What to Expect at Well-Baby Visits
By Susan K Gower

Your baby is growing and changing right before your eyes. Even if she seems healthy and happy, frequent check-ups allow the doctor to monitor her progress and answer your questions.

The American Academy of Pediatrics recommends the newborn infant see a physician for a check-up at birth, two weeks, two months, four months, six months, nine months, 12 months, 15 months, 18 months and 24 months, and annually thereafter. Most doctors follow some version of this schedule for well-baby visits.

When you and your baby come in for your visit, you will be asked questions about your baby’s general health and development. The physical examination will include measurements of length and height, weight and head circumference (the distance around the head), vital developmental milestones and a general physical examination. The measurements will be plotted on a growth chart. Try not to get obsessed with the percentages. What the doctor is generally looking for is steady growth.

Be sure to mention any concerns you might have, but the doctor will generally want to examine the baby’s head, ears, eyes, mouth, skin, heart and lungs, abdomen, hips and legs and genitalia.

Your doctor or her assistant will ask questions about the baby’s activities to help determine whether the baby’s development is on track. The staff at the Mayo Clinic suggest that, depending on the baby’s age, parents be prepared to answer questions such as:

• How well does your baby control his or her head?
• Does your baby imitate your facial expressions and sounds?
• Does your baby put objects into his or her mouth?
• Does your baby attempt to roll over?
• Can your baby sit with support?
• Does your baby pull up into a standing position?
• Does your baby use individual fingers to pick up small objects?

The doctor or nurse practitioner will ask how everything is going. What is your baby’s schedule on an average day? How often does he eat? How much per feeding? Are you having any problems with breastfeeding? How many hours does he sleep during the day? How do the nights go? How many wet diapers per day? What are his bowel movements like? (Yes, you really need to pay attention to this.)

Your medical care provider will also want to discuss safety issues, such as sleep positions, car seats and home safety. Depending on the age of your baby, you may discuss when and how to introduce solid foods.

Try not to guess what the doctor is thinking by the questions he or she asks, or the expression on his face. If something is worrying you, ask. And keep asking until you get a clear answer. If you are having problems of your own dealing with the needs of your little one, or are feeling depressed, mention that to the doctor as well.

Practical tips for doctor visits:

If possible, schedule the appointment at a good time of day for your baby.

Bring a list of questions. It is easy to get distracted and forget what you wanted to ask.

Skip the adorable outfit with all the tiny buttons. Dress baby in an outfit that is easy to take on and off.

Bring a blanket – once the baby is undressed, he or she can get chilly.

Bring a bottle, snack or a favorite toy or book in case of a wait.

Call the doctor if…

No matter how careful or protective you are, sometimes your baby may get sick. Here are a few signs to watch out for:

Fever: The presence of a fever in a baby is a signal that he is sick and you should call the doctor’s office for further advice.

Difficulty Breathing: If baby has a stuffy nose, time to learn how to use the bulb syringe (clearing the nasal passages just makes feeding easier.) But if your baby is having real difficulty breathing – watch for flared nostrils, or if the skin around her ribs sucks in with each breath, or she appears to be turning blue – call 911 or head for the emergency room immediately.

Dehydration - contact the doctor if your baby doesn’t wet a diaper for six hours or longer or if the soft spot on the top of your baby’s head seems to sink, or the baby is crying without tears.

Abnormal bowel movements: The key here is to be very familiar with the type and pattern of your baby’s bowel movements and call the doctor to discuss any changes which might indicate diarrhea or constipation.

Changes in appetite

Changes in skin color

Tender navel or penis

Vomiting

Upper respiratory infections

Ear Pain

Rash

Eye discharge

Minor injuries - if you are unsure how to treat a minor injury, call the doctor.

Changes in your baby’s temperament or unusual or extreme crying could indicate illness. When in doubt, call.

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