A significant part of your baby’s visits to the pediatrician will occur during their first year of life. In fact, your baby’s first pediatric checkup takes place seconds after birth. During a baby’s first year of life, for a child that is not showing any health problems and is growing and developing adequately, the American Academy of Pediatrics recommends well-child care visits at the first week (3-5 days old), one month, two months, four months, six months, nine months and twelve months (first year). Your pediatrician may want to see your baby more often, especially if they present any developmental, psychosocial, or chronic condition. While most parents know they should take their children to the pediatrician when they are sick, well-child visits are essential for healthy children.
Ideally, both parents (or any other regular caregiver) should attend the initial visits. It is the best moment to get to know each other and have a round of questions and answers. You should not limit your discussion to medical-related topics. Your pediatrician is also well-informed about other child-related issues such as childcare, parental support groups, or any other kind of assistance you may need.
If only one parent or caregiver can attend the pediatrician visit, it is a good idea to ask a friend or a relative to join you. During the early days, it might be troublesome for just one person to pay attention and take notes of all the valuable information the pediatrician is offering while also being in charge of undressing and dressing the baby during the medical exam, carrying the baby’s diaper bag and gathering all their things. Until you get used to these trips, some extra help for simple things such as taking the diaper bag and holding the door for you might be extremely useful.
During well-child care visits, the pediatrician will make sure your baby is growing and developing satisfactorily. They w犀利士
ill make sure there are no abnormalities. They will guide you and follow up your baby through any supplemental examinations in case of any suspicions. Specifically, the pediatrician will check the following areas.
- Growth: The pediatrician will ask you to undress your baby to be weighed and measured. These measurements will be plotted in a graph to determine the adequacy of your baby’s growth patterns, also taking into account their age. These measurements should be plotted at each visit, and these points will help determine your baby’s growth curve. This is the best way to determine if your baby is growing normally. It will also tell your baby’s position with the average of other children their age.
- Head: For the first few months, the soft spots on your baby’s head (anatomically known as fontanelles) will be open and flat. By your baby’s second to third month, the spot in the back should be closed. The one in the front takes longer to close, around 18 months to 2 years.
- Ears: During your baby’s first days, at the newborn nursery or at the first week’s visit (3-5 days), the doctor will perform advanced hearing tests. If any issue is suspected or confirmed, your pediatrician will complete additional sensory evaluations to evaluate your child’s hearing as they grow. If the tests performed soon after birth came back normal, your doctor will only use an otoscope (ear examination tool) to look inside both ear canals and eardrums during the well-child visits. They will reassure there is no fluid accumulation or infection. They will also ask you if your baby typically responds to sound stimulation.
- Eyes: The pediatrician will catch your baby’s attention and track how their eyes move in response. Using an ophthalmoscope (the medical term for a lighted eye examination tool), the pediatrician will conduct an internal evaluation of the eye. This is routinely done in the newborn nursery as well, soon after your baby is born.
- Mouth: The mouth is first examined to check for infection. As your baby grows, the doctor will also track the teething development. Another important condition pediatricians will look for is cleft palate, in which the bones and tissue in the roof of the mouth do not close completely during the unborn baby’s development.
- Heart and Lungs: Using a stethoscope, the doctor will listen to the front and back of your baby’s chest for their heart and lung sounds. They will look for heart rhythm, sounds, and breathing patterns. This examination determines whether there are any heart abnormalities or breathing difficulties.
- Abdomen: During the abdominal examination, the doctor will place their hand on your baby’s stomach and gently press. This helps them determine if there are any enlarged organs, abnormal masses, or tenderness.
- Genitalia: At each visit, the doctor will examine the baby’s genitals in search of any tenderness, signs of infection, or any unusual lumps. In the case a male baby has been circumcised, the doctor will pay special attention to the penis healing process in the first visits. In boys, doctors also assess if both testes are down in the scrotum.
- Hips and Legs: The pediatrician will move your baby’s legs using a special technique to determine hip joints issues, such as dislocation. Early detection of these issues is critical, as they allow for prompt referral and correction. Once your child starts walking, the pediatrician will watch them take a few steps to confirm if their legs and feet are adequately aligned and move normally.
- Developmental Milestones: During the well-child visits, your doctor will ask you about your baby’s movements: have they rolled over, sat up, or walked? They will also ask you how they use their arms and legs and if they make certain gestures, such as smiling. These questions are prompted to determine their development. The pediatrician will also physically examine your baby’s reflexes and general muscle tone.
Another critical aspect of these visits is immunizations. In fact, your baby will receive most of their child immunizations between birth and their second year! Many major diseases are vaccine-preventable. These include chickenpox, diphtheria, Haemophilus influenzae type B infections (causes lung and brain infections), hepatitis A and B, influenza (flu), measles, mumps, pertussis (whooping cough), polio, pneumococcus infection (causes lung infections), rubella, and tetanus. Also, once your baby is six months of age, they will receive an annual flu vaccine.
We have covered the basics of well-child visits until the first year of age. However, your child and future adolescent should visit the pediatrician periodically. These subsequent visits should be at 15 months, 18 months, 24 months (2 years), 30 months (2 years and a half), and then yearly from 3 years until 21 years of age. Remember that your child is a unique individual, and the questions that are specific to them will be best addressed by their pediatrician.
Estefanía Henríquez Luthje, MD