Well and Preventative Pediatric Care
from Birth to One Year Old
Two Week Visit
Between hospital discharge and two weeks, the newborn usually will have been seen in the office a few times. At the two week visit, the baby is weighed, to be sure he/she is up at the original birth weight. We will discuss feeding, stooling, sleep, family adjustment, skin care, and any other concerns parents may have.
One Month Visit
At one month, the baby will be weighed and measured. We will discuss again feeding, stooling, sleep (at every visit). We will also discuss the parents’ adjustment to life with a newborn, as this can often be a “fussy” time for infants. Developmental milestones at this age include following objects and faces with the eyes, smiling in response to others, and ability to calm down from a fussy state.
We administer a questionnaire called the “Edinburgh Questionnaire” to assess mothers for postpartum depression. We are always interested in the emotional health of the family, especially new parents. We have resources for parents and encourage families to share all of their concerns about emotional health. At this age many parents are either returning to work or considering options for child care as they plan to return to work, and we will ask questions about child care plans.
Immunization: Hepatitis B (the second in a series of three). The baby usually receives the first Hepatitis Bvaccine in the hospital.
Two Month Visit
As at every visit, we will measure the weight, height, and head circumference. At these visits we plot these measurements on a growth chart. We will let you know the “percentile” for each of these measurements, which gives you an idea of where the baby’s measurements are compared to babies of a similar age. As pediatricians, we are most concerned with the “path” on the growth chart, not the specific percentile. That is, the 90th percentile is not inherently better than the 20th percentile, each child has his/her own path.
We look to see if the child is growing too much or too little in weight, height and head growth because these can be important clues to nutritional and medical issues. We will discuss feeding, stooling, sleep. Developmental milestones at this age include smiling, making cooing noises, and improving head control. We will discuss child care plans, family living arrangements, and sibling adjustment.
Immunization at two months is the beginning of a series of vaccines to protect infants from serious illnesses. We encourage parents to learn as much as possible about these illnesses and immunizations prior to the visit. See our section on Vaccine Information for more information. We will distribute Vaccine Information Statements prior to giving the child any vaccine.
If you would like to review any of these Vaccine Information Statements (VIS), visit http://www.immunize.org/vis at any time.
Immunizations: One injection is the Pentacel vaccine, which provides protection against diphtheria, tetanus, pertussis, polio, and Hib. A second injection, Prevnar 13, provides protection against pneumococcal disease. A oral vaccine againstRotavirus, a gastrointestinal illness, will also be given.
We will discuss possible side effects to the vaccines and care for these side effects.
Four Month Visit
We will measure weight, length, and head circumference. We will discuss feeding, including when to begin solid foods, and stool patterns. Developmental milestones including laughing, making noises, interest in people, grabbing objects, and increased movement.
Sleep habits usually become more routine at this age, and we will talk about starting to be sure the baby can settle him/herself to sleep. As the baby is more mobile, safety and childproofing are important at this age. As always, we will discuss child care, your child’s reaction to new people and environments, and family changes and issues.
Immunizations: Second Pentacel (which provides protection against diphtheria, tetanus, pertussis, polio, and Hib), second Prevnar 13, and second Rotavirus vaccine.
Six Month Visit
Measurement of weight, length, and head circumference. Feeding and solid food discussion. Sleep issues are important, as they can be easier to resolve at this age than at later stages of infancy. Developmental milestones including making “gaga” type sounds, responding to other’s voices, exploring infant toys, rolling, and sitting up.
Safety concerns are very important, as infants of this age put everything in their mouths and are trying to move everywhere. We will discuss child care and family life.
Immunizations: Third Pentacel (which provides protection against diphtheria, tetanus, pertussis, polio, and Hib), and third Prevnar 13.
Nine Month Visit
Measurement of weight, length, and head circumference. We will discuss feeding, especially advancing to more solid foods and finger foods, and the resulting changes in stool patterns. We will discuss sleep, child care, and family life.
Developmental milestones at this age include using the fingers to pick up small objects, crawling, pulling to stand, responding to one’s own name, and more exploration with toys and household objects. Because of their increasing mobility and curiosity, safety regarding medications, household cleaners, and small toys is important. At around nine months, babies become more aware of people they know and do not know, and show a definite preference for parents and close caregivers.
Immunization: Third Hepatitis B vaccine
Twelve Month Visit
We will do measurements, discuss feeding , the change to whole milk and possible weaning from the breast. We will discuss sleep, child care, and family changes. Developmental milestones include first words, specific MaMa and DaDa, clapping, waving, walking holding on and alone, and exploration of everything.
Safety is reinforced, especially climbing hazards, window safety, car seat safety, and water safety. At this visit we do blood tests to check for iron-deficiency anemia (the hemoglobin level) and a screening test for lead exposure.
Immunization: MMR (vaccine to protect against measles, mumps, and rubella) and Hepatitis A vaccine.