The first pediatrician visit is generally 3-5 days after discharge from the hospital for all healthy, full-term babies. This appointment is for the pediatrician to assess the newborn weight, feeding schedule, voiding and stooling pattern and perhaps, most importantly, to answer parent questions. The hospital can be a daunting environment and many questions often go unanswered.
Call your Pediatrician’s office ahead of time to see what their policy is for visitors. Many COVID rules have been relaxed regarding visitors. However, it is a good idea to double check before arrival if both parents are permitted these first few visits. Masking is generally required within all medical facilities so have a mask prior to entering the office. Know that some offices will have families wait outside and text upon arrival, whereas some have a newborn waiting room.
First Pediatrician Visit
The first pediatrician visit with a newborn is no easy feat, I recommend a late morning, early afternoon appointment just to make it easier for the parents. Bring any insurance paperwork you may have. Bring a diaper bag with extra diapers, wipes, and clothing. If bottle fed, a spare bottle is always helpful should the baby become hungry, breastfeeding can be done within the office as well.
Generally, this is a quick visit, lots of anticipatory guidance and the best time to have questions answered. I always recommend writing down all questions prior to arrival so nothing is left unanswered; a baby notebook is a good idea.
Newborns can lose up to 10% of their birth weight, so don’t be discouraged to see a weight several ounces less that birth weight at this visit. Feeding is a common question whether breast or bottle fed, babies will need to eat 8-10 times a day. This allows for proper weight gain, and in the case of breast feeding this frequent feeding will help develop mom’s milk production. Once examined and questions are answered, the baby is seen again in 2 weeks.
The only vaccine that may be given at this first pediatrician visit is Hepatitis B, if declined by the parents at the hospital. The routine vaccine series starts at 6-8 weeks.
2 Week Old Pediatrician Visit
At this point the baby should be back to birth weight. From this point a typical measurement of weight gain is 1⁄2-3⁄4 ounce per day. The umbilical cord has usually fallen off by this time. Some oozing of blood is normal (it is like peeling off a scab). Once the umbilical cord is off, the baby can have a real tub bath.
What is Examined at Newborn Appointments?
At all newborn appointments multiple systems are examined. The baby will be weighed, measured for length and head circumference. These measurements are plotted into a growth chart and can be followed over time. Many Pediatric offices will calculate the weight and length percentile. The baby will have their fontanelles examined (soft spots on head). Their eyes, nose and mouth will be inspected for hydration and many babies who have trouble latching should be carefully examined for tongue tie. Lactation specialists are also involved at this juncture to ensure baby is gaining weight adequately, be it breast or bottle feeding. The heart, lungs, abdomen, hips, extremities (10 fingers, 10 toes) are inspected. If circumcised, this will also be examined for proper healing. Hips are checked to ensure proper placement.
1 Month Old Pediatrician Visit
The baby is seen again at 1 month old as long as feeding is going well, there are many wet diapers and stooling well. At the 1 month pediatrician visit, the average weight gain is approximately 2 pounds over birth weight.
If there are any concerns or questions a parent has, there should be no hesitation to call the pediatrician in between visits. In particular, an infant less than 2-3 months old who has not been vaccinated who has a fever over 100.4 needs to be seen immediately! The most accurate way to take a baby’s temperature is with a rectal thermometer. It is best to take a rectal temperature when the baby is well. This will provide a baseline for when an infant feels warm and a true comparison can be made. Tylenol (or other fever reducer) is NOT recommended until after the first vaccination series.
Coming home with a newborn can feel overwhelming. I encourage you to invite a Newborn Care Expert into your home to support and guide you. She can help with feeding, diapering, forming healthy sleep habits, answering questions, and so much more! Reach out to Boston Baby Nurse & Nanny today for postpartum support and newborn care services.
About The Author
Susan M Stuart, DO, MS, MSHPE, FAAP is a Pediatrician in Rhode Island. She has 25 years of Board Certified Experience in General Pediatrics. Dr. Stuart’s specific interests are ADHD and Childhood obesity.