infantum Other inborn problems do not show up until a few weeks after birth. The doctor will also ask questions about the parents' health and medical histories. Some medical problems can be inherited, and some can run in families. It is important for the new baby's medical record to show such background information. If the child later shows signs of problems that have appeared before in the family, the doctor will be able to make a diagnosis more quickly. The first visit will also include checking to see that the umbilical cord is healing as it should, that the circumcision (if it was done) is healing, and that the child has had no ill effects from labor and delivery. Feeding schedules, vitamins, and immunizations will be discussed as well. Usually, regular return visits are scheduled at the first visit. The number and spacing of the visits will depend on the baby's health, the parents' needs and wishes, and when the baby should have immunizations. If the baby's health and development seem normal, some or all of the later visits may be handled by a pediatric nurse practitioner or a physician's assistant. These health professionals are specially trained to be extensions of the doctor. They can work with you to clear up any questions you have about taking care of your baby. Of course, any question or problem that the nurse or assistant cannot handle is referred to the doctor. LATER VISITS As the child grows past babyhood, questions will come up about how to handle toilet training, rivalries with brothers and sisters, obedience, temper tantrums, and the like. These are areas where your doctor and his or her staff can help. Go ahead and ask about them. A child's doctor is not concerned only with the child's physical health and development. Social and psychological development are also a part of every child's growth and affect health in many ways. THE DOCTOR'S PROCEDURES In a complete physical examination, the doctor uses a combination of his or her senses and knowledge of the body to check over your child, system by system. The doctor uses instruments to extend the senses. For example, the stethoscope magnifies sounds, and the otoscope (for examining the ears) and ophthalmoscope (for examining the eyes) have lights and magnifying lenses in them to extend the doctor's vision. In the process of an examination, the doctor will look at the child's skin, ears, eyes, nose, bone structure, and body openings. He or she will feel the lymph nodes and the organs that can be felt through the skin. The doctor will tap over body cavities and listen to the sounds that result. He or she will also listen to the sounds made by the heart, the lungs, and the digestive system. A blood pressure reading is an important part of the child's examination from an early age. The doctor's senses are further extended by laboratory tests. Some of these tests are routine, such as vision and hearing tests, hemoglobin and hematocrit blood tests, and a urinalysis. chicken