Every child in Germany has the right to nine free healthy child check-ups (Vorsorgeuntersuchungen), which extend from birth to age five and, additionally, to an adolescent exam (Jugendgesundheitsberatung) at age 13. The purpose of these exams is to monitor the development of your child so that diseases or developmental deficiencies can be detected and treated as early as possible. If your child is born in Germany, you will be given yellow examination booklet at the birth. If you arrive in Germany after the birth of your child, you will be issued the booklet upon making an appointment with a pediatrician for an exam. Even if you think your child is developing normally, it is wise to attend every exam during the time recommended. The exams are also a good opportunity to ask any questions you have about the development of your child. Most pediatricians reserve extra time for such exams so it is the perfect opportunity to discuss any questions or problems while you have the undivided attention of your doctor.
Here is a short overview of when the ten exams should be scheduled and what the doctor will be looking for. If your child is born in Germany, you will get a sticker on the front of your booklet indicating the exact dates for scheduling the nine childhood exams. Otherwise, there is a grid for writing in the dates on your own.
An Apgar test will be done to evaluate the baby’s breathing, heartbeat, muscle tone, reflexes and skin color. Your child will also be weighed and measured. Recently introduced is a hearing test, which can also be carried out by some pediatricians during the U2 or U3. Upon parental approval, Vitamin K will be administered orally to prevent internal bleeding.
This exam is usually carried out in the hospital before you and your baby have been released; however, if you have a home birth or an out-patient birth, your pediatrician will most likely make a house call to carry out the exam or you will have to make an office visit. Most important at this exam is evaluating your baby’s metabolism. The Guthrie test will be carried out, in which the doctor removes blood from the baby’s heel. The doctor will also check for jaundice and digestive disturbances. The mobility of your baby’s hips will be examined via ultrasound. Your baby will be weighed and measured. The doctor will inform you about supplementing your baby’s diet with Vitamin D. If you have accepted the Vitamin K supplement, the second dosis will be orally administered.
This exam, as well as all the remaining, will take place at your pediatrician’s office. The hips will once again be examined via ultrasound. By this time, your baby should be smiling, and the doctor will ask questions about drinking and sleeping patterns. Your baby will be weighed and measured. The third and final dosis of Vitamin K will be orally administered.
Your baby will be weighed and measured, and the inner organs, as well as the reflexes will be examined. By this time, your child should be able to push him or herself up from the stomach position and look straight ahead. Your pediatrician will begin discussing immunizations and nutrition if you are no longer nursing.
Your baby will be weighed and measured. The most important factor at this exam is your baby’s mobility or rather, attempts at mobility. From the stomach position, your baby should be able to support him or herself with one arm while reaching for a toy with the other. Your baby should also be able to hold toys in both hands and rotate toys to observe from all sides. Eyes and ears will be examined. Your baby could begin to exhibit stranger anxiety, making it a potentially difficult exam.
You child will be weighed and measured. He or she should weigh three times the birth weight and be 50 per cent longer than he or she was at birth. By this time, your child should be able to crawl and sit up straight. He or she might also be able to talk, pull up to standing or even walk independently. The doctor will examine any teeth your baby might have and give advice on good oral hygiene. Whether you choose to supplement your child’s oral hygiene program with fluoride or not is an important decision.
This exam takes place at the beginning of the Terrible Twos so doctor and parents should be prepared for a child reluctant to being examined. Your child will be weighed and measured. Your child’s emotional development is the main focus of this exam. Can your child communicate using two-word phrases? Can your child climb stairs while holding on to the railing? Can your child use a fork or spoon to eat? Does your child sleep through the night? Does your child notice when his or her diaper is wet or soiled and request a clean diaper? Seventy per cent of all children do not meet one or all of these criteria by the two-year exam.
Your child will be weighed and measured. The doctor will also thoroughly examine hearing, seeing and speaking skills. A urine sample will be requested to test the kidneys. The doctor will want to know if your child allows him or herself to be separated from you. Can your child play with others in a group? Does it like to be read to? Can he or she entertain him or herself for a certain length of time? Does he or she have continence problems, day or night? Can your child stand on one leg?
Your child will be weighed and measured. The focus of this exam is on language development, fine motor skills and muscle coordination. The doctor will want to know if your child knows his or her name and address, can draw basic shapes, can hop on one leg and walk a straight line. Can your child judge distances? Does he or she have a basic concept of time? When you register your child for the First Grade at a German school, you will be requested to present the results of this exam to the school.
Your teenager will be thoroughly examined by the doctor. In addition to a physical exam, the doctor will ask about any psychosomatic symptoms such as stomach aches or headaches. He will advise your teenager about diet, exercise and sexuality, as well as the hazards of drug, alcohol and nicotine use.