Well-Baby Checkup: Up to 1 Month
After your first newborn visit, your baby will likely have a checkup within his or her first month of life. At this checkup, the healthcare provider will examine the baby and ask how things are going at home. This sheet describes some of what you can expect.
Development and milestones
The healthcare provider will ask questions about your baby. He or she will observe the baby to get an idea of the infant’s development. By this visit, your baby is likely doing some of the following:
Smiling for no apparent reason (called a “spontaneous smile”)
Making eye contact, especially during feeding
Making random sounds (also called “vocalizing”)
Trying to lift his or her head
Wiggling and squirming. Each arm and leg should move about the same amount. If not, tell the healthcare provider.
Becoming startled when hearing a loud noise
At around 2 weeks of age, your baby should be back to his or her birth weight. Continue to feed your baby either breastmilk or formula. To help your baby eat well:
During the day, feed at least every 2 to 3 hours. You may need to wake the baby for daytime feedings.
At night, feed when the baby wakes, often every 3 to 4 hours. You may choose not to wake the baby for nighttime feedings. Discuss this with the healthcare provider.
Breastfeeding sessions should last around 15 to 20 minutes. With a bottle, lowly increase the amount of formula or breastmilk you give your baby. By 1 month of age, most babies eat about 4 ounces per feeding, but this can vary.
If you’re concerned about how much or how often your baby eats, discuss this with the healthcare provider.
Ask the healthcare provider if your baby should take vitamin D.
Don't give the baby anything to eat besides breastmilk or formula. Your baby is too young for solid foods (“solids”) or other liquids. An infant this age does not need to be given water.
Be aware that many babies begin to spit up around 1 month of age. In most cases, this is normal. Call the healthcare provider right away if the baby spits up often and forcefully, or spits up anything besides milk or formula.
Some babies poop (have a bowel movement) a few times a day. Others poop as little as once every 2 to 3 days. Anything in this range is normal. Change the baby’s diaper when it becomes wet or dirty.
It’s fine if your baby poops even less often than every 2 to 3 days if the baby is otherwise healthy. But if the baby also becomes fussy, spits up more than normal, eats less than normal, or has very hard stool, tell the healthcare provider. The baby may be constipated (unable to have a bowel movement).
Stool may range in color from mustard yellow to brown to green. If the stools are another color, tell the healthcare provider.
Bathe your baby a few times per week. You may give baths more often if the baby enjoys it. But because you’re cleaning the baby during diaper changes, a daily bath often isn’t needed.
It’s OK to use mild (hypoallergenic) creams or lotions on the baby’s skin. Avoid putting lotion on the baby’s hands.
At this age, your baby may sleep up to 18 to 20 hours each day. It’s common for babies to sleep for short spurts throughout the day, rather than for hours at a time. The baby may be fussy before going to bed for the night (around 6 p.m. to 9 p.m.). This is normal. To help your baby sleep safely and soundly:
Put your baby on his or her back for naps and sleeping until your child is 1 year old. This can lower the risk for SIDS, aspiration, and choking. Never put your baby on his or her side or stomach for sleep or naps. When your baby is awake, let your child spend time on his or her tummy as long as you are watching your child. This helps your child build strong tummy and neck muscles. This will also help keep your baby's head from flattening. This problem can happen when babies spend so much time on their back.
Ask the healthcare provider if you should let your baby sleep with a pacifier. Sleeping with a pacifier has been shown to decrease the risk for SIDS. But it should not be offered until after breastfeeding has been established. If your baby doesn't want the pacifier, don't try to force him or her to take one.
Don't put a crib bumper, pillow, loose blankets, or stuffed animals in the crib. These could suffocate the baby.
Don't put your baby on a couch or armchair for sleep. Sleeping on a couch or armchair puts the baby at a much higher risk for death, including SIDS.
Don't use infant seats, car seats, strollers, infant carriers, or infant swings for routine sleep and daily naps. These may cause a baby's airway to become blocked or the baby to suffocate.
Swaddling (wrapping the baby in a blanket) can help the baby feel safe and fall asleep. Make sure your baby can easily move his or her legs.
It’s OK to put the baby to bed awake. It’s also OK to let the baby cry in bed, but only for a few minutes. At this age, babies aren’t ready to “cry themselves to sleep.”
If you have trouble getting your baby to sleep, ask the health care provider for tips.
Don't share a bed (co-sleep) with your baby. Bed-sharing has been shown to increase the risk for SIDS. The American Academy of Pediatrics says that babies should sleep in the same room as their parents. They should be close to their parents' bed, but in a separate bed or crib. This sleeping setup should be done for the baby's first year, if possible. But you should do it for at least the first 6 months.
Always put cribs, bassinets, and play yards in areas with no hazards. This means no dangling cords, wires, or window coverings. This will lower the risk for strangulation.
Don't use baby heart rate and monitors or special devices to help lower the risk for SIDS. These devices include wedges, positioners, and special mattresses. These devices have not been shown to prevent SIDS. In rare cases, they have caused the death of a baby.
Talk with your baby's healthcare provider about these and other health and safety issues.
To avoid burns, don’t carry or drink hot liquids, such as coffee, near the baby. Turn the water heater down to a temperature of 120°F (49°C) or below.
Don’t smoke or allow others to smoke near the baby. If you or other family members smoke, do so outdoors while wearing a jacket, and then remove the jacket before holding the baby. Never smoke around the baby
It’s usually fine to take a newborn out of the house. But stay away from confined, crowded places where germs can spread.
When you take the baby outside, don't stay too long in direct sunlight. Keep the baby covered, or seek out the shade.
In the car, always put the baby in a rear-facing car seat. This should be secured in the back seat according to the car seat’s directions. Never leave the baby alone in the car.
Don't leave the baby on a high surface such as a table, bed, or couch. He or she could fall and get hurt.
Older siblings will likely want to hold, play with, and get to know the baby. This is fine as long as an adult supervises.
Call the healthcare provider right away if the baby has a fever (see Fever and children, below).
Based on recommendations from the CDC, your baby may get the hepatitis B vaccine if he or she did not already get it in the hospital after birth. Having your baby fully vaccinated will also help lower your baby's risk for SIDS.
Fever and children
Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.
For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.
Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.
Infant under 3 months old:
Ask your child’s healthcare provider how you should take the temperature.
Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider
Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider
Signs of postpartum depression
It’s normal to be weepy and tired right after having a baby. These feelings should go away in about a week. If you’re still feeling this way, it may be a sign of postpartum depression, a more serious problem. Symptoms may include:
Feelings of deep sadness
Gaining or losing a lot of weight
Sleeping too much or too little
Feeling tired all the time
Feeling worthless or guilty
Fearing that your baby will be harmed
Worrying that you’re a bad parent
Having trouble thinking clearly or making decisions
Thinking about death or suicide
If you have any of these symptoms, talk to your OB/GYN or another healthcare provider. Treatment can help you feel better.
Next checkup at: _______________________________
August 08, 2018
Technical Report: SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment. Task Force on Sudden Infant Death Syndrome. Pediatrics. 2011;128(5):s1341-67.
Adler, Liora C, MD,Freeborn, Donna, PhD, CNM, FNP,Image reviewed by StayWell art team.,Turley, Ray, BSN, MSN