Well-Child Visits: A Guide to Taking Your Baby to the Doctor
When you have a newborn, life can become a blur of feedings, diapers, and an elusive quest for rest. And then there are all the doctor’s appointments. While they might seem excessive, regular checkups, called well-child visits or well visits by doctors, are incredibly important, especially during a baby’s first year of life.
The American Academy of Pediatrics (AAP) recommends a schedule of well-child visits from birth until age 21, designed to help make sure your child is healthy and developing normally. The schedule calls for frequent well visits in a baby’s early months. During that first year, a parent is advised to bring their baby to the pediatrician the week after the birth (when they’re 3 to 5 days old) and then at ages 1, 2, 4, 6, 9, and 12 months.
The pace of appointments slows down a bit during the second year, with well visits recommended at 15, 18, and 24 months. Another appointment is recommended at 2 1/2 years of age, and then at age 3. After that, a healthy child needs only annual checkups, according to the recommendation.
What Is a Well-Child Visit Like?
Each appointment will be slightly different, but the ultimate goal remains the same: to look for and identify health issues and provide parents with the information and support they need to keep their child healthy and thriving.
“It’s very important that parents maintain well-child visits so they get the best and most up-to-date health advice and to make sure the body is growing and developing well,” says Daniel Ganjian, M.D., board certified pediatrician at Providence Saint John’s Health Center in Santa Monica, California.
“You don’t want your pediatrician to only see your child when they’re sick,” he says. Ganjian explains that checkups allow the doctor to track a child’s development over time and get a sense of how they’re doing when they’re healthy. Pediatricians use well visits in this way to be able to more easily notice changes or signs of something wrong.
Assessing Physical Health
Gina Posner, M.D., board-certified pediatrician at MemorialCare Orange Coast Medical Center in Fountain Valley, California, says that it’s helpful for pediatricians at the very first well-child visit if parents come prepared with information about the baby’s birth as well as about the pregnancy. For example, they’ll want to know whether the baby was born breech, or whether you had medical issues that could affect the baby’s health.
And bring your questions! Some people find that writing them down ahead of time helps them remember what they want to ask.
During the early well-child visits, doctors are checking out the baby from head to toe. One of the main things they’re measuring is the baby’s weight, length, and head size, which help indicate whether the infant is getting adequate nutrition and growing at an expected rate.
Posner says babies are expected to lose a small amount of weight between the time they leave the hospital and the first-week visit. However, it’s important that they’re gaining and growing.
Initial well visits will also include questions about how many diapers the baby is wetting and dirtying and whether there are any issues with feeding. Doctors also tend to check in with the parent who gave birth about their own well‑being and monitor them for postpartum depression.
A full physical is performed on the child at each well visit to check their general health, which can be vital, Posner says. Often, doctors can identify problems early this way, which means better odds of successful treatment.
Vaccines to Expect in the First 4 Months
Doctors say that vaccinations are among the most important things that happen at well-child visits. Major public health institutions, including the Centers for Disease Control and Prevention (CDC), the AAP, the American Academy of Family Physicians, and the World Health Organization, emphasize the importance of pediatric vaccines. While no one likes hearing their child cry from getting poked with a needle, vaccines help protect children from a host of diseases that can cause serious complications or even death.
“Keeping [babies] on track with vaccines is super important so we protect them against things we can actually protect them against, because there’s so much we can’t,” Posner says.
The exact schedule of vaccines may vary a bit depending on your pediatrician, but you can generally expect the following to happen during your first few well-child visits:
First week: If your baby hasn’t already received their first shot for hepatitis B at the hospital, then it will be administered at this appointment.
1 month: Some doctors may do a second dose of the hepatitis B vaccine at this well visit, while others will wait until your child is 2 months old to administer it.
2 months: Understand that your baby may receive several shots at this well visit, including the following vaccines:
- Hepatitis B (if the child hasn’t already received the second dose)
- Diphtheria, tetanus, acellular pertussis (DTaP)
- Haemophilus influenzae type B (Hib)
- Pneumococcal conjugate vaccine (PCV)
- Inactivated polio vaccine (IPV)
4 months: This well-child visit is typically a time of second doses. Your baby is likely to receive another dose of the same vaccines they received when they were 2 months old (see above).
For a comprehensive list of the vaccines your child may receive at each appointment from birth through 18 years of age, visit the CDC’s Recommended Child and Adolescent Immunization Schedule.
During well-child visits, pediatricians also look for indication that babies are hitting all the right developmental milestones. In the early months, the pediatrician will be making observations and asking questions about what your baby has been doing, such as offering social smiles, babbling, and turning their head to see who’s talking—all signs that development is going as expected.
“We know what developmental stages should be going on at certain times,” Posner says. “We can make sure that if something is falling off with a child, we can get them into services earlier rather than later.” Those individualized services can help babies establish important skills for their learning, social development, and/or physical development.
Curious what your baby should be doing, and when? The CDC publishes a full list of developmental milestones—the social/emotional, language/communication, cognitive, and physical/movement milestones that most children have reached by each age.
If your pediatrician finds your baby isn’t hitting milestones as expected, they should be able to provide recommendations and resources to help.
What Happens If You Miss a Well Visit?
Although well-child visits are vitally important, it’s not always easy to stay on track, and occasionally a parent will miss an appointment. Posner says that the pandemic, in particular, has caused some parents to fall behind. This is not ideal, she says, because it may hamper the pediatrician’s ability to monitor developmental stages. But it’s also understandable.
If you miss any well visits, be sure to get back on schedule as soon as you can. Your pediatrician can adjust the vaccine schedule to help your child catch up. It’s important, however, not to continue putting it off.
Sick Visits and Other Reasons to See the Doctor
Of course, there are times when your baby may need to see your pediatrician outside the recommended schedule of well visits. Call your baby’s pediatrician anytime you’re concerned about their health. They’ll help you figure out whether the problem requires a sick visit to the office, a trip to an urgent care center, or a visit to the emergency room.
Any baby younger than 4 weeks old who has a fever should be seen by a doctor immediately. A fever is a temperature over 100.4 degrees Fahrenheit if using a rectal thermometer, or over 99 degrees Fahrenheit if using an oral thermometer.
If your child doesn’t need urgent or emergency care, it’s still a good idea to take them to their pediatrician for a sick visit if they don’t seem to be feeling well or have symptoms that concern you. Many pediatricians can see their patients the same day or the following day.
Posner says that in general, she recommends that people bring their child to the doctor anytime they’re experiencing any of these symptoms:
- Trouble breathing
- Ear pain (or signs of it, such as tugging on the ear)
- Sore throat (or signs of it, like refusing to eat)
- Fever that has lasted four or five days and isn’t going down
- Prolonged fever with no accompanying symptoms (like a runny nose, sore throat, or cough)
And of course, you should always feel free to call your pediatrician any time you have a question about your child’s health or development or are wondering if a symptom or behavior is worth a sick visit. Even a subtle change or something that seems off is worth getting checked out, for example, when a baby stops doing an activity they were previously doing, like rolling over, or if they seem weak or get tired quickly.
“I always tell parents, ‘No question is a stupid question,’” Ganjian says. “You can always ask. [Parenting] is a learning process.”
If you have a baby and haven’t already scheduled their next well-child visit, get out your calendar and call the pediatrician’s office. And next time you’re there, it’s a good idea to make the following appointment with the receptionist so you don’t forget.
Making regular pediatric appointments is one of the most effective ways to keep your child on the healthiest path possible—and the bonus is that those well visits may help get you and your baby out of the house.
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