Your Newborn's First Checkup: What to Expect

You just brought your baby home, and within a few days you are back in the car for the first doctor visit. It can feel like a lot so soon. This first checkup is one of the most useful visits of the whole first year, though. It is a chance to make sure feeding is going well, check for jaundice, and get answers to the questions that come up in those first long days and nights.

When the first visit happens

The American Academy of Pediatrics recommends that babies see their pediatrician within 48 to 72 hours after leaving the hospital. For most babies, that is around 3 to 5 days old. Your baby may need to be seen sooner if they went home early, had jaundice in the hospital, were born a little early, or if breastfeeding is just getting started. The hospital usually tells you when to schedule. If they did not, call your pediatrician's office as soon as you get home.

What to bring

• Hospital papers. Discharge papers show your baby's birth weight, discharge weight, jaundice level, vaccines given and screening results.
• Insurance information. Bring your card, even if your baby is not on the plan yet. Ask the office how to add your newborn.
• A feeding and diaper log. Write down roughly how often your baby eats, how long or how much, and how many wet and dirty diapers they have each day. A notes app works fine.
• Your questions. Write them down as they come to you. It is easy to forget once you are in the exam room.
• Supplies. Diapers, wipes, a change of clothes, a blanket, and a bottle or formula if you use them.

Use a properly installed rear-facing car seat for the drive, and dress your baby in clothes that are easy to take off for weighing.

Weight check

Weight is the main number at this visit. Most newborns lose some weight in the first few days. That is normal. Your pediatrician compares today's weight with the birth weight to see how much was lost and whether your baby is starting to gain it back. Most babies are back to birth weight by about 2 weeks of age. If your baby has lost more than expected, your pediatrician will help you make a feeding plan and may ask you to come back for another weight check in a day or two.

Jaundice check

Jaundice is a yellow color in the skin and eyes. It is common in newborns and often peaks around 3 to 5 days old, which is exactly when this visit happens. Your pediatrician looks at your baby's skin and eyes and may check a bilirubin level with a light meter on the skin or a small blood sample. Most jaundice goes away on its own. Higher levels may need treatment with special lights. Bring up any yellow color you have noticed, especially if it is spreading down to the belly or legs.

Feeding questions

Expect plenty of feeding talk. Your pediatrician may ask:

• How often your baby eats and whether they wake for feeds
• If breastfeeding, whether your milk is coming in and if latching hurts
• If formula feeding, which formula and how you mix it
• How many wet and dirty diapers your baby has, and what the stool looks like

This is a good time to ask for help with latch, pumping or bottle feeding. Breastfed babies usually need a vitamin D supplement starting in the first days. Ask your pediatrician which product and amount to use.

The physical exam

Your pediatrician will undress your baby and check from head to toe. That includes the soft spots on the head, eyes, mouth and palate, heart and lungs, belly, the umbilical cord stump, the genitals and any circumcision, hips, skin and reflexes. They may also ask how your baby sleeps and make sure you know about safe sleep: on the back, alone, in a crib or bassinet with nothing else in it.

Newborn screening results

Before leaving the hospital, your baby had a hearing screen, a heart screen using a sensor on the skin, and a heel-stick blood test that checks for many rare but serious conditions. Your pediatrician will review those results. If the hearing screen needs to be repeated, they will help you set that up.

In Texas, babies get a second newborn blood screen at about 1 to 2 weeks of age. This is often done at the pediatrician's office, so ask where and when your baby's will be. The second screen can catch some conditions the first one misses. Learn more from the Texas DSHS Newborn Screening Program.

Your pediatrician will also check which vaccines your baby received in the hospital and talk with you about any vaccines or RSV protection due on the schedule they recommend.

Questions to ask

• Is my baby eating enough? How will I know?
• When should I call about a fever, and how do I take a rectal temperature?
• How do I care for the cord stump and circumcision?
• Is this rash, sneeze, hiccup or breathing pattern normal?
• How do I reach the office after hours?
• When is the next visit?

Your pediatrician will also ask how you are doing. Feeling weepy in the first couple of weeks is common. Feeling hopeless, unable to sleep even when the baby sleeps, or having thoughts of harming yourself or your baby needs help right away. Please say something. The AAP has a first week checkup checklist you can review before the visit.

When to call us

Call your A thru Z Pediatrics office right away if your newborn:

• Has a temperature of 100.4°F or higher taken in the bottom
• Looks more yellow, or the yellow spreads to the belly, arms or legs
• Is too sleepy to feed, or feeds poorly
• Has fewer wet diapers than your pediatrician told you to expect
• Has redness, a bad smell or drainage around the cord stump

Call 911 or go to the ER if your baby has trouble breathing, turns blue or gray around the lips, is limp or hard to wake, or has a seizure.

Ready to book your newborn's first visit? You can request a visit.