What is the U4?
The U4 preventive examination is part of the preventive program for babies and children to observe their physical and mental development and to be able to intervene directly in case of difficulties. The U4 is particularly concerned with the baby’s sleeping and eating habits, motor skills and attention. Furthermore, the child can be prescribed fluoride and vitamin D again and the preventive appointment can also be used as a vaccination appointment for the six-fold vaccination against tetanus, diphtheria, whooping cough, haemophilus, hepatitis B and pneumococcus.
When will the U4 take place?
The fourth preventive examination is performed in the third to fourth month of life. The earliest time is from the second month of life and the latest possible time is at four and a half months. If the examination is to be carried out outside this time frame, the parents must pay for it themselves. The appointment can be adapted to the baby’s vaccination calendar, so no additional appointment with the pediatrician is necessary.
Which examinations are carried out?
First, parents are given a questionnaire in which they fill in what they have observed in their child. Only after the evaluation of this questionnaire does the actual examination of the child begin. The first part of the examination includes a detailed physical examination, which includes measuring and weighing the child.
The physical examination is followed by a visual and hearing examination: in addition to the physical examination, the parents are given advice on nutrition and sleeping behaviour. If desired by the parents and in accordance with the schedule, the second six-fold vaccination is given. This is a vaccination against tetanus, diphtheria, haemophilus influenza type B, whooping cough, hepatitis B and pneumococcus.
The pediatrician also recommends the administration of vitamin D and fluoride. Further appointments for vaccinations and precautions can be made afterwards.
- The pediatrician will look at the baby’s eyes and skin and assess the color and texture.
This way the doctor can already see possible liver dysfunction or a lack of oxygen from the color of the skin.
- The pediatrician also examines the baby’s abdomen and listens to the heart, lungs and stomach. The examiner pays attention to noticeable heart and breathing sounds, as well as digestive sounds that are too strong or too weak. By palpating the abdomen, a possible enlargement of the spleen or liver can also be detected.
If there is any uncertainty, the pediatrician can also perform an ultrasound of the affected areas.
- The pediatrician also palpates the baby’s fontanelles, i.e. the gaps in the skull, to assess whether the head can grow sufficiently.
- Part of the physical examination is also a test of the mobility of the baby’s joints. In the next step, the doctor tests various reflexes and the strength of the baby’s muscles. To do this, the examiner pulls the baby up by the hands and checks whether the baby can already hold the head by itself.
- The baby should be able to turn its head towards a sound source. This is tested by the pediatrician making different sounds with paper or rattles.
- Furthermore, the child should be able to fixate persons with their eyes and follow them.
- The baby should also emit babbling sounds, which indicates the beginning of speech development.
