Observe the abdomen for any masses. An umbilical hernia is common in this age group, especially in darker skinned children. Large peristaltic waves moving from the left to the right in the upper abdomen are occasionally present in infants with pyloric stenosis. These are especially easy to note during or after a feeding.
Inspect the umbilicus. In healthy children, the umbilical cord stump falls off before the end of the second week after birth. Persistence of the stump past this period suggests the presence of white cell adhesion defect or a patent urachus. After the umbilical cord stump has fallen off, the examiner must check for an umbilical granuloma, which if present should be cauterized with silver nitrate.
Auscultate, percuss, and palpate the abdomen, using light and deep palpation. Are any masses present?
Palpate for the liver, spleen, and kidneys. The estimated liver span of a 6-month-old infant varies from 1 to 1.2 inches (2.5 to 3 cm). At 1 year of age, the span is approximately 1.2 inches (3 cm).
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