Regardless of whether this is your first or fourth child, you’re still going to have to look up the newborn checkup schedule when your baby arrives.
That’s totally not on you – baby checkups after birth SEEM kind of sporadic and random. I mean, couldn’t we just say weekly and then monthly and then yearly?
The truth is that there is a reason for the way your baby’s checkups are scheduled, and if I’m good for nothing else, at least (hopefully!) I can clear up some of that confusion for you!
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We all wonder at some point how often a newborn should to go to the doctor. The answer? As often as they need to!
Kidding – kind of.
Many newborns will get through their well child checkups without a hiccup (well, with maybe JUST the hiccups), so the question remains whether it was completely “necessary” to visit the doctor so often. But think about it, momma – you don’t know there’s a problem until ya know. You know?
That’s why it’s in both your best interests to avoid missing a well child visit – it’s easy for us to miss something important. Some things present very small symptoms and a big issue, while other apparent issues present BIG symptoms and a minuscule problem (if one at all).
A solid pound of green poop, for example. Perfectly normal. Unfortunately.
The truth is, sometimes the only way you can tell the difference between your baby’s normal cry and something more serious is by letting the doctor tell you that your baby is, in fact, fine. This doctor is, of course, not taking YOUR mental state into consideration at the blue-in-the-face, two-hours-of-nonstop-screaming-and-crying-for-no-reason stage.
With all of that said (and especially if this little rascal is your first) I want to make sure you know it WILL get easier to understand your baby’s needs based on their cry and other cues. Just not yet.
Because the timing of well checks can be confusing, I have listed the American Academy of Pediatric’s recommended newborn checkup schedule (although the scope of this post includes only those well checks that occur from birth to four months of age).
Since all babies are unique little snowflakes, your doctor may opt for a different newborn checkup schedule. That’s perfectly okay – they know what’s best for you and your baby.
- 3-5 days
- 2 weeks
- 1 month
- 2 months
- 4 months
- 6 months
- 9 months
- 12 months
- 15 months
- 18 months
- 24 months
What is checked at every baby appointment?
There are a few things that your doctor is going to do at every baby checkup. Listed below is a short description of what you can expect at every baby appointment.
Physical growth of your newborn
Your nurse will measure the kiddo from head to toe, weigh them, and check how big their head is. This is all documented throughout your baby’s first couple of years.
Remember, whether baby is in the 10th or 90th percentile isn’t that important as long as their trends continue at a normal pace. Your doctor is more concerned about consistent trends at every appointment. Despite this, you will still find yourself watching to make sure that little chubbers is still in the bajillionth percentile in awesomeness. I’m not going to tell you not to, because you won’t listen.
And honestly, there’s no harm in it. Just don’t freak out if one well check your baby is in the 20% percentile for something. You only get so accurate a result scribbling on a paper liner as a munchkin tries to worm their way out of your grasp. #lovenursing
It wouldn’t be a proper doctor visit without an equally proper physical exam.
This means they’ll be checking your baby’s eyes, ears, mouth, skin, hips, legs, abdomen, heart, lungs, and genitalia. Most clinics will check baby’s oxygenation levels using a pulse oximeter (a test to tell how much oxygen is in your baby’s blood). Don’t worry, bloodless and painless. If you’ve ever had that little clampy thing over the end of your finger, that’s your guy.
For the first little while, your doctor will be paying extra close attention to your baby’s head. Your baby will have a few soft spots that will need to be monitored so that you know they close up appropriately.
Babies are born with pretty soft skulls, and the shape of their head can be molded fairly easily. Plagiocephaly (flat head syndrome) occurs in around 20-25% of babies, so your doctor will be keeping a close eye on their head shape for a while. Usually changes don’t start taking place until around 2-4 months of age, so it’s definitely not something you need to worry about in your first couple of newborn appointments.
The physical examination differs a little depending on your baby’s age, so we’ll go over the different things that are checked for if and when they come up. If I don’t specifically call out a difference, you can assume this stock standard physical exam is all you’ll get on any given visit.
Baby development milestones
Your doctor or nurse will ask you a lot of questions related to your baby’s activities in order to gauge whether they’re hitting all of their newborn developmental milestones.
Unlike the growth markers, it’s SUPER important that you keep a close eye on your baby’s actions, as the smallest (and darndest) things can be pretty significant. Caveat: I KNOW how tired you are, momma; don’t stress if you don’t remember something.
The CDC has specific milestone guidelines they want to see your baby meeting, which you can find here. For your benefit, we’ll briefly go over the milestones they’ll be asking about at each visit so that you can better prepare yourself for what to watch for.
If someone had told me to keep an eye on how many syllables were in each babble, I might not have looked quite so dumb a couple of choice times in my life.
Newborn checks after birth
While your baby is still in the hospital, they’ll have what’s technically their “first” newborn checkup. If you want to get that technical, they will also have their second, third, and probably fourth checkup, since the doc will literally check them at least three times throughout your stay.
Below we’ll discuss some of the checks and newborn screen tests that are done at this time. Keep in mind that some of these take place in the back and are not performed with you present unless you specifically ask for them.
Necessary to ask to be present? Not so much. We’ll let you know if there’s something to know. I promise.
Your doctor will perform one of two hearing tests, as we’re sometimes able to see whether your baby has a hearing problem from birth. Your baby will probably go through one or both of these tests, depending on the hospital. Keep in mind – both are quality tests, and both are painless for your little one.
Otoacoustic Emissions Test (OAE)
In this test, a tiny microphone and earphone are placed in your baby’s ear. Sounds are played from the earphone. Whether or not sounds coming from the speaker echo through the microphone can indicate hearing loss in your little one.
Auditory Brain Stem Response (ABR)
This test uses a set of earphones, which deliver sounds directly into the infant’s ears. Electrodes are placed on the baby’s head to detect neural stimulation along the auditory brain stem, which lights up when sound information is being passed from the ear to the brain. As you can probably guess, no sparks (or rather, inconsistent sparks) means there is a good chance the ear is not passing information correctly if at all.
It’s important to keep in mind that both of these tests are tacked with a big huge “may” anywhere a doctor can fit a thumbtack. There is always a margin for error, so be sure you don’t take it too hard up front if your baby is coming back with weird results. These things will require verification and further testing before you’ll know for sure that your little one will need special care in this department.
There is a myriad of newborn screening tests done with new babies. If you’re interested, you can see the disorders currently recommended for screening here. The tests are quite simple – your baby’s heel will be pricked to collect a small sample of blood.
You or your partner can hold baby while this happens. The drops of blood are put onto a kind of filter paper, then sent to a lab for testing. The testing is typically done for around 30 of the disorders listed by the Health Resources & Service Administration (you can check with your local health department regarding testing done in your state).
Regardless, sad as it is to have your baby go through the blood draw, this testing can save your baby’s life if they do come back positive with one of the disorders that are tested for. A few seconds of screaming from a poor little creature who won’t remember this moment, versus a lifetime of wishing you’d caught something earlier? It’s worth it.
Newborn first doctor appointment
The first doctor visit after your baby is released usually happens between 3-5 days after birth, and these first appointments are crucial for making sure your baby is thriving.
Your doctor will check all of the typical things like weight, height, and head circumference. Your doctor is going to do a few extra things that you aren’t going to see them do at your other appointments.
- Umbilical cord stump: Your doctor will check the tissue remaining from the severing of the umbilical cord to make sure it’s healing normally, but don’t worry – we definitely don’t expect for the umbilical cord to have fallen off by now. Usually the umbilical cord falls off within 10 to 14 days, but it can take up to three weeks.
- Jaundice: Jaundice is a SUPER normal (and usually temporary) condition that we see with some newborns. This is where the skin and the whites of the eyes take on a yellowish tint. Jaundice happens when there is excess bilirubin (which comes from the liver) in the bloodstream. This excess is caused by your baby’s body not getting rid of old red blood cells properly. Don’t worry – it’s usually a pretty easy fix when your doctor identifies it.
- Circumcision: If you had your baby circumcised, the doctor will check on the incision and see how well it’s healing. Your baby still has at least another week before their penis will be completely healed, but we definitely want to make sure it’s on the right track.
No routine injections will be given at this first visit. The exception to this is if your baby did not receive the HepB (Hepatitis-B) vaccine at birth (which MOST babies do), it’ll be recommended to do it now.
One week milestones
Now that your baby is here, you’re going to see drastic changes week to week (sometimes day to day!) The following are some of the milestones that your provider will check for at this very first newborn well check. Keep in mind – ALL babies are going to be a little different and can meet these milestones at different times. Just talk with your doctor if you’re concerned about how your baby is progressing.
During this time, some babies can
- Turn their head toward your voice, or toward other noises
- Demonstrate the Moro reflex, which is when they startle suddenly and throw out their arms and legs (which is kind of alarming the first time you see it)
- Cries when they have a need (hungry, wet, etc), and stops crying when that need is met
- Demonstrate the rooting reflex, which is when they turn toward a bottle or breast and start sucking
- Show the grasp reflex, which is when they can hold onto your finger when it’s placed in their hand (they can have a pretty strong death grip with this!)
Newborn First Appointment Tips
- Make sure you take any paperwork you received at the hospital with you, especially if you saw a different pediatrician while you were there.
- Don’t worry if your baby has lost weight since birth. Most babies will lose weight after birth (and breastfed babies most of all), but they should gain it all back by two weeks of age.
- Start writing down questions you have BEFORE your appointment. #mombrain is a thing and this is especially true right now because you’re pretty sleep deprived and still recovering from childbirth.
- The biggest indicator that your baby is getting enough milk is if they’re gaining weight and have the right amount of soiled diapers throughout the day (so keep track!) While your baby is going to initially lose weight, they shouldn’t lose more than 10% of their birth weight. By the way – if you’re struggling with breastfeeding (I KNOW it’s hard), consider checking out Stacey’s awesome breastfeeding course. Having a good education surrounding breastfeeding is one of the best things you can do to maximize your chance of success – so consider it!
- If you’re exclusively breastfeeding – make sure and let your doctor know. They may want to start you on a Vitamin D supplement, as most breastfed babies do not get enough Vitamin D, and supplements can help prevent rickets.
Newborn two week checkup
The main purpose of this newborn check up is to make sure baby is growing and gaining weight properly.
Remember, your newborn should be back to their birth weight by the two week mark, so this weight measurement can be pretty telling regarding how your baby is doing and how well they are eating.
This exam is fairly uneventful, and won’t include anything different from your last appointment. Your baby’s umbilical stump may have fallen off at this point, so this is something your doctor will check.
There are no immunizations that’ll be given to your baby at this appointment.
Two week milestones
The milestones at this age are fairly similar to the ones we looked at for the first newborn appointment. Some things you may be seeing from your two week old baby include the following:
- Crying when uncomfortable
- Very briefly lifting their head up
- Being able to look at your face from a distance
- Toe curling. Stroke the inside sole of your newborn’s foot and see them curl their toes. Stroke the outside of his sole and you’ll see them splay their toes
Two week baby appointment tips
- We hope that your little one is back at their birth weight by this appointment. If they aren’t there yet that CAN be okay, but your doctor will want to keep a close eye on it.
- Log your baby’s eating and sleeping habits if possible. If a problem does arise, this is a great way for you to have a big picture of your baby’s habits. Trust me – as a sleep-deprived new momma, this ISN’T something you’ll be able to remember unless you write it down.
- Colic is ROUGH – and if your baby is one of the unlucky, they can start getting colicky at any time now. Colic is defined as your baby crying for at least three hours a day, three days a week. If you suspect your baby may be suffering from this, try and clock the time they are crying. It often FEELS like they are crying longer than they actually are. Because doctors don’t know for sure what causes colic, there isn’t a specific remedy. If you suspect your baby is suffering from colic, talk with your doctor because they may have some ideas of things you can try.
One month baby check up
Your baby’s one month checkup may be a little more exciting than the previous two. You’ve probably seen more growth and change with your baby, so there are even more milestones that your doctor will be asking about.
The physical examination will be similar to the last two – checking your baby’s growth and tracking results on their growth chart. In addition to this, your baby’s belly button should be fully healed at this point so your doctor will confirm this.
Your baby may or may not receive their second dose of the HepB vaccine. If not this time around, your baby will receive it at their second month appointment. Other than this, nothing else will be given.
One month milestones
At this age, your baby should:
- Be able to move arms and legs equally
- Lift their head for brief periods of time (this will continually improve)
- Begin to extend their legs instead of keeping them constantly in a curled position
- Reacting to noises with body language, responding with things like startling or becoming quiet
- Focus on and follow objects and faces – the distance at which they can do this will become greater
- Grasp, root, and demonstrate Moro reflex in full force (although I promise they’ll grow out of this within a few months)
One month appointment tips
- Make sure you’re still writing out any questions that come up so you can ask your doctor when you go in for your appointment. These things will come up and you will forget otherwise.
- Continue writing down your baby’s eating/sleeping/diaper habits. This includes keeping track of what their stool looks like (exciting, I know!)
- Make sure you’re giving your baby tummy time at home. Yes, many babies hate it – but it’s still considered developmentally helpful for them, so it’s worth doing.
- Ask your doctor about the results for the newborn screening tests. The timing in which they can get results back varies among doctor offices, but it doesn’t hurt to check in with your doctor and see if they’re available yet.
Two month baby check up
The two month check up is a tough one. Your baby is going to be getting their first serious round of shots, so prepare yourself for some tears. Luckily, your little one’s eating and sleeping schedules may be normalizing, and SOME lucky momma’s have a baby who sleeps through the night at this point!
This physical examination will include checking all the same things (eyes, ears, heart, lungs, etc.) as well as make sure your baby is still growing consistently on their growth chart.
This is the first BIG vaccine appointment for your baby. Talk with your doctor in advance if you’re interested in trying to give baby something like Tylenol. Some practitioners prefer that nothing is given so that they can keep an eye out for possible reactions without the potential that an over-the-counter might be contributing to or suppressing that reaction.
Be aware that Ibuprofen is NOT SAFE AT ALL for infants under six months of age. I’m gonna say that again. Ibuprofen is NOT SAFE AT ALL for infants under six months.
Just wanted to make sure that was clear. Anyway.
The following vaccinations will likely be given to your little one:
- HepB: the second dose is given at either one or two months, so if your baby hasn’t received their second dose they’ll get it now.
- DTaP vaccine (diphtheria, tetanus, acellular pertussis): Over the next six years, your baby will get a total of five doses. You can expect this shot again at four and six months. It’s also done at 15-18 months and 4-6 years of age.
- Hib vaccine (Haemophilus influenzae type b): This nasty little bugger was once the leading cause of meningitis in kids under five, as well as a common cause of pretty serious infection of the ears, skin, blood, lungs, and joints of kids. Your baby will receive another two doses by the time they’re six months old, and one final dose at 12-15 months of age.
- IPV vaccine (polio): You baby will get this vaccine at 2, 4, between 6-18 months, and between 4-6 years of age. Polio used to be a pretty serious epidemic and was incredibly contagious. It’s pretty rare in the U.S. now, but every once in a while we still hear about cases of it.
- PCV vaccine (pneumococcal): As you may have guessed, this vaccine helps protect your baby from certain bacterial infections that can cause things like pneumonia and bacterial meningitis. This is another vaccine that your little one will get at 2, 4, 6, and 12-15 months.
- RV vaccine (rotavirus): This vaccine is given orally so your little one avoids a poke with this one. Hurray! It’s typically recommended at 2, 4, and sometimes 6 months (depending on the manufacturer). Rotavirus can cause some pretty nasty vomiting and diarrhea, which can lead to hospitalization for some kids. Daycare environments are a common culprit of this virus.
2 month milestones
- Smiling (which starts as early as six weeks!)
- Briefly self-soothing by bringing thumb to mouth
- Coos and gurgles
- Follows things more steadily with eyes
- Recognizes people from further distances
- May appear bored when under-stimulated
- Can hold head up for increased periods of time
- Pushes up when lying on stomach
- Smoother movements with arms and legs
Two month appointment tips
- If you’re noting that stool is hard or pellet like, make sure you mention it. This could indicate constipation, dehydration, or both.
- This is the period where many babies get over the colicky phase (yay!) Make sure and pay attention to your baby’s mood and mention any changes to your doctor.
- Some babies can start rolling at this point, although this more commonly happens around four months of age. Keep a close eye on this, and let your doctor know if your baby has started rolling.
- Just as an FYI – there is no three month baby checkup. Most newborn checkup schedules recommend your next visit to be at four months.
Four month baby checkup
Provided you haven’t had to drop in unexpectedly, it’s now been two months since you last saw your pediatrician. A LOT has probably changed for your little one. Be aware that the American Academy of Pediatrics recommends screening for postpartum depression at this time. Make a point of talking with your doctor about the moods you’ve been experiencing, even or especially if you find it uncomfortable to discuss.
Here’re some of the things you can expect at the four month baby checkup.
Your baby will receive all of the same vaccines that they received at the two month appointment, with the exception of HepB. This lovely little poke won’t repeat for at least another two months.
To recap, this round of vaccines will include:
- Hib vaccine
- IPV vaccine
- PCV vaccine
- RV vaccine
Four month baby milestones
- Beginning to mimic facial expressions and actions
- Holds head steady without any support from the tummy or when held
- May be able to roll (most babies roll during this time, but it’s not a big deal if yours isn’t!)
- Will not only focus on and even reach for toys, but will shake them in a Jurassic Park sort of way
- May begin to copy a few sounds – interestingly, they actually call these rambling sounds “canonical babble”, which are an alteration of vowels and consonants
- Pushes or even kicks off when feet touch a hard surface
- Randomly busts out that epic and ridiculously infectious (though possibly still spontaneous or, ah… gastric…) smile
Tips for the four month baby appointment
- Four months is the age that you may receive a green light for starting baby food. The AAP states that your baby is ready to be introduced to baby food if they meet a few qualifications (such as being able to hold their head up, sit upright in a highchair, and close their mouth around a spoon). This isn’t necessary, but there’s a potential that it may prime your baby for both preference and allergies. If you want to jump on this wagon as early as possible, definitely check with your pediatrician.
- Some babies experience a sleep regression at this age. My advice? Hang in there, momma – it’ll pass. In the meantime, talk with your doctor about what ideas they have to help you both get through this faster. I’d love to give you more than that. The truth is that regression is really sometimes just about baby and only something that will be fixed with time. Stick to your sleepy time routine and you’ll come through it generally intact.
I do hope you found this guide helpful in giving you some clarity regarding the newborn checkup schedule your pediatrician will (probably) employ. Having a newborn can definitely be an overwhelming time, so make sure you have the support of a pediatrician who is knowledgeable and who takes an active interest in your specific needs. You deserve the best, and so does that little bundle!
Leave me a comment below and tell me what you think! Do you feel more prepared because of this newborn checkup schedule? How has your experience been?