By the time your due date arrives, you’ve become a pro at prenatal doctor’s visits and while labor and delivery marks the end of your nearly constant prenatal check ups, now it’s baby’s turn to frequent the pediatrician for numerous check ups! Between “well baby” visits and “sick appointments,” it can feel like you are always in the doctor’s office with your little one.
To help you sort through these numerous appointments and all the things your MD will be assessing baby for, we’ve created this blog. So, read on to learn more about the first pediatrician visits baby will experience from birth until they’re 3 months old:
Preparing for Baby’s Arrival
Even before baby’s born, you’ll be making arrangements for their health and wellbeing. Before baby is born, you’ll be finding a pediatrician that works best for your family’s lifestyle - consider location to / from home, work, or daycare as well as the MD’s hours, practices, and policies.
At this stage, it’s also important to know if your pediatrician has the ability to visit baby while they’re still in hospital or if they’ll first be meeting your newborn in their office after discharge. While it’s not at all vital to select a pediatrician that has “rights” at the hospital or birth center where you are delivering, it is something you’ll be asked when you arrive in Labor & Delivery so they can properly plan for your baby’s medical care in the hospital - e.g., if your pediatrician does make rounds at the hospital, baby won’t be seen by the staff pediatrician and vice versa.
It’s important to know that in the hospital, baby will receive a lot of monitoring to make sure they are healthy and transitioning well to life outside the womb.
Baby’s 1st Pediatrician Visit - In the Doctor's Office
Baby gets lots of monitoring in the hospital by the nurses and pediatrician to make sure they are ready to go home. Once baby is discharged from the hospital, you’ll need to go back and check in with his pediatrician within 2 - 4 days after coming home. If your doctor was able to see baby while in the hospital, this won’t be the first time baby is seeing his MD, but if not, this will be their first meeting. If it is the first meeting, the hospital should have sent over baby’s medical records to the office in advance.
Before we dive into what to expect, let's review a few pro tips to ensure this visit goes smoothly:
Leave extra time / Don’t be rushed:
Trying to get out of the house with a newborn can take a long time! You are still new to diapering, feeding, and dressing baby so these trying to do all these activities at once can take an hour or more.
- Often times baby isn’t on a schedule or can be unpredictable, like needing an emergency diaper change the minute you get him strapped into the car seat, thinking you are finally ready to be on your way.
- Instead of worrying, plan to leave yourself plenty of time to get ready and make it to the doctors office.
- A late morning or early afternoon appointment can help take the pressure off getting out of the house early in the morning with baby.
Don’t go alone:
Have your partner, family member, or friend come with you. You’ll appreciate the extra set of hands plus many women with stitches (either from a C-section or vaginal delivery) might not be allowed to drive in the first week or two after giving birth.
- Another benefit to having someone go with you is a backup set of ears (and mind) to ensure all your questions are answered and you understand everything the pediatrician has told you during the visit.
Don’t spend too much time in the doctor’s waiting area:
Often, sick children are in the same waiting area, breathing the same air and playing with the same toys, as children in for their well visit. When baby is so young and their immune system still new, it’s best not to spend any extra time around those germs. If you arrive at the office really early, just spend some time relaxing out in your car instead of in the waiting area.
Especially during your first few visits, baby’s pediatrician will want to know a lot about baby’s eating and pooping habits.
- Keep track of all dirty diapers (wet and poopy) as well as baby’s feedings.
- For feedings noting when baby eats in addition to the amount (in ounces for formula or pumped breast milk) or duration (e.g., 10 minutes right breast, 5 minutes left breast) are helpful.
Talk to your pediatrician about you:
Don’t be afraid to share with your pediatrician anything about yourself as it might relate to baby. For example, if you have cracked or bleeding nipples, it might affecting baby’s feeding or require a lactation consultation. Something your pediatrician is capable of helping you with!
Don’t forget to meet the rest of the staff:
Whether it’s the receptionist, the nurse, or another pediatrician in the practice, meeting the whole team helping to keep your baby healthy can be a huge asset for new parents. Everyone in the doctor’s office plays a role and can help you out if the doctor is busy or you have an urgent question crop up while at home. Relying on these supports can mean the difference between a great experience with your pediatrician and slipping through the cracks and not getting the care your baby needs.
Now that we’ve reviewed how to make the most of your partnership with the pediatrician, let’s review some of the specifics you can expect during some of baby’s first visits.
Usually occurring 2 - 4 days after discharge from the hospital, you can expect the doctor to:
- Check baby’s vital signs including heart rate, breathing, and temperature.
- Check weight
- Confirm other measurements - height, head circumference, etc
- MD to ask about baby’s diapers
- Check on how baby is feeding
- Check bilirubin levels
- Newborn Screen (if not done in hospital)
- Hepatitis B vaccination (if not done in hospital)
1 month Visit
As the name implies, baby will need to see their pediatrician for a checkup around 1 months old mark. At this visit you can expect:
- Check vital signs - heart rate, breathing, and temperature
- Check baby’s growth - measuring height and weight
- Assessing any lingering feedings or diaper related concerns or issues
- Milestones - baby’s development is tracked by important physical, cognitive, emotional and language related milestones.
- 2nd hepatitis B vaccination
- Tuberculosis test (if MD requires) - just like for adults, baby will be injected with an inactivated serum and you’ll need to monitor their skin for any bumps or swelling which could indicate a positive test requiring immediate follow up by your doctor.
2 month Visit
In addition to checking baby’s vital signs (heart rate, breathing, temperature), growth (height and weight), and milestones, this well visit at 2 month of age has the doctor administering several vaccinations. Fortunately, some of these can be administered together limiting the number of injections your baby needs to get. The vaccines you can expect to be administered include:
- 2nd hepatitis B vaccine (if not done at 1 month)
- Rotovirus: a common virus that affects the digestive tract causing nausea, vomiting, and diarrhea
- Diphtheria, Tetanus, and Pertussis (DTaP): 3 different severe illnesses in a single vaccine. For more information visit the CDC’s vaccination information page here.
- Haemophilus influenzae type B (Hib): a serious bacteria disease that can lead to bacterial meningitis or a swelling and infection of the fluid surround the brain and spinal cord.
- Pneumococcal (PCV): prevents 13 different types of bacteria that cause pneumonia.
- Inactivated Polio (IPV): a crippling infection that can cause irreversible damage to the brain and spinal cord causing paralysis.
Sick Visits - When to Call the Doctor
While the above is a good reference for well baby visits and checkups, there will be times during your babies first months where you may need to go to the doctor because something is wrong. Here are a few things to be aware so you know if you’ve got to make yet another trip to your pediatrician’s:
Signs of an Infection or Other Basic Issues:
There are a few general signs that something is wrong with baby and it’s time to call the doctor. These may occur with or without any additional specific symptoms we list below related to their umbilical cord, circumcision site, digestion or vaccine related reactions:
- Fever over 100.4F
- Any vomiting (e.g., throwing up an entire meal vs. spitting up a small amount after feeding)
- Two or more diapers with diarrhea - a watery stool with no solid parts or seeds
- Mucus in baby’s stool two or more times in a few hours or days.
- A significant decrease in the number of wet diapers a baby has per day, especially if it’s not resolved with increasing their breastmilk or formula intake.
- Excessive sleepiness or lethargy, especially if they are having difficulty feeding because they are too sleepy.
- Any bleeding that doesn’t quickly resolve when pressure is applied to the area.
After birth, the umbilical cord is clamped and cut and within a day or two it will dry up and after 7 to 14 days will fall off on its own leaving baby’s belly button behind. If during this process you notice any of the following though, call your doctor right away:
- Any bleeding beyond the first minute after clamping or anything more than a drop or two of blood after the cord stump falls off.
- Redness around the umbilical cord area, especially if it occurs suddenly or gets worse over time.
- Hot to the touch.
- Baby is irritated or sensitive when that area is touched.
- Purulent discharge (or pus), like snot or boogers but coming from the umbilical cord.
- Any foul smell from that area.
After baby’s circumcision, you’ll need to keep any eye out for proper healing and call the doctor if you notice any of the following signs of trouble:
- Persistent bleeding or more than quarter-sized spot of blood on his diaper.
- Persistent redness more than five days after circumcision.
- Yellow discharge lasting more than a week.
- Any swelling beyond day 1.
- Crusty, fluid-filled sores.
- Trouble urinating.
Jaundice is common a few days after baby is born and usually starts to appear visually from head to toe. It usually gets worse, progressing slowly down baby’s body before it gets better and ultimately resolves. While some jaundice is usually minor and not worrisome, here are some thing to watch out for:
- A significant change in appearance - for example, yesterday baby’s head was slightly jaundice but now all of baby is jaundice.
- Baby is excessively sleep and even too sleepy to feed or feed well.
A common yeast infection in breastfeeding babies that can be passed easily between mother and baby making it difficult to treat. Besides the discomfort, it’s not harmful long term but it is annoying so seek treatment immediately if you notice any of the following:
- White rash on inside of baby's mouth.
- Painful sores on mom’s breasts.
Baby’s diapers are chock full of information about baby’s digestion so if you notice any of the following warning signs call baby’s doctor ASAP:
- Lime green frothy poop similar to algae could be a sign of difficulties breastfeeding or a stomach bug.
- Black coffee ground type poop AFTER baby’s poop transitions from meconium. This poop is thick and sticky and a sign that baby has some bleeding in their digestive tract.
- Red tinged poop or poop with red flecks that is normal in consistency could indicate a milk protein allergy.
- Red, bloody diarrhea is a sign of a bacterial infection that needs a doctor’s attention ASAP.
- Chalky white clay or playdough type poop is a sign of liver or gallbladder issues so call the doctor immediately.
- Red currant jelly poop consisting entirely of blood that has a “congealed fat” consistency as it indicates a serious bacterial infection that needs medical treatment quickly.
- Chronic constipation.
Vaccine Related Reaction:
While vaccine related reactions are rare, it’s worth noting what they are and contact the doctor if you are worried. Some common minor side effects include fussiness, tiredness, loss of appetite, vomiting, and occasionally a generalized mild swelling of baby’s entire limb where the injection occurred. While you may want to alert your doctor to these, it’s more important to call the doctor if you see any of these moderate to severe reactions within a few minutes or hours of a vaccination:
- Non-stop crying for more than 3 hours.
- Fever over 105F.
- Febrile seizure.
- Allergic reaction which may take the form of one or more of the following:
- Swelling of the face or throat
- Difficulty breathing
- Any unusual behavior.
When you leave the hospital, consider that your baby’s “normal” and contact the doctor if there are any clear or immediate changes in this new “norm.” You know your baby best so when in doubt, always consult with your doctor’s office. They are happy to answer calls from new parents who they understand are still absorbing copious amounts of information about baby and have a plethora of questions. They really do expect your calls for all things big and small so don’t fret about this rite of passage as a new parent and call your doctor whenever you suspect something is wrong! In the best causes, you’ll catch something serious early and if you’re wrong, you’ll at least have a good laugh later about how your doctor told you not to worry.
Of course, this won’t be the end of your well baby visits during baby’s first few years of life, but it does cover baby’s first 3 months! You’ll be back to the doctor’s every 2 to 3 months until baby’s first birth day and then 3 more times before they turn 2. Specifically, you can plan on check ups at 4 months, 6 months, 9 months, and 12 months with additional visits at 15 month, 18 months, and 24 months. It’s a ton of time spent at the doctor’s office but you’ll be happy to do it to ensure your baby’s healthy, happy, and developing normally!
Between all the well baby and sick visits, you and baby will be well acquainted with your pediatrician and his team and we hope this blog as provided you with insight into what to expect in the first few months after baby’s arrival.