Well Visit Schedule
Regular check-ups with a child’s pediatrician, also called “well visits,” are essential to a healthy childhood. The American Academy of Pediatrics recommends eight visits within the first year. Here is a breakdown of what parents can expect at each visit.
Newborn Visit:
The first post-birth visit to a child’s pediatrician is important because, for some parents, it can be the first time they have met their child’s physician or have seen the pediatrician’s office. (read more)
Two Week Well Visit:
The two-week visit is typically scheduled if any issues arose at the initial newborn visit. The focus of this visit is simple: Did the baby gain weight? Measurements will be taken and evaluated by the pediatrician. This visit also gives the parents an opportunity to ask questions.
Around this time, babies are typically feeding (via breast or bottle) every two to three hours. The pediatrician will visit with the parents about feeding and how it’s going for the baby. Typically by this point, babies have six to 12 soiled diapers a day.
There are no vaccines given at this visit.
One Month Well Visit:
The baby’s visit to the pediatrician at one month old will include a head-to-toe physical exam, with measurements being plotted on the growth chart and provided to parents. The pediatrician will again offer guidance on feeding, as most babies experience a growth spurt around this time. Breastfed babies are eating less with each feeding session, but are typically eating more frequently, while bottle fed babies are typically eating four to six ounces every two to three hours.
This visit may include one vaccine – a second dose of the Hepatitis B shot, depending on when the first dose was given. The pediatrician will be sure to note certain safety measures to the parents, including car seat and sleep safety.
By this visit, babies are more awake and alert than the previous two visits, and parents may notice the baby’s eyes cross occasionally. This is normal and nothing to be concerned about.
Two Month Well Visit:
The two month visit is a big one, as this visit is when the baby receives the next round of vaccinations.
There are two vaccines typically given at this visit – two shots and an oral vaccine. The first shot is DTap-IPV-Hib, a combination of diptheria, tetanus, pertussis, Haemophilus type B and polio. In the past, these shots were all given separately, but research found that combining the vaccines was not only more effective, but also had fewer side effects.
The second shot is Prevnar, which fights strep penumoniae bacteria that causes bacterial meningitis, pneumonia and blood infections. The oral vaccine prevents rotavirus, a vomiting and diahhrea illness. If a baby is going to have a reaction to a vaccine, this is the most likely visit for that reaction to occur.
Between 24 to 36 hours after vaccines, babies often experience fussiness and may be more tired and less hungry than usual, which is normal. Babies can receive a small dose of tylenol if they experience a slight fever.
A head-to-toe examination is also done at this visit, with measurements being taken. Babies around four months old are typically breastfeeding every three to four hours or, if bottlefeeding, eating four to eight ounces every three to four hours. By this point, babies are typically tracking movement with their eyes, wiggling more, smiling and looking around.
Four Month Well Visit:
The four month well visit is a fun one, because babies are typically smiling and laughing by this point, and the parents are adjusting to sleeping a little more. Feeding is a big topic at this visit, because many parents want to know when they can start feeding their baby solid foods.
The recommendation from the American Academy of Pediatrics is to hold on starting solids until the baby is six months old, particularly if the baby has eczema or any history of wheezing, or if any first degree relative (sibling or parent) of the baby has food allergies.
There are two signs a baby might be ready for food – they are able to hold their head up on their own, and they show an interest in food, by reaching for things or watching parents intently as they eat.
At this age, babies are typically rolling over, and many babies may begin teething, with half of all babies having at least one tooth by the six month visit. During this visit, babies will also receive the second dose of the vaccines they received at the two month visit.
Six Month Well Visit:
The main topic of the six month well visit is feeding, and, at six months old, babies are ready to begin trying solid foods, with the main source of their nutrition still being breast milk or formula.
Pediatricians recommend starting with rice cereal, then, once baby adapts to being fed with a spoon, moving to green vegetables, then orange and yellow vegetables, then finishing with fruit. Dr. James recommends trying each food by itself for three days to ensure the baby does not have an allergic reaction. The amount of food eaten varies, but by nine months old, babies should be eating solid foods three meals a day. At this stage, parents are encouraged to feed babies as much as they want.
Around this time, babies can also drink between four to six ounces of water or juice, as they learn to drink out of a sippy cup. Developmentally, babies should be sitting up (with support), rolling over and making lots of sounds. It is important to baby-proof as babies begin moving around at this age.
Babies will again receive a physical exam at this visit, as well as another round of vaccinations.
Nine Month Well Visit:
There are typically many new skills and development to show the pediatrician at the nine month well visit. By this point, most babies are crawling and some may even be walking. Babies are usually adjusting well to eating, and, by this point, should be eating three meals a day, and continuing to drink breast milk or formula.
There are no vaccines given at this appointment, but measurements will be taken and noted on the baby’s growth chart. This visit is typically more relaxed, giving the parents one-on-one time to visit with the pediatrician about the baby’s development.
The doctor will visit with parents about safety, particularly around crawling/walking and choking. Babies will start learning how to grasp things with their fingers, which means they can grab even smaller things, so it is important for parents to watch children closely to prevent choking.
One Year Well Visit:
At the one year well visit, the pediatrician will focus on development, asking the parents how the baby is moving around and what new skills they have learned. All babies should be crawling by this visit, with many children already walking.
The baby’s fine motor skills are becoming more and more developed, which helps with eating. All food restrictions are removed at this visit, so parents can feed their child honey, nuts or shellfish, as long as the child is closely monitored while eating. Babies should be transitioned from formula to whole milk by this age, and they should be drinking out of a sippy cup. Breastfed babies can also transition to whole milk, depending on the preference of the mother.
There are a few shots given at this visit, including the final dose of Prevnar (also given at two, four and six months), a Hepatitis A vaccine that prevents food poisoning, and the Chicken Pox vaccine, which is typically the first live vaccine a child receives. Depending on where the child lives, a finger poke blood test may be conducted to test for lead or anemia.
In regards to vocabulary, one-year-olds should be saying at least two to three words – mama, dada, hi, bye, and no are the most common words said at this age.
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