Health checks
health; check; personal; record; vision; hearing; growth; development; developmental; screening; PHR;
Contents
Regular health and development checks are recommended for all young children to see that they are growing and developing normally, and to find health problems so that they can be treated early. These checks can be done by a doctor or a community child health nurse. In South Australia they can be done through Childrens, Youth and Women's Health Service.
Australian health check guidelines
Guidelines that are used across Australia recommend checks at:
- birth
- 1 - 4 weeks
- 6 - 8 weeks
- 6 - 8 months
- 18 months
- 2½ -3½ years
- 4 - 5 years
These regular visits to your doctor or community child health nurse give you an opportunity to raise and discuss any aspects of caring for your child and your child's health and progress. Visits at other times may focus on problems, leaving little time for discussing more general concerns.
In each state and territory in Australia the questions asked and the things checked may vary slightly, but generally they will be very similar. The information given below includes the questions asked and the checks done in South Australia.
Personal
Health Record (PHR)
Each baby born in Australia will have a Personal Health Record (in South Australia this may be called the 'Blue Book') given to the parents at the time of the child's birth. In this book are special pages for recording the health checks, and also some questions to think about before the health check. There will also be some information about the things that will be checked at the visit. These could include weight, length or height, head circumference, vision, hearing, hips and development. Boys will also have a check to see that their testes are in the usual position.
Parents should take the PHR with them every time they visit a doctor, child health clinic or hospital and ask that the visit be recorded in the book.
The first check, after birth.
At the time of a baby's birth and again before the baby leaves hospital, the baby will be checked to find any health problems that may be present.
- A record will be made in the baby's Personal Health Record (PHR) of information about the pregnancy and birth and about how healthy the baby was in the first few minutes, hours and days.
- The baby's birth weight, length and head circumference measurements will be recorded, as will any treatment that was needed.
- Vitamin K (which helps prevent a bleeding problem) will usually be given on the first day, and this will be recorded (see the topic 'Vitamin K' for more information.
- It is recommended that the first Hepatitis B immunisation is given within 24 hours of birth, and this will be recorded. See 'Hepatitis B'
- The Neonatal Screening test (also known as the Heelprick test or the Guthrie test) will be done on day 2 (in South Australia) or maybe on day 5 in other places, and this will also be recorded in the PHR. See 'Neonatal screening test'
- Before a baby leaves hospital a doctor will usually give the baby a full examination and the results of this check will be written in the 'Newborn Examination' section of the PHR.
The first visit, 1 to 4 weeks.
This visit to your doctor or child health nurse can be used to discuss any concerns you have about your baby's health, growth and development.
- It is also a good time to talk about feeding, helping your baby to settle and looking after your baby.
- You can also talk about how you are feeling and any worries you have about your own health.
- If you want to you can just focus on the baby during this visit, but you can also talk about yourself and being a parent.
Your doctor or nurse will have some questions for you. These could include:
- Do you have any concerns about your baby?
- What sort of birth did your baby have?
- What health problems (if any) has your baby had since birth?
- What health problems do you or others in your family have that could affect your baby?
- Could your baby have a hearing or vision problem? (See 'Hearing and hearing loss')
- Has anyone in the family had a hip problem as a baby? (See 'Developmental dysplasia of the hips')
- How are you managing?
- What are your plans for having your baby immunised? (See 'Immunisation')
Remember, you can ask questions too: perhaps you could write them down in your baby's PHR to remind you when you go for the health check.
6 - 8 week health check
At this visit your doctor or nurse will check, weight and measure your baby. The visit can also be used to discuss any concerns you have about your baby's health, growth and development. It will also be a good time to talk about feeding, settling and looking after your baby. Many babies cry a lot at this age, and you could talk about how you are managing.
Your nurse or doctor will have some questions for you. These could include:
- Do you have any worries about your baby?
- What health problems (if any) has your baby had since birth?
- Could your baby have a hearing or vision problem? (see 'Hearing and hearing loss')
- Has anyone in the family had a hip problem as a baby?
- How are you managing?
- What are your plans for having your baby immunised? (See 'Immunisation')
Remember to have your questions ready too.
6 - 8 month check
At this check, as well as having your baby's health, growth and development checked you might like to talk about
- food and drinks for babies, starting solids
- sleep patterns
- playing with babies
- keeping babies safe when they start to move and crawl
- helping babies learn to talk
- caring for teeth
- sun protection
- family planning.
The nurse or doctor may ask you whether you have any concerns about your child's health, growth and development, behaviour, vision or hearing (see Hearing and Vision below), and the way your baby relates to others.
18 month check
Again, your doctor or nurse will check your child's health, growth and development, and weigh and measure your child. At this health check you may like to discuss some of the following topics:
- behaviour, including separation anxiety
- keeping children safe at home and while out
- playing with children
- toilet training
- discipline
- child care and play groups
- immunisation (see Times for immunisation below).
Your doctor or nurse may ask if you have any concerns about how your child is developing, learning and behaving, including how she is moving, walking, using her hands and fingers, talking and understanding what others say. Also whether she seems to be hearing and seeing normally.
2½ to 3½ years
At this check the doctor or nurse will check your child's height and weight, eyes, and the way your child walks. You can discuss any concerns that you have about your child's health, growth and development. The list given above will still be relevant at this age. Your doctor or nurse may ask you again about your child's development and behaviour, especially about talking, hearing and seeing.
4 to 5 years
In many areas this check will be offered at your child's pre-school centre (kindergarten), but you can take your child to your doctor or child health nurse.
- The check is better if you can be there when the check is done.
- Your child's health, growth and development will be checked, and your doctor or nurse will ask you if you have any concerns.
- You can use this time to talk about your child's behaviour.
- The next lot of immunisations are due from 4 years of age, (see 'Immunisation'), and this can be a good time to ask any questions you have about immunisation.
- Sometimes your child may be able to have the immunisation at the time of the health check (if the health check is done at your doctor's centre or a child health centre, but not usually at the pre-school centre). You could check this at the time that you make the appointment.
Times for immunisation
Immunisation is a very effective way of protecting your child against many serious health problems. In Australia it is recommended that all babies have Hepatitis B immunisation soon after birth, (usually on the day they are born). The times for immunisations for children under 5 years are:
- birth
- 2 months
- 4 months
- 6 months
- 12 months
- 18 months
- 4 to 5 years
See 'Immunisation' for more information.
The PHR is the official record across Australia for recording immunisation and should be used by whoever gives the immunisation, eg Council, GP, Child Health Nurse or hospital.
Hearing and vision
Severe hearing and vision problems in young babies are rare, but if your baby or a member of your family has had one of the illnesses or health problems which are listed below, your baby may have a hearing or vision problem.
- Most babies who have these problems do not have a vision or hearing problem, but it is important for your baby to be tested as soon as possible, because if the problems are found early, more can be done to help that child's development.
- Many babies will be tested in the first few days after birth for hearing problems (Neonatal Hearing Screening). In South Australia, if this is not done, you can ring the Child and Youth Health Hearing Assessment Centre to get your baby checked if you think there could be a problem, 8303 1530.
Questions to think about:
- Have any close family members had a hearing or vision problem since childhood, or required a hearing aid or needed special education because of a hearing or vision problem?
- Was your baby very premature (for example weighing less than 1500 grams when born), or sick, or severely jaundiced? Did you baby have severe breathing problems around the time of birth?
- Has your baby had meningitis (which is the main cause of severe hearing loss in children after birth)?
- Did you have any infections such as rubella (German Measles), toxoplasmosis or CMV (cytomegalovirus) while you were pregnant?
- Does your baby have any problem with physical or intellectual development? These problems can include cleft palate, unusually shaped ears, cerebral palsy or 'syndromes' such as Down Syndrome.
If the answer to any of these questions is 'Yes', make sure that you talk to your doctor or community child health nurse about hearing and vision.
Some children with vision or hearing problems do not have any of these 'risk factors', so if you are concerned about whether your child is hearing or seeing normally, make sure that you have your baby's vision and hearing checked.
There is more information about eyes and vision in the pamphlet 'Healthy eyes happy kids' from Can do 4 kids.
More information
For more information about your baby's health checks, read your baby's Personal Health Record.
Resources
South Australia
- You can make appointments to see a Child and Family Health nurse for a health check by ringing 1300 733 606 (9am - 4.30pm, Monday to Friday).
- To see where your nearest centre is, look under 'Locations' at the top of this topic.
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).
This topic may use 'he' and 'she' in turn - please change to suit your
child's sex.