Visits to the pediatrician are important for a child’s overall health, and not just when a child is sick. Especially during baby’s first year, well visits are just as important when a child is healthy. Because babies grow and develop so quickly, checkups start immediately after birth and happen frequently throughout the first year.
But what exactly are baby checkups? When do they happen? What should you bring? Can you prepare for them? Is there anything you can do to make them easier? Pregnancy & Newborn asks the experts.
What to Expect
Well-child visits are appointments with a health care provider at specific ages throughout infancy and adolescence that help ensure children are growing and developing well. They are critical moments to “monitor physical and developmental milestones, review important safety prevention measures, and provide anticipatory guidance,” says Lisa Stern, MD, FAAP, a pediatrician practicing in Los Angeles and medical advisor for Perelel. She also adds that these visits “cement a partnership between the child’s doctor and family that will hopefully be a long-term relationship as your child grows and matures.”
The American Academy of Pediatrics (AAP) recommends infants receive preventive care in the office at 3 to–5 days of life, as well as by 1 month, 2 months, 4 months, 6 months, 9 months, and 12 months. According to the Centers for Disease Control and Prevention (CDC) recommendations, immunizations are given at 2 months, 4 months, 6 months, and 12 months. Additionally, “blood test screening for anemia and lead exposure may occur at 9 or 12 months,” notes Kimberly Montez, MD, MPH, assistant professor of pediatrics at Wake Forest School of Medicine and associate director of Integrating Special Populations for the Maya Angelou Center for Health Equity in Winston-Salem, North Carolina. She also explains that if your baby does not receive the Hepatitis B vaccine in the newborn nursery, the first dose will be given by the child’s doctor at the newborn or 1-month visit.
In addition to a full physical exam, the most common exams and screenings for infants are physical growth measurements charting length, height, weight, and head circumference, and screening tests for development, behavior, and psychosocial needs.
“Many pediatricians also conduct screening tests for maternal and paternal depression or other family needs,” says Neal Davis, MD, medical director of Pediatric Community-Based Care for Intermountain Healthcare in Murray, Utah. “These screenings allow parents and physicians to discuss interventions as early as possible to continue to promote the child’s development and family’s well-being.”
Because of this, parents should expect to answer a wide array of questions at each visit. “Parents can expect questions about nutrition, elimination, sleep, development, behavior, social questions about the household and family coping with a new baby, and any concerns the family may have about their child’s health care,” Dr. Montez explains. Additionally, before you leave, your provider may present you with written information, either as a handout or electronically, about the matters you discussed to help support your baby, Dr. Davis includes.
What to Bring
Preparing for a well visit is helpful to parents and the pediatrician. Similar to the hospital bag you most likely packed before your baby’s delivery, having a prepared bag will also help checkups go more smoothly. Dr. Stern suggests having a change of clothing, diapers, a blanket to keep your little one warm during their exam, and a bottle if your baby is on formula. “So many babies will pee or spit up on the outfits they are wearing during the process of weighing and measuring them,” she says.
Dr. Davis also suggests bringing your baby’s favorite toy, teether, or book, as doing so will help provide helpful distractions or comfort as needed.
She also advises parents to be prepared to feed their baby after any vaccines are administered. “Your baby may be slightly hungry during the examination part of the visit, but will calm down quickly after getting poked if they are offered the breast or a bottle,” she says.
During the 2-month visit, the first doses of the Rotavirus, Diphtheria, Tetanus and Acellular Pertussis, Haemophilus Influenzae Type B, Pneumococcal Conjugate, and Inactivated Poliovirus vaccines are administered. The second dose of Hepatitis B may also be administered if it was not given at the 1-month visit. Dr. Stern advises purchasing children’s acetaminophen at the store before the 2-month visit. “Some babies might have a fever or will be fussy during the first 24 hours after getting vaccines, and you can be prepared by having a fever-reducer on hand.” That said, until your child is 2 years old, be sure to consult a pediatrician about dosages before administrating the medication.
Prior to the Visit
Typically parents must complete paperwork about their child’s development and other health information. “These forms may be completed online or on paper by mail or in the office either before or during the office visit,” Dr. Montez explains. That said, although these forms may be completed at the pediatrician’s office, it may be best to fill them out at home prior to the visit when you have minimal distractions.
Dr. Davis also recommends creating a list of questions or concerns you have and then bringing it to the office visit. “The list can be kept on a notepad or a smartphone and include anything from feeding and sleep schedules to fussiness and diaper rash,” he says. And such a list should include questions about dosing, Dr. Stern urges, as many medications are weight-based and have a disclaimer that reads “under 2 years consult your doctor” on the label.
Safety and Schedule Tips
The pandemic has caused many clinics to impose various safety measures. Such precautions include social distancing, masking, sanitized waiting room furniture, and rapid rooming of newborns (bypassing the waiting room and bringing the baby directly into the exam room to avoid crowded areas that may expose the child to infection), Dr. Montez outlines. However, for added protection and minimal exposure to others, she suggests putting a weather-permitting blanket over the carrier, and scheduling the first available appointments in the early morning or right after lunch.
Because development assessments and physical examinations are a crucial part of well-child care, scheduling an appointment after a nap is also a great idea so that your child is likely to be awake and engaged during the visit. This will also help to “avoid crankiness from missing a nap or being awakened in the middle of a nap for the examination,” Dr. Montez says. If your newborn is struggling with feeding, particularly with chestfeeding, you may also want to consider scheduling an appointment with your child’s doctor around feeding time. This will ensure “the pediatrician and/or lactation consultants can assess the feeding,” she adds.
Although regularly seeing your baby’s pediatrician for care visits can be tiring, it’s important to remember that every checkup counts and is instrumental in keeping your baby healthy. Whether or not you’ve already been through a baby’s first year of checkups, staying informed about and preparing for them will help you make the most of them.