Pediatrician Exam Diaper on or off?

[sent]

We have been to the pediatrician 3 times now for my 6 week old for well baby checks.  The nurses always ask me to remove her diaper to weigh her naked, but the doctor always does her exam with the diaper on.  We saw the doctor this Wednesday.  On Friday afternoon I discovered that DD had her first diaper rash but it had probably been there for a while before Friday. 

My mom is all on my case about what kind of a pediatrician does an exam and doesn't check the diaper area.  If she had checked, the rash might have been caught sooner.  The doctor might have checked her diaper area at the very first visit but I don't remember. Then she says what kind of office gives new parents no education on common baby problems and ailments.  I don't know.  I have 0 mom friends in this area to ask what other pediatrician office experiences are like.

Are they supposed to do this stuff?

[water*drop]

Jan 20, 2014 11:56:18 GMT -5 @mrswindycity said:

They weigh them with a dry diaper. The pedi does the exam with the diaper on, but does unfasten it to check out the diaper area for a minute.

This is how both our current office and our previous office does them.

[babyrn]

DD is weighed naked. Diaper on for the pedi but he unfastens it to examine the diaper area.

[schrodinger]

My pedi takes DD's diaper off to exam her genitals and to do her hip dysplasia check. I do think its weird for your pedi not to examine her genital area during a well-baby check. A sick baby check, I can see how this wouldn't be part of the exam. I got no real education from my doctors office. I just lurk a lot here and get all my answers.

[ryry]

Jan 20, 2014 11:56:18 GMT -5 @mrswindycity said:

They weigh them with a dry diaper. The pedi does the exam with the diaper on, but does unfasten it to check out the diaper area for a minute.

Same. The pedi usually peeks in the diaper quickly.

Eta: diaper rashes come on quickly. I would be really surprised if it had been there for awhile and you didn't notice. I don't claim to be the most observant person in the world, but I know when something changes on my kid-a tiny pimple, bump, or rash, I notice it. I really doubt it had been there for two days and you didn't notice.

[slipsey]

My pedi does most of his exam with his diaper on, and then checks his diaper area at the end. It's not a long part of the exam, but she definitely checks him.

[pupcake]

We always have the weight taken with the diaper off. The doctor will undo the diaper during the exam to check the diaper area. We didn't get any handouts on common problems.

[Ashley&Scott]

Naked weight, exam with diaper on but the pedi has always taken a quick look in the diaper area.

[kangaroo11]

Jan 20, 2014 11:59:33 GMT -5 pupcake said:

We always have the weight taken with the diaper off. The doctor will undo the diaper during the exam to check the diaper area. We didn't get any handouts on common problems.

Same. 

[ijack]

Jan 20, 2014 11:59:33 GMT -5 pupcake said:

We always have the weight taken with the diaper off. The doctor will undo the diaper during the exam to check the diaper area. We didn't get any handouts on common problems.

this. though she really only checks the vaginal area so I don't know that she would find a diaper rash even if I expected her to (which I don't).

[bearbaby]

Same as PP - dry diaper weighed, exam with diaper on but Pedi checks diaper area - (I have a son and a brief but thorough exam is done checking continued circ healing/genital area).

A diaper rash is something I'd expect to catch myself during diaper changes/bathing/etc. We weren't given any kind of booklet/guide beyond early newborn info regarding fevers and any immunization paperwork/side-effects/etc. I think your Mom is in the wrong on this one if she's "blaming" the Pedi.

[catbus]

Ditto others: weighed naked, exam in diaper but doctor checks diaper area visually and palpates lymph nodes.

[dcn]

Weighed naked, she does take the diaper off for a min to take a quick look.

[jenn248]

Jan 20, 2014 11:59:27 GMT -5 ryry said:

Jan 20, 2014 11:56:18 GMT -5 @mrswindycity said:

They weigh them with a dry diaper. The pedi does the exam with the diaper on, but does unfasten it to check out the diaper area for a minute.

Same. The pedi usually peeks in the diaper quickly.

Eta: diaper rashes come on quickly. I would be really surprised if it had been there for awhile and you didn't notice. I don't claim to be the most observant person in the world, but I know when something changes on my kid-a tiny pimple, bump, or rash, I notice it. I really doubt it had been there for two days and you didn't notice.

Ditto all of this.

[CloudBee]

DS is always weighed with his diaper off, and then at some point during the exam he doctor opens the diaper. She even does this at sick visits.

I don't understand how a doctor could catch a rash you can't even see yet? Sounds like there was no rash when you were seen.

I am surprised, however, that with such a tiny baby the doctor didn't check the diaper area.

[egishere]

weigh with dry diaper and then the pedi would usually undo the diaper to take a look down there and re-fasten it.

[gibbinator]

We go to a family Dr. He always weighed ds with his diaper on, but did take a quick look at his diaper area during his exam.

Eta: I'll agree that if you hadn't noticed the rash until now, it probably just appeared. I find that ds goes from 0 to rash between one diaper change.

[hocus2]

My kids were weighted naked until 18 months. I felt like the doctor's took off the diapers at every visit under a year to check hips and do a quick inspection of genitals. At 4 years they didn't do that sort of check. In fact I think my kid wore pants the whole time she had her 4 year check in.

In general my doctors (I see a practice with 6) don't educat me, but answer any questions I ask. I do remember my doctor offing me a food plan at 6 months that I promptly threw out because I though it was too much too soon. I have baby 411 for routine stuff and go with a certainly amount of instinct.

[soozy87]

They weigh him with a clean diaper and then the doctor opens it to check under it.

[sent]

How did I miss the rash? The room where we change DD is not the most brightly lit room in our apartment. I suspect she had this rash before we noticed it because she had been screaming for over a week at diaper changes, but we thought she had just learned to use her vocal cords and decided she hated diaper changes. It never occurred to us there would be a diaper rash.

I noticed redness late Friday morning when the room is the brightest and immediately I took her over to another room with better light to see what was going on. I had scheduled an appointent with a visiting nurse to come that day and she showed up like a few minutes after I moved DD to the brighter room and was so helpful about the rash and other topics. She mentioned that we might have missed the rash earlier not just because of the lighting situation, but also because with DD's skin tone, red rashes don't necessarily jump out right away unless you are looking for them or they get pretty bad.

I will see what they do with the diaper at the next visit and go from there.

ETA - she does check hip flexion but has done this with the diaper on.  

[MadamePresident]

The nurse does a weigh with no diaper and the doctor will often unfasten the diaper for a quick check. She lets us put it back on though. She says she never gets it right with cloth.

My doctor does educate us and takes as long as we need to answer any questions. It means if you see her later in the day, you are probably going to have a long wait, but you never ever feel rushed when you are in your appointment.

She also wears her 7 month old, during appointments.

[sent]

Oh yeah, and let me add that my husband noticed the redness on Thursday evening but he didn't know it was diaper rash and thus the source of her pain so he didn't mention anything to me. He told me this after I called him in tears on Friday. From now on we have agreed that we will point oout anything we notice on the baby to the other person so two pairs of eyes can look and make a decision and keep an eye on it.

To improve the rash, we have stopped using commercial wipes and are now only using cotton pads and water to clean her.  We have her without a diaper in the daytime when in front of us and a loose diaper otherwise.  I bought Pampers "sensitive" diapers or something if that is going to make a difference.  It is much better today.  

[karinothing]

weighed naked. Leave diaper on for majority of exam. Diaper taken off to check hips and testes.

[sent]

Jan 20, 2014 12:34:48 GMT -5 @ojo said:

Jan 20, 2014 12:32:26 GMT -5 sent said:

Oh yeah, and let me add that my husband noticed the redness on Thursday evening but he didn't know it was diaper rash and thus the source of her pain so he didn't mention anything to me. He told me this after I called him in tears on Friday. From now on we have agreed that we will point on anything we notice on the baby to the other person so two pairs of eyes can look and make a decision and keep an eye on it.

And go buy a new damn light bulb.

Has your baby had a bath yet?  You do that in the dark?  How do you know you got all the poop off if you don't have decent light?

We need an overhead lamp. It's just a dimly lit room.  I actually complained about this for a while.  Poo is yellow-orange and is easy to see.  

I have bathed her, but that's another point of contention.  We do this in my bathroom in a baby bathtub placed within my bath tub, but I think the tub is designed for slightly older babies.  It is hard for me to reach over in there and hold her head with one hand and try to wash and rinse everything with the other hand.  The entire time I am so afraid she is going to squirm and bonk her head.  I think she should be washed in the kitchen sink but he doesn't want to agree to this.  We've only done this bath thing 3x so far (I do washcloth rinses on in-between days), though with this diaper rash we have been washing her diaper area every day now.  I put a table in my bathroom to be able to lay her on there to make sure everything is clean before putting the new diaper back on.  

[sent]

Jan 20, 2014 12:37:34 GMT -5 tulips said:

Glad it looks better today sent

X gets an occasional rash. The purple tube of Desitin works the best for him.

Thanks.  Forgot to write that I am also using extra strength Butt Paste.

[gibbinator]

Jan 20, 2014 12:45:20 GMT -5 sent said:

Jan 20, 2014 12:34:48 GMT -5 @ojo said:

And go buy a new damn light bulb.

Has your baby had a bath yet?  You do that in the dark?  How do you know you got all the poop off if you don't have decent light?

We need an overhead lamp. It's just a dimly lit room.  I actually complained about this for a while.  Poo is yellow-orange and is easy to see.  

I have bathed her, but that's another point of contention.  We do this in my bathroom in a baby bathtub placed within my bath tub, but I think the tub is designed for slightly older babies.  It is hard for me to reach over in there and hold her head with one hand and try to wash and rinse everything with the other hand.  The entire time I am so afraid she is going to squirm and bonk her head.  I think she should be washed in the kitchen sink but he doesn't want to agree to this.  We've only done this bath thing 3x so far (I do washcloth rinses on in-between days), though with this diaper rash we have been washing her diaper area every day now.  I put a table in my bathroom to be able to lay her on there to make sure everything is clean before putting the new diaper back on.  

The baby baths were really awkward for me too. What we ended up doing was putting some towels down on the kitchen floor, then putting the baby tub on top of them. There was a lot more room to maneuver on the floor instead of leaning over the adult tub too.

[shell24]

We've had 2 different docs/offices and they both weigh with the diaper off, and do the exam with the diaper on but do unfasten it to check.

[zeewifeandmama]

Jan 20, 2014 11:56:18 GMT -5 @mrswindycity said:

They weigh them with a dry diaper. The pedi does the exam with the diaper on, but does unfasten it to check out the diaper area for a minute.

Same here. This has been the way it has always been for both kids.

[Jalapeñomel]

My kid would pee all over the doc if she examined him naked. She does check his junk though.

[mandapanda18]

Jan 20, 2014 11:56:18 GMT -5 @mrswindycity said:

They weigh them with a dry diaper. The pedi does the exam with the diaper on, but does unfasten it to check out the diaper area for a minute.

This