Well baby care

• Find a health care provider for your baby.
• Take your baby for regular checkups, even if he’s not sick.
• Keep baby healthy by making sure she gets her vaccinations.

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Even when things are going well, regular checkups during the first two years can keep your baby happy and healthy. During well-baby visits, you find out about your baby's growth, weight gain, health and immunizations, as well as whether your baby is meeting normal development goals.

Scheduling checkups
Most babies have their first checkup within a few weeks of birth. After this, regular well-baby appointments help you make sure your baby's development is on track. They also let your baby's health provider check up on areas of concern.

Usually, a baby sees the provider for a well-baby visit at least once every two months during the first six months (at about 2, 4, and 6 months old). After this, it's common to have visits scheduled at 9, 12, 15, 18, and 24 months old.

Different providers have their own schedules and routines, of course. Be sure to ask your baby's health care provider about the regular schedule for well-baby visits. Also remember that extra visits may be needed if a problem is found.

At the health care provider’s office
As your baby grows, the provider will be looking for different things during the visits. Common parts of any well-baby checkup are:

• Charting growth: Visits usually begin with weight, length, and head measurements that are plotted on a chart. You can use this to see how your baby's growth compares to others at the same age.
• Physical examination: A thorough physical exam – from head to toe – is done. The provider will look for signs that your baby is healthy and meeting normal physical development goals.
• General development: The provider will check to make sure your baby is meeting the goals for motor skills and emotional development. These can range from rolling over and head control during early visits to walking, talking, and following simple instructions during later visits.
• Nutrition: Your provider will give you advice about feeding and breastfeeding, vitamins, and other nutritional issues. As your baby grows, you'll be asked questions about your child's eating habits, as well.
• General discussion: The provider will also want to tell you what to expect in your baby's growth during the coming months. You'll also talk about other issues, such as the use of car seats, and how to babyproof your home. You may also be asked about how you and your family are caring for and interacting with the baby. Be sure to ask any questions you have during the visit, no matter how small. Don't be afraid to talk about it if you are feeling run-down, stressed, or depressed.
• Tests: Lab tests are not usually needed at these visits. During the first year, your baby may be tested for anemia (low blood iron) with a simple finger-prick test. Depending on where you live and your baby’s environment, the provider may do a blood test for lead poisoning or a tuberculosis skin test.
• Immunizations: At different ages, your baby will need different types of vaccinations during these visits.

At the end of the visit
Schedule the next well-baby visit. Make sure you know how to reach the provider between visits if you're concerned about a problem, illness or unusual behavior. Call the health care provider right away if your baby:

• Does not have stools
• Has yellowish skin
• Has diarrhea
• Has a temperature higher than 100 degrees F (38 degrees C) taken under the arm
• Vomits (more than just spit up) more than 2-3 times a day
• Refuses to feed or nurses poorly
• Has fewer than four wet diapers in 24 hours
• Has another problem that concerns you

March 2008