular to good and crying)Each sign is given a score between 0 to 2, which are then added up to give the Apgar score for each check.In case of a low score, the Apgar score will be repeated at a five minute interval until the baby is in a good and stable condition.Most baby’s score between 7 and 10 and don’t need any immediate treatment.This method of evaluation isn’t designed to predict a baby’s long-term health or development. If a baby has a low score at five minutes it may still be perfectly healthy, as most baby’s are. The Apgar score is only one measure of the baby’s health. There will be further checks and examinations over the coming weeks which will assess the baby’s health.In order to be sure that the newborn baby has been given enough oxygen during the birth, blood is taken from the umbilical cord and pH (acidity) is determined.They will look for externally recognizable malformations.The baby will be measured and weighed and will receive vitamin K to prevent internal bleeding.Usually within 72 hours after birth a physical examination is offered including a screening test to find out if there are problems related to the baby’s eyes, heart, hips and testicles for boys.The next exam should take place three to ten days after birth at the latest and will screen for a number of rare diseases, including cystic fibrosis and sickle cell diseases. Usually the midwife will make a blood spot test, called heel prick, by taking a tiny amount of blood from the baby’s heel.With this blood sample following conditions are going to be tested:An inherited condition called phenylketonuria (PKU), which affects the way proteins are metabolizedCystic fibrosis, which affects the lungs and digestive systemMCADD, a condition that affects the way the body converts fat into energySickle cell disease, a genetic blood disorderThyroid deficiencyHomocystinuria, an inherited metabolic disorderMaple syrup urine disease, glutaric aciduria type 1, and isovaleric acidaemia, which are all inherited disorders in which the body is unable to process certain protein building (amino acids)These conditions are rare and early detection will give the baby the best chance of successful treatment.In-depth physical examination of the baby should identify congenital diseases and malformations (eg, malformations of the heart) and avoid life-threatening complications. This includes recognizing jaundice requiring treatment, as it may be an indication of bile duct obstruction.In this and all other examinations, the baby will be measured and weighed. Particular attention is paid to:the skinthe sense organsthe thoracic and abdominal organsthe genitalsthe head (mouth, nose, eyes, ears)the skeletal system with muscles and nervesThe doctor will discuss with the mother what is important for the healthy development of the baby. In this exam, the baby will receive vitamin K again to prevent bleeding. In addition, he/she will inform about vitamin D for the prevention of rickets and fluoride, a bone disease that is important for later dental hardening. If necessary, he/she will be prescribed for the baby. During this exam, advice on breastfeeding and nutrition, as well as measures to reduce the risk of Sudden Infant Death Syndrome (SIDS) will also be given.A newborn hearing screening test helps identify babies who have permanent hearing loss as early as possible. This means parents can get the support and advice they need right from the start.Most baby’s are born into families with no history of permanent hearing loss.Permanent hearing loss can significantly affect baby’s’ development.Finding out early can give him/her a better chance of developing language, speech, and communication skills.At around six weeks there will be another physical assessment and a review of the baby’s development so far. These checks are a follow-up to the assessment the baby had as a newborn. It also gives parents the chance to discuss with the health professionals any physical or emotional problems they may have.Related to the baby, the doctor will check that it is growing healthily by carrying out a series of examinations to ensure that heart, lungs, spine and genitals are all developing as they should and that the newborn’s hearing is normal.All key information, such as the baby’s weight, are recorded in the baby’s red book, which is the personal child health record (PCHR).An important goal of this screening and all further investigations is to recognize developmental problems as early as possible. For example, during this screening, the doctor pays attention to whether the baby can hold his/her head while lying prone, whether he/she can open and close his/her hands spontaneously and finally, whether he/she looks attentively at close faces.In addition to a thorough physical examination, the hip joints of the baby are additionally checked with ultrasound in order to treat possible malformations in time.He/she will ask if there are any abnormalities when sleeping, drinking, digesting or other behavior of your baby. He/she will again discuss breastfeeding and nutrition, as well as measures that reduce the risk of Sudden Infant Death Syndrome. In addition, it is generally about accident prevention and threats to your baby through dependence and addiction in the family.The family will also receive detailed advice on which immunization are useful. The first immunization is at around 6 weeks and will be registered in the personal child health record.At each screening exam, the child is screened for possible serious illnesses and his development is reviewed. Depending on the age of the child, the focus here is on different areas, such as agility and skill, speaking and understanding, social behavior, etc. There are, depending on the age, additional topics and focal points, such as vaccination, prevention of SIDS, accident prevention, dental health, nutrition issues.If the doctor detects a condition or abnormality, or signs of possible disruption or delay in development, all options will be discussed with the parents/guardians and, in consultation with them, the next steps for further diagnose and required treatment will be initiated.