What is the U3?

The U3 is the third childhood check-up to assess the child's developmental status and to focus on specific illnesses. In addition, the study is a way for parents to ask questions and receive additional information about caring for their baby. The results are recorded in the yellow booklet that parents receive from their birthing center or midwife.

When will the U3 be performed?

The U3 will be conducted in the fourth to fifth week of life. It is possible at the earliest from the third week of life and should have taken place by the eighth week of life at the latest. Mostly the U3 is the first contact with the resident pediatrician because the U1 and U2 are still in the hospital.

Which examinations are carried out?

First, the pediatrician asks the parents if they have noticed something and how the new family member has developed.

The doctor makes contact with the child and addresses it. This can be assessed as to whether the child can fix faces and hears normally.
A physical examination begins with the measurement and weighing of the child, since it is already possible to compare children of the same age.

The pediatrician looks at the skin and eyes of the child and scans the organs and bone points. These include tactile examination of the liver and spleen, as well as the development of the spine.

In the U3, special attention is paid to the development of the hip of the child. For this purpose, an ultrasound is performed, at which the pediatrician can judge whether the hip position is age-appropriate normal. Not every pediatrician does this part of the exam himself. Some refer the children to an orthopedist.

Also part of the check-up is that the pediatrician observes what the relationship between the parent and the child is.

With the help of some gymnastic exercises, the pediatrician can get an overview of what the child already knows. For this purpose, the doctor holds the child, for example, only on the stomach and checks whether the child turns his head and how it holds the arms and legs. In prone position, the child should be able to turn his head to the side.

Furthermore, the examining doctor tests the reflexes of the child. The grasp reflex, for example, is checked by the doctor stroking the palm of his hand and closing the child's hand. Another reflex at this age is the sucking reflex, which can be triggered by touching the corner of the mouth. This completes the actual investigation.

However, an important part of the U3 is not only the physical examination of the child, but also a consultation of the parents. Here, various topics are addressed.

There is a consultation of the parents on the subject of vaccinations in the baby, since the first vaccination appointments can be performed at the age of six to eight weeks. This is about the vaccinations against:
-Rotavirus
-Tetanus
-Diphterie
-Whooping cough
-Poliomyelitis
Hepatitis B
Hemophilus Influenzae and
-Pneumokokken
The parents are informed about the vaccinations and the diseases and a vaccination is recommended. If desired by the parents, an appointment for the first vaccinations can take place directly here.

There is also advice on preventing sudden child death, accident prevention and breastfeeding and nutrition. U3 also includes the third dose of vitamin K to promote blood clotting and recommends the use of vitamin D and fluoride.

Procedure of the investigation

Preventive examinations usually take place according to a certain pattern, which, however, varies slightly from doctor to doctor. In most cases, an examination starts with a conversation in which the pediatrician asks the parents if they have noticed anything unusual or if they have other questions.

Then the pediatrician contacts the child and first looks for externally visible abnormalities such as the skin or the eyes and observes the reaction of the child. This is followed by physical examination with weighing, measuring and palpation of organs and skeleton. Furthermore, some age-appropriate development tests are carried out and the child's reflexes are tested.

If not desired by the parents, the child gets vitamin K.

If the pediatrician himself carries out the ultrasound examination of the hip, this comes after the other physical examinations.

After the actual examination, the consultation on vaccinations, accident prevention and nutrition will take place. The parents get the opportunity to ask further questions and the next appointment will be arranged.
In case of abnormalities, the further procedure is discussed and possibly issued a referral to a specialist. Furthermore, the pediatrician refers to support offers in the region.

Does my child have to go to the U3?

Depending on the federal state, the provisions for preventive examinations vary.

In Bavaria, Hesse and Baden-Württemberg, examinations one to nine are compulsory and must also be proven when registering in a kindergarten or school.

In the other states, the parents get a written reminder. If no appointment has taken place four weeks later, the pediatrician informs the youth welfare office. This must then examine a possible endangerment of the child, but can not insist on the investigation.

In order to prove the examinations in day nurseries, the yellow exam booklet includes a stamp card, since only the execution, but not the result of the examination, has to be proven.

Who bears the cost of the U3?

Childhood screening, which includes the U3, is a compulsory health insurance benefit. Only if the maximum age at which U3 reaches the eighth week of life is exceeded, the examination must be billed privately.

Duration of the U3

The actual examination usually takes less than half an hour. The ultrasound examination, if carried out by the pediatrician, extends the examination by several minutes. Mainly the length of the U3 is determined by the advice of the parents and their questions.


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