Well-Child Visits: The Checkup Schedule From Birth to Age 3

Before you leave the hospital

• Vitamin K shot, to prevent rare but dangerous bleeding.
• Antibiotic eye ointment, to prevent a serious eye infection.
• Hepatitis B vaccine, first dose, which the AAP recommends within 24 hours of birth.
• Newborn blood spot screen: a few drops from the heel, usually at 24-48 hours, checking for dozens of rare but treatable conditions. Some babies need a repeat; the office will call if so.
• Hearing screen, plus a pulse oximetry check (a light sensor on the hand and foot) for critical congenital heart disease, done after 24 hours.
• A bilirubin check for jaundice before discharge.
• An RSV antibody shot if your baby is born during or heading into RSV season (roughly fall to spring) and the birth parent didn't get the RSV vaccine at least 2 weeks before delivery.

The checkup schedule

The AAP recommends visits at 3-5 days, by 1 month, 2, 4, 6, 9, 12, 15, 18, 24 and 30 months, and 3 years, then yearly. The first visit is soon after discharge because of weight and jaundice (see the newborn weight and jaundice guide).

What happens at each visit

• Measurements: weight, length or height, and head size until age 2, plotted on growth charts. BMI from age 2.
• Exam: heart, hips, eyes, skin, belly, genitals, and the soft spot.
• Development: questions about milestones at every visit, with a formal developmental screen at 9, 18 and 30 months and autism screening at 18 and 24 months (see the milestones guide).
• Vaccines: most shots fall at 2, 4, 6, 12-15 and 18 months (see the vaccines guide).
• Parent wellbeing: a screen for postpartum depression at the 1, 2, 4 and 6 month visits. This is routine and meant to help.
• Hearing and vision: risk questions and eye checks at every visit, with a vision screening device often used from 12 months and a formal screen by age 3.
• Blood tests: a check for anemia around 12 months and lead risk questions from 6 months, with a blood lead test at 12 and 24 months for many children (required for Medicaid).
• Teeth: fluoride varnish from the first tooth, every 3-6 months, and a dental home by age 1.
• Talking points: feeding, sleep, safe sleep, car seats, babyproofing and how you're doing.

Getting ready

• Write questions down as they come up during the week, and put the top three first.
• Bring the vaccine record, a list of any medicines or vitamins, and notes on feeding, sleep and diapers if something worries you. Photos or short videos of odd movements, rashes or breathing help a lot.
• Dress the baby in easy-off clothes, and bring a feed and a spare diaper.
• Useful questions: Is growth on track? What should we expect before the next visit? Which shots today, and what reactions are normal? When should we start solids, cups, or the dentist?

Checkups versus sick visits

• A checkup is for prevention and growth. If your child is sick on the day, call; mild colds usually don't stop vaccines, but the office may reschedule.
• A sick visit is a separate, shorter visit for a specific problem. Don't save a worry for the next checkup if it's affecting feeding, breathing or behavior now.
• If a checkup is missed, book a catch-up; vaccines and screens can be caught up.

When to check in

Call the pediatrician the same day if: - A baby under 3 months has a temperature of 100.4°F (38°C) or higher (rectal). - There are fewer wet diapers than expected, poor feeding, or a baby who is hard to wake. - The office calls about an abnormal newborn screen: follow up the same day.