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Partnering with Your Pediatrician

By the time you hold your new baby in your arms for the first time, chances are you've already chosen one of the most important people in your little one's early life — a doctor. You and your baby will probably visit the doctor more often during the first year than at any other time.

You may have had a prenatal visit with your baby's doctor-to-be to discuss some specifics, such as when he or she will see your newborn for the first time, office hours and on-call hours, who fills in when your doctor is out of the office, and how the office handles after-hours emergencies. You may have also learned the doctor's views on certain issues.

In this way, you've begun to forge a relationship with your baby's doctor that should last through the bumps, bruises, and midnight fevers to come.

Looking for a supportive pediatrician? We've got you covered

What Happens Right After Birth

Depending on your desires and the rules of the hospital or birth center where your baby is delivered, the first exam will either take place in the nursery or at your side:

  • Weight, length, and head circumference will be measured.
  • Temperature will be taken, and your baby's breathing and heart rate will be measured.
  • The doctor or nurse will monitor skin color and your newborn's activity.
  • Eye drops or ointment to prevent eye infections.
  • A shot of vitamin K will be given to prevent the possibility of bleeding.

Your baby will be given a first bath, and the umbilical cord stump will be cleaned. Most hospitals and birthing centers give personal instructions (and sometimes videos) to new parents that cover feeding, bathing, and other important aspects of newborn care.

The pediatircian's Hospital Visit

The hospital or birth center where you deliver will notify your child's doctor of the birth. If you had any medical problems during pregnancy, if your baby might have a medical problem, or if you're having a C-section, a pediatrician or your baby's doctor will be standing by to take care of the baby.

The doctor you've chosen for your newborn will give your baby a physical examination within 24 hours of birth. This is a good time to ask questions about your baby's care.

A sample of your baby's blood (usually done by pricking the baby's heel) will be screened for a number of diseases that are important to diagnose at birth so effective treatment can begin quickly.

Every newborn should be seen and examined at the doctor's office within 3 to 5 days after birth and within 72 hours after discharge from hospital. If your baby is sent home sooner than 48 hours after delivery, your doctor will want your baby to be brought to the office for a check within 48 hours after discharge.

The First Office Visit

Your baby's first office visit usually takes place when your baby is 3 days old. During the first office visit, your pediatrician will assess your baby in a variety of ways. The first office visit will differ from doctor to doctor, but you can probably expect:

  • measurement of weight, length, and head circumference to assess how your baby's been doing since birth
  • observation of your newborn's vision, hearing, and reflexes
  • a complete physical examination of your newborn
  • questions about how you're doing with the new baby and how your baby is eating and sleeping
  • advice on what you can expect in the coming month
  • a discussion of your home environment and how it could affect your baby (for example, smoking in the house can harm your baby's health in many ways)

Also, if they're ready, the results of screening tests done on your newborn after birth may be discussed with you. Jot down any specific instructions given regarding special baby care, and bring up your questions or concerns. Keep a permanent medical record for your baby that includes information about growth, immunizations, medicines, and any problems or illnesses.

Vaccines

Babies are born with some natural immunity against infectious diseases because their mothers' infection-preventing antibodies are passed to them through the umbilical cord. This immunity is only temporary, but babies will develop their own immunity against many infectious diseases.

Breastfed babies receive antibodies and enzymes in breast milk that help protect them from some infections and even some allergic conditions.

Infants should get their first shot of the hepatitis B vaccine in the hospital within 24 hours after birth. Babies will get more vaccines in the coming months based on a standard immunization schedule.

When to Call the Doctor

Call your doctor if you have concerns about your newborn. Some common difficulties to be aware of during this first month:

  • Eye problems can be caused by blockage of one or both tear ducts. Normally the ducts open on their own before too long, but sometimes they remain clogged, which can cause tearing and eye discharge. Call your doctor if you suspect an eye infection.
  • Fever in a newborn (rectal temperature above 100.4°F or 38°C) should be reported to your doctor right away.
  • A runny nose can make it hard for a baby to breathe well, especially during feeding. You can help ease discomfort by using a rubber bulb aspirator to gently suction mucus from the nose. Call your doctor if you have concerns about your baby's breathing.
  • It's normal for newborns to have loose stools (poop) or to spit up after feedings. However, very loose and watery stools and forceful vomiting could mean there is a problem. Call your doctor if your baby has diarrhea, is vomiting, or has signs of dehydration, which include a decreased number of wet diapers, a dry mouth, and lethargy (being very sluggish or drowsy).
Reviewed by: Mary L. Gavin, MD
Date reviewed: July 2017

The 1-month and 2-month visits

Wondering how often your baby should visit the doctor? What if you have questions between visits

How often you see the doctor in the first 2 months will depend on your baby's health, but most infants are seen at 1 month and again at 2 months for routine care. During these early months, you might have many questions about your baby's health. Most doctors have phone hours when parents can call with routine questions. Don't hesitate to call with your concerns, no matter how minor they might seem.

Of course, if you think your baby could have an illness, don't wait for phone hours — call your doctor immediately. As in the newborn period, illness at this age needs immediate attention.

During routine visits your baby will be checked for growth, development, and feeding, among other things. These regular checkups also let your doctor follow up on any concerns from earlier checkups and are a chance for you to ask questions.

What Happens at the Office Visit

During these early months, your doctor will check your baby's progress and growth. Common parts of a checkup include:

  • weight, length, and head circumference measurements that are plotted on your baby's growth chart
  • a physical exam with special attention to any previous problems
  • assessing development (for example, head control, cooing, and smiling)
  • questions about how you're doing with your baby
  • advice about feeding and other aspects of nutrition
  • what to expect during the coming months, including a discussion about safety precautions
  • immunizations during some visits

Bring up any questions you have, and write down the answers or specific instructions the doctor gives you. At home, update your baby's medical record, tracking growth and any problems or illnesses.

Vaccines

At 1–2 months old, your baby should receive the second dose of the hepatitis B vaccine (HBV).

At 2 months, your baby will get other immunizations:

  • DTaP (diphtheria, tetanus, acellular pertussis) vaccine
  • Hib (Haemophilus influenzae type b) vaccine
  • IPV (polio vaccine)
  • PCV (pneumococcal) vaccines
  • RV (rotavirus vaccine)
  • possibly HBV (hepatitis B vaccine), if not previously given

Babies at high risk for meningococcal disease, which can lead to bacterial meningitis and other serious conditions, may get the meningococcal vaccine. (Otherwise, the meningococcal vaccine is routinely given at 11–12 years old.)

Vaccines protect against serious childhood illnesses. Vaccines, like any other medicine, may cause reactions (usually mild), such as fever or irritability. Be sure to discuss side effects with your doctor and get guidelines for when to call the office.

When to Call the Doctor

Some common medical problems at this age may need a doctor's attention, including:

  • diarrhea and vomiting, which could be caused by an infection and put your infant at risk for dehydration
  • ear infections; a baby with an ear infection may become irritable, and could have a fever
  • rashes, which are common in infants. Some may not seem to bother your baby, but skin conditions like eczema can result in dry, itchy skin. Your doctor can recommend lotions, creams, and soaps to try.
  • upper respiratory tract infections (including the common cold), which affect infants just like the rest of us. Babies can't blow their own noses, so you may need to help clear mucus with a rubber bulb aspirator. Don't give your baby any medicines without checking first with your doctor. Call the doctor's office right away if your baby has trouble breathing, refuses to eat, has a rectal temperature above 100.4°F (38°C), or is excessively cranky or sleepy.

Again, don't hesitate to contact the doctor's office about any health or behavior concerns.

The 4-month visit

Babies really begin to show their personality during these months. So you might find yourself talking to your baby's doctor less about sleeping and eating and more about physical and social development.

Most likely your baby will now be seen at 4 months and at 6 months, but your doctor may schedule extra visits to check on any problems found earlier.

Colds and ear infections can become more common at this age, especially in winter. Once babies can reach out and grab objects and start having contact with more people, they can be at increased risk for contagious illnesses, especially if they're in childcare or have older siblings.

What to Expect at the Office Visit

Well-baby checkups vary from doctor to doctor, but usually will include:

  • Measurement of your baby's length, weight, and head circumference. Growth will be plotted on a growth chart, and you'll be advised of the progress.
  • A physical exam.
  • A review of your baby's development through both observation and your progress report. Can your baby hold up his or her head? Is your tot rolling over? Sitting with or without support? Can he or she transfer an object from hand to hand? Respond to own name? Has your baby started to babble? Your doctor may ask you these questions and more.
  • You may be asked how you are doing with your baby and how the rest of the family is doing. Your doctor may go over safety questions with you: Have you babyproofed your home? Is your little one in an appropriate safety seat while in the car?
  • A discussion of your baby's eating habits, including the likelihood that solid foods will be introduced soon.
  • Advice on what to expect in the coming months.
  • Your baby will receive immunizations during some visits.

Bring to the doctor any questions or concerns you may have at this time. Make sure to write down any specific instructions you receive regarding special baby care. Keep updating your child's medical record, listing information on growth and any problems or illnesses.

Immunizations Your Baby Will Receive

Immunizations usually given at the 4-month visit:

  • second diphtheria, tetanus, acellular pertussis (DTaP) vaccine
  • second Haemophilus influenzae type b (Hib) vaccine
  • second polio vaccine (IPV)
  • second pneumococcal conjugate (PCV) vaccine
  • second rotavirus (RV) vaccine

At the 6-month visit, your baby also may get (depending on the brand of vaccine given, and whether your child has had earlier doses):

  • the third DTaP vaccine
  • the third polio vaccine (IPV)
  • the third hepatitis B vaccine
  • the third Hib vaccine
  • the third PCV vaccine
  • the third rotavirus (RV) vaccine
  • a flu shot

Babies at high risk of developing a meningococcal disease, which can lead to bacterial meningitis and other serious conditions, may receive an additional vaccine. (Otherwise, kids usually get the meningococcal vaccine at 11–12 years old.)

When to Call the Doctor

Colds and other illnesses are a part of growing up. Your baby is beginning to explore and probably is being exposed to other kids. While it's hard to see your baby fight a stuffy nose or suffer with an ear infection, rest assured that most kids grow out of the frequent-illness stage as they build their immunity.

Meanwhile, these safeguards can help keep your baby well:

  • Breastfeeding your baby will provide antibodies and enzymes that help protect against illness.
  • Try to keep your baby away from kids you know are sick, especially those with infectious diseases such as the flu.
  • Family members who are sick should not share food or drink with the baby, and they should wash their hands well before handling the baby and your tot's toys.
  • Stay up to date with your baby's vaccines. Stick to the immunization schedule recommended by your doctor.

Call your doctor if your baby has a fever, is acting sick, refuses to eat, suddenly has trouble sleeping, has diarrhea, or is vomiting.

Reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: February 2017

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