Pregnancy Articles

Wellness Check-Ups: What to Expect Throughout Baby's First Year

Plus, Questions to Ask Your Health-Care Provider

After your baby's initial check-up at the hospital, your pediatrician will want to see your child throughout her first year of life to make sure she is keeping pace with developmental milestones and staying healthy. These regular check-ups occur at 1, 2, 4, 6, 9, and 12 months of age. Here's what to expect!

(For information on immunizations recommended for each age, see the end of this article.)

1 month: The pediatrician will begin this and every appointment by weighing your baby and measuring length and head circumference. He might also tell you a growth "percentile," which compares her physical development to other babies her age. The actual figure your baby is assigned is not as important as whether her doctor thinks that she is healthy. Percentiles can fluctuate considerably during the first year, so concentrate on working with her pediatrician to attain your baby's developmental goals rather than comparing her with numbers on a scale or a chart.

Next, the doctor will check to see if your baby's cord-stump has fallen off and is healing properly. If you had a boy and he was circumcised, the doctor will examine his penis to make sure it is healing properly. Expect him to review proper care instructions for your baby's incision sites to allow them quick and safe recovery. He will then check your baby's eyesight and hearing and discuss any noticeable health issues with you, such as diaper rash or cradle cap.

Sleeping and feeding routines will become a hot topic during the next few visits, and the doctor will help you learn more about how often and how much your child should be sleeping and eating.

Questions to expect:
  • How is baby's sleeping and eating? (How much/long? How often?)
  • How many wet and dirty diapers does your baby have in a 24-hour period?
  • How is your baby's muscle development? (Can she lift her head while on her tummy?)
  • How does your baby react to certain noises? (Is she soothed by your voice? Does she seem distressed in noisy environments?)
  • How does your baby act during periods of wakefulness? (Does she seem alert or show interest in her environment?)
  • Does she coo while awake and content?
  • Are there any noticeable abnormalities in her eyesight or hearing?
  • Is she fussier at certain times during the day or night? (Any patterns in mood are keys to helping your baby begin to develop her day and nighttime routine.)
Try to keep a journal of questions, concerns, and anything else you'd like to review with your doctor. This will help him develop a health-care plan unique to your baby, as well as help you stay organized for your visits.

2 months: Your baby's weight, length, and head circumference will be measured, and she will be given another percentile based on her statistics for her age group. Remember, the most important thing is that your doctor feels confident that your baby's development is healthy for her. The percentile scale is used as a guide to track your baby's growth, but expect fluctuations, as percentages may jump during growth spurts and then level out again. Her measurements will be charted and, by her 6- and 9-month appointments, your doctor should be able to show you how she has measured up throughout the year.

Next, the pediatrician will discuss any health concerns with you, such as baby acne, cradle cap, diaper rash, as well as her development, hearing and eyesight, and behavior and/or temperament. (Learn more about a newborn's appearance here.) He'll tell you what is normal, what is not and what to monitor. If you are breastfeeding and returning to work, now is the time to discuss your plans. The doctor can give you some tips that may help ease the transition for both you and your baby, including information on buying or renting a breast pump, and helping your baby adjust from breast to bottle feeding.

Questions to expect:
  • How are your baby's sleeping/feeding patterns? (You should be working toward some sort of routine by now; her patterns may be subtle, but any signs will help you figure out the best schedule.)
  • How many wet/dirty diapers does she have in a 24-hour period?
  • Do you notice any crying patterns? (Does she seem to have different-sounding cries when she is hungry, tired, or bored?)
  • How is her muscle coordination/development? (Can she hold her head up while on her tummy/in a sitting position? Can she push up on her forearms? Can she bear any weight on her legs?)
  • Is she showing signs of personality? (Is she smiling? Laughing?)
  • How does she respond to different sounds? (Is she soothed by your voice? Does she show excitement or distress in noisy environments?)
  • Are there any noticeable abnormalities in her eyesight or hearing?
  • Is she fussier at certain times during the day or night?

4 months: Aside from measuring your baby's weight, length, and head circumference, the pediatrician will want to discuss other aspects of physical development. By now, your baby should begin to show better muscle control and coordination. Her jerky and involuntary movements should begin to taper off. Your doctor will want to address normal health concerns with you as well. These might include constipation/diarrhea, cold/flu symptoms and treatments, symptoms and treatments of ear or sinus infections, and healthy development of behavior/temperament, and eyesight and hearing.

Also, your baby has reached the age that routines are becoming more important. By now, she should be establishing recognizable sleeping/eating patterns throughout a 24-hour period. If she hasn't already, she may soon go through a phase where she has "mixed up" her days and nights (awake longer during the night and sleeping more throughout the day). Establishing a routine may be difficult at first, but it is certainly beneficial to your baby's health. Her doctor can give you tips to help regulate her schedule.

Questions to expect:
  • What are her sleeping and eating patterns?
  • How many wet and dirty diapers does your baby have during a 24-hour period?
  • Can she roll over? Sit up without support, even for just a few seconds?
  • Is your baby able to hold her head and move it around without support?
  • Can she push up onto her forearms while controlling her head?
  • Is your baby making cooing or babbling noises?
  • How are your baby's motor skills developing? (Can she follow an object with her eyes? Is she reaching for/grasping objects?)
  • Have you noticed any abnormalities in eyesight or hearing?

6 months: The doctor will take the normal measurements and discuss any new or continuing health concerns (unusual bowel movements, cradle cap, diaper rash, etc.), as well as check for normal development of eyesight and hearing, behavior and temperament, and routines. If your baby still isn't sleeping through the night (or at least waking less), the doctor may have some tips on taking a more assertive approach. Some families are not bothered by tending to baby's nighttime needs; however, at this age your baby has the ability to sleep through the night without eating (barring any health issues).

The body goes through numerous sleep cycles throughout the night--the most important being REM, or rapid eye movement. This is the deepest and most restful sleep cycle, during which the body most effectively restores itself to prepare for wakefulness the next day. A healthy adult will go through many REM cycles throughout the night, often waking in between. However, adults have developed the ability to put themselves back to sleep--often without noticing any moments of wakefulness--whereas a baby must learn this technique to get the most out of a healthy and full night's rest. It's important to remember that your child's sleep needs will adjust with age, but the habits you set up for her today will likely follow her for years to come.

Questions to expect:
  • How are her sleeping/eating patterns developing?
  • How many wet and dirty diapers does she have during a 24-hour period?
  • Is she rolling over in both directions?
  • Is she sitting up on her own? (If she is sitting up unsupported, your doctor will likely suggest introducing solid foods, like cereal and purees. Find more information on starting solids in this article.)
  • Is she cooing and babbling more?
  • Does she show interest in play and in her environment?
  • Is she able to bear weight on her legs or even pull herself up to a standing position?
  • How are her motor skills developing? (Is she grabbing objects with her whole fist? Does she bring objects to her mouth, or pass them from one hand to the other?)
  • Is she showing any signs of teething? (Excessive drooling or chewing on things, sometimes accompanied by fever or even diarrhea from swallowing the excess saliva; unusual fussiness or discomfort, etc.)
  • Any abnormalities in eyesight and hearing?

9 months: Your baby will be measured as usual to make sure she is on track for growth, and probably checked for anemia (iron deficiency). Among new things your doctor may want to discuss are childproofing your home and poison control, as your baby may be moving her way through the house now by rolling, crawling, or scooting. You will likely discuss usual developmental milestones in her behavior and temperament as well.

Questions to expect:
  • How is she sleeping/eating? (Is she handling solids and finger foods?)
  • Does she have a favorite method of getting around? (Rolling, crawling, scooting, etc?)
  • Does she understand/respond to you? (Does she respond to her own name? Recognize who "Mommy" or "Daddy" are?)
  • Does she show interest in her environment? (Does she point to objects? Recognize a bottle or favorite teddy bear?)
  • Does she show interest in play? (Play games like "Peek-a-boo" or "Patty-Cake"?)
  • Is she developing fine motor skills, such as the "pincher grasp" (grasping objects between thumb and forefingers)?
  • Do you notice any abnormalities in eyesight and hearing?

12 months: Congratulations! You've made it to toddlerhood! Aside from the usual measurements, your pediatrician may want to discuss how to treat and prevent cuts, bumps, and bruises. If she hasn't already, your 1-year-old will soon be making her way upright! She'll be wobbly for awhile, so childproofing your home and choosing proper footwear are likely to be up for discussion this visit. The doctor will want to make sure she is continuing to learn new skills (like how to do a "high-five" or using a sippy cup), as well as retaining the old ones. You may also want to discuss early discipline strategies, as your baby's new mobility may get her into some mischief.

Questions to expect:
  • How is your baby sleeping? (If she has been sleeping through the night, don't be surprised if she begins to wake periodically again. She may likely begin to experience "separation anxiety"; ask your doctor for tips on how to handle this.)
  • Is she tolerating solid foods? (By 12 months, your baby may be able to chew bigger chunks of soft foods, as well as make the transition from breast milk or formula to whole milk.)
  • How many teeth does she have?
  • Is she pulling herself up, standing, cruising, or walking?
  • Does she show an interest in her environment? (Pointing at objects, for example)
  • Does she show an interest in others' conversations? Is she jabbering?
  • Does she understand or recognize objects/activities? (Does she mimic brushing her hair? Understand that she drinks from a cup?)
  • Is she developing motor skills? (Using both hands to play?)
  • Any abnormalities in eyesight and hearing?
*Vaccinations: Immunization is a personal decision, one that each family has to resolve on their own. Though many health-care providers recommend vaccinations, if you are opposed to them for any reason, stand your ground. You have the right to decide what is best for the health of your children, and your pediatrician should always respect your wishes. If you feel excessively pressured or uncomfortable, you can always find a new pediatrician. If you wish to proceed with immunizations for your child, be sure to discuss all possible side effects and necessity of each vaccine with your doctor beforehand.

For a list of questions to ask your child's health-care provider and to see a vaccinations schedule, click here.
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