Below, we would like to provide you with an overview of the early detection screenings from birth to the end of your baby's first year of life (U1, U2, U3, U4, U5, U6). We describe what these baby check-ups entail and why they are necessary. However, please note while reading that our blog post cannot in any way replace an actual examination by a pediatrician. For more in-depth information about medical baby check-ups or if you have any questions, it is best to contact your pediatrician directly. In the vast majority of cases, you will receive the reassuring answer that everything is fine with your baby.
A developmental screening examination is a medical check-up used to rule out specific health issues, malformations, and potential diseases. Age-appropriate development is also assessed. These preventative check-ups are performed regularly for babies to identify developmental delays early on and to treat them as quickly and effectively as possible. Beyond the examination itself, the visit to the pediatrician provides parents with an opportunity to address any doubts or concerns and receive professional advice.
As a standard, ten of these early baby examinations are performed. Shortly after birth, they take place at closer intervals and become less frequent later on. Of the ten childhood preventative check-ups, six take place in the newborn's first year of life. In general, the screening examinations differ based on the symptoms checked, which depend on the child's stage of development in different months of life. The designated time frames should generally be adhered to in order to ensure that the examinations are fully covered by health insurance.
The goal of early childhood health examinations is to identify potential malformations or developmental deficits in the child at an early stage. While this may not necessarily mean a cure in all cases, early treatment often leads to better outcomes. Since the child's developmental steps build upon one another, targeted support helps close potential gaps early and gives the baby a chance to catch up in their development.
The very first early childhood baby examination, also known as the U1, is performed within the first hour after birth, depending on the situation and the availability of doctors, midwives, or maternity nurses. Vital functions such as breathing, heartbeat, and oxygen supply during birth are examined, as are reflexes and the baby's muscle tone. If external malformations or conditions requiring treatment are identified, immediate measures are taken to treat the baby quickly and effectively.
During the U1, the baby is also measured and weighed and, in consultation with the parents, receives Vitamin K. This is extremely important for blood clotting; however, many infants suffer from a Vitamin K deficiency. To prevent brain hemorrhages, the vitamin is administered in three doses after birth.
In addition to advice on infant nutrition and breastfeeding, parents receive the yellow childhood examination booklet, into which all the results of the screening examinations are entered. Furthermore, new parents are recommended to have additional examinations performed, such as a test for congenital heart defects, congenital metabolic disorders, cystic fibrosis, and a hearing test. These should all be completed within the first 72 hours of life. If all U1 results show no problems, parents and child can relax, recover from the strains of birth, and enjoy the moment together.
The second childhood preventative check-up, the U2, which takes place between the 3rd and 10th day of life, is also often still performed at the maternity hospital. For home or outpatient births, this can also be done at a pediatrician's office, though an appointment should be made as early as possible for this. During this examination, the newborn is weighed again and thoroughly examined, e.g., for heart malformations or jaundice requiring treatment. The doctor pays particular attention during the U2 to the sensory organs and the head, including the mouth, nose, eyes, and ears. The skin, genitals, chest and abdominal organs, as well as the child's skeletal system, including muscles and nerves, are also examined in detail.
If blood tests for metabolic disorders or cystic fibrosis and a hearing test have not already been performed, they will take place as part of the U2. In the case of a family history of hip problems, the ultrasound hip screening, which is normally scheduled for the next exam (U3), can be performed early. During the U2, another dose of Vitamin K is administered, and parents are informed about rickets. This disease, which can develop due to a Vitamin D deficiency and causes a child's bones to soften and deform, can be counteracted with Vitamin D. Fluoride may also be prescribed by the doctor for future tooth hardening and caries protection even before teeth emerge. Besides breastfeeding, the doctor also educates parents on measures for preventing sudden infant death syndrome (SIDS).
The third early childhood preventative check-up for babies is usually the first visit to the pediatrician's office. It is scheduled for the 4th to 5th week of life, and the appointment should be made early. The purpose of this examination is to identify developmental abnormalities at an early stage. For example, it is checked whether the child can lift their head while lying on their stomach, opens their hands spontaneously, and looks at nearby faces. The ultrasound examination of the hip joints also takes place, and the child is checked again for signs of jaundice. During the U3, the doctor typically asks about irregularities in sleeping, feeding, and digestion.
Even if parents and child have often become well-accustomed to each other after the first month together, the major change and short nights can strain the nerves. The U3 baby examination provides space for an open conversation about the challenges of everyday life together. The doctor knows and understands the parents' situation and can often provide useful advice on how to better manage challenging situations. During the appointment, accident prevention and potential dangers for the child due to dependency or addiction in the family are also discussed. Additionally, the first vaccination consultation takes place. Upon the parents' consent to the child's first vaccination at 6 weeks of age, they receive the vaccination card, and the first vaccination appointment is scheduled.
For the U4 examination in the 3rd to 4th month of life, the focus is on age-appropriate physical and mental development. The child's movements, visual and auditory abilities, and the contact between parent and child are examined. During the physical examination, the fontanelle—the opening in the child's skull at the forehead—is primarily examined. This ensures unhindered skull growth. The doctor's consultation covers accident prevention and how to optimally encourage the child's language development through speaking and singing. Another topic is the best way to handle situations where the baby cries a lot, has feeding problems, or has difficulty falling asleep.
If agreed upon, one of the recommended vaccinations can be carried out during the U4 examination. Most babies are vaccinated during the U4 against diphtheria, tetanus, Haemophilus influenzae (Hib), hepatitis B, polio, whooping cough (pertussis), and pneumococci. The next vaccination appointments do not fall on the upcoming U5 baby examination. If possible, appointments for upcoming vaccinations should be made directly. Fears or worries regarding the child's development can also be addressed. For some children, their sleep rhythm has regulated well, while others still wake up often at night, which can overwhelm parents. This and similar topics can and should be addressed; the doctor is familiar with these issues and may have helpful advice ready.
The 5th preventative check-up for babies, which should take place between the 6th and 7th month of life, revolves entirely around the child's physical development. The baby is now a good half-year old, moving with increasing agility, and can purposefully reach for objects. At this age, some babies are already eating their first solid meals and beginning to teethe. The U5 examination primarily checks the child's eyes, mobility, and tooth formation. Furthermore, a vaccination consultation is conducted based on the vaccination schedule; the baby's vaccination status is checked, and any missing vaccinations can be caught up.
Topics in the doctor's consultation include nutrition, digestion, accident prevention, and the prevention of sudden infant death syndrome (SIDS). All questions and concerns from parents can be discussed at length, especially regarding teething or language development. The pediatrician also advises parents on infant oral hygiene.
The last screening examination in the first year of life is the U6, which usually takes place between the 10th and 12th month of life. The baby is now almost one year old and developing rapidly. At the U6 baby examination, the pediatrician once again examines the child's eyes and mobility and pays special attention to parent-child interaction, which can, among other things, provide insights into the child's social skills. Nutrition, language development, and infant oral hygiene are discussed. Your pediatrician has lots of important information regarding dental screening examinations.
At the U6, vaccinations are once again a topic: The child's basic immunization is likely complete by now. This means they have received all doses against diphtheria, tetanus, whooping cough, hepatitis B, polio, and pneumococci. Other upcoming vaccinations include those against measles, mumps, rubella, and chickenpox, for which a follow-up vaccination is necessary after four weeks, and a one-time vaccination against meningococcal C. These should take place shortly after the child's first birthday; booking an appointment early is recommended.
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