Well-Child Visit: 3 to 5 Days

What to Expect During This Visit

The doctor and/or nurse will probably:

1. Check your baby's weight, length, and head circumference and plot the measurements on a growth chart.

2. Ask questions, address any concerns, and offer advice about how your baby is:

Feeding. Newborns should be fed whenever they seem hungry. Breastfed infants eat about every 1–3 hours, and formula-fed infants eat about every 2–4 hours. Your doctor or nurse can watch as you breastfeed and offer help with any problems. Burp your baby midway through a feeding and again at the end.

Peeing and pooping. Newborns should have about 6 wet diapers a day. The number of poopy diapers varies, but most newborns have 3 or 4 soft bowel movements a day. Tell your doctor if you have any concerns about your newborn's bowel movements.

Sleeping. A newborn may sleep 14 to 17 hours or more in 24 hours, waking up often (day and night) to breastfeed or take a bottle. Breastfed babies usually wake to eat every 1–3 hours, while formula-fed babies may sleep longer, waking every 2–4 hours to eat (formula takes longer to digest so babies feel fuller longer). Newborns should not sleep more than 4 hours between feedings until they have good weight gain, usually within the first few weeks. After that, it's OK if a baby sleeps for longer stretches.

Developing. In the first month, babies should:

• pay attention to faces or bright objects 8–12 inches (20–30 cm) away
• respond to sound — they may quiet down, blink, turn head, startle, or cry
• hold arms and legs in a flexed position
• move arms and legs equally
• lift head briefly when on stomach (babies should be placed on the stomach only while awake and under supervision)
• have strong newborn reflexes, such as:
  • rooting and sucking: turns toward, then sucks breast/bottle nipple
  • grasp: tightly grabs hold of a finger placed within the palm
  • fencer's pose: straightens arm when head is turned to that side and bends opposite arm
  • Moro reflex (startle response): throws out arms and legs, then curls them in when startled

3. Do an exam with your baby undressed with you present. This exam will include an eye exam, listening to your baby's heart and feeling pulses, inspecting the umbilical cord, and checking the hips.

4. Do screening tests. Your doctor will review the screening tests from the hospital and repeat tests, if needed. If a hearing test wasn't done then, your baby will have one now.

5. Update immunizations.Immunizations can protect infants from serious childhood illnesses, so it's important that your baby get them on time. Immunization schedules can vary from office to office, so talk to your doctor about what to expect.

Looking Ahead

Here are some things to keep in mind until your next routine visit at 1 month:

Feeding

1. Continue to feed whenever your baby is hungry. Pay attention to signs that your baby is full, such as turning away from the nipple or bottle and closing the mouth.
2. Don't give solid foods or juice.
3. Don't put cereal in your baby's bottle unless directed to by your doctor.
4. If you breastfeed:
   • Help your baby latch on correctly: mouth opened wide, tongue down, with as much breast in the mouth as possible.
   • Continue to take a prenatal vitamin or multivitamin daily.
   • Ask your doctor about vitamin D drops for your baby.
   • Don't use a bottle or pacifier until nursing is well established (usually about 1 month).
5. If you formula-feed:
   • Give your baby iron-fortified formula.
   • Follow the formula package's instructions when making and storing bottles.
   • Don't prop bottles or put your baby to bed with a bottle.
   • Talk to your doctor before switching formulas.

Routine Care

1. Wash your hands before handling the baby and avoid people who may be sick.
2. Keep the diaper below the umbilical cord so the stump can dry. The umbilical cord usually falls off in 10–14 days.
3. For circumcised boys, put petroleum jelly on the penis or diaper's front.
4. Give sponge baths until the umbilical cord falls off and a boy's circumcision heals. Make sure the water isn't too hot — test it with your wrist first.
5. Use fragrance-free soaps and lotions.
6. Hold your baby and be attentive to their needs. You can't spoil a newborn.
7. Sing, talk, and read to your baby. Babies learn best by interacting with people.
8. It's normal for infants to have fussy periods. But for some, crying can be excessive, lasting several hours a day. If an otherwise well baby develops colic, it usually starts when they’re around 3 weeks old.
9. Call your baby's doctor if your infant has a fever of 100.4ºF (38ºC) or higher, taken in your baby’s bottom. Call the doctor if your baby is acting sick, isn't eating, isn't peeing or  pooping, looks yellow, or has increasing redness or pus around umbilical cord or circumcision. Don't give medicine to an infant younger than 2 months old without talking to your doctor first.
10. It's common for new moms to feel tired and overwhelmed at times. But if these feelings are intense, or you feel sad, moody, or anxious, call your doctor.
11. Talk to your doctor if you're worried about your living situation. Do you have the things that you need to take care of your baby? Do you have enough food, a safe place to live, and health insurance? Your doctor can tell you about community resources or refer you to a social worker.

Safety

1. To reduce the risk of sudden infant death syndrome (SIDS):
   • Always place your baby to sleep on a firm, flat mattress on their back, and not on the stomach or side, in a crib or bassinet without any crib bumpers, blankets, quilts, pillows, or plush toys.
   • Breastfeed your baby, if possible.
   • Let your baby sleep in your room in a bassinet or crib next to the bed until your baby's first birthday, or for at least 6 months, when the risk of SIDS is highest.
   • Avoid overheating by keeping the room temperature comfortable. Dress your baby for the room temperature and don't overbundle. Don't cover your baby's head while they're sleeping. Watch for signs of overheating, such as sweating or feeling hot to the touch.
   • Consider putting your baby to sleep sucking on a pacifier. If your baby rejects the pacifier, don't force it. If the pacifier falls out during sleep, you don't have to replace it. If you're breastfeeding, wait until breastfeeding is established before introducing the pacifier.
   • Don’t let your baby fall asleep on a product that isn’t specifically designed for sleeping babies, such as a sitting device (like a car seat), a feeding pillow (like the Boppy pillow), or an infant lounger (like the Dock-a-Tot, Podster, and Bummzie).
   • Don’t use products or devices that claim to lower the risk of SIDS, such as sleep positioners (like wedges or incliners) or monitors that can detect a baby’s heart rate and breathing pattern. No known products can actually do this.
   • Make sure that all sleep surfaces and products you use to help your baby sleep have been approved by the U.S. Consumer Product Safety Commission (CPSC) and meet federal safety standards.
2. Don't smoke or use e-cigarettes. Don't let anyone else smoke or vape around your baby.
3. Always put your baby in a rear-facingcar seat in the back seat. Never leave your baby alone in a car.
4. While your baby is awake, don't leave your little one unattended, especially on high surfaces or in the bath.
5. Never shake your baby — it can cause bleeding in the brain and even death. If you are ever worried that you will hurt your baby, put your baby in the crib or bassinet for a few minutes. Call a friend, relative, or your health care provider for help.
6. Avoid sun exposure by keeping your baby covered and in the shade when possible. Sunscreens are not recommended for infants younger than 6 months. However, you may use a small amount of sunscreen on an infant younger than 6 months if shade and clothing don't offer enough protection.

These checkup sheets are consistent with the American Academy of Pediatrics (AAP)/Bright Futures guidelines.