pediatrician 4 month visit

Family Life

AAP Schedule of Well-Child Care Visits

Parents know who they should go to when their child is sick. But pediatrician visits are just as important for healthy children.

The Bright Futures /American Academy of Pediatrics (AAP) developed a set of comprehensive health guidelines for well-child care, known as the " periodicity schedule ." It is a schedule of screenings and assessments recommended at each well-child visit from infancy through adolescence.

Schedule of well-child visits

• The first week visit (3 to 5 days old)
• 1 month old
• 2 months old
• 4 months old
• 6 months old
• 9 months old
• 12 months old
• 15 months old
• 18 months old
• 2 years old (24 months)
• 2 ½ years old (30 months)
• 3 years old
• 4 years old
• 5 years old
• 6 years old
• 7 years old
• 8 years old
• 9 years old
• 10 years old
• 11 years old
• 12 years old
• 13 years old
• 14 years old
• 15 years old
• 16 years old
• 17 years old
• 18 years old
• 19 years old
• 20 years old
• 21 years old

The benefits of well-child visits

Prevention . Your child gets scheduled immunizations to prevent illness. You also can ask your pediatrician about nutrition and safety in the home and at school.

Tracking growth & development . See how much your child has grown in the time since your last visit, and talk with your doctor about your child's development. You can discuss your child's milestones, social behaviors and learning.

Raising any concerns . Make a list of topics you want to talk about with your child's pediatrician such as development, behavior, sleep, eating or getting along with other family members. Bring your top three to five questions or concerns with you to talk with your pediatrician at the start of the visit.

Team approach . Regular visits create strong, trustworthy relationships among pediatrician, parent and child. The AAP recommends well-child visits as a way for pediatricians and parents to serve the needs of children. This team approach helps develop optimal physical, mental and social health of a child.

More information

Back to School, Back to Doctor

Recommended Immunization Schedules

Milestones Matter: 10 to Watch for by Age 5

Your Child's Checkups

• Bright Futures/AAP Recommendations for Preventive Pediatric Health Care (periodicity schedule)

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Baby's doctor visits: The 4-month checkup

At the 4-month checkup, the doctor will weigh and measure your baby, do a complete physical, address any concerns you have, and ask questions about your little one's eating, sleeping, and development. Your baby will likely get two shots and an oral vaccine.

4-month vaccines

What the doctor will do at the 4-month checkup.

To prepare for your baby's 4-month checkup, learn what will happen at the visit. You may also want to consider the questions the doctor is likely to ask and jot down your own questions beforehand.

Your baby will typically receive the DTaP , Hib , polio , and pneumococcal vaccines (combined in two shots) and the rotavirus vaccine (given orally).

A nurse or medical assistant will probably give your baby the vaccines. This is usually done at the end of the appointment in case your baby gets upset (which could make the exam part of the visit difficult), and so you can have some privacy to comfort them.

Find out how to make shots less painful for your baby and more about the immunizations your baby needs .

Weigh and measure your baby

You'll need to undress your baby completely for weighing. The doctor weighs your baby, measures length and head circumference, and plots the numbers on a growth chart .

The chart enables you to see how your baby compares with other children the same age. But it doesn't matter whether they're in the 5th or the 95th percentile, as long as their rate of growth is steady from one visit to the next.

Do a complete physical

• Heart and lungs: Uses a stethoscope to listen for a heart murmur or breathing problems.
• Eyes : Checks for signs of congenital eye conditions and other problems. Watches your baby's eye tracking to see if there's any asymmetry in eye movements or eye crossing. May also check for blocked tear ducts and discharge.
• Ears: Looks for signs of infection and observes how your baby responds to sound .
• Mouth: Looks for signs of thrush (an oral yeast infection) and any signs of emerging teeth .
• Head: Checks the soft spots (fontanels) and the shape of your baby's head. Also checks to see if your baby's head is developing a flat spot .
• Body: Checks your baby's reflexes and muscle tone, and examines their skin for rashes. Puts your baby on their tummy to check their head control .
• Belly: Presses gently on the abdomen to check for a hernia or any enlarged organs.
• Genitals: Opens your baby's diaper and checks for signs of infection.
• Hips and legs: Moves your baby's legs around to look for problems in the hip joints.

Address any other concerns

Your doctor may recommend giving your baby a vitamin D supplement of 400 IU daily. (Babies who drink 32 ounces of formula a day won't need this.)

They'll also address any health concerns (such as how to deal with constipation , colds , and the flu ), ask you some questions (see below), and help you understand what's normal at this age.

Ask questions

• How's your baby sleeping? Your baby's sleep may be falling into a more predictable routine, with three to four daytime naps and a longer nighttime sleep period of six hours or more.
• When, how, and how often is your baby eating? Your baby will probably be ready for solid foods between 4 and 6 months old – so go ahead and talk to the doctor about it now. Ask the doctor how and when you should begin, and whether your baby needs any extra vitamins.
• What are your baby's bowel movements like? Soft poops are best, and color can vary.
• Can your baby roll over one way or sit with support? Both of these are skills that your baby will begin to develop around now, though they probably won't be able to roll over in both directions or sit without support until around 6 months old.
• Can your baby do a baby pushup ? This skill is typical for 4-month-olds and shows that their physical development is on track. If your baby is still having difficulty controlling or lifting their head , let the doctor know.
• What sounds does your baby make? Your baby's language skills may include cooing, squealing, and even laughing . They're probably smiling at you even more now, too. Your baby is also mouthing – using their mouth to explore objects. If your baby is making fewer sounds than before, tell their doctor.
• How are your baby's motor skills? Your baby may now reach for and grab things. They may also be able to bring their hands together in front of their chest. If your baby uses one hand more than the other, mention it to the doctor. Your baby should also be kicking with both legs and bouncing on them when held upright above your lap or the floor. If your baby holds their legs straight a lot of the time, tell the doctor.
• Have you noticed anything unusual about your baby's eyes or the way they look at things? At every well-baby visit, the doctor should check the structure and alignment of the eyes and your baby's ability to move them correctly.
• How's your baby's hearing? If your baby doesn't turn toward sounds, be sure to tell the doctor. The sooner potential hearing problems are investigated, the sooner they can be treated.

Learn more:

• Your 4-month-old baby's development
• Your 4-month-old's sleep
• What's in store at the 6-month doctor visit

Was this article helpful?

How can I make getting shots less painful for my child?

Baby's doctor visits: The 6-month checkup

How to cope with postpartum hair loss

When do babies push up on their hands?

BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies .

AAP. 2022. AAP Schedule of Well-Child Care Visits. https://www.healthychildren.org/English/family-life/health-management/Pages/Well-Child-Care-A-Check-Up-for-Success.aspx Opens a new window [Accessed November 2022]

CDC. Recommended Vaccinations for Infants and Children, Parent-Friendly Version. https://www.cdc.gov/vaccines/schedules/easy-to-read/child-easyread.html Opens a new window [Accessed November 2022]

U.S. Department of Health and Human Services. 2022. Make the Most of Your Baby's Visits to the Doctor. https://health.gov/myhealthfinder/doctor-visits/regular-checkups/make-most-your-babys-visit-doctor-ages-0-11-months Opens a new window [Accessed November 2022]

Where to go next

KATHERINE TURNER, MD

Am Fam Physician. 2018;98(6):347-353

Related letter: Well-Child Visits Provide Physicians Opportunity to Deliver Interconception Care to Mothers

Author disclosure: No relevant financial affiliations.

The well-child visit allows for comprehensive assessment of a child and the opportunity for further evaluation if abnormalities are detected. A complete history during the well-child visit includes information about birth history; prior screenings; diet; sleep; dental care; and medical, surgical, family, and social histories. A head-to-toe examination should be performed, including a review of growth. Immunizations should be reviewed and updated as appropriate. Screening for postpartum depression in mothers of infants up to six months of age is recommended. Based on expert opinion, the American Academy of Pediatrics recommends developmental surveillance at each visit, with formal developmental screening at nine, 18, and 30 months and autism-specific screening at 18 and 24 months; the U.S. Preventive Services Task Force found insufficient evidence to make a recommendation. Well-child visits provide the opportunity to answer parents' or caregivers' questions and to provide age-appropriate guidance. Car seats should remain rear facing until two years of age or until the height or weight limit for the seat is reached. Fluoride use, limiting or avoiding juice, and weaning to a cup by 12 months of age may improve dental health. A one-time vision screening between three and five years of age is recommended by the U.S. Preventive Services Task Force to detect amblyopia. The American Academy of Pediatrics guideline based on expert opinion recommends that screen time be avoided, with the exception of video chatting, in children younger than 18 months and limited to one hour per day for children two to five years of age. Cessation of breastfeeding before six months and transition to solid foods before six months are associated with childhood obesity. Juice and sugar-sweetened beverages should be avoided before one year of age and provided only in limited quantities for children older than one year.

Well-child visits for infants and young children (up to five years) provide opportunities for physicians to screen for medical problems (including psychosocial concerns), to provide anticipatory guidance, and to promote good health. The visits also allow the family physician to establish a relationship with the parents or caregivers. This article reviews the U.S. Preventive Services Task Force (USPSTF) and the American Academy of Pediatrics (AAP) guidelines for screenings and recommendations for infants and young children. Family physicians should prioritize interventions with the strongest evidence for patient-oriented outcomes, such as immunizations, postpartum depression screening, and vision screening.

Clinical Examination

The history should include a brief review of birth history; prematurity can be associated with complex medical conditions. 1 Evaluate breastfed infants for any feeding problems, 2 and assess formula-fed infants for type and quantity of iron-fortified formula being given. 3 For children eating solid foods, feeding history should include everything the child eats and drinks. Sleep, urination, defecation, nutrition, dental care, and child safety should be reviewed. Medical, surgical, family, and social histories should be reviewed and updated. For newborns, review the results of all newborn screening tests ( Table 1 4 – 7 ) and schedule follow-up visits as necessary. 2

PHYSICAL EXAMINATION

A comprehensive head-to-toe examination should be completed at each well-child visit. Interval growth should be reviewed by using appropriate age, sex, and gestational age growth charts for height, weight, head circumference, and body mass index if 24 months or older. The Centers for Disease Control and Prevention (CDC)-recommended growth charts can be found at https://www.cdc.gov/growthcharts/who_charts.htm#The%20WHO%20Growth%20Charts . Percentiles and observations of changes along the chart's curve should be assessed at every visit. Include assessment of parent/caregiver-child interactions and potential signs of abuse such as bruises on uncommonly injured areas, burns, human bite marks, bruises on nonmobile infants, or multiple injuries at different healing stages. 8

The USPSTF and AAP screening recommendations are outlined in Table 2 . 3 , 9 – 27 A summary of AAP recommendations can be found at https://www.aap.org/en-us/Documents/periodicity_schedule.pdf . The American Academy of Family Physicians (AAFP) generally adheres to USPSTF recommendations. 28

MATERNAL DEPRESSION

Prevalence of postpartum depression is around 12%, 22 and its presence can impair infant development. The USPSTF and AAP recommend using the Edinburgh Postnatal Depression Scale (available at https://www.aafp.org/afp/2010/1015/p926.html#afp20101015p926-f1 ) or the Patient Health Questionnaire-2 (available at https://www.aafp.org/afp/2012/0115/p139.html#afp20120115p139-t3 ) to screen for maternal depression. The USPSTF does not specify a screening schedule; however, based on expert opinion, the AAP recommends screening mothers at the one-, two-, four-, and six-month well-child visits, with further evaluation for positive results. 23 There are no recommendations to screen other caregivers if the mother is not present at the well-child visit.

PSYCHOSOCIAL

With nearly one-half of children in the United States living at or near the poverty level, assessing home safety, food security, and access to safe drinking water can improve awareness of psychosocial problems, with referrals to appropriate agencies for those with positive results. 29 The prevalence of mental health disorders (i.e., primarily anxiety, depression, behavioral disorders, attention-deficit/hyperactivity disorder) in preschool-aged children is around 6%. 30 Risk factors for these disorders include having a lower socioeconomic status, being a member of an ethnic minority, and having a non–English-speaking parent or primary caregiver. 25 The USPSTF found insufficient evidence regarding screening for depression in children up to 11 years of age. 24 Based on expert opinion, the AAP recommends that physicians consider screening, although screening in young children has not been validated or standardized. 25

DEVELOPMENT AND SURVEILLANCE

Based on expert opinion, the AAP recommends early identification of developmental delays 14 and autism 10 ; however, the USPSTF found insufficient evidence to recommend formal developmental screening 13 or autism-specific screening 9 if the parents/caregivers or physician have no concerns. If physicians choose to screen, developmental surveillance of language, communication, gross and fine movements, social/emotional development, and cognitive/problem-solving skills should occur at each visit by eliciting parental or caregiver concerns, obtaining interval developmental history, and observing the child. Any area of concern should be evaluated with a formal developmental screening tool, such as Ages and Stages Questionnaire, Parents' Evaluation of Developmental Status, Parents' Evaluation of Developmental Status-Developmental Milestones, or Survey of Well-Being of Young Children. These tools can be found at https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Screening/Pages/Screening-Tools.aspx . If results are abnormal, consider intervention or referral to early intervention services. The AAP recommends completing the previously mentioned formal screening tools at nine-, 18-, and 30-month well-child visits. 14

The AAP also recommends autism-specific screening at 18 and 24 months. 10 The USPSTF recommends using the two-step Modified Checklist for Autism in Toddlers (M-CHAT) screening tool (available at https://m-chat.org/ ) if a physician chooses to screen a patient for autism. 10 The M-CHAT can be incorporated into the electronic medical record, with the possibility of the parent or caregiver completing the questionnaire through the patient portal before the office visit.

IRON DEFICIENCY

Multiple reports have associated iron deficiency with impaired neurodevelopment. Therefore, it is essential to ensure adequate iron intake. Based on expert opinion, the AAP recommends supplements for preterm infants beginning at one month of age and exclusively breastfed term infants at six months of age. 3 The USPSTF found insufficient evidence to recommend screening for iron deficiency in infants. 19 Based on expert opinion, the AAP recommends measuring a child's hemoglobin level at 12 months of age. 3

Lead poisoning and elevated lead blood levels are prevalent in young children. The AAP and CDC recommend a targeted screening approach. The AAP recommends screening for serum lead levels between six months and six years in high-risk children; high-risk children are identified by location-specific risk recommendations, enrollment in Medicaid, being foreign born, or personal screening. 21 The USPSTF does not recommend screening for lead poisoning in children at average risk who are asymptomatic. 20

The USPSTF recommends at least one vision screening to detect amblyopia between three and five years of age. Testing options include visual acuity, ocular alignment test, stereoacuity test, photoscreening, and autorefractors. The USPSTF found insufficient evidence to recommend screening before three years of age. 26 The AAP, American Academy of Ophthalmology, and the American Academy of Pediatric Ophthalmology and Strabismus recommend the use of an instrument-based screening (photoscreening or autorefractors) between 12 months and three years of age and annual visual acuity screening beginning at four years of age. 31

IMMUNIZATIONS

The AAFP recommends that all children be immunized. 32 Recommended vaccination schedules, endorsed by the AAP, the AAFP, and the Advisory Committee on Immunization Practices, are found at https://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html . Immunizations are usually administered at the two-, four-, six-, 12-, and 15- to 18-month well-child visits; the four- to six-year well-child visit; and annually during influenza season. Additional vaccinations may be necessary based on medical history. 33 Immunization history should be reviewed at each wellness visit.

Anticipatory Guidance

Injuries remain the leading cause of death among children, 34 and the AAP has made several recommendations to decrease the risk of injuries. 35 – 42 Appropriate use of child restraints minimizes morbidity and mortality associated with motor vehicle collisions. Infants need a rear-facing car safety seat until two years of age or until they reach the height or weight limit for the specific car seat. Children should then switch to a forward-facing car seat for as long as the seat allows, usually 65 to 80 lb (30 to 36 kg). 35 Children should never be unsupervised around cars, driveways, and streets. Young children should wear bicycle helmets while riding tricycles or bicycles. 37

Having functioning smoke detectors and an escape plan decreases the risk of fire- and smoke-related deaths. 36 Water heaters should be set to a maximum of 120°F (49°C) to prevent scald burns. 37 Infants and young children should be watched closely around any body of water, including water in bathtubs and toilets, to prevent drowning. Swimming pools and spas should be completely fenced with a self-closing, self-latching gate. 38

Infants should not be left alone on any high surface, and stairs should be secured by gates. 43 Infant walkers should be discouraged because they provide no benefit and they increase falls down stairs, even if stair gates are installed. 39 Window locks, screens, or limited-opening windows decrease injury and death from falling. 40 Parents or caregivers should also anchor furniture to a wall to prevent heavy pieces from toppling over. Firearms should be kept unloaded and locked. 41

Young children should be closely supervised at all times. Small objects are a choking hazard, especially for children younger than three years. Latex balloons, round objects, and food can cause life-threatening airway obstruction. 42 Long strings and cords can strangle children. 37

DENTAL CARE

Infants should never have a bottle in bed, and babies should be weaned to a cup by 12 months of age. 44 Juices should be avoided in infants younger than 12 months. 45 Fluoride use inhibits tooth demineralization and bacterial enzymes and also enhances remineralization. 11 The AAP and USPSTF recommend fluoride supplementation and the application of fluoride varnish for teeth if the water supply is insufficient. 11 , 12 Begin brushing teeth at tooth eruption with parents or caregivers supervising brushing until mastery. Children should visit a dentist regularly, and an assessment of dental health should occur at well-child visits. 44

SCREEN TIME

Hands-on exploration of their environment is essential to development in children younger than two years. Video chatting is acceptable for children younger than 18 months; otherwise digital media should be avoided. Parents and caregivers may use educational programs and applications with children 18 to 24 months of age. If screen time is used for children two to five years of age, the AAP recommends a maximum of one hour per day that occurs at least one hour before bedtime. Longer usage can cause sleep problems and increases the risk of obesity and social-emotional delays. 46

To decrease the risk of sudden infant death syndrome (SIDS), the AAP recommends that infants sleep on their backs on a firm mattress for the first year of life with no blankets or other soft objects in the crib. 45 Breastfeeding, pacifier use, and room sharing without bed sharing protect against SIDS; infant exposure to tobacco, alcohol, drugs, and sleeping in bed with parents or caregivers increases the risk of SIDS. 47

DIET AND ACTIVITY

The USPSTF, AAFP, and AAP all recommend breastfeeding until at least six months of age and ideally for the first 12 months. 48 Vitamin D 400 IU supplementation for the first year of life in exclusively breastfed infants is recommended to prevent vitamin D deficiency and rickets. 49 Based on expert opinion, the AAP recommends the introduction of certain foods at specific ages. Early transition to solid foods before six months is associated with higher consumption of fatty and sugary foods 50 and an increased risk of atopic disease. 51 Delayed transition to cow's milk until 12 months of age decreases the incidence of iron deficiency. 52 Introduction of highly allergenic foods, such as peanut-based foods and eggs, before one year decreases the likelihood that a child will develop food allergies. 53

With approximately 17% of children being obese, many strategies for obesity prevention have been proposed. 54 The USPSTF does not have a recommendation for screening or interventions to prevent obesity in children younger than six years. 54 The AAP has made several recommendations based on expert opinion to prevent obesity. Cessation of breastfeeding before six months and introduction of solid foods before six months are associated with childhood obesity and are not recommended. 55 Drinking juice should be avoided before one year of age, and, if given to older children, only 100% fruit juice should be provided in limited quantities: 4 ounces per day from one to three years of age and 4 to 6 ounces per day from four to six years of age. Intake of other sugar-sweetened beverages should be discouraged to help prevent obesity. 45 The AAFP and AAP recommend that children participate in at least 60 minutes of active free play per day. 55 , 56

Data Sources: Literature search was performed using the USPSTF published recommendations ( https://www.uspreventiveservicestaskforce.org/BrowseRec/Index/browse-recommendations ) and the AAP Periodicity table ( https://www.aap.org/en-us/Documents/periodicity_schedule.pdf ). PubMed searches were completed using the key terms pediatric, obesity prevention, and allergy prevention with search limits of infant less than 23 months or pediatric less than 18 years. The searches included systematic reviews, randomized controlled trials, clinical trials, and position statements. Essential Evidence Plus was also reviewed. Search dates: May through October 2017.

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Baker RD, Greer FR Committee on Nutrition, American Academy of Pediatrics. Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0–3 years of age). Pediatrics. 2010;126(5):1040-1050.

Mahle WT, Martin GR, Beekman RH, Morrow WR Section on Cardiology and Cardiac Surgery Executive Committee. Endorsement of Health and Human Services recommendation for pulse oximetry screening for critical congenital heart disease. Pediatrics. 2012;129(1):190-192.

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American Academy of Pediatrics, Joint Committee on Infant Hearing. Year 2007 position statement: principles and guidelines for early hearing detection and intervention programs. Pediatrics. 2007;120(4):898-921.

Maisels MJ, Bhutani VK, Bogen D, Newman TB, Stark AR, Watchko JF. Hyperbilirubinemia in the newborn infant > or = 35 weeks' gestation: an update with clarifications. Pediatrics. 2009;124(4):1193-1198.

Christian CW Committee on Child Abuse and Neglect, American Academy of Pediatrics. The evaluation of suspected child physical abuse [published correction appears in Pediatrics . 2015;136(3):583]. Pediatrics. 2015;135(5):e1337-e1354.

Siu AL, Bibbins-Domingo K, Grossman DC, et al. Screening for autism spectrum disorder in young children: U.S. Preventive Services Task Force recommendation statement. JAMA. 2016;315(7):691-696.

Johnson CP, Myers SM American Academy of Pediatrics Council on Children with Disabilities. Identification and evaluation of children with autism spectrum disorders. Pediatrics. 2007;120(5):1183-1215.

Moyer VA. Prevention of dental caries in children from birth through age 5 years: U.S. Preventive Services Task Force recommendation statement. Pediatrics. 2014;133(6):1102-1111.

Clark MB, Slayton RL American Academy of Pediatrics Section on Oral Health. Fluoride use in caries prevention in the primary care setting. Pediatrics. 2014;134(3):626-633.

Siu AL. Screening for speech and language delay and disorders in children aged 5 years and younger: U.S. Preventive Services Task Force recommendation statement. Pediatrics. 2015;136(2):e474-e481.

Council on Children with Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee, Medical Home Initiatives for Children with Special Needs Project Advisory Committee. Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening [published correction appears in Pediatrics . 2006;118(4):1808–1809]. Pediatrics. 2006;118(1):405-420.

Bibbins-Domingo K, Grossman DC, Curry SJ, et al. Screening for lipid disorders in children and adolescents: U.S. Preventive Services Task Force recommendation statement. JAMA. 2016;316(6):625-633.

National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents. October 2012. https://www.nhlbi.nih.gov/sites/default/files/media/docs/peds_guidelines_full.pdf . Accessed May 9, 2018.

Moyer VA. Screening for primary hypertension in children and adolescents: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2013;159(9):613-619.

Flynn JT, Kaelber DC, Baker-Smith CM, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents [published correction appears in Pediatrics . 2017;140(6):e20173035]. Pediatrics. 2017;140(3):e20171904.

Siu AL. Screening for iron deficiency anemia in young children: USPSTF recommendation statement. Pediatrics. 2015;136(4):746-752.

U.S. Preventive Services Task Force. Screening for elevated blood lead levels in children and pregnant women. Pediatrics. 2006;118(6):2514-2518.

Screening Young Children for Lead Poisoning: Guidance for State and Local Public Health Officials . Atlanta, Ga.: U.S. Public Health Service; Centers for Disease Control and Prevention; National Center for Environmental Health; 1997.

O'Connor E, Rossom RC, Henninger M, Groom HC, Burda BU. Primary care screening for and treatment of depression in pregnant and post-partum women: evidence report and systematic review for the U.S. Preventive Services Task Force. JAMA. 2016;315(4):388-406.

Earls MF Committee on Psychosocial Aspects of Child and Family Health, American Academy of Pediatrics. Incorporating recognition and management of perinatal and postpartum depression into pediatric practice. Pediatrics. 2010;126(5):1032-1039.

Siu AL. Screening for depression in children and adolescents: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2016;164(5):360-366.

Weitzman C, Wegner L American Academy of Pediatrics Section on Developmental and Behavioral Pediatrics; Committee on Psychosocial Aspects of Child and Family Health; Council on Early Childhood; Society for Developmental and Behavioral Pediatrics; American Academy of Pediatrics. Promoting optimal development: screening for behavioral and emotional problems [published correction appears in Pediatrics . 2015;135(5):946]. Pediatrics. 2015;135(2):384-395.

Grossman DC, Curry SJ, Owens DK, et al. Vision screening in children aged 6 months to 5 years: U.S. Preventive Services Task Force recommendation statement. JAMA. 2017;318(9):836-844.

Donahue SP, Nixon CN Committee on Practice and Ambulatory Medicine, Section on Ophthalmology, American Academy of Pediatrics; American Association of Certified Orthoptists, American Association for Pediatric Ophthalmology and Strabismus, American Academy of Ophthalmology. Visual system assessment in infants, children, and young adults by pediatricians. Pediatrics. 2016;137(1):28-30.

Lin KW. What to do at well-child visits: the AAFP's perspective. Am Fam Physician. 2015;91(6):362-364.

American Academy of Pediatrics Council on Community Pediatrics. Poverty and child health in the United States. Pediatrics. 2016;137(4):e20160339.

Lavigne JV, Lebailly SA, Hopkins J, Gouze KR, Binns HJ. The prevalence of ADHD, ODD, depression, and anxiety in a community sample of 4-year-olds. J Clin Child Adolesc Psychol. 2009;38(3):315-328.

American Academy of Pediatrics Committee on Practice and Ambulatory Medicine, Section on Ophthalmology, American Association of Certified Orthoptists, American Association for Pediatric Ophthalmology and Strabismus, American Academy of Ophthalmology. Visual system assessment of infants, children, and young adults by pediatricians. Pediatrics. 2016;137(1):28-30.

American Academy of Family Physicians. Clinical preventive service recommendation. Immunizations. http://www.aafp.org/patient-care/clinical-recommendations/all/immunizations.html . Accessed October 5, 2017.

Centers for Disease Control and Prevention. Recommended immunization schedule for children and adolescents aged 18 years or younger, United States, 2018. https://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html . Accessed May 9, 2018.

National Center for Injury Prevention and Control. 10 leading causes of death by age group, United States—2015. https://www.cdc.gov/injury/images/lc-charts/leading_causes_of_death_age_group_2015_1050w740h.gif . Accessed April 24, 2017.

Durbin DR American Academy of Pediatrics Committee on Injury, Violence, and Poison Prevention. Child passenger safety. Pediatrics. 2011;127(4):788-793.

American Academy of Pediatrics Committee on Injury and Poison Prevention. Reducing the number of deaths and injuries from residential fires. Pediatrics. 2000;105(6):1355-1357.

Gardner HG American Academy of Pediatrics Committee on Injury, Violence, and Poison Prevention. Office-based counseling for unintentional injury prevention. Pediatrics. 2007;119(1):202-206.

American Academy of Pediatrics Committee on Injury, Violence, and Poison Prevention. Prevention of drowning in infants, children, and adolescents. Pediatrics. 2003;112(2):437-439.

American Academy of Pediatrics Committee on Injury and Poison Prevention. Injuries associated with infant walkers. Pediatrics. 2001;108(3):790-792.

American Academy of Pediatrics Committee on Injury and Poison Prevention. Falls from heights: windows, roofs, and balconies. Pediatrics. 2001;107(5):1188-1191.

Dowd MD, Sege RD Council on Injury, Violence, and Poison Prevention Executive Committee; American Academy of Pediatrics. Firearm-related injuries affecting the pediatric population. Pediatrics. 2012;130(5):e1416-e1423.

American Academy of Pediatrics Committee on Injury, Violence, and Poison Prevention. Prevention of choking among children. Pediatrics. 2010;125(3):601-607.

Kendrick D, Young B, Mason-Jones AJ, et al. Home safety education and provision of safety equipment for injury prevention (review). Evid Based Child Health. 2013;8(3):761-939.

American Academy of Pediatrics Section on Oral Health. Maintaining and improving the oral health of young children. Pediatrics. 2014;134(6):1224-1229.

Heyman MB, Abrams SA American Academy of Pediatrics Section on Gastroenterology, Hepatology, and Nutrition Committee on Nutrition. Fruit juice in infants, children, and adolescents: current recommendations. Pediatrics. 2017;139(6):e20170967.

Council on Communications and Media. Media and young minds. Pediatrics. 2016;138(5):e20162591.

Moon RY Task Force on Sudden Infant Death Syndrome. SIDS and other sleep-related infant deaths: evidence base for 2016 updated recommendations for a safe infant sleeping environment. Pediatrics. 2016;138(5):e20162940.

American Academy of Pediatrics Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2012;129(3):e827-e841.

Wagner CL, Greer FR American Academy of Pediatrics Section on Breastfeeding; Committee on Nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents [published correction appears in Pediatrics . 2009;123(1):197]. Pediatrics. 2008;122(5):1142-1152.

Huh SY, Rifas-Shiman SL, Taveras EM, Oken E, Gillman MW. Timing of solid food introduction and risk of obesity in preschool-aged children. Pediatrics. 2011;127(3):e544-e551.

Greer FR, Sicherer SH, Burks AW American Academy of Pediatrics Committee on Nutrition; Section on Allergy and Immunology. Effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas. Pediatrics. 2008;121(1):183-191.

American Academy of Pediatrics Committee on Nutrition. The use of whole cow's milk in infancy. Pediatrics. 1992;89(6 pt 1):1105-1109.

Fleischer DM, Spergel JM, Assa'ad AH, Pongracic JA. Primary prevention of allergic disease through nutritional interventions. J Allergy Clin Immunol Pract. 2013;1(1):29-36.

Grossman DC, Bibbins-Domingo K, Curry SJ, et al. Screening for obesity in children and adolescents: U.S. Preventive Services Task Force recommendation statement. JAMA. 2017;317(23):2417-2426.

Daniels SR, Hassink SG Committee on Nutrition. The role of the pediatrician in primary prevention of obesity. Pediatrics. 2015;136(1):e275-e292.

American Academy of Family Physicians. Physical activity in children. https://www.aafp.org/about/policies/all/physical-activity.html . Accessed January 1, 2018.

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8 Questions to Ask at a Well-Child Visit With Your Pediatrician

A well-child visit is an important part of keeping your child healthy. From babyhood through the teen years, these routine checkups are a great time to talk to your doctor about your child’s growth, development and behavior.

Lauren Nguyen, MD, MPH , a pediatrician with Children’s Medical Group in Torrance, California, part of the  Children’s Hospital Los Angeles Care Network , shares eight key questions to ask your pediatrician during your appointment.

1. Are my child’s growth and weight healthy?

At each visit, your doctor will do basic measurements of your child, including height and weight (and head circumference for babies and toddlers).

“Children are in a rapid phase of growth, so we want to make sure they’re following their own growth curve,” Dr. Nguyen says. “If there are any dramatic changes or concerns about that growth, the pediatrician will address them.”

Growth and weight are important beyond the baby years. For older children and teens, gaining too much weight is a common issue. Other children may experience early puberty. Talk to your doctor about any concerns you have about your child’s growth.

2. Is my child on schedule for his/her vaccinations?

At the end of the visit, your child will receive any needed vaccinations. These shots are critical for protecting your child from a host of serious diseases, including whooping cough, polio, measles and more.

Your doctor should explain which vaccines your child is receiving and what they protect against. Ask which shots are coming up for the next visit as well.

“It’s extremely important for your child to not only get these vaccinations, but to also get them on schedule ,” Dr. Nguyen says. “It can sometimes take weeks or multiple doses of a vaccine before a child is fully protected. The schedule is carefully designed to make sure your child is protected at the right time.”

Children will receive most vaccinations before the age of 6 or after 10 years old. But don’t skip a well-child visit during this gap just because no shots are needed. These are key growing years, plus your child should receive the flu shot every year, so it’s important to still have regular checkups with your pediatrician.

3. What should my child eat (and not eat)?

Nutrition is a big part of a child’s growth and development. Talk to the doctor about your child’s diet. For babies and toddlers, you might have questions around breastfeeding, when to introduce solid foods and what to do if your child is a picky eater.

Ask your doctor which foods your child should eat—and which they should not. Dr. Nguyen tells her patients to avoid juices and sodas, for example. “You want to establish healthy behaviors at a young age,” she says. “It’s so much harder to change these habits later on.”

Be sure to also tell your doctor about any vitamins or supplements your child is taking. “Gummy vitamins have become very popular for young children, but they’re one of the biggest causes of childhood cavities,” Dr. Nguyen explains. “A multivitamin is fine, but it should be a chewable tablet.”

4. Which milestones should my child reach next?

Your doctor will want to know if your child is achieving the typical milestones for his or her age group. In the early years, these include smiling, walking, throwing, grabbing and talking. In addition, ask which milestones your child should reach by the next appointment.

“For example, at the 15-month checkup I’ll say, ‘By 18 months, I’d like your baby to be able to say 10 words, to be able to almost run, to scribble and color and use utensils,’” Dr. Nguyen explains. “That lets parents know what to look for in their baby’s development.”

5. How can I keep my child safe?

For babies and toddlers, safety questions can cover car seats, child-proofing your home, sun exposure and more. For older children, questions might include: When can my child graduate from a booster seat? How much screen time is appropriate?

For adolescents and teens, safety conversations often center around social media use, drugs and alcohol, and sex. Your pediatrician may want to talk one-on-one with your teen about these issues. Talk to your doctor about what you are comfortable with.

6. What about my child’s mental health?

Mental health is important at every age, but this is a particular focus for adolescents. Is your child depressed or anxious? Struggling in school? Having trouble making friends?

“There is a significant increase of depression and anxiety right now among children and adolescents,” Dr. Nguyen says. “The earlier you can identify a mental health issue, the earlier you can treat it. Don’t be afraid to bring up these issues.”

7. Is it normal that my child … ?

This can be anything you’re concerned about—from a recurring rash or a strange bump to weight gain, picky eating or trouble making friends.

Tip: Write down your questions before the appointment. Put the most important ones at the top of the list. If a question comes up after your appointment, call and ask.

“Parents know their child best,” Dr. Nguyen says. “If you feel something is off, definitely ask your pediatrician. There might be an issue we need to address. Fortunately, most of the time your doctor can reassure you that your child is fine.”

8. When is my next appointment?

Before you head home, don’t forget to book your next well-child visit.

“Many parents don’t schedule that next visit, and then it’s easy to start falling behind,” Dr. Nguyen says. “You can always change the date later if you need to. Making the appointment while you’re still at the office is the best way to ensure you’ll stay on track.”

Related content

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When Can My Baby Have Solid Food?

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Well-Child Visits: Parent and Patient Education

The Bright Futures Parent and Patient Educational Handouts help guide anticipatory guidance and reinforce key messages (organized around the 5 priorities in each visit) for the family. Each educational handout is written in plain language to ensure the information is clear, concise, relevant, and easy to understand. Each educational handout is available in English and Spanish (in HTML and PDF format). Beginning at the 7 year visit , there is both a Parent and Patient education handout (in English and Spanish).

For the Bright Futures Parent Handouts for well-child visits up to 2 years of age , translations of 12 additional languages (PDF format) are made possible thanks to the generous support of members, staff, and businesses who donate to the AAP Friends of Children Fund . The 12 additional languages are Arabic, Bengali, Chinese, French, Haitian Creole, Hmong, Korean, Polish, Portuguese, Russian, Somali, and Vietnamese.

Reminder for Health Care Professionals:  The  Bright Futures Tool and Resource Kit, 2nd Edition ​ is available as an online access product. For more detailed information about the Toolkit, visit  shop.aap.org . To license the Toolkit to use the forms in practice and/or incorporate them into an Electronic Medical Record System, please contact  AAP Sales .

Parent Educational Handouts

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American Academy of Pediatrics

Doctor Visits

Make the Most of Your Baby’s Visit to the Doctor (Ages 0 to 11 Months)

Take Action

Babies need to go to the doctor or nurse for a “well-baby visit” 6 times before their first birthday.

A well-baby visit is when you take your baby to the doctor to make sure they’re healthy and developing normally. This is different from other visits for sickness or injury.

At a well-baby visit, the doctor or nurse can help catch any problems early, when they may be easier to treat. You’ll also have a chance to ask any questions you have about caring for your baby.

Learn what to expect so you can make the most of each well-baby visit.

Well-Baby Visits

How often do i need to take my baby for well-baby visits.

Babies need to see the doctor or nurse 6 times before their first birthday. Your baby is growing and changing quickly, so regular visits are important.

The first well-baby visit is 2 to 3 days after coming home from the hospital, when the baby is about 3 to 5 days old. After that first visit, babies need to see the doctor or nurse when they’re:

• 1 month old
• 2 months old
• 4 months old
• 6 months old
• 9 months old

If you’re worried about your baby’s health, don’t wait until the next scheduled visit — call the doctor or nurse right away.

Child Development

How do i know if my baby is growing and developing on schedule.

Your baby’s doctor or nurse can help you understand how your baby is developing and learning to do new things — like smile or turn their head to hear your voice. These are sometimes called “developmental milestones.”

At each visit, the doctor or nurse will ask you how you’re doing as a parent and what new things your baby is learning to do. 

By age 2 months, most babies:

• Lift their head when lying on their stomach
• Look at your face
• Smile when you talk to them
• React to loud sounds

See a complete list of milestones for kids age 2 months .

By age 4 months, most babies:

• Bring their hands to their mouth
• Make cooing sounds
• Hold toys that you put in their hand
• Turn their head to the sound of your voice
• Make sounds when you talk to them

See a complete list of milestones for kids age 4 months .

By age 6 months, most babies:

• Lean on their hands for support when sitting
• Roll over from their stomach to their back
• Show interest in and reach for objects
• Recognize familiar people
• Like to look at themselves in a mirror

See a complete list of milestones for kids age 6 months . 

By age 9 months, most babies:

• Make different sounds like “mamamama” and “bababababa”
• Smile or laugh when you play peek-a-boo
• Look at you when you say their name
• Sit without support

See a complete list of milestones for kids age 9 months . 

What if I'm worried about my baby's development? 

Remember, every baby develops a little differently. But if you’re concerned about your child’s growth and development, talk to your baby’s doctor or nurse. 

Learn more about newborn and infant development .

Take these steps to help you and your baby get the most out of well-baby visits.

Gather important information.

Take any medical records you have to the appointment, including a record of vaccines (shots) your baby has received and results from newborn screenings . Read about newborn screenings .

Make a list of any important changes in your baby’s life since the last doctor’s visit, like:

• Falling or getting injured
• Starting daycare or getting a new caregiver

Use this tool to  keep track of your baby’s family health history .

What about cost?

Under the Affordable Care Act, insurance plans must cover well-child visits. Depending on your insurance plan, you may be able to get well-child visits at no cost to you. Check with your insurance company to find out more.

Your child may also qualify for free or low-cost health insurance through Medicaid or the Children’s Health Insurance Program (CHIP). Learn about coverage options for your family.

If you don’t have insurance, you may still be able to get free or low-cost well-child visits. Find a health center near you and ask about well-child visits.

To learn more, check out these resources:

• Free preventive care for children covered by the Affordable Care Act
• How the Affordable Care Act protects you and your family
• Understanding your health insurance and how to use it [PDF - 698 KB]

Ask Questions

Make a list of questions to ask the doctor..

Before the well-baby visit, write down 3 to 5 questions you have. Each well-baby visit is a great time to ask the doctor or nurse any questions about:

• How your baby is growing and developing
• How your baby is sleeping
• Breastfeeding your baby
• When and how to start giving your baby solid foods
• What changes and behaviors to expect in the coming months
• How to make sure your home is safe for a growing baby

Here are some questions you may want to ask:

• Is my baby up to date on vaccines?
• How can I make sure my baby is getting enough to eat?
• Is my baby at a healthy weight?
• How can I make sure my baby is sleeping safely — and getting enough sleep?
• How can I help my baby develop speech and language skills?
• Is it okay for my baby to have screen time?
• How do I clean my baby's teeth?

Take a notepad, smartphone, or tablet and write down the answers so you can remember them later.

Ask what to do if your baby gets sick.

Make sure you know how to get in touch with a doctor or nurse when the office is closed. Ask how to reach the doctor on call, or if there's a nurse information service you can call at night or on the weekend.

What to Expect

Know what to expect..

During each well-baby visit, the doctor or nurse will ask you about your baby and do a physical exam. The doctor or nurse will then update your baby’s medical history with all of this information.

The doctor or nurse will ask questions about your baby.

The doctor or nurse may ask about:

• Behavior — Does your baby copy your movements and sounds?
• Health — How many diapers does your baby wet each day? Does your baby spend time around people who are smoking or using e-cigarettes (vaping)?
• Safety — If you live in an older home, has it been inspected for lead? Do you have a safe car seat for your baby?
• Activities — Does your baby try to roll over? How often do you read to your baby?
• Eating habits — How often does your baby eat each day? How are you feeding your baby?
• Family — Do you have any worries about being a parent? Who can you count on to help you take care of your baby?

Your answers to questions like these will help the doctor or nurse make sure your baby is healthy, safe, and developing normally.

Physical Exam

The doctor or nurse will also check your baby’s body..

To check your baby’s body, the doctor or nurse will:

• Measure height, weight, and the size of your baby’s head
• Take your baby’s temperature
• Check your baby’s eyes and hearing
• Check your baby’s body parts (this is called a physical exam)
• Give your baby shots they need

Learn more about your baby’s health care:

• Read about what to expect at your baby’s first checkups
• Find out how to get your baby’s shots on schedule

Content last updated March 30, 2023

Reviewer Information

This information on well-baby visits was adapted from materials from the Centers for Disease Control and Prevention and the National Institutes of Health.

Reviewed by: Sara Kinsman, M.D., Ph.D. Director, Division of Child, Adolescent, and Family Health Maternal and Child Health Bureau Health Resources and Services Administration

Bethany Miller, M.S.W. Chief, Adolescent Health Branch Maternal and Child Health Bureau Health Resources and Services Administration

Diane Pilkey, R.N., M.P.H. Nursing Consultant, Division of Child, Adolescent, and Family Health Maternal and Child Health Bureau Health Resources and Services Administration

September 2021

You may also be interested in:

Breastfeed Your Baby

Take Care of Your Child's Teeth

Eat Healthy During Pregnancy: Quick Tips

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Your New Baby's Well-Child Check-Up Schedule (and What to Expect)

Introduction

Well-baby visits are a staple of every new parent’s life. From the day they are born throughout their first year, your baby will have several wellness visits to ensure that they are healthy, happy, and reaching developmental milestones. 

Well-baby visits are vital for immunizations, healthcare, and support from your pediatrician. At Juno Pediatrics, we love establishing relationships with parents that last throughout their baby’s childhood. From newborn through adulthood, Juno is there for every step along the way. 

In this guide, we will explore new-baby visits in-depth, including what to expect, when to schedule them, and how to give your little one the best care possible.

What Are Well-Baby Visits? 

Also known as well-child check-ups, these appointments are pivotal points in their development and healthcare. From the day your baby is born, doctor’s visits will become a regular part of your life. A baby’s first year is filled with trips to the pediatrician where parents can ask questions, get advice and address any concerns they may have. 

In addition to spotting any issues or developmental warning signs, parents can seek out advice on common concerns, such as how to soothe teething, when to expect their baby to start walking, weaning, and breastfeeding. 

Bear in mind that well-child visits are different from additional doctor’s appointments you may need. For example, if your baby falls ill, is injured or you are concerned about something, you can schedule additional evaluations outside of their well-visit schedule. 

Well-Baby Visit Schedule 

Each baby receives a well-baby check-up at 2-5 days,1 month, 2 months, 6 months, 9 months, and 12 months from their birth date. You can, of course, also schedule additional appointments to address any concerns with your pediatrician. 

Remember that well-visits aren’t just for your baby — they are meant to help you, too! There are many parenting milestones you will reach your baby’s first year. From feeding to sleeping, walking to teething, the team at Juno Pediatrics is here to help you nurture your little one every step of the way. 

The First Check-Up: 2-5 Days

The first visit is also important to establish a baby’s feeding habits. All babies lose weight after birth, and it is critical to make sure that the baby is within a healthy range of weight loss and maintains adequate hydration while they learn to eat. Sometimes, a newborn needs assistance with latching onto the breast or learning to take a bottle, which the doctor can address and assist with.

Some babies become jaundiced , a condition caused by too much bilirubin in the bloodstream. This is a yellow substance produced by red blood cells as they break down and accumulate in the baby’s skin.  This will be closely monitored with physical exams and bloodwork if necessary. If your baby had feeding issues or jaundice at birth, you may have daily visits from birth until their condition improves.

If you have a home birth, then your baby should visit the doctor one to two days after entering the world.  This is important because an infant needs vital exams within the first 48 hours of life. Certain tests that were not done at your home birth will be done at this visit, including taking a sample of the baby’s blood for a Newborn Screen. This metabolic screening during this early check-up ensures that your newborn’s body systems are all functioning as they should.

Depending on how your baby is growing and feeding, you will have a weight check between your first and second well-child visits. At this exam, your pediatrician will take your baby’s measurements and start to build their health record. They will address subjects like regular feedings, sleep schedules, and skills like diaper changing and swaddling. 

This visit is the perfect time to establish a connection with your baby’s doctor. They are here for you, so don’t hesitate to ask all your questions, share any concerns and be honest about how you’re feeling. 

Many new parents struggle in the early days, and if you’re feeling overwhelmed, your pediatrician can help. 

The Second Visit: 1 Month

Your baby will grow rapidly throughout its first four weeks of life. You don’t have to schedule this well-visit on the exact 1-month date but aim to make it during the milestone week. 

From birth, babies will typically gain 1 ounce every day for the first 30 days. By the time they reach 1-month old , most will have gone through two small but rapid growth periods and gained at least 2 additional pounds. 

During their 1-month well-visit, the doctor will begin by checking your baby’s vital signs and taking their measurements. Then, the doctor will check in with you and how you’re feeling. They can offer tips and suggestions on how to nurture your baby’s development through play, tummy time and reading. 

Through feeding, playing, cuddling, and rest, your baby will develop according to their own body. If they have a condition that will affect their health and development, the pediatrician will discuss this in detail and give you advice on what to look for. 

The Third Check-Up: 2 Months

At the 8-week mark, your baby will be far more alert than when they were born. The average 2-month old is more visually engaged and able to look at an object for several seconds as well as watch you when you move. 

At the beginning of this and every visit, your baby’s vital signs measurements will be taken and documented. Your pediatrician will review how they are eating, voiding, stooling, and sleeping.  In addition, your pediatrician will review their development and milestone and give you guidance on what to expect for the next two months before their next checkup

This visit is also the time to start immunization. At the 2-month well-visit, your infant will obtain 4 vaccines and be protected against 8 serious bacterial and viral diseases. 

The following vaccines are administered at the 2-month visit, and comprises the first set of their primary series:

Hepatitis B

Diphtheria/Tetanus/Pertussis (DTaP) 

Haemophilus influenzae type b (Hib) 

Pneumococcal (PCV)

Polio (IPV) 

Rotavirus (RV)

Be sure to voice any concerns or questions you have about vaccines and immunization with your pediatrician. Many parents who never second-guessed immunization can become anxious after they have a baby. They will discuss everything you need to know, listen to how you feel and answer your questions. 

At Juno Pediatrics , we are committed to providing the highest level of care and protection, and toward that goal, we ensure that all of our patients are vaccinated on schedule and on time.  You can find more on our approach to pediatric vaccines on our website . Your pediatrician will be there to answer any and all questions along the way.

The Fourth Check-Up: 4 Months

Four-month-olds are smiling, cooing babies, reaching for toys and your hair, looking around, and holding their heads up with more stability. 

The care assistant will take your baby’s vitals and measurements, as usual, review how the child is doing, answer your questions, and let you know what to expect in the coming two months.  Additionally, at this visit, we will start discussing introducing solid foods to your baby, a fun new adventure!

Your infant will also receive his second set of vaccines, the exact same one they received at the 2-month visit.  This is the second of three of their primary series vaccines.

The Fifth Check-Up: 6 Months

The half-year mark is a major milestone in a baby’s life. Their personality will have emerged and begun to shine through as they engage more with you, their family, and the world around them. By this age , they may begin to sit on their own, enjoy looking at their reflection in mirrors and show emotional responses to others. 

Your pediatrician will take your baby’s vitals and measurements as usual, then discuss some of the 6-month-old milestones to expect. If you are worried about your baby’s development, the doctor will listen intently and offer reassurance and guidance.

If your baby is not mobile, does not sit up or hold things, does not laugh or smile, or does not respond to its caretakers, then make sure you bring these issues up with your doctor. 

The final 4 vaccines of the primary series will be administered at this visit by the pediatrician. During flu season, your baby is eligible to receive its first influenza vaccine. This is administered to children in 2 doses roughly 1 month apart. 

The Sixth Check-Up: 9 Months

A 9-month-old is curious, adventurous, and always interested in the world around them. They will be eating solid foods 2-3x a day in addition to breast milk and formula and are starting to express their independence. At this stage , most babies are very vocal and have some ability to move. 

They will have a range of emotional expressions from deep frowns to big, happy smiles. They can also express anger and frustration more clearly, so it will be easier to differentiate their cries and understand their feelings. 

Your pediatrician will ensure the baby’s growth is on par with their sex and age. Then, they will begin to discuss their oral hygiene, as your baby may have a tooth erupted. . If you are concerned about any developmental delays, they can be addressed during this time.

Lack of emotional response, limited eye contact, infrequent mobility, and poor motor skills can indicate an issue that the doctor should know about. They can address these concerns and, if need be, refer you and your baby to a specialist. 

Bear in mind that every baby is unique, and some children reach milestones later without having any major conditions.

The Seventh Check-Up: 1 Year

As you celebrate your child’s first year of life, your pediatrician will offer advice on how to nurture them through late infancy into early toddlerhood. Over the next year, they will experience many changes to their cognitive, mental, and emotional development.

Your baby’s personality will emerge even more from this point forward, especially as they become more mobile, taking first steps, and communicative, saying first words and phrases.

At the 12-month-old check-up , your baby will undergo a blood test that checks lead level and hemoglobin screening, which checks for anemia . 

The 1-year mark is also time for babies to receive the following vaccines:

Measles, Mumps, and Rubella (MMR)

Chickenpox (varicella)

Hepatitis A 

Their final boosters of DTaP and Hib vaccines will be given at their 15-month check-up, and their final Hepatitis A vaccine and PCV vaccine will be completed at the 18-month visit.

Your Baby’s Health Journey Starts Here

At Juno, we provide comprehensive healthcare for the entire family. Our medical team includes board-certified pediatricians who take the time to listen to your experiences, hear your concerns, and ensure your baby gets the highest quality care. If you are looking for a long-term practice to nurture your baby, schedule an appointment with Juno Pediatrics today .

10 questions to ask a pediatrician at well visits

A well child visit is the best time to talk to your pediatrician about normal growth, development and behavior.

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A well child visit is the best time to talk to your pediatrician about normal growth, development and behavior. We’ve put together the top 10 questions to ask a pediatrician during your visit.

• Is my child’s development and growth appropriate for her age?
• What vaccine(s) does my child need during this visit? What does it protect against?
• Is everything up to date, and may I get a record of my child’s shots?
• What infectious diseases are going around and how can I best keep my kids safe from them?
• Is my child old enough to graduate from a car seat to booster seat? Is it time to get rid of a booster seat? Can I turn my child’s car seat forward?
• When should my child start using regular toothpaste?
• Should my child be going to the dentist?
• Is bedwetting normal for older potty-trained kids?
• When should I bring my child back?
• And finally, ask about any specific concerns you have, like “Why is my child always tired?” or “How can I manage my child’s allergies?”

It’s also important to ask questions about any sort of treatment that is being prescribed. Parents should understand the diagnosis, how long to give their child the prescribed medicine and what dosage to give. Do not hesitate to ask the pediatrician to clarify instructions.

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Posts from daniel felten, md, mph, my toddler loves to touch himself. how do i handle this.

Thanks for your tip to hire a pediatrician that can help with your child’s development. I like how you said that it’s important to ask them about how often they should be visiting. My husband and I are considering medications for our little girl now that she should probably start seeing some sort of doctor regularly.

You’re welcome! And good luck!

I appreciate that you talked about how it’s important to ask questions about any sort of treatment that is being prescribed. My aunt is looking to hire pediatricians to take her kids to. I’ll be sure to talk to her about asking smart questions to make sure she hires the right professional for her.

Thank you Kyle!

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Feeding your baby, your changing baby, healthy teeth, what to expect at your baby’s 6 month visit, bright futures parent handout: 4 month visit.

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Bright Futures Parent Handout: 4 Month Visit. Pediatric Patient Education 2021; 10.1542/peo_document248

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Here are some suggestions from Bright Futures experts that may be of value to your family.

Learn if your home or drinking water has lead and take steps to get rid of it. Lead is toxic for everyone.

Take time for yourself and with your partner. Spend time with family and friends.

Choose a mature, trained, and responsible babysitter or caregiver.

You can talk with us about your child care choices.

For babies at 4 months of age, breast milk or iron-fortified formula remains the best food. Solid foods are discouraged until about 6 months of age.

Avoid feeding your baby too much by following the baby’s signs of fullness, such as

Leaning back

Turning away

If Breastfeeding

Providing only breast milk for your baby for about the first 6 months after birth provides ideal nutrition. It supports the best possible growth and development.

Be proud of yourself if you are still breastfeeding. Continue as long as you and your baby want.

Know that babies this age go through growth spurts. They may want to breastfeed more often and that is normal.

If you pump, be sure to store your milk properly so it stays safe for your baby. We can give you more information.

Give your baby vitamin D drops (400 IU a day).

Tell us if you are taking any medications, supplements, or herbal preparations.

If Formula Feeding

Make sure to prepare, heat, and store the formula safely.

Feed on demand. Expect him to eat about 30 to 32 oz daily.

Hold your baby so you can look at each other when you feed him.

Always hold the bottle. Never prop it.

Don’t give your baby a bottle while he is in a crib.

Create routines for feeding, nap time, and bedtime.

Calm your baby with soothing and gentle touches when she is fussy.

Make time for quiet play.

Hold your baby and talk with her.

Read to your baby often.

Encourage active play.

Offer floor gyms and colorful toys to hold.

Put your baby on her tummy for playtime. Don’t leave her alone during tummy time or allow her to sleep on her tummy.

Don’t have a TV on in the background or use a TV or other digital media to calm your baby.

Go to your own dentist twice yearly. It is important to keep your teeth healthy so you don’t pass bacteria that cause cavities on to your baby.

Don’t share spoons with your baby or use your mouth to clean the baby’s pacifier.

Use a cold teething ring if your baby’s gums are sore from teething.

Don’t put your baby in a crib with a bottle.

Clean your baby’s gums and teeth (as soon as you see the first tooth) 2 times per day with a soft cloth or soft toothbrush and a small smear of fluoride toothpaste (no more than a grain of rice).

Use a rear-facing–only car safety seat in the back seat of all vehicles.

Never put your baby in the front seat of a vehicle that has a passenger airbag.

Your baby’s safety depends on you. Always wear your lap and shoulder seat belt.

Never drive after drinking alcohol or using drugs. Never text or use a cell phone while driving.

Always put your baby to sleep on her back in her own crib, not in your bed.

Your baby should sleep in your room until she is at least 6 months of age.

Make sure your baby’s crib or sleep surface meets the most recent safety guidelines.

Don’t put soft objects and loose bedding such as blankets, pillows, bumper pads, and toys in the crib.

Drop-side cribs should not be used.

Lower the crib mattress.

If you choose to use a mesh playpen, get one made after February 28, 2013.

Prevent tap water burns. Set the water heater so the temperature at the faucet is at or below 120°F /49°C.

Prevent scalds or burns. Don’t drink hot drinks when holding your baby.

Keep a hand on your baby on any surface from which she might fall and get hurt, such as a changing table, couch, or bed.

Never leave your baby alone in bathwater, even in a bath seat or ring.

Keep small objects, small toys, and latex balloons away from your baby.

Don’t use a baby walker.

We will talk about

Caring for your baby, your family, and yourself

Teaching and playing with your baby

Brushing your baby’s teeth

Introducing solid food

Keeping your baby safe at home, outside, and in the car

The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances. Original handout included as part of the Bright Futures Tool and Resource Kit , 2nd Edition.

Listing of resources does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication.

The American Academy of Pediatrics (AAP) does not review or endorse any modifications made to this handout and in no event shall the AAP be liable for any such changes.

© 2019 American Academy of Pediatrics. All rights reserved.

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• Safe Sleep and Your Baby: How Parents Can Reduce the Risk of SIDS and Suffocation
• VIS—Hib (Haemophilus Influenzae type b) Vaccine
• VIS—Pneumococcal Conjugate Vaccine
• Crying and Your Baby: How to Calm a Fussy or Colicky Baby
• VIS—Polio Vaccine
• VIS—Rotavirus Vaccine
• VIS—DTaP (Diphtheria, Tetanus, Pertussis) Vaccine
• Bright Futures Parent Handout: 6 Month Visit
• Bright Futures Parent Handout: 2 Month Visit
• How to Prevent Tooth Decay in Your Baby
• TIPP—Birth to 6 Months: Safety for Your Child

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• 10 Questions to Ask During Your Child’s Pediatrician Appointment

Following the recommended schedule for checkups is the best thing you can do for your child’s long-term health. These appointments are the perfect opportunity to talk to your pediatrician about growth, development and behavior.

Here are 10 questions to ask your pediatrician at each well-child visit to help you get the most out of your appointment:

1. Is my child’s development and growth appropriate for his/her age?

Especially during the infant months, it can be easy to become fixated on the percentiles for your child’s height and weight. Whether your child is in the 25th percentile or the 90th, both can be considered normal. The more important factor is the rate of growth and development.

2. What vaccine(s) does my child need during the visit? What does it protect against?

For some physicians, immunizations are so commonplace that they may neglect to thoroughly explain exactly what vaccinations they are administering at each appointment. Don’t be afraid to ask questions. Be sure to ask about possible adverse reactions and in what cases you should contact the doctor should they appear.

3. Is everything up to date, and may I get a record of my child’s shots?

In accordance with Georgia state law, licensed childcare facilities and public schools are required to verify immunizations prior to admittance for all children. There are only two types of exemptions–medical and religious, both of which require either a valid Georgia Immunization Certificate or a signed, notarized statement called an affidavit of religious exemption. You may also be asked to provide a shot record for sports or other extracurricular activities. Go ahead and request a copy of your child’s shot records before you leave the pediatrician’s office so that you already have it when the need arises.

4. What infectious diseases are going around and how I can best protect against them?

Your pediatrician can tell you if there is currently an outbreak of contagious illnesses such as RSV, the flu, whooping cough or norovirus, and measures you can take to help keep your child from contracting it.

5. Can I turn my child’s car seat forward? Is he/she old enough for a booster seat or to get rid of the booster seat?

When it comes to child safety seats, it’s less about age and more about height, weight and the limitations of the safety seat that you are using. Before turning the seat around, moving to a booster or getting rid of a booster seat, consult with your child’s pediatrician.

6. When should my child start using regular toothpaste?

Ask your doctor if your child should be using fluoride or fluoride-free toothpaste, and whether your child can benefit from fluoride varnish.

7. At what age should my child go to the dentist and how often?

If you haven’t already chosen a pediatric dentist, ask for recommendations in your area. You may also want to verify with your insurance provider at what age preventative coverage starts for children.

8. Is bedwetting normal for older potty-trained kids?

Accidents well after your child is potty-trained can be normal, particularly overnight. If you have concerns over whether your child’s accidents are considered excessive or indicative of another problem, ask at your next appointment. Your provider may have recommendations about ways you can help your child.

9. When should I bring my child back?

During the first two years of your child’s life, you will visit the pediatrician more frequently. Beyond that, checkups will space out. Ask when you should bring your child back. In many cases, physician schedules won’t be available that far out to book your next appointment before you leave, but be sure to ask how far in advance you should call or request an appointment online to ensure you’re able to see your preferred provider.

10. And finally, ask about any specific concerns you have, like “what can I do to encourage my picky eater to eat?” or “How can I manage my child’s allergies?”

Your pediatrician only sees your child a few times a year, or in some cases only once a year. And typically,  appointments are fairly brief. If you don’t raise specific concerns you have, they may not be able to tell as your child may not present symptoms while in front of them.

Schedule Your Child’s Well Visit Today

If it is time for your child’s well visit, please contact our office at (706) 876-2130 to schedule an appointment or request an appointment online. White’s Pediatrics has three locations in Dalton, Chatsworth and Calhoun, Georgia to best serve you

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Child Well-Visits: 8 Questions to Ask at Your Next Appointment

July 20, 2021

Whether you are a new parent or have older kids, there are always things to learn about your child’s development and health. That’s why it’s important for you to schedule child-well visits with a pediatrician. Pediatricians are highly trained in the conditions of childhood, so they have a wealth of information you can use to keep your child healthy and happy.

When you take your child to the doctor for an illness or injury, it’s easy to keep track of what you want to talk about with the pediatrician. However, at a well-visit, your child’s overall health is the focus, so it can be hard to keep track of what you want to discuss with the doctor. In order to make sure you get the most out of your next appointment for a child well-visit, make a list of questions to ask using these eight suggestions as a starting point.

1. Is my child meeting milestones for growth and development?

Every child is different, so they do not always hit the same milestones at the same exact age. However, your pediatrician can discuss the age ranges certain developmental milestones should be met, especially in babies and toddlers. If your child is not meeting milestones for development or physical growth, then you and your doctor can discuss any steps you can take to help your child, like special diets for growth, speech therapy, or help with fine motor skills.

2. What vaccines does my child need now or in the near future? Can I get a copy of my child’s shot record?

Your child’s doctor will likely make sure you get reminders about needed vaccines, and yearly visits are a good way to keep up-to-date. The Centers for Disease Control and Prevention (CDC) also has a guide on the recommended child and adolescent immunization schedule . If the pediatrician does not give you information on what vaccines or boosters your child needs, make sure to ask so you can discuss what’s coming up and when your child needs certain shots.

3. What kind of seat should my child be using in the car?

You probably know the guidelines about what kind of car seat is safest for your child based on age, weight, and height, but you might still want to check in with their doctor to make sure you are using the safest option for your child. Plus, since your child will be weighed and measured during the well-visit, you will have the most up to date numbers.

4. Are there any infectious illnesses going around and how can I prevent my child from getting sick?

Ask your child’s doctor if they know of any illnesses affecting your area at the time. And if so, ask if there are steps you can take to protect your family from getting sick. While many contagious conditions can be vaccinated against, some things like stomach bugs, colds, and hand-foot-and-mouth disease cannot be prevented with vaccines. The pediatrician can give you tips on avoiding these conditions.

Also, some communities are still vulnerable to illnesses that have vaccines because a percentage of the population has chosen not to vaccinate, harming herd immunity. Outbreaks of measles, mumps, chickenpox, and other preventable diseases have occurred in several areas in recent years. So, make sure your child is up to date on vaccines and boosters they need.

5. When should my child go to the dentist?

Generally, pediatricians and pediatric dentists recommend that your child start seeing the dentist by their first birthday, if not as soon as their first teeth come in. However, if you want more guidance in your child’s case, then ask the pediatrician when your child should start having check-ups and when they need to move on to get regular cleanings. Also, if you have questions about when the right time is for your child to switch from training toothpaste to a toothpaste with fluoride.

6. Questions about any specific concerns you have about your child’s health or behavior.

No two children are the same, so if you have specific concerns about your child, make sure to bring them up with the pediatrician. They can be pretty thorough, but they cannot cover every possible issue. So, if your child is exhibiting unusual behavior or physical symptoms, put those questions on the list of things to be addressed. Possible topics might include:

• Vision problems (squinting, not being able to see the board at school, sitting too close to the TV)
• Behavioral issues (acting out of anger, difficulty paying attention, hyperactivity)
• Sleep issues or unusual fatigue
• Allergies and food sensitivities
• Breathing issues/asthma

7. Can you give me a referral for a specialist?

If your child has a problem that the pediatrician is not equipped to treat, like vision issues, your pediatrician is a good resource for recommendations on good providers. Many pediatricians have working relationships with doctors who specialize in pediatric dentistry, optometry/ophthalmology, allergies, or dermatology. They may also be able to provide you with options for counselors or mental health professionals if you have concerns about behavioral or emotional health.

8. When do I need to bring my child back?

Make sure you are familiar with the recommended schedule of well-visits. The American Academy of Pediatrics’ website for parents, healthychildren.org has a summary of the recommended schedule. Well-visits should be more frequent for babies and toddlers and then become yearly around age 3. Of course, you should make sure your child sees the pediatrician in cases of illness and injury, as well as for vaccinations.

Make an Appointment

Holly Springs Pediatrics is a family-oriented practice with two healthcare providers serving the Holly Springs area. We aim to create a safe and comfortable medical home for children and parents and believe in having an open and collaborative relationship with each patient. If you have questions or concerns about your child’s health or want to schedule a child well-visit, call (919) 249-4700. You can also request an appointment online .

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Colorado Avalanche player suspended for 6 months just one hour before playoff loss

DENVER — Colorado Avalanche forward Valeri Nichushkin was suspended for at least six months without pay and placed in stage 3 of the league’s player assistance program before Game 4 on Monday night of  a second-round series  with Dallas.

The National Hockey League and National Hockey League Players’ Association announced the news about an hour before the start of the game with the Stars. It’s the second time this season he’s been in the program. Stage 3 means Nichushkin violated the terms of the program.

The 29-year-old Russian forward will miss the rest of the postseason and the first month next season at a minimum.

His teammates heard the news as they arrived at the rink Monday night before a 5-1 loss to the Stars that pushed them to the brink of elimination. They were outshot by a 16-2 margin in the first period and trail the best-of-seven series 3-1.

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Game 5 is Wednesday in Dallas. Nichushkin leads the team with nine playoff goals this season.

“Val is obviously struggling with something,” Avalanche coach Jared Bednar said after the game. ”Yeah, it sucks for our team. We’ve got to turn the page. We’ve got to go play way better than we did today. There’s still 20-plus guys in that room that care and want to win and that are here. That’s what we have to focus on. It hurts our team. There’s no question. He’s a great player.”

Bednar wasn’t willing to travel down the path when asked if Nichushkin may have let down the team.

“I’ve gotten to know Val as a person and I’ve gotten to know him as one of our teammates and I want what’s best for him,” Bednar said. “I want him to be happy and I want him to be content in his life, whether that is with our team or not with our team. I want the best for him and his family. I think all of our guys are the same. We hope that he can find some peace and get help.”

Stars coach Pete DeBoer echoed those thoughts.

“On the human side, you feel for any athlete who is dealing with issues like that,” DeBoer said.

Nichushkin was gone for nearly two months earlier this season to  receive care from the  NHLPA/NHL Player Assistance Program for issues that were not disclosed. This was on the heels of missing the final five games of a playoff loss last season for what the team explained as personal reasons.

Nichushkin wasn’t available to the team from Jan. 13 to March 7 after entering the program. He became the second Avalanche player to enter the program during the regular season, following defenseman Samuel Girard, who said in November that anxiety and depression led to alcohol abuse. Girard returned in mid-December.

In a first-round playoff series  last spring against Seattle , Nichushkin abruptly left the team with only the explanation that it was for personal reasons. His absence started after officers responded to a crisis call at the Four Seasons Hotel in Seattle before Game 3. A 28-year-old woman was in an ambulance when officers arrived, and medics were told to speak with an Avalanche team physician to gather more details.

The report, obtained at the time from the Seattle Police Department by The Associated Press, said the Avalanche physician told officers that team employees found the woman when they were checking on Nichushkin. The physician told officers the woman appeared to be heavily intoxicated, too intoxicated to have left the hotel “in a ride share or cab service,” and requested EMS assistance.

Before the season, Nichushkin dodged questions about the situation, saying only, “I know you guys want to find something there, but it’s nothing really interesting. I think we should close it.”

Asked after the game if he could see a scenario where Nichushkin and the team could at some point reunite, Bednar simply responded: “I have no idea.”

Royal Rules of Ohio

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