Well-Baby Care

During your baby's first three years of life, she will see her doctor a number of times. These visits are important to check that she is growing and developing appropriately. Her doctor will ask you a number of questions about how the baby is doing, and he will examine your baby, checking for normal growth and looking for problems.

Routine and regular checkups are particularly important for your baby during her first three years of life. Problems found at this age, if not treated early, may have serious implications for her later in life.

It used to be that your baby's doctor would see her for the first time within 24 hours of her birth. For some babies, this may still be the case. But with changes in insurance and hospitalization coverage, most new babies leave the hospital with their mother 24 to 48 hours after the birth.

So the first time the doctor sees the baby is now commonly at her first visit to the doctor's office. Most doctors like to see the new baby when she's one to two weeks old.

Whenever your baby and her doctor first meet, the doctor will perform a complete physical examination of the baby and talk to you about your pregnancy, labor, and delivery. If you smoked, took any drugs (prescribed or recreational), or drank any alcohol, you need to tell this to the doctor. These factors may affect your baby's health and growth.

When you visit the doctor's office, the doctor's staff will probably ask you some questions before you see the doctor. Here are just a few samples: How is the baby feeding? Is she sleeping well? Does she seem to have any problems with her bowels? Does she have any skin problems? They will also measure your baby's growth, including her weight, length, and head circumference (the distance around her head). The doctor goes over all this information and may ask more questions.

Next comes the examination of your baby. With your baby completely undressed, the doctor will examine your baby's heart, lungs, abdomen, arms and legs, eyes, ears, nose, throat, and everything in between. Essentially, the doctor will examine your baby from head to toe -- though not necessarily in that order.

Rarely are there any surprises found at this visit, although occasionally a congenital abnormality (a birth defect) is found that was not apparent when the baby was in the hospital. At this age, no immunizations are given.

During her first month, the baby changes a lot. You will have many questions and concerns about your new baby, and this visit gives you the opportunity to ask them. Write down your questions ahead of time so you don't forget anything. Never be afraid or ashamed to ask a question; the doctor should take time to address all your concerns. Your doctor can also give you advice on taking care of your new baby, such as feeding and sleeping instructions and safety tips.

Regular Office Visits

Doctors like to see infants at regular intervals to monitor their growth, development, and health. Regular visits are important because they improve the chance of finding any health problem early so appropriate treatment can begin immediately. Although your doctor may have a slightly different schedule of visits, most infants are seen when they are 2, 4, 6, 9, 12, 15, 18, and 24 months old, and then once a year until they are of school age.

In addition to the doctor physically examining your baby, a nurse or the doctor will measure the baby's weight, head circumference, and body length. These measurements are important for monitoring your baby's growth. Each is plotted on a growth chart. These charts are the best way to determine if your baby is growing well. If your baby's rate of growth is abnormal, follow-up is necessary.

The doctor will also ask you questions about your baby's behavior and development. The doctor looks for certain developmental milestones -- features babies usually demonstrate at certain ages. It's important to understand these milestones are only guidelines, but if a baby consistently fails to reach them by certain ages, further investigation is necessary.

After the Second Year

As your baby grows, he does not need to visit the doctor routinely as often as when he was an infant. Yearly visits are for the same reasons as the earlier ones -- to make sure your child is growing and developing as he should and to provide you with an opportunity to ask questions. New topics become important, although you may need to discuss many of the old ones, such as behavior and eating, again.

The Well-Baby Examination

Your doctor's well-baby examination consists of many different parts, each designed to discern certain information. You may have to watch closely to see the doctor perform each part of the exam because the doctor has probably developed tricks and techniques for making the exam as comfortable for your baby as possible.

While the doctor may just seem to be simply talking to your infant, he or she is carefully checking the baby's skin or eyes. Some doctors like to have the baby on the examination table; others prefer that a parent hold the baby. If you prefer to hold your baby during the examination, most doctors will respect your choice; however, the doctor may require your baby to be on the table during some portions of the exam.

Here are some of the major areas your doctor considers and what he or she looks for:

General Appearance: cleanliness, problems associated with poor nutrition, alertness


Skin: good color, rashes, bruises, swelling, condition of hair and nails


Head: shape, softness of the anterior fontanel (soft spot)


Eyes: "lazy eye," good movement, light reflexes, vision (when child is old enough to understand)


Ears: irritation or infection of the ear canals or middle ear


Nose: congestion, discharge


Mouth: condition of gums, tongue, throat, tonsils


Neck: swelling of the thyroid or lymph nodes, mobility


Heart: rate and rhythm, murmurs


Lungs: breathing rate and pattern, abnormal noises, air exchange, movement of the chest wall


Abdomen: bowel sounds (normal stomach gurglings), enlarged organs or tenderness


Genitals: in girls -- normal appearance of external genitals, redness; in boys -- normal appearance of penis (if circumcised, check that it has healed well; if not, check that foreskin is normal), both testicles in scrotum


Arms and Legs: normal movement and color, any swelling and discoloration


Hips: in infants-normal placement in sockets


Pulses: equal femoral pulses-located in the groin region above each leg


Muscles: muscle movement and coordination, tone, strength


Doctor visits will be a commonplace, and sometimes scary, thing as your child gets older. But regular medical care will ensure that your child is always healthy and happy.