The first year of a baby’s life: routine examinations, tests, vaccinations

Why do babies need frequent screenings?

Despite the fact that modern medicine has a high level of development, doctors continue to face untimely detection of pathologies in children in the first year of life.
Many of these disorders could be prevented with regular medical examination. From the moment of birth, the baby needs constant medical monitoring, medical supervision, and thorough diagnostics. According to the order of the Ministry of Health of the Russian Federation, medical examination of children in the first year of life implies regular preventive examinations at established age periods.

The purpose of a comprehensive medical examination of infants is the early detection of pathological processes, diseases and factors of their development. In addition to examination by specialists, preventive measures include instrumental and laboratory research methods.

How is vaccination carried out?

• Before vaccination, the pediatrician conducts a pre-vaccination examination.
• Parents provide informed consent for vaccination.
• The pediatrician issues a Certificate of Preventive Vaccinations.
• Vaccination is carried out by a nurse in the vaccination room.
• Within 30 min. After vaccination, the child is monitored (WHO recommendations) to prevent possible allergic reactions.

Please note that as part of the pre-vaccination examination, the preparation and adjustment of the vaccination schedule, consultation on diseases and examinations are not carried out. To solve the above problems, you must schedule a consultation.

Medical examination of infants at different periods

Let's consider the list of diagnostic measures that are indicated for children under the age of one year.

Neonatal screening

In the maternity hospital, each child undergoes neonatal screening to exclude severe hereditary pathologies. These include:

• phenylketonuria - a disorder of amino acid metabolism;
• cystic fibrosis - cystic fibrosis, which is characterized by damage to the exocrine glands and dysfunction of the respiratory system;
• galactosemia - a disorder of carbohydrate metabolism: galactose metabolism;
• hypothyroidism - insufficient production of thyroid hormones by the thyroid gland;
• adrenogenital syndrome is a complex of disorders in the production of corticosteroids.

If neonatal screening was not carried out immediately after birth, it can be done before the age of 1 month.

Also in the maternity hospital, audiological screening is carried out, with the help of which specialists can diagnose even the most minimal hearing impairment in an infant. If this test was not performed after birth, it should be performed before 3 months of age.

Vaccinations

If the child is healthy and you consent to his vaccination, then immunization is carried out against:

1. Viral hepatitis B is an infectious disease that damages liver cells. Severe consequences of infection - cirrhosis, oncology;
2. Tuberculosis is an infection that affects the lungs and other internal organs. Immunization is carried out using the BCG vaccine.

First month of life

The day after the newborn is discharged from the maternity hospital, a local pediatrician will come to your home. Visiting the clinic with the child begins later: when the baby is 1 month old. The pediatrician will listen to the baby with a phonendoscope, examine the throat, nose, and genitals, and give useful recommendations for caring for the baby.

At the age of 1 month, the baby undergoes its first comprehensive examination :

• Ultrasound of the brain . The study is carried out through the fontanelles. During an ultrasound, the doctor receives a two-dimensional image of the structure of the brain, information about the state of brain tissue and the circulatory system.
• Ultrasound of the heart. The study can detect myocardial pathologies, fluid inside the heart sac, abnormal shape of the chambers, coronary heart disease and many other disorders.
• Ultrasound of the abdominal cavity . During diagnosis, the condition of the stomach, pancreas, intestines, liver, urinary and reproductive organs is assessed.
• Ultrasound of the hip joints . A newborn's bones are soft. This is necessary for its successful passage through the birth canal. In the first months of life, bone tissue begins to strengthen, so at this time it is necessary to monitor possible pathologies. For example, ultrasound can exclude or confirm the presence of hip dysplasia.
• Examination by a neurologist. The specialist evaluates the condition of the fontanelles, muscle tone, intracranial pressure, symmetry and proportions of the body, head position and circumference.
• Examination by a pediatric surgeon. The doctor conducts a visual examination of the baby. The examination allows you to identify or exclude the presence of inguinal, umbilical hernia, phimosis, torticollis and other pathologies.
• Examination by an ophthalmologist. Consists of a visual assessment of the tear ducts, examination of the fundus to exclude increased intraocular pressure and inflammatory processes.
• Examination by an otolaryngologist. The purpose of the examination is to conduct audiological screening.
• Examination by a pediatrician. During the consultation, the child’s weight and height, basic reflexes, and muscle tone are monitored.

Vaccinations

Based on research by specialists, the pediatrician makes a conclusion whether the child has any contraindications for vaccinations. If they are not detected, then a second vaccination against viral hepatitis B is carried out.

Age 2-5 months

During this period, preventive examination of the baby consists of a monthly visit to the pediatrician. In addition, at 2 months, clinical blood and urine tests are taken, and at 3 months of age, the child is examined by a traumatologist-orthopedist.

Vaccinations

Age 2-3 months:

• revaccination against viral hepatitis B. It is carried out for children included in the risk group: living in unfavorable social conditions, with reduced immunity, autoimmune pathologies;
• first anti-pneumococcal vaccination . Pneumococcal infection can cause pneumonia, acute otitis, inflammation of the inner lining of the heart, pleural layers, joints;
• administration of DTP - adsorbed pertussis-diphtheria-tetanus vaccine. Whooping cough, diphtheria and tetanus are acute infectious diseases that can lead to serious disruption of the functioning of internal organs, as well as death;
• the first vaccination against polio - spinal paralysis;
• vaccination against hemophilus influenzae . Recommended for babies included in the risk group: with an immunodeficiency state, on artificial feeding, born from mothers with HIV infection.

At the age of 4.5 months, revaccination is carried out against:

• pneumococcal infection;
• polio;
• whooping cough, diphtheria and tetanus;
• hemophilus influenzae infection (risk group).

Age 6 months

At six months the child undergoes a second comprehensive examination. The baby should be examined by an orthopedist. By 6 months of age, many babies begin to crawl and sit up. Using these skills, the specialist will assess the condition of the child’s muscles.

In addition, consultations with a neurologist, ophthalmologist, and pediatrician are indicated every six months.

Vaccinations

Revaccination is carried out against:

• diphtheria, whooping cough, tetanus;
• viral hepatitis B;
• polio;
• hemophilus influenzae infection (risk group).

Age 7-11 months

This period is relatively calm. Preventive examination consists of a monthly visit to the pediatrician. Vaccination is not performed.

Age 12 months

At one year old, babies begin to pronounce their first words and are able to express their emotions using gestures. The child’s communication skills are assessed by a neurologist during a consultation.

It is important to show the baby to an orthopedist. At the age of one, many children begin to walk, so the load on the feet and bones of the lower extremities increases. A visit to an orthopedist will allow you to exclude or notice in time the development of longitudinal and transverse flat feet, deformation of the knee and hip joints.

Also recommended per year:

• consultations with an ophthalmologist, otolaryngologist, dentist, pediatric surgeon, orthopedic traumatologist, pediatrician;
• conducting an electrocardiogram;
• taking clinical blood and urine tests.

Vaccinations

1. Vaccination against measles, rubella, mumps.
2. Revaccination against viral hepatitis B (risk groups).

Do I need to take a coronavirus test before vaccination?

The procedure does not imply this, but some teachers and doctors plan to get tested - just in case. Is it worth spending money?

Photo: Vitaly Nevar/TASS

Today, medical and educational workers aged 18 to 60 years can sign up to be vaccinated against coronavirus with the promising Sputnik V vaccine from the Gamaleya Center.

There are few additional requirements: absence of chronic diseases and pregnancy, two weeks without ARVI symptoms and a month without other vaccinations. There is no talk of any preliminary tests for COVID-19.

True, a question arises. If you don’t need to get sick during vaccination, how can you rule out the asymptomatic form of coronavirus? Moscow teacher Irina Viktorovna , who herself has no intention of getting vaccinated, shares her opinion

“Some are planning, but I’m somehow in no hurry to get vaccinated, because I know that there is a vaccine, but it has only passed laboratory tests, and there are still some internal concerns. From the perspective of a young girl who is planning children, I still worry about what is being put into my body. That's why I'm in no hurry to get vaccinated.

— Before vaccination, if you were going, do you need to get tested for antibodies or PCR?

- In any case, this is an indicator of your health. The disease can occur in a hidden form, you just don’t know about it. Therefore, I consider any analysis necessary and important in our current situation.

And here’s what Moscow otolaryngologist Irina Osipova , who recently recovered from COVID-19, says.

— Logically, in addition to the examination, of course, it would be good to donate antibodies. But if this is not possible, then the specificity of the signs of the disease, asymptomaticity, during the interview can be identified by the doctor. If the doctor is trained, then some relative signs of the disease will still be revealed. PCR may not detect it, because there are cases when there is a disease itself, but PCR is negative.

— Maybe you and your colleagues discussed whether they would be vaccinated?

— There are probably 20% who categorically refuse, and there are doubters. In most cases they will be vaccinated.

The hypothesis about the danger of vaccination in asymptomatic cases of coronavirus is based on the idea that vaccination will put some additional pressure on the body and increase the severity of the disease. However, there is no reason to consider these fears justified.

Firstly, the requirement for the absence of ARVI symptoms during vaccination is aimed primarily at ensuring that people do not consider the vaccination a cause of poor health. The level of confidence in the vaccine in Russia is already quite low - according to a study published in the journal Nature, only 55% of Russians are ready to be vaccinated with a drug that has proven its effectiveness. This is the worst performance among the 19 large countries covered in the survey. Even though at least 18,000 trial participants have already received both injections, with no credible reports of serious side effects.

Secondly, there is no requirement for PCR testing before vaccination not only in Russia, but also abroad. The UK has already begun vaccinating nursing home residents and workers without any testing.

Finally, the test is unlikely to detect the presence of the virus at the presymptomatic stage of the disease. The window of time when there is enough virus in the body for the test to work, but not enough for symptoms to occur, is quite small. Therefore, a negative PCR test before vaccination does not exclude that you will get sick in the coming days.

As for the asymptomatic form of the virus, vaccination will not do any harm here, says immunologist Vladimir Bolibok.

Vladimir Bolibok, immunologist, “In principle, no additional tests other than measuring temperature are needed. People don’t get sick with Covid asymptomatically – it’s just a virus carrier. If a person feels healthy and does not have any symptoms, he does not need to do any additional tests, such as PCR for coronavirus. He can be vaccinated regardless of whether he is an asymptomatic carrier of the virus or not. There will be no consequences for humans."

Meduza published new data on the obstacles to mass vaccination on Friday. According to the publication’s sources, the production partners of the Gamaleya Center have already launched the production of the first dose of the vaccine, but the second one turned out to be more “capricious.” “It is quite possible to vaccinate two million with the first dose by the end of the year. All our efforts are now focused on increasing the production of the second dose,” the source said.

According to the publication, problems with the second component should be resolved in the near future, and by the end of 2021, 2 million Sputnik V vaccines will be released in Russia.

Add BFM.ru to your news sources?

The doctor chooses the optimal combination of vaccines for the child

Only a specialist can individually select the optimal vaccination regimen. The choice of a specific drug and regimen is determined by a combination of many factors that the doctor must evaluate:

• child's health condition
• age-related immunological features
• epidemic situation in the country and region
• safety of vaccines, their effectiveness, ease of use
• compatibility of the drug with other vaccines and drugs
• possible reactions to the vaccine and side effects
• the need for emergency immunoprophylaxis according to indications

Restriction or postponement of vaccination: medical exemption from vaccinations

Only a doctor limits vaccinations. Vaccination is a complex immunological process. It should not be carried out in situations that increase the risk of post-vaccination complications.

An absolute contraindication to vaccination is

Severe allergic reaction in the form of angioedema to a previous vaccine administration.

For certain vaccines, pregnancy or breastfeeding

Relative contraindications are:

• presence of acute or chronic diseases
• a certain period immediately after recovery
• taking certain medications

The doctor will clearly explain to you why and for what period a medical exemption is given, and will tell you when it is necessary to resume vaccination. For drugs that are vaccinated in stages, it is necessary to complete all stages of vaccination to form stable immunity.

Important advice for parents

Don't forget to take your Vaccination Certificate! Without it, we will not be able to vaccinate, because... it contains the necessary and reliable information about what vaccinations have already been done, which is very important for the doctor.

1. Children do not require any medical preparation for vaccination.
2. A few days before vaccination, do not give your child unfamiliar fruits, vegetables or vitamins, so as not to provoke an allergic reaction, which can easily be confused with a post-vaccination reaction.
3. If the vaccine is intended to be an injectable one, dress the child so that the clothing can be easily removed and put on. For children under 2 years of age, injections are given in the upper outer part of the thigh; for children over two years of age, injections are given in the deltoid muscle of the shoulder.
4. Always remain calm. Vaccination is a certain stress for any child, and the baby will perceive you as the main signal whether he should be afraid or not.
5. You yourself should know and explain to your child (if his age allows) that vaccination does not hurt. The drugs themselves are painless when administered. Modern needles are as thin as possible; the skin is punctured instantly.
6. Please keep in mind: the child is not crying from pain. He cries from fear of the unknown, general nervousness and limited movement.
7. For older children, it is enough to explain what will happen. The baby needs to be distracted with a toy, conversation, or favorite gadget.
8. You should know that for high-quality vaccination and accurate placement of the needle into the injection site, the nurse needs “free hands”, and the child should not move during the injection. This means that it is you, not the nurse or doctor, who must restrain the child from moving. This corresponds to the instructions of the medical staff and is absolutely correct from the point of view of vaccination techniques.