two month old baby doctor visit

• Baby & Toddler
• Baby Health & Wellness
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What to Expect at Baby’s 2 Month Checkup

By the time baby is 2 months old, you both have probably settled into a more predictable routine. Your little cutie is likely growing rapidly and learning new things each day, and they may be a little more alert during the day by this age—and paying more attention to you, watching you as you move around, cooing when you talk to them or even smiling from time to time. To ensure all of these milestones and baby’s overall development is on track, your pediatrician will want to bring them in for their two-month checkup. Here’s what to expect during the visit and how to prepare.

What Happens at the 2-Month Checkup

At two months old , baby is developing their senses and starting to follow objects with their eyes, recognizing familiar faces and attempting to communicate with different cries for different needs. During this visit, your pediatrician will still want to hear about baby’s growth, feeding and sleeping patterns, as well as the early developmental milestones they’re hitting, says Elizabeth Cilenti , MD, MPH, a pediatrician with Northern Virginia Family Practice.

Physical screenings at the 2-month checkup

It’ll be similar to baby’s one month checkup . Your pediatrician will start off baby’s two-month well child check by measuring their height, weight and head circumference for their growth chart , which shows the average height and weight for boys and girls in baby’s age range, explains Preeti Parikh , MD, a pediatrician in New York City. But don’t worry too much about baby’s specific measurements, as doctors really just use these to ensure baby’s growth is on track. They’ll also check baby’s heart, joints, eyes, ears, mouth, lungs, genitals and reflexes, as well as the shape of baby’s head and their fontanelles (the soft spots on baby’s head) to make sure they’re developing properly.

Along with checking baby’s physical development, your pediatrician may also inquire about your mental health. They’ll want to know if you’re having any struggles with postpartum recovery , breastfeeding , anxiety , sadness and depression or anything else concerning your well-being.

Milestone assessment at 2 months

“Babies are learning new skills every day. [They] change quickly, so a lot of what we went over last visit has changed completely,” Cilenti says. At this age baby will be interested in looking around and at moving objects—and they may even start to show off their social smile. Plus, they may also be able to hold their head up during tummy time and move their limbs a little more, Cilenti says. For more information on how baby will progress, she recommends looking at the Center of Disease Control and Prevention’s (CDC) milestone tracker . “It’s a great resource for parents to familiarize themselves with what we expect at each age.” Below, some questions your pediatrician may ask at this visit:

• How are things going? Is there anything new going on? Do you have any concerns?
• Is baby gurgling, cooing and smiling?
• Do you have any concerns about baby’s vision ?
• Does baby follow moving objects and faces?
• Does baby respond to loud sounds?
• Does baby recognize their parents and their voices?
• How often does baby do tummy time? Do they try to lift their head up?
• Are they able to grasp an object placed in their hand?

Nutrition check-in at the 2 month well child check

Eating is a big part of baby’s early life, and you want to ensure they’re growing well and putting on enough weight. By 2 months old, you and baby probably have a good rhythm for mealtimes—and your pediatrician will want to hear all about it. These are the questions you can expect them to ask, according to experts:

• How many times does baby eat each day and overnight?
• Are you using formula or breast milk?
• How many ounces does baby drink at each feeding (if measurable)?
• Have you introduced a bottle yet?
• How many times does baby pee in a day?
• How many times does baby poop each day?
• What is baby’s stool consistency?
• Are there any signs of dairy intolerance , like diarrhea or blood in stools?
• How are you ensuring baby is getting enough Vitamin D? Do you use supplements or vitamin D drops?
• What is your breastfeeding diet like?
• Are you and baby having any issues with feeding?

Sleep check-in at the 2 month checkup

By 2 months old, baby probably has a slightly more predictable sleeping pattern—and a few may even be sleeping through the night , Cilenti says. Still, your pediatrician will want to hear all about baby’s sleeping habits and patterns. Below, some questions they might have:

• What is baby’s sleep schedule like?
• How long does baby sleep each night?
• How often does baby wake to feed?
• What is baby’s nap schedule during the day?
• Is baby put on their back to sleep both at night and during naps?
• What is baby’s sleep environment like? Does it follow safe sleep practices ?

Child safety check-in at the 2-month checkup

Similar to baby’s previous one month checkup, your pediatrician will want to ask you about several topics related to baby’s safety. Here are some of the questions your pediatrician will ask:

• Are you returning to work? Do you need help finding childcare ?
• Do you have a changing table? If so, how high is it, and do you keep a hand on baby at all times?
• How do you calm baby when they cry or are fussy?
• Do you ever get frustrated when baby cries? How do you handle it?
• Have you already baby proofed your home and vehicles?
• Do you have any questions about car seat safety ?

Do Babies Get Shots at the 2-Month Checkup?

Baby will get first doses of multiple vaccinations to protect against diseases at their two month well child check, Cilenti says. These include:

• Pneumococcal conjugate vaccine (PCV)
• Diphtheria, tetanus, acellular pertussis vaccine (DTaP)
• Haemophilus influenza type B vaccine (Hib)
• Inactivated polio vaccine (IPV)
• Rotavirus vaccine (given orally)
• Hepatitis B (HBV) (if not already given at the previous checkup)

It may seem like a lot of shots, but the good news is, depending on your provider’s practice, there are many different combination vaccines available, which means less poking (and fewer tears) for your little one, Cilenti says. “Practically speaking, you should expect baby to receive one to four shots, depending on which products your pediatrician’s office carries.”

Parikh notes that your provider will likely give baby these vaccines towards the end of the visit. There may be some mild side effects, Cilenti adds, including fussiness, redness or nodules at the injection site and a fever lasting 24 to 48 hours after the immunizations. “Ask your doctor about when to call the office if baby has a fever after vaccines,” Cilenti says, as well as if to give Tylenol and at what dosage.

The CDC also notes that babies younger than 8 months will also be receiving their first dose of the new RSV vaccine starting in the fall of 2023, but doesn’t yet specify exactly when.

Questions to Ask at the 2-Month Checkup

You’ll undoubtedly have a better grasp on life with baby as the weeks go by—but that doesn’t mean there won’t be questions. Cilenti recommends parents bring a list of any and all questions they have, as well as all baby updates since the last visit. Consider writing these down as they occur between visits on a notepad or in an app on your phone so you don’t forget anything. Below, Cilenti and the AAP note some questions to ask at baby’s 2 month well child check:

• Is it normal for baby to smile only at me (not at anyone else)?
• When should baby start solids ?
• How can I handle my older kids while I’m breastfeeding baby?
• Are the medicines I’m currently taking or wish to take safe to take while breastfeeding?
• How should I introduce formula? A bottle?
• Should I increase feedings in the next few weeks?
• Is baby sleeping enough?
• How can I make sure baby’s sleeping safely?
• What should I do if baby rolls over in their sleep?
• When should I stop swaddling baby?
• What should the water temperature be for baby’s baths ?
• What should I look for developmentally in baby over the next few weeks?
• What should I do when I feel myself get frustrated with baby’s cries?
• What recommendations do you have for finding a support system? Trustworthy childcare?
• What should I do when baby gets sick ? When should I call you, and when should I manage it at home?
• What medications can I give baby when they’re sick?
• How can I support baby’s learning and development?
• When is it okay to take baby outside ?
• How can I manage baby’s gas and constipation ?
• What should I do when baby spits up ?
• What should I do about baby’s acne ? Cradle cap ? How can I protect their skin?
• How can I protect baby from sun exposure and other seasonal dangers?

Clienti says to be sure that your pediatrician knows about your plans for childcare if you already have them, and if there are any changes to the health of other household family members. Don’t forget to bring an extra change of clothes, diapers and wipes, in case baby needs them and there’s a wait at the doctor’s office. Rest assured, while baby’s next well visit won’t be for another two months, you can always reach out to your pediatrician with any and all questions or concerns whenever they occur.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.

Elizabeth Cilenti , MD, MPH, is a pediatrician with Northern Virginia Family Practice. She completed her medical degree and residency at Indiana University School of Medicine and her master’s degree in public health at the Harvard T.H. Chan School of Public Health.

Preeti Parikh , MD, is a pediatrician with Westside Pediatrics, located in New York City, as well as a spokesperson for the AAP. She earned her medical degree from Rutgers University and completed her pediatric residency at Mount Sinai Hospital.

Centers for Disease Control and Prevention, Important Milestones: Your Baby By Two Months , June 2023

Johns Hopkins All Children’s Hospital, Your Child's Checkup: 2 Months , 2023

Healthy Children (American Academy of Pediatrics), Checkup Checklist: 2 Months Old) , September 2021

Centers for Disease Control and Prevention, Respiratory Syncytial Virus (RSV) Immunizations , August 2023

Learn how we ensure the accuracy of our content through our editorial and medical review process .

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Important Milestones: Your Baby By Two Months

CDC’s milestones and parent tips have been updated and new checklist ages have been added (15 and 30 months). For more information about the updates to CDC’s developmental milestones, please review the Pediatrics journal article  and these  important key points .

How your child plays, learns, speaks, acts, and moves offers important clues about your child’s development. Developmental milestones are things most children (75% or more) can do by a certain age.

Check the milestones your child has reached by 2 months by completing a checklist with CDC’s free Milestone Tracker  mobile app, for  iOS  and  Android  devices, using the Digital Online Checklist , or by printing the checklist  [755 KB, 2 Pages, Print Only]  below.

“Learn the Signs. Act Early.” materials are not a substitute for standardized, validated developmental screening tools .

What most babies do by this age:

Social/emotional milestones.

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Language/Communication Milestones

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Cognitive Milestones (learning, thinking, problem-solving)

Movement/physical development milestones, calms down when spoken to or picked up.

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Looks at your face

Seems happy to see you when you walk up to her

Smiles when you talk to or smile at her

Watches you as you move.

Looks at a toy for several seconds

Holds head up when on tummy

Other important things to share with the doctor…

• What are some things you and your baby do together?
• What are some things your baby likes to do?
• Is there anything your baby does or does not do that concerns you?
• Has your baby lost any skills he/she once had?
• Does your baby have any special healthcare needs or was he/she born prematurely?

Concerned About Your Child’s Development? Act Early.

You know your child best. Don’t wait. If your child is not meeting one or more milestones, has lost skills he or she once had, or you have other concerns, act early. Talk with your child’s doctor, share your concerns, and ask about developmental screening.

If you or the doctor are still concerned:

• Ask for a referral to a specialist who can evaluate your child more; and
• Call your state or territory’s early intervention program to find out if your child can get services to help. Learn more and find the number at cdc.gov/FindEI .

For more on how to help your child, visit cdc.gov/Concerned .

As your baby’s first teacher, you can help his or her learning and brain development. Try these simple tips and activities in a safe way. Talk with your baby’s doctor and teachers if you have questions or for more ideas on how to help your baby’s development.

• Respond positively to your baby. Act excited, smile, and talk to him when he makes sounds. This teaches him to take turns “talking” back and forth in conversation.
• Talk, read, and sing to your baby to help her develop and understand language.
• Spend time cuddling and holding your baby. This will help him feel safe and cared for. You will not spoil your baby by holding or responding to him.

Click here for more tips and activities

• Being responsive to your baby helps him learn and grow. Limiting your screen time when you are with your baby helps you be responsive.
• Take care of yourself. Parenting can be hard work! It’s easier to enjoy your new baby when you feel good yourself.
• Learn to notice and respond to your baby’s signals to know what she’s feeling and needs. You will feel good and your baby will feel safe and loved. For example, is she trying to “play” with you by making sounds and looking at you, or is she turning her head away, yawning, or becoming fussy because she needs a break?
• Lay your baby on his tummy when he is awake and put toys at eye level in front of him. This will help him practice lifting his head up. Do not leave your baby alone. If he seems sleepy, place him on his back in a safe sleep area (firm mattress with no blankets, pillows, bumper pads, or toys).
• Feed only breast milk or formula to your baby. Babies are not ready for other foods, water or other drinks for about the first 6 months of life.
• Learn when your baby is hungry by looking for signs. Watch for signs of hunger, such as putting hands to mouth, turning head toward breast/bottle, or smacking/licking lips.
• Look for signs your baby is full, such as closing her mouth or turning her head away from the breast/bottle. If your baby is not hungry, it’s ok to stop feeding.
• Do not shake your baby or allow anyone else to—ever! You can damage his brain or even cause his death. Put your baby in a safe place and walk away if you’re getting upset when he is crying. Check on him every 5–10 minutes. Infant crying is often worse in the first few months of life, but it gets better!
• Have routines for sleeping and feeding. This will help your baby begin to learn what to expect.
• Hold a rattle off to one side of your baby’s head, shake it, and see if your baby looks for the noise.
• Practice staying calm when your baby is upset by talking softly, holding, rocking, or singing to her. This will help her calm down and lessen her stress and fears.
• Limit screen time (TV, tablets, phones, etc.) to video calling with loved ones. Screen time is not recommended for children younger than 2 years of age. Babies learn by talking, playing, and interacting with others.
• Talk and play with your baby while feeding, dressing, and bathing.
• Help your baby learn some ways to self-soothe by letting her suck on her fingers or a pacifier.
• Copy your baby’s sounds and see how long your baby “talks” by making sounds back and forth with you.
• Place a baby-safe mirror near your baby so she can look at herself. She will begin to develop a sense of who she is.
• Look at pictures with bright colors or faces with your baby and talk about them.

Special acknowledgments to the subject matter experts and others who contributed to the review of data and selection of developmental milestones, especially Paul H. Lipkin, MD, Michelle M. Macias, MD, Julie F. Pajek, PhD, Judith S. Shaw, EdD, MPH, RN, Karnesha Slaughter, MPH, Jane K. Squires, PhD, Toni M. Whitaker, MD, Lisa D. Wiggins, PhD, and Jennifer M. Zubler, MD.

Sincere gratitude to Natalia Benza, MD and José O. Rodríguez, MD, MBA for their thoughtful review of the Spanish-language translation of these milestones.

• Child Development
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• National Center on Birth Defects and Developmental Disabilities

Print Milestone Checklist

English [755 KB, 2 Pages, Print Only] Spanish [788 KB, 2 Pages, Print Only]

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Well Baby Visits, 1 and 2 Months

Topics to discuss with patients during their well baby visit at 1 and 2 months.

• Babies should gain ½ lb per week
• Infants gain approximately 1 inch per month during this time
• Continuing exclusive breastfeeding or formula without supplemental water or juice
• Ask mothers who are working whether allowances are made in the workplace for breastfeeding support. Federal law requires providing breaks and adequate place for expressing breast milk.
• Breastfed infants continue to require 8 to 12 feedings per day
• Daily formula intake should increase from 24 oz (at 1 month) to 30 to 32 oz (by 4 months)

Consider Referral

• Growth faltering (failure to thrive) [Nutrition Related Illnesses and Concerns/Growth faltering]
• Persistent dysphagia [Optimizing Nutrition for Newborns and Infants/Breastfeeding the Newborn/Feeding Issues]
• Dysphagia of unknown cause

Additional Information

• Gastroesophageal reflux and gastroesophageal reflux disease: Parent FAQs , American Academy of Pediatrics.
• Parent’s Guide to GER (Gastroesophageal Reflux Disease) and GERD (Gastroesophageal Reflux Disease) (handout), American Academy of Pediatrics
• Breastfeeding Your Baby: Getting Started (handout), American Academy of Pediatrics
• New Mother’s Guide to Breastfeeding, 3rd Edition (book), American Academy of Pediatrics (also available in Spanish)
• Breastfeeding-Baby Questions (handout)
• Preparing Infant Formula: Important Safety Information (handout), American Academy of Pediatrics
• Healthy Active Living—Responsive Feeding (handout) American Academy of Pediatrics
• Bottle Feeding (Formula) Questions (handout), American Academy of Pediatrics

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American Academy of Pediatrics

Family Life

AAP Schedule of Well-Child Care Visits

Parents know who they should go to when their child is sick. But pediatrician visits are just as important for healthy children.

The Bright Futures /American Academy of Pediatrics (AAP) developed a set of comprehensive health guidelines for well-child care, known as the " periodicity schedule ." It is a schedule of screenings and assessments recommended at each well-child visit from infancy through adolescence.

Schedule of well-child visits

• The first week visit (3 to 5 days old)
• 1 month old
• 2 months old
• 4 months old
• 6 months old
• 9 months old
• 12 months old
• 15 months old
• 18 months old
• 2 years old (24 months)
• 2 ½ years old (30 months)
• 3 years old
• 4 years old
• 5 years old
• 6 years old
• 7 years old
• 8 years old
• 9 years old
• 10 years old
• 11 years old
• 12 years old
• 13 years old
• 14 years old
• 15 years old
• 16 years old
• 17 years old
• 18 years old
• 19 years old
• 20 years old
• 21 years old

The benefits of well-child visits

Prevention . Your child gets scheduled immunizations to prevent illness. You also can ask your pediatrician about nutrition and safety in the home and at school.

Tracking growth & development . See how much your child has grown in the time since your last visit, and talk with your doctor about your child's development. You can discuss your child's milestones, social behaviors and learning.

Raising any concerns . Make a list of topics you want to talk about with your child's pediatrician such as development, behavior, sleep, eating or getting along with other family members. Bring your top three to five questions or concerns with you to talk with your pediatrician at the start of the visit.

Team approach . Regular visits create strong, trustworthy relationships among pediatrician, parent and child. The AAP recommends well-child visits as a way for pediatricians and parents to serve the needs of children. This team approach helps develop optimal physical, mental and social health of a child.

More information

Back to School, Back to Doctor

Recommended Immunization Schedules

Milestones Matter: 10 to Watch for by Age 5

Your Child's Checkups

• Bright Futures/AAP Recommendations for Preventive Pediatric Health Care (periodicity schedule)

Your New Baby's Well-Child Check-Up Schedule (and What to Expect)

Introduction

Well-baby visits are a staple of every new parent’s life. From the day they are born throughout their first year, your baby will have several wellness visits to ensure that they are healthy, happy, and reaching developmental milestones. 

Well-baby visits are vital for immunizations, healthcare, and support from your pediatrician. At Juno Pediatrics, we love establishing relationships with parents that last throughout their baby’s childhood. From newborn through adulthood, Juno is there for every step along the way. 

In this guide, we will explore new-baby visits in-depth, including what to expect, when to schedule them, and how to give your little one the best care possible.

What Are Well-Baby Visits? 

Also known as well-child check-ups, these appointments are pivotal points in their development and healthcare. From the day your baby is born, doctor’s visits will become a regular part of your life. A baby’s first year is filled with trips to the pediatrician where parents can ask questions, get advice and address any concerns they may have. 

In addition to spotting any issues or developmental warning signs, parents can seek out advice on common concerns, such as how to soothe teething, when to expect their baby to start walking, weaning, and breastfeeding. 

Bear in mind that well-child visits are different from additional doctor’s appointments you may need. For example, if your baby falls ill, is injured or you are concerned about something, you can schedule additional evaluations outside of their well-visit schedule. 

Well-Baby Visit Schedule 

Each baby receives a well-baby check-up at 2-5 days,1 month, 2 months, 6 months, 9 months, and 12 months from their birth date. You can, of course, also schedule additional appointments to address any concerns with your pediatrician. 

Remember that well-visits aren’t just for your baby — they are meant to help you, too! There are many parenting milestones you will reach your baby’s first year. From feeding to sleeping, walking to teething, the team at Juno Pediatrics is here to help you nurture your little one every step of the way. 

The First Check-Up: 2-5 Days

The first visit is also important to establish a baby’s feeding habits. All babies lose weight after birth, and it is critical to make sure that the baby is within a healthy range of weight loss and maintains adequate hydration while they learn to eat. Sometimes, a newborn needs assistance with latching onto the breast or learning to take a bottle, which the doctor can address and assist with.

Some babies become jaundiced , a condition caused by too much bilirubin in the bloodstream. This is a yellow substance produced by red blood cells as they break down and accumulate in the baby’s skin.  This will be closely monitored with physical exams and bloodwork if necessary. If your baby had feeding issues or jaundice at birth, you may have daily visits from birth until their condition improves.

If you have a home birth, then your baby should visit the doctor one to two days after entering the world.  This is important because an infant needs vital exams within the first 48 hours of life. Certain tests that were not done at your home birth will be done at this visit, including taking a sample of the baby’s blood for a Newborn Screen. This metabolic screening during this early check-up ensures that your newborn’s body systems are all functioning as they should.

Depending on how your baby is growing and feeding, you will have a weight check between your first and second well-child visits. At this exam, your pediatrician will take your baby’s measurements and start to build their health record. They will address subjects like regular feedings, sleep schedules, and skills like diaper changing and swaddling. 

This visit is the perfect time to establish a connection with your baby’s doctor. They are here for you, so don’t hesitate to ask all your questions, share any concerns and be honest about how you’re feeling. 

Many new parents struggle in the early days, and if you’re feeling overwhelmed, your pediatrician can help. 

The Second Visit: 1 Month

Your baby will grow rapidly throughout its first four weeks of life. You don’t have to schedule this well-visit on the exact 1-month date but aim to make it during the milestone week. 

From birth, babies will typically gain 1 ounce every day for the first 30 days. By the time they reach 1-month old , most will have gone through two small but rapid growth periods and gained at least 2 additional pounds. 

During their 1-month well-visit, the doctor will begin by checking your baby’s vital signs and taking their measurements. Then, the doctor will check in with you and how you’re feeling. They can offer tips and suggestions on how to nurture your baby’s development through play, tummy time and reading. 

Through feeding, playing, cuddling, and rest, your baby will develop according to their own body. If they have a condition that will affect their health and development, the pediatrician will discuss this in detail and give you advice on what to look for. 

The Third Check-Up: 2 Months

At the 8-week mark, your baby will be far more alert than when they were born. The average 2-month old is more visually engaged and able to look at an object for several seconds as well as watch you when you move. 

At the beginning of this and every visit, your baby’s vital signs measurements will be taken and documented. Your pediatrician will review how they are eating, voiding, stooling, and sleeping.  In addition, your pediatrician will review their development and milestone and give you guidance on what to expect for the next two months before their next checkup

This visit is also the time to start immunization. At the 2-month well-visit, your infant will obtain 4 vaccines and be protected against 8 serious bacterial and viral diseases. 

The following vaccines are administered at the 2-month visit, and comprises the first set of their primary series:

Hepatitis B

Diphtheria/Tetanus/Pertussis (DTaP) 

Haemophilus influenzae type b (Hib) 

Pneumococcal (PCV)

Polio (IPV) 

Rotavirus (RV)

Be sure to voice any concerns or questions you have about vaccines and immunization with your pediatrician. Many parents who never second-guessed immunization can become anxious after they have a baby. They will discuss everything you need to know, listen to how you feel and answer your questions. 

At Juno Pediatrics , we are committed to providing the highest level of care and protection, and toward that goal, we ensure that all of our patients are vaccinated on schedule and on time.  You can find more on our approach to pediatric vaccines on our website . Your pediatrician will be there to answer any and all questions along the way.

The Fourth Check-Up: 4 Months

Four-month-olds are smiling, cooing babies, reaching for toys and your hair, looking around, and holding their heads up with more stability. 

The care assistant will take your baby’s vitals and measurements, as usual, review how the child is doing, answer your questions, and let you know what to expect in the coming two months.  Additionally, at this visit, we will start discussing introducing solid foods to your baby, a fun new adventure!

Your infant will also receive his second set of vaccines, the exact same one they received at the 2-month visit.  This is the second of three of their primary series vaccines.

The Fifth Check-Up: 6 Months

The half-year mark is a major milestone in a baby’s life. Their personality will have emerged and begun to shine through as they engage more with you, their family, and the world around them. By this age , they may begin to sit on their own, enjoy looking at their reflection in mirrors and show emotional responses to others. 

Your pediatrician will take your baby’s vitals and measurements as usual, then discuss some of the 6-month-old milestones to expect. If you are worried about your baby’s development, the doctor will listen intently and offer reassurance and guidance.

If your baby is not mobile, does not sit up or hold things, does not laugh or smile, or does not respond to its caretakers, then make sure you bring these issues up with your doctor. 

The final 4 vaccines of the primary series will be administered at this visit by the pediatrician. During flu season, your baby is eligible to receive its first influenza vaccine. This is administered to children in 2 doses roughly 1 month apart. 

The Sixth Check-Up: 9 Months

A 9-month-old is curious, adventurous, and always interested in the world around them. They will be eating solid foods 2-3x a day in addition to breast milk and formula and are starting to express their independence. At this stage , most babies are very vocal and have some ability to move. 

They will have a range of emotional expressions from deep frowns to big, happy smiles. They can also express anger and frustration more clearly, so it will be easier to differentiate their cries and understand their feelings. 

Your pediatrician will ensure the baby’s growth is on par with their sex and age. Then, they will begin to discuss their oral hygiene, as your baby may have a tooth erupted. . If you are concerned about any developmental delays, they can be addressed during this time.

Lack of emotional response, limited eye contact, infrequent mobility, and poor motor skills can indicate an issue that the doctor should know about. They can address these concerns and, if need be, refer you and your baby to a specialist. 

Bear in mind that every baby is unique, and some children reach milestones later without having any major conditions.

The Seventh Check-Up: 1 Year

As you celebrate your child’s first year of life, your pediatrician will offer advice on how to nurture them through late infancy into early toddlerhood. Over the next year, they will experience many changes to their cognitive, mental, and emotional development.

Your baby’s personality will emerge even more from this point forward, especially as they become more mobile, taking first steps, and communicative, saying first words and phrases.

At the 12-month-old check-up , your baby will undergo a blood test that checks lead level and hemoglobin screening, which checks for anemia . 

The 1-year mark is also time for babies to receive the following vaccines:

Measles, Mumps, and Rubella (MMR)

Chickenpox (varicella)

Hepatitis A 

Their final boosters of DTaP and Hib vaccines will be given at their 15-month check-up, and their final Hepatitis A vaccine and PCV vaccine will be completed at the 18-month visit.

Your Baby’s Health Journey Starts Here

At Juno, we provide comprehensive healthcare for the entire family. Our medical team includes board-certified pediatricians who take the time to listen to your experiences, hear your concerns, and ensure your baby gets the highest quality care. If you are looking for a long-term practice to nurture your baby, schedule an appointment with Juno Pediatrics today .

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What to Expect at Your Baby’s First Pediatrician Visit

Nervous about your baby's first pediatrician visit? Here's what to expect, from paperwork to meeting the doctor, plus tips for making the visit easier for you and your baby.

Your baby should have their first well-baby visit at the pediatrician's office three to five days after birth, according to the American Academy of Pediatrics (AAP). After that, you'll be going in for checkups every few months over the course of the first year.

Since your baby's first pediatrician visit might be the first time your newborn leaves home, it's natural to feel some trepidation. But remember that this visit is often empowering and informative for new parents. Read on to learn what to expect during your baby's first pediatrician visit, from exams to vaccinations, as well as tips for timing and preparation.

There Will Be Paperwork

Be prepared to fill out paperwork when you arrive. Remember to pack the following:

• Your ID and health insurance card
• Information about your newborn's discharge weight
• Any complications during pregnancy or birth
• Your family's medical history

Knowing that your older child has asthma or your parents have diabetes, for example, focuses your pediatrician's attention on likely problems, says Christopher Pohlod, DO , assistant professor of pediatrics at Michigan State University's College of Osteopathic Medicine.

The Nurse Will Do Some Exams

A nurse will probably handle the first part of your baby's exam. They'll do the following:

• Weigh your naked baby on a scale
• Extend their limbs to measure height and width
• Use a tape measure to determine the head circumference

According to the AAP, it's normal for babies to lose weight after birth (up to 10% of their body weight). But they'll generally gain it back within a couple of weeks.

You'll Get to Know the Doctor

The pediatrician will examine your baby, educate you about their health, and answer any questions. One of the biggest components of the first pediatrician visit is developing a relationship with your child's new doctor. They will be a source of information, support, and troubleshooting in the many years to come.

They'll Check Your Baby's Neck and Collarbone

At your baby's first pediatrician visit, a health care provider will feel along your baby's neckline to check for a broken collarbone during the physical exam. That's because some babies fracture their clavicle while squeezing through the birth canal.

If your pediatrician finds a small bump, that could mean a break is starting to heal. It will mend on its own in a few weeks. In the meantime, they may suggest pinning the baby's sleeve across their chest to stabilize the arm so the collarbone doesn't hurt.

They'll Check Your Baby's Head

A pediatrician will also palm your baby's head to check for a still-soft fontanel. They will do this at every well visit for the first one to two years.

Your baby's head should grow about 4 inches in the first year, and the two soft spots on their skull are designed to accommodate that rapid growth. But if the soft spots close up too quickly, it can lead to a condition called craniosynostosis, which is when the tight quarters can curb brain development, and your child may need surgery to fix it.

They'll Check Your Baby's Hips

The doctor will roll your baby's hips to check for signs of developmental hip dysplasia, a congenital malformation of the hip joint that affects 1 in every 1,000 babies. You can expect this exam starting at your baby's first pediatrician visit and every visit until your baby can walk.

"The exam looks completely barbaric," says Vinita Seru, MD , a pediatrician in Seattle. "I tell families what I'm doing so they don't think I'm trying to hurt the baby."

If your pediatrician feels a telltale click from the hips, they'll order an ultrasound. Luckily, when dysplasia is found early, treatment is simple: The baby wears a pelvic harness for a few months.

They'll Check Your Baby's Reflexes

To check for a Moro reflex, a health care provider startles your baby. For the first 3 or 4 months, whenever something startles your infant, they'll fling their arms out as if they're falling. It's an involuntary response that shows your baby is developing normally.

This exam starts at the first pediatrician visit and continues through the first four well-child visits. A health care provider might also check whether your little one grasps a finger or fans their toes after you touch their foot.

They'll Check Your Baby's Pulse

By pressing the skin along the side of the baby's groin, a health care provider checks for your baby's pulse in the femoral artery, which runs up from your baby's thigh. Your pediatrician wants to see if the pulse is weak or hard to detect on one or both sides as that may suggest a heart condition.

You can expect this exam at the first pediatrician visit and all baby well visits. Around 1 in 125 babies are diagnosed with a heart defect every year in the US. This check is a simple way to screen for problems, says Dr. Seru: "When a heart condition is caught early, it can increase the likelihood of a good recovery."

They'll Check Your Baby's Genitalia

Starting at the first pediatrician visit and every well-baby visit after that, a health care provider will check your baby's genitals to ensure everything looks normal.

In about 1 to 3% of babies with testicles, the testicles don't descend into the scrotum before birth. While the problem usually corrects itself by 3 to 4 months of age, your doctor will keep an eye on things to see if your baby needs surgical assistance in the future. They will also check for signs of infection if your baby has been circumcised .

In babies with vulvas, it's not uncommon to find labial adhesions. Although the labia should open up over time, adhesions can shrink the vaginal opening and make your baby more prone to urinary tract infections (UTIs) . "If we know that they're there when your baby has a high fever, we look for a UTI first," says Melissa Kendall, MD , a pediatrician in Orem, Utah.

They'll Ask About Your Baby’s Feeding Patterns

The doctor will want information about your baby's feeding patterns. You don't need to keep super-detailed records, but you should have a general idea of the following:

• How often your baby is eating
• How long they feed (if nursing)
• How much they consume (if bottle-feeding)

This is an excellent time to raise concerns or questions about latching, formula brands, and other feeding issues.

They'll Check Your Baby’s Digestive System

You should have a general idea of how often you change your baby's diapers each day. If your doctor knows the consistency, frequency, and color of your baby's poop , they can better assess their digestive system and nutrient absorption.

They'll Ask About Your Baby's Sleeping Patterns

A health care provider will also probably inquire about sleeping patterns at your first pediatrician visit. They'll also make sure you're following safe sleep practices to help reduce the risk of sudden infant death syndrome (SIDS).

They'll Review the Childhood Vaccination Schedule

Hospitals usually give babies their first dose of the hepatitis B vaccine shortly after birth, but if your baby was born at home or at a birth center, they might receive it at their first pediatrician visit.

Most vaccinations start when your baby is 2 months old, and a health care provider might review the vaccine schedule with you so you're prepared for the many vaccines your baby will receive in the months ahead.

There Will Be Time for Questions

You will cover a lot of ground during your baby's first pediatrician visit. Ask the doctor to slow down, repeat, or clarify information if needed. It's also wise to come prepared with any questions you have.

Here are some examples:

• Is this behavior normal?
• Is my baby eating enough?
• Should their stool look like that?
• When should I schedule the next appointment?
• What should I expect in the next few days and weeks?

When you have a written list of talking points, you won't worry about your mind going blank if your baby starts to fuss, says Dr. Pohlod.

You'll Schedule Your Next Appointment

The lineup of well-baby checkups during the first year includes at least a half dozen more pediatrician visits.

Recommended Baby Checkup Schedule

Here is a quick-glance list of what ages the AAP recommends that your child be seen for well-child pediatrician visits through their second year:

• 3 to 5 days old
• 1 month old
• 2 months old
• 4 months old
• 6 months old
• 9 months old
• 12 months old
• 15 months old
• 18 months old
• 24 months old

At first glance, the recommended number of checkups may seem like a lot. But trust the process: This schedule was designed to closely monitor your baby's growth and development to ensure their health and well-being.

The checkups, depending on the age of your baby, will include measurements, sensory screening, and developmental health, which include social, behavioral, and mental health. It will also include vaccinations, oral health, and advice for parents and caregivers.

Frequent appointments with your baby's health care provider are also the best way to get personalized expert answers to your questions about your baby. Ultimately, it's important to be comfortable with your doctor, and seeing them frequently in the first year helps you develop a relationship you may have for years to come.

When you schedule your next appointment, ask about the office's hours of operation, billing policies, and how after-hours communication works. Keep the doctor's phone number handy, and be informed of what to do and who to contact in an emergency or when you have a question.

Tips for Your Baby's First Pediatrician Visit

Leaving the house with a newborn isn't easy, and it can be especially stressful when you're on a timetable (like when you're trying to make it to a scheduled appointment). But your baby's first pediatrician visit doesn't have to be super stressful. Here are some tips for smooth sailing:

• Plan your time. Ask for an appointment during the least busy part of the day. You can also see if a health care provider has specific time slots dedicated to seeing newborns. Expect the visit to take about 25 minutes, but plan for waiting and setbacks as well.
• Bring a support person. Consider bringing your partner or another caregiver to your baby's first doctor appointment. Two people can more effectively care for the baby, remember the doctor's advice, and recall questions you plan to ask.
• Dress your baby with the exam in mind. Since the doctor will examine your baby's entire body, dress them in easy-on, easy-off clothing or even just a diaper and comfortable blanket if weather permits.
• Be prepared, but pack light. Definitely bring a change of clothes, extra diapers, wipes, pacifiers, feeding supplies, and other necessities, but try not to overpack. Ultimately, "warmth, cuddling, loving, and reassuring voices are more helpful than a stuffed animal" at a newborn exam, says Brian MacGillivray, MD, a family medicine specialist in San Antonio.
• Wait in the car, if you can. If you attend the appointment with another person, send them inside to fill out paperwork while you wait in the car with the baby. This limits your newborn's exposure to germs. Some offices even have systems in place that allow you to fill out the paperwork online, wait in your car, and receive a call or text when it's time to go in.
• Keep your distance from others. If you must sit in the waiting room, have your baby face the corner. According to  Mary Ellen Renna, MD , a pediatrician from Jericho, New York, the chances of catching sickness are lower if you maintain a 3-foot radius from others.

AAP Schedule of Well-Child Care Visits . American Academy of Pediatrics . 2023.

Weight Loss . The American Academy of Pediatrics . 2020.

Clavicular Fractures in Newborns: What Happens to One of the Commonly Injured Bones at Birth? . Cureus . 2021.

Facts About Craniosynostosis . Centers for Disease Control and Prevention . 2023.

Developmental Dislocation (Dysplasia) Of the Hip (DDH) . American Academy of Orthopaedic Surgeons . 2022.

Moro Reflex . StatPearls . 2023.

A five (5) chamber heart (Cor Triatriatum) in Infancy: A rare congenital heart defect .  Niger Med J . 2013.

Undescended Testicles: What Parents Need To Know . American Academy of Pediatrics . 2022.

Periodicity Schedule . American Academy of Pediatrics . 2023.

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2-Month Vaccines: What You Should Know

2-month vaccinations, diphtheria, tetanus, acellular pertussis (dtap), haemophilus influenzae type b (hib), polio vaccine (ipv), pneumococcal conjugate vaccine (pcv), hepatitis b (hbv), rotavirus (rv), side effects, when to contact the pediatrician, when to call 911.

At their 2-month wellness check, babies are usually scheduled to receive several vaccines, including:

• Diphtheria , tetanus , acellular pertussis ( DTaP )
• Haemophilus influenzae type B ( Hib )
• Inactivated polio vaccine ( IPV )
• Pneumococcal conjugate vaccine ( PCV )
• Hepatitis B vaccine ( HBV )
• Rotavirus vaccine ( RV )

This article discusses recommended vaccinations, possible side effects, and how to comfort infants during and after their appointment.  

SDI Productions / Getty Images

While babies are born with a fairly strong immune system, there are some diseases that can be severe and are hard to fight on their own. Vaccinations are given to help their immune system prevent these diseases. 

The Centers for Disease Control and Prevention (CDC) recommends an immunization schedule that includes six vaccinations for 2-month old babies.

Most vaccinations are given as a shot. However, the rotavirus vaccine (RV) is given by mouth through liquid drops. 

Alternate Names for Vaccinations

Vaccinations may also be referred to as:

• Innoculation
• Immunization

Comforting Your Baby

Write down questions you have and bring available shot records with you to the appointment. It’s also helpful to pack your baby’s favorite toy, pacifier, or blanket to comfort them during the visit.

During the appointment, you can help your baby by:

• Holding them
• Distracting them with toys or singing
• Smiling and whispering reassuring words

After the appointment, you can comfort your baby by:

• Breastfeeding or bottle-feeding
• Offering a pacifier
• Swaddling with their favorite blanket
• Giving them Tylenol (acetaminophen) as needed for pain if approved by your healthcare provider

The DTaP vaccination is given in five doses. The first dose begins at 2-months and the final at 4-6 years old. DTaP helps prevent the following diseases:

• Tetanus  
• Pertussis (whooping cough)

Is it DTaP or Tdap?

Both the DTaP and Tdap are vaccines that protect against the same diseases. The first five doses given are the DTaP. Tdap is the booster given around 11 years or older. 

Haemophilus influenzae type B ( Hib ) is often confused with seasonal influenza ( flu ) because of their similar names. However, these are two different diseases. Seasonal influenza is a virus, while Hib is a bacteria that can cause:

• Pneumonia (lung infection)
• Sepsis (bloodstream infection)
• Epiglottitis (swelling in the upper airway or windpipe) 

The Hib vaccine is scheduled as three or four doses depending on the brand. It is given at the following ages:

• 6 months (if needed depending on vaccine brand)
• 12-14 months

Hib Statistics

Between 1989 and 2000, Hib rates in the United States dropped by 99% due to vaccinations.

In the late 1940s, polio was a highly feared disease that caused paralysis. After polio vaccinations, infections in the U.S. decreased dramatically.  

Children in the U.S. get a shot called an inactivated polio vaccine (IPV). Other countries may use an oral polio vaccine (OPV).

IPV is given over four doses at the following ages:

• 6-18 months

Polio Cases in the United States

No cases of polio have originated in the U.S since 1979. In 1993 one case came into the country through travel. Healthcare providers may choose to increase the pace of polio vaccines for children traveling to a high-risk country.

The pneumococcal conjugate vaccine ( PCV ) protects against a bacterial infection that causes ear or sinus infections, meningitis, and pneumonia.

The PCV vaccine is given in four doses at the following ages:

• 12-15 months

Pneumococcal Disease

Streptococcus pneumoniae or pneumococcus are bacteria that cause pneumococcal disease. Immunization against these diseases is important because they can be invasive and severe.

Hepatitis B (HBV) is a potentially serious viral infection that causes damage to the liver. It is passed through body fluids or from mother to baby. The hepatitis B vaccine ( HBV ) is given in three doses at the following ages:

• Shortly after birth
• 1-2 months 

Protecting Your Baby from Hepatitis B After Delivery

Moms can have hepatitis B without symptoms and unknowingly pass it to their babies at birth. This is why infants usually receive the first dose within the first 12 hours of their life.

Rotavirus (RV) is a gastrointestinal virus that causes stomach pain, severe vomiting, diarrhea, and dehydration (loss of fluid). The RV vaccination is given as drops in the mouth. 

There are two brands of this vaccine. One brand is given at 2- and 4-months-old. The other brand includes a third dose given at 6-months-old.

If babies experience side effects after vaccines they are usually mild.

The most common side effects include:

• Soreness, redness, or swelling at the site of the shot 
• Low-grade fever (100-102 degrees or lower) 

Less common side effects include:

• Fussiness or irritability
• Loss of appetite
• Diarrhea or vomiting

What About Severe Side Effects?

Severe side effects or allergic reactions are very rare. If you are concerned about this possibility, talk to your healthcare provider before the appointment.

What to Do If Your Baby Has Side Effects

To help minimize mild reactions, you can try the following:

• A cool cloth to reduce redness and swelling 
• A room temperature sponge bath for low-grade fevers
• Feed your baby more often for comfort and hydration
• Give Tylenol (acetaminophen) if approved by your pediatrician

Medications to Reduce Fever and Discomfort

Motrin or Advil (ibuprofen) is usually not given to babies less than 6-months-old. Tylenol (acetaminophen) is safe for infants 2-months-old and up with approval from their healthcare provider. Children should not receive aspirin unless directed by their healthcare provider.

If your baby has any of the following symptoms, contact their healthcare provider:

• Fever greater than 104 degrees
• Redness at the shot site larger than 1 inch or lasting longer than three days
• High-pitched crying lasting over one hour
• Nonstop crying for three hours or more
• Fussiness for more than three days 
• Severe vomiting or diarrhea

If you think your infant is having a life-threatening emergency or any of the following rare reactions, call 911 immediately:

• Trouble breathing
• Trouble swallowing
• Lethargy (not moving or very weak)
• Not waking up

Vaccinations are usually given at an infant’s 2-month wellness visit to help protect them from preventable diseases. You can help comfort your baby by holding them and offering them their favorite blanket, pacifier, or toy. Vaccination side effects are generally mild and can be treated at home to ease any discomfort.

A Word From Verywell

It's understandable that parents may have concerns about infant vaccinations. It's important to know that while mild reactions are possible, severe ones are extremely rare. A child's safety is paramount, so you shouldn’t hesitate to discuss any concerns with your child’s healthcare providers. Vaccinations play a crucial role in safeguarding your child's health and providing protection against serious diseases, and the benefits of timely vaccination far outweigh the minimal risks.

Centers for Disease Control and Prevention (CDC). Vaccines for your children: 1-2 months .

Centers for Disease Control and Prevention (CDC). Immunization schedules .

Centers for Disease Control and Prevention (CDC). 9 things to make shots less stressful .

Centers for Disease Control and Prevention (CDC). DTaP (diphtheria, tetanus, pertussis) vaccine: What you need to know.

Immunization Action Coalition. Ask the Experts: Haemophilus influenzae type b (Hib) .

Centers for Disease Control and Prevention. Hib vaccination: What everyone should know .

Centers for Disease Control and Prevention (CDC). Vaccines and preventable diseases: polio .

Centers for Disease Control and Prevention (CDC). Pneumococcal vaccine recommendations .

Centers for Disease Control and Prevention (CDC). Pneumococcal disease .

Centers for Disease Control and Prevention (CDC). Hepatitis B .

Centers for Disease Control and Prevention (CDC). Rotavirus . 

Seattle Children’s Hospital. Immunization reactions .

Daley M, O'Leary S, Nyquist A, et al. Current Diagnosis & Treatment: Pediatrics . 25th ed. New York: McGraw Hill;Chapter 10:2022.

Immunization Action Coalition. After the shots . Immunize.org.

St Louis Children’s Hospital. Acetaminophen (Tylenol) dose table .

Contemporary Pediatrics. 2021 CDC vaccine schedule .

By Brandi Jones, MSN-ED RN-BC Jones is a registered nurse and freelance health writer with more than two decades of healthcare experience.

KATHERINE TURNER, MD

Am Fam Physician. 2018;98(6):347-353

Related letter: Well-Child Visits Provide Physicians Opportunity to Deliver Interconception Care to Mothers

Author disclosure: No relevant financial affiliations.

The well-child visit allows for comprehensive assessment of a child and the opportunity for further evaluation if abnormalities are detected. A complete history during the well-child visit includes information about birth history; prior screenings; diet; sleep; dental care; and medical, surgical, family, and social histories. A head-to-toe examination should be performed, including a review of growth. Immunizations should be reviewed and updated as appropriate. Screening for postpartum depression in mothers of infants up to six months of age is recommended. Based on expert opinion, the American Academy of Pediatrics recommends developmental surveillance at each visit, with formal developmental screening at nine, 18, and 30 months and autism-specific screening at 18 and 24 months; the U.S. Preventive Services Task Force found insufficient evidence to make a recommendation. Well-child visits provide the opportunity to answer parents' or caregivers' questions and to provide age-appropriate guidance. Car seats should remain rear facing until two years of age or until the height or weight limit for the seat is reached. Fluoride use, limiting or avoiding juice, and weaning to a cup by 12 months of age may improve dental health. A one-time vision screening between three and five years of age is recommended by the U.S. Preventive Services Task Force to detect amblyopia. The American Academy of Pediatrics guideline based on expert opinion recommends that screen time be avoided, with the exception of video chatting, in children younger than 18 months and limited to one hour per day for children two to five years of age. Cessation of breastfeeding before six months and transition to solid foods before six months are associated with childhood obesity. Juice and sugar-sweetened beverages should be avoided before one year of age and provided only in limited quantities for children older than one year.

Well-child visits for infants and young children (up to five years) provide opportunities for physicians to screen for medical problems (including psychosocial concerns), to provide anticipatory guidance, and to promote good health. The visits also allow the family physician to establish a relationship with the parents or caregivers. This article reviews the U.S. Preventive Services Task Force (USPSTF) and the American Academy of Pediatrics (AAP) guidelines for screenings and recommendations for infants and young children. Family physicians should prioritize interventions with the strongest evidence for patient-oriented outcomes, such as immunizations, postpartum depression screening, and vision screening.

Clinical Examination

The history should include a brief review of birth history; prematurity can be associated with complex medical conditions. 1 Evaluate breastfed infants for any feeding problems, 2 and assess formula-fed infants for type and quantity of iron-fortified formula being given. 3 For children eating solid foods, feeding history should include everything the child eats and drinks. Sleep, urination, defecation, nutrition, dental care, and child safety should be reviewed. Medical, surgical, family, and social histories should be reviewed and updated. For newborns, review the results of all newborn screening tests ( Table 1 4 – 7 ) and schedule follow-up visits as necessary. 2

PHYSICAL EXAMINATION

A comprehensive head-to-toe examination should be completed at each well-child visit. Interval growth should be reviewed by using appropriate age, sex, and gestational age growth charts for height, weight, head circumference, and body mass index if 24 months or older. The Centers for Disease Control and Prevention (CDC)-recommended growth charts can be found at https://www.cdc.gov/growthcharts/who_charts.htm#The%20WHO%20Growth%20Charts . Percentiles and observations of changes along the chart's curve should be assessed at every visit. Include assessment of parent/caregiver-child interactions and potential signs of abuse such as bruises on uncommonly injured areas, burns, human bite marks, bruises on nonmobile infants, or multiple injuries at different healing stages. 8

The USPSTF and AAP screening recommendations are outlined in Table 2 . 3 , 9 – 27 A summary of AAP recommendations can be found at https://www.aap.org/en-us/Documents/periodicity_schedule.pdf . The American Academy of Family Physicians (AAFP) generally adheres to USPSTF recommendations. 28

MATERNAL DEPRESSION

Prevalence of postpartum depression is around 12%, 22 and its presence can impair infant development. The USPSTF and AAP recommend using the Edinburgh Postnatal Depression Scale (available at https://www.aafp.org/afp/2010/1015/p926.html#afp20101015p926-f1 ) or the Patient Health Questionnaire-2 (available at https://www.aafp.org/afp/2012/0115/p139.html#afp20120115p139-t3 ) to screen for maternal depression. The USPSTF does not specify a screening schedule; however, based on expert opinion, the AAP recommends screening mothers at the one-, two-, four-, and six-month well-child visits, with further evaluation for positive results. 23 There are no recommendations to screen other caregivers if the mother is not present at the well-child visit.

PSYCHOSOCIAL

With nearly one-half of children in the United States living at or near the poverty level, assessing home safety, food security, and access to safe drinking water can improve awareness of psychosocial problems, with referrals to appropriate agencies for those with positive results. 29 The prevalence of mental health disorders (i.e., primarily anxiety, depression, behavioral disorders, attention-deficit/hyperactivity disorder) in preschool-aged children is around 6%. 30 Risk factors for these disorders include having a lower socioeconomic status, being a member of an ethnic minority, and having a non–English-speaking parent or primary caregiver. 25 The USPSTF found insufficient evidence regarding screening for depression in children up to 11 years of age. 24 Based on expert opinion, the AAP recommends that physicians consider screening, although screening in young children has not been validated or standardized. 25

DEVELOPMENT AND SURVEILLANCE

Based on expert opinion, the AAP recommends early identification of developmental delays 14 and autism 10 ; however, the USPSTF found insufficient evidence to recommend formal developmental screening 13 or autism-specific screening 9 if the parents/caregivers or physician have no concerns. If physicians choose to screen, developmental surveillance of language, communication, gross and fine movements, social/emotional development, and cognitive/problem-solving skills should occur at each visit by eliciting parental or caregiver concerns, obtaining interval developmental history, and observing the child. Any area of concern should be evaluated with a formal developmental screening tool, such as Ages and Stages Questionnaire, Parents' Evaluation of Developmental Status, Parents' Evaluation of Developmental Status-Developmental Milestones, or Survey of Well-Being of Young Children. These tools can be found at https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Screening/Pages/Screening-Tools.aspx . If results are abnormal, consider intervention or referral to early intervention services. The AAP recommends completing the previously mentioned formal screening tools at nine-, 18-, and 30-month well-child visits. 14

The AAP also recommends autism-specific screening at 18 and 24 months. 10 The USPSTF recommends using the two-step Modified Checklist for Autism in Toddlers (M-CHAT) screening tool (available at https://m-chat.org/ ) if a physician chooses to screen a patient for autism. 10 The M-CHAT can be incorporated into the electronic medical record, with the possibility of the parent or caregiver completing the questionnaire through the patient portal before the office visit.

IRON DEFICIENCY

Multiple reports have associated iron deficiency with impaired neurodevelopment. Therefore, it is essential to ensure adequate iron intake. Based on expert opinion, the AAP recommends supplements for preterm infants beginning at one month of age and exclusively breastfed term infants at six months of age. 3 The USPSTF found insufficient evidence to recommend screening for iron deficiency in infants. 19 Based on expert opinion, the AAP recommends measuring a child's hemoglobin level at 12 months of age. 3

Lead poisoning and elevated lead blood levels are prevalent in young children. The AAP and CDC recommend a targeted screening approach. The AAP recommends screening for serum lead levels between six months and six years in high-risk children; high-risk children are identified by location-specific risk recommendations, enrollment in Medicaid, being foreign born, or personal screening. 21 The USPSTF does not recommend screening for lead poisoning in children at average risk who are asymptomatic. 20

The USPSTF recommends at least one vision screening to detect amblyopia between three and five years of age. Testing options include visual acuity, ocular alignment test, stereoacuity test, photoscreening, and autorefractors. The USPSTF found insufficient evidence to recommend screening before three years of age. 26 The AAP, American Academy of Ophthalmology, and the American Academy of Pediatric Ophthalmology and Strabismus recommend the use of an instrument-based screening (photoscreening or autorefractors) between 12 months and three years of age and annual visual acuity screening beginning at four years of age. 31

IMMUNIZATIONS

The AAFP recommends that all children be immunized. 32 Recommended vaccination schedules, endorsed by the AAP, the AAFP, and the Advisory Committee on Immunization Practices, are found at https://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html . Immunizations are usually administered at the two-, four-, six-, 12-, and 15- to 18-month well-child visits; the four- to six-year well-child visit; and annually during influenza season. Additional vaccinations may be necessary based on medical history. 33 Immunization history should be reviewed at each wellness visit.

Anticipatory Guidance

Injuries remain the leading cause of death among children, 34 and the AAP has made several recommendations to decrease the risk of injuries. 35 – 42 Appropriate use of child restraints minimizes morbidity and mortality associated with motor vehicle collisions. Infants need a rear-facing car safety seat until two years of age or until they reach the height or weight limit for the specific car seat. Children should then switch to a forward-facing car seat for as long as the seat allows, usually 65 to 80 lb (30 to 36 kg). 35 Children should never be unsupervised around cars, driveways, and streets. Young children should wear bicycle helmets while riding tricycles or bicycles. 37

Having functioning smoke detectors and an escape plan decreases the risk of fire- and smoke-related deaths. 36 Water heaters should be set to a maximum of 120°F (49°C) to prevent scald burns. 37 Infants and young children should be watched closely around any body of water, including water in bathtubs and toilets, to prevent drowning. Swimming pools and spas should be completely fenced with a self-closing, self-latching gate. 38

Infants should not be left alone on any high surface, and stairs should be secured by gates. 43 Infant walkers should be discouraged because they provide no benefit and they increase falls down stairs, even if stair gates are installed. 39 Window locks, screens, or limited-opening windows decrease injury and death from falling. 40 Parents or caregivers should also anchor furniture to a wall to prevent heavy pieces from toppling over. Firearms should be kept unloaded and locked. 41

Young children should be closely supervised at all times. Small objects are a choking hazard, especially for children younger than three years. Latex balloons, round objects, and food can cause life-threatening airway obstruction. 42 Long strings and cords can strangle children. 37

DENTAL CARE

Infants should never have a bottle in bed, and babies should be weaned to a cup by 12 months of age. 44 Juices should be avoided in infants younger than 12 months. 45 Fluoride use inhibits tooth demineralization and bacterial enzymes and also enhances remineralization. 11 The AAP and USPSTF recommend fluoride supplementation and the application of fluoride varnish for teeth if the water supply is insufficient. 11 , 12 Begin brushing teeth at tooth eruption with parents or caregivers supervising brushing until mastery. Children should visit a dentist regularly, and an assessment of dental health should occur at well-child visits. 44

SCREEN TIME

Hands-on exploration of their environment is essential to development in children younger than two years. Video chatting is acceptable for children younger than 18 months; otherwise digital media should be avoided. Parents and caregivers may use educational programs and applications with children 18 to 24 months of age. If screen time is used for children two to five years of age, the AAP recommends a maximum of one hour per day that occurs at least one hour before bedtime. Longer usage can cause sleep problems and increases the risk of obesity and social-emotional delays. 46

To decrease the risk of sudden infant death syndrome (SIDS), the AAP recommends that infants sleep on their backs on a firm mattress for the first year of life with no blankets or other soft objects in the crib. 45 Breastfeeding, pacifier use, and room sharing without bed sharing protect against SIDS; infant exposure to tobacco, alcohol, drugs, and sleeping in bed with parents or caregivers increases the risk of SIDS. 47

DIET AND ACTIVITY

The USPSTF, AAFP, and AAP all recommend breastfeeding until at least six months of age and ideally for the first 12 months. 48 Vitamin D 400 IU supplementation for the first year of life in exclusively breastfed infants is recommended to prevent vitamin D deficiency and rickets. 49 Based on expert opinion, the AAP recommends the introduction of certain foods at specific ages. Early transition to solid foods before six months is associated with higher consumption of fatty and sugary foods 50 and an increased risk of atopic disease. 51 Delayed transition to cow's milk until 12 months of age decreases the incidence of iron deficiency. 52 Introduction of highly allergenic foods, such as peanut-based foods and eggs, before one year decreases the likelihood that a child will develop food allergies. 53

With approximately 17% of children being obese, many strategies for obesity prevention have been proposed. 54 The USPSTF does not have a recommendation for screening or interventions to prevent obesity in children younger than six years. 54 The AAP has made several recommendations based on expert opinion to prevent obesity. Cessation of breastfeeding before six months and introduction of solid foods before six months are associated with childhood obesity and are not recommended. 55 Drinking juice should be avoided before one year of age, and, if given to older children, only 100% fruit juice should be provided in limited quantities: 4 ounces per day from one to three years of age and 4 to 6 ounces per day from four to six years of age. Intake of other sugar-sweetened beverages should be discouraged to help prevent obesity. 45 The AAFP and AAP recommend that children participate in at least 60 minutes of active free play per day. 55 , 56

Data Sources: Literature search was performed using the USPSTF published recommendations ( https://www.uspreventiveservicestaskforce.org/BrowseRec/Index/browse-recommendations ) and the AAP Periodicity table ( https://www.aap.org/en-us/Documents/periodicity_schedule.pdf ). PubMed searches were completed using the key terms pediatric, obesity prevention, and allergy prevention with search limits of infant less than 23 months or pediatric less than 18 years. The searches included systematic reviews, randomized controlled trials, clinical trials, and position statements. Essential Evidence Plus was also reviewed. Search dates: May through October 2017.

Gauer RL, Burket J, Horowitz E. Common questions about outpatient care of premature infants. Am Fam Physician. 2014;90(4):244-251.

American Academy of Pediatrics; Committee on Fetus and Newborn. Hospital stay for healthy term newborns. Pediatrics. 2010;125(2):405-409.

Baker RD, Greer FR Committee on Nutrition, American Academy of Pediatrics. Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0–3 years of age). Pediatrics. 2010;126(5):1040-1050.

Mahle WT, Martin GR, Beekman RH, Morrow WR Section on Cardiology and Cardiac Surgery Executive Committee. Endorsement of Health and Human Services recommendation for pulse oximetry screening for critical congenital heart disease. Pediatrics. 2012;129(1):190-192.

American Academy of Pediatrics Newborn Screening Authoring Committee. Newborn screening expands: recommendations for pediatricians and medical homes—implications for the system. Pediatrics. 2008;121(1):192-217.

American Academy of Pediatrics, Joint Committee on Infant Hearing. Year 2007 position statement: principles and guidelines for early hearing detection and intervention programs. Pediatrics. 2007;120(4):898-921.

Maisels MJ, Bhutani VK, Bogen D, Newman TB, Stark AR, Watchko JF. Hyperbilirubinemia in the newborn infant > or = 35 weeks' gestation: an update with clarifications. Pediatrics. 2009;124(4):1193-1198.

Christian CW Committee on Child Abuse and Neglect, American Academy of Pediatrics. The evaluation of suspected child physical abuse [published correction appears in Pediatrics . 2015;136(3):583]. Pediatrics. 2015;135(5):e1337-e1354.

Siu AL, Bibbins-Domingo K, Grossman DC, et al. Screening for autism spectrum disorder in young children: U.S. Preventive Services Task Force recommendation statement. JAMA. 2016;315(7):691-696.

Johnson CP, Myers SM American Academy of Pediatrics Council on Children with Disabilities. Identification and evaluation of children with autism spectrum disorders. Pediatrics. 2007;120(5):1183-1215.

Moyer VA. Prevention of dental caries in children from birth through age 5 years: U.S. Preventive Services Task Force recommendation statement. Pediatrics. 2014;133(6):1102-1111.

Clark MB, Slayton RL American Academy of Pediatrics Section on Oral Health. Fluoride use in caries prevention in the primary care setting. Pediatrics. 2014;134(3):626-633.

Siu AL. Screening for speech and language delay and disorders in children aged 5 years and younger: U.S. Preventive Services Task Force recommendation statement. Pediatrics. 2015;136(2):e474-e481.

Council on Children with Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee, Medical Home Initiatives for Children with Special Needs Project Advisory Committee. Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening [published correction appears in Pediatrics . 2006;118(4):1808–1809]. Pediatrics. 2006;118(1):405-420.

Bibbins-Domingo K, Grossman DC, Curry SJ, et al. Screening for lipid disorders in children and adolescents: U.S. Preventive Services Task Force recommendation statement. JAMA. 2016;316(6):625-633.

National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents. October 2012. https://www.nhlbi.nih.gov/sites/default/files/media/docs/peds_guidelines_full.pdf . Accessed May 9, 2018.

Moyer VA. Screening for primary hypertension in children and adolescents: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2013;159(9):613-619.

Flynn JT, Kaelber DC, Baker-Smith CM, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents [published correction appears in Pediatrics . 2017;140(6):e20173035]. Pediatrics. 2017;140(3):e20171904.

Siu AL. Screening for iron deficiency anemia in young children: USPSTF recommendation statement. Pediatrics. 2015;136(4):746-752.

U.S. Preventive Services Task Force. Screening for elevated blood lead levels in children and pregnant women. Pediatrics. 2006;118(6):2514-2518.

Screening Young Children for Lead Poisoning: Guidance for State and Local Public Health Officials . Atlanta, Ga.: U.S. Public Health Service; Centers for Disease Control and Prevention; National Center for Environmental Health; 1997.

O'Connor E, Rossom RC, Henninger M, Groom HC, Burda BU. Primary care screening for and treatment of depression in pregnant and post-partum women: evidence report and systematic review for the U.S. Preventive Services Task Force. JAMA. 2016;315(4):388-406.

Earls MF Committee on Psychosocial Aspects of Child and Family Health, American Academy of Pediatrics. Incorporating recognition and management of perinatal and postpartum depression into pediatric practice. Pediatrics. 2010;126(5):1032-1039.

Siu AL. Screening for depression in children and adolescents: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2016;164(5):360-366.

Weitzman C, Wegner L American Academy of Pediatrics Section on Developmental and Behavioral Pediatrics; Committee on Psychosocial Aspects of Child and Family Health; Council on Early Childhood; Society for Developmental and Behavioral Pediatrics; American Academy of Pediatrics. Promoting optimal development: screening for behavioral and emotional problems [published correction appears in Pediatrics . 2015;135(5):946]. Pediatrics. 2015;135(2):384-395.

Grossman DC, Curry SJ, Owens DK, et al. Vision screening in children aged 6 months to 5 years: U.S. Preventive Services Task Force recommendation statement. JAMA. 2017;318(9):836-844.

Donahue SP, Nixon CN Committee on Practice and Ambulatory Medicine, Section on Ophthalmology, American Academy of Pediatrics; American Association of Certified Orthoptists, American Association for Pediatric Ophthalmology and Strabismus, American Academy of Ophthalmology. Visual system assessment in infants, children, and young adults by pediatricians. Pediatrics. 2016;137(1):28-30.

Lin KW. What to do at well-child visits: the AAFP's perspective. Am Fam Physician. 2015;91(6):362-364.

American Academy of Pediatrics Council on Community Pediatrics. Poverty and child health in the United States. Pediatrics. 2016;137(4):e20160339.

Lavigne JV, Lebailly SA, Hopkins J, Gouze KR, Binns HJ. The prevalence of ADHD, ODD, depression, and anxiety in a community sample of 4-year-olds. J Clin Child Adolesc Psychol. 2009;38(3):315-328.

American Academy of Pediatrics Committee on Practice and Ambulatory Medicine, Section on Ophthalmology, American Association of Certified Orthoptists, American Association for Pediatric Ophthalmology and Strabismus, American Academy of Ophthalmology. Visual system assessment of infants, children, and young adults by pediatricians. Pediatrics. 2016;137(1):28-30.

American Academy of Family Physicians. Clinical preventive service recommendation. Immunizations. http://www.aafp.org/patient-care/clinical-recommendations/all/immunizations.html . Accessed October 5, 2017.

Centers for Disease Control and Prevention. Recommended immunization schedule for children and adolescents aged 18 years or younger, United States, 2018. https://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html . Accessed May 9, 2018.

National Center for Injury Prevention and Control. 10 leading causes of death by age group, United States—2015. https://www.cdc.gov/injury/images/lc-charts/leading_causes_of_death_age_group_2015_1050w740h.gif . Accessed April 24, 2017.

Durbin DR American Academy of Pediatrics Committee on Injury, Violence, and Poison Prevention. Child passenger safety. Pediatrics. 2011;127(4):788-793.

American Academy of Pediatrics Committee on Injury and Poison Prevention. Reducing the number of deaths and injuries from residential fires. Pediatrics. 2000;105(6):1355-1357.

Gardner HG American Academy of Pediatrics Committee on Injury, Violence, and Poison Prevention. Office-based counseling for unintentional injury prevention. Pediatrics. 2007;119(1):202-206.

American Academy of Pediatrics Committee on Injury, Violence, and Poison Prevention. Prevention of drowning in infants, children, and adolescents. Pediatrics. 2003;112(2):437-439.

American Academy of Pediatrics Committee on Injury and Poison Prevention. Injuries associated with infant walkers. Pediatrics. 2001;108(3):790-792.

American Academy of Pediatrics Committee on Injury and Poison Prevention. Falls from heights: windows, roofs, and balconies. Pediatrics. 2001;107(5):1188-1191.

Dowd MD, Sege RD Council on Injury, Violence, and Poison Prevention Executive Committee; American Academy of Pediatrics. Firearm-related injuries affecting the pediatric population. Pediatrics. 2012;130(5):e1416-e1423.

American Academy of Pediatrics Committee on Injury, Violence, and Poison Prevention. Prevention of choking among children. Pediatrics. 2010;125(3):601-607.

Kendrick D, Young B, Mason-Jones AJ, et al. Home safety education and provision of safety equipment for injury prevention (review). Evid Based Child Health. 2013;8(3):761-939.

American Academy of Pediatrics Section on Oral Health. Maintaining and improving the oral health of young children. Pediatrics. 2014;134(6):1224-1229.

Heyman MB, Abrams SA American Academy of Pediatrics Section on Gastroenterology, Hepatology, and Nutrition Committee on Nutrition. Fruit juice in infants, children, and adolescents: current recommendations. Pediatrics. 2017;139(6):e20170967.

Council on Communications and Media. Media and young minds. Pediatrics. 2016;138(5):e20162591.

Moon RY Task Force on Sudden Infant Death Syndrome. SIDS and other sleep-related infant deaths: evidence base for 2016 updated recommendations for a safe infant sleeping environment. Pediatrics. 2016;138(5):e20162940.

American Academy of Pediatrics Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2012;129(3):e827-e841.

Wagner CL, Greer FR American Academy of Pediatrics Section on Breastfeeding; Committee on Nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents [published correction appears in Pediatrics . 2009;123(1):197]. Pediatrics. 2008;122(5):1142-1152.

Huh SY, Rifas-Shiman SL, Taveras EM, Oken E, Gillman MW. Timing of solid food introduction and risk of obesity in preschool-aged children. Pediatrics. 2011;127(3):e544-e551.

Greer FR, Sicherer SH, Burks AW American Academy of Pediatrics Committee on Nutrition; Section on Allergy and Immunology. Effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas. Pediatrics. 2008;121(1):183-191.

American Academy of Pediatrics Committee on Nutrition. The use of whole cow's milk in infancy. Pediatrics. 1992;89(6 pt 1):1105-1109.

Fleischer DM, Spergel JM, Assa'ad AH, Pongracic JA. Primary prevention of allergic disease through nutritional interventions. J Allergy Clin Immunol Pract. 2013;1(1):29-36.

Grossman DC, Bibbins-Domingo K, Curry SJ, et al. Screening for obesity in children and adolescents: U.S. Preventive Services Task Force recommendation statement. JAMA. 2017;317(23):2417-2426.

Daniels SR, Hassink SG Committee on Nutrition. The role of the pediatrician in primary prevention of obesity. Pediatrics. 2015;136(1):e275-e292.

American Academy of Family Physicians. Physical activity in children. https://www.aafp.org/about/policies/all/physical-activity.html . Accessed January 1, 2018.

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Doctor Visits

Make the Most of Your Child’s Visit to the Doctor (Ages 1 to 4 Years)

Take Action

Young children need to go to the doctor or nurse for a “well-child visit” 7 times between ages 1 and 4.

A well-child visit is when you take your child to the doctor to make sure they’re healthy and developing normally. This is different from other visits for sickness or injury.

At a well-child visit, the doctor or nurse can help catch any problems early, when they may be easier to treat. You’ll also have a chance to ask questions about things like your child’s behavior, eating habits, and sleeping habits.

Learn what to expect so you can make the most of each visit.

Well-Child Visits

How often do i need to take my child for well-child visits.

Young children grow quickly, so they need to visit the doctor or nurse regularly to make sure they’re healthy and developing normally.

Children ages 1 to 4 need to see the doctor or nurse when they’re:

• 12 months old
• 15 months old (1 year and 3 months)
• 18 months old (1 year and 6 months)
• 24 months old (2 years)
• 30 months old (2 years and 6 months)
• 3 years old
• 4 years old

If you’re worried about your child’s health, don’t wait until the next scheduled visit — call the doctor or nurse right away.

Child Development

How do i know if my child is growing and developing on schedule.

Your child’s doctor or nurse can help you understand how your child is developing and learning to do new things — like walk and talk. These are sometimes called  “developmental milestones.”

Every child grows and develops differently. For example, some children will take longer to start talking than others. Learn more about child development .

At each visit, the doctor or nurse will ask you how you’re doing as a parent and what new things your child is learning to do.

Ages 12 to 18 Months

By age 12 months, most kids:.

• Stand by holding on to something
• Walk with help, like by holding on to the furniture
• Call a parent "mama," "dada," or some other special name
• Look for a toy they've seen you hide

Check out this complete list of milestones for kids age 12 months .

By age 15 months, most kids:

• Follow simple directions, like "Pick up the toy"
• Show you a toy they like
• Try to use things they see you use, like a cup or a book
• Take a few steps on their own

Check out this complete list of milestones for kids age 15 months.

By age 18 months, most kids:

• Make scribbles with crayons
• Look at a few pages in a book with you
• Try to say 3 or more words besides “mama” or “dada”
• Point to show someone what they want
• Walk on their own
• Try to use a spoon

Check out this complete list of milestones for kids age 18 months . 

Ages 24 to 30 Months

By age 24 months (2 years), most kids:.

• Notice when others are hurt or upset
• Point to at least 2 body parts, like their nose, when asked
• Try to use knobs or buttons on a toy
• Kick a ball

Check out this complete list of milestones for kids age 24 months . 

By age 30 months, most kids:

• Name items in a picture book, like a cat or dog
• Play simple games with other kids, like tag
• Jump off the ground with both feet
• Take some clothes off by themselves, like loose pants or an open jacket

Check out this complete list of milestones for kids age 30 months .

Ages 3 to 4 Years

By age 3 years, most kids:.

• Calm down within 10 minutes after you leave them, like at a child care drop-off
• Draw a circle after you show them how
• Ask “who,” “what,” “where,” or “why” questions, like “Where is Daddy?”

Check out this complete list of milestones for kids age 3 years . 

By age 4 years, most kids:

• Avoid danger — for example, they don’t jump from tall heights at the playground
• Pretend to be something else during play, like a teacher, superhero, or dog
• Draw a person with 3 or more body parts
• Catch a large ball most of the time

Check out this complete list of milestones for kids age 4 years . 

Take these steps to help you and your child get the most out of well-child visits.

Gather important information.

Bring any medical records you have to the appointment, including a record of vaccines (shots) your child has received.

Make a list of any important changes in your child’s life since the last doctor’s visit, like a:

• New brother or sister
• Serious illness or death in the family
• Separation or divorce
• Change in child care

Use this tool to  keep track of your child’s family health history .

Ask other caregivers about your child.

Before you visit the doctor, talk with others who care for your child, like a grandparent, daycare provider, or babysitter. They may be able to help you think of questions to ask the doctor or nurse.

What about cost?

Under the Affordable Care Act, insurance plans must cover well-child visits. Depending on your insurance plan, you may be able to get well-child visits at no cost to you. Check with your insurance company to find out more.

Your child may also qualify for free or low-cost health insurance through Medicaid or the Children’s Health Insurance Program (CHIP). Learn about coverage options for your family.

If you don’t have insurance, you may still be able to get free or low-cost well-child visits. Find a health center near you and ask about well-child visits.

To learn more, check out these resources:

• Free preventive care for children covered by the Affordable Care Act
• How the Affordable Care Act protects you and your family
• Understanding your health insurance and how to use it [PDF - 698 KB]

Ask Questions

Make a list of questions you want to ask the doctor..

Before the well-child visit, write down 3 to 5 questions you have. This visit is a great time to ask the doctor or nurse any questions about:

• A health condition your child has (like asthma or an allergy)
• Changes in sleeping or eating habits
• How to help kids in the family get along

Here are some questions you may want to ask:

• Is my child up to date on vaccines?
• How can I make sure my child is getting enough physical activity?
• Is my child at a healthy weight?
• How can I help my child try different foods?
• What are appropriate ways to discipline my child?
• How much screen time is okay for young children?

Take a notepad, smartphone, or tablet and write down the answers so you remember them later.

Ask what to do if your child gets sick. 

Make sure you know how to get in touch with a doctor or nurse when the office is closed. Ask how to get hold of the doctor on call — or if there's a nurse information service you can call at night or during the weekend. 

What to Expect

Know what to expect..

During each well-child visit, the doctor or nurse will ask you questions about your child, do a physical exam, and update your child's medical history. You'll also be able to ask your questions and discuss any problems you may be having.

The doctor or nurse will ask questions about your child.

The doctor or nurse may ask about:

• Behavior — Does your child have trouble following directions?
• Health — Does your child often complain of stomachaches or other kinds of pain?
• Activities — What types of pretend play does your child like?
• Eating habits — What does your child eat on a normal day?
• Family — Have there been any changes in your family since your last visit?

They may also ask questions about safety, like:

• Does your child always ride in a car seat in the back seat of the car? 
• Does anyone in your home have a gun? If so, is it unloaded and locked in a place where your child can’t get it?
• Is there a swimming pool or other water around your home?
• What steps have you taken to childproof your home? Do you have gates on stairs and latches on cabinets?

Your answers to questions like these will help the doctor or nurse make sure your child is healthy, safe, and developing normally.

Physical Exam

The doctor or nurse will also check your child’s body..

To check your child’s body, the doctor or nurse will:

• Measure your child’s height and weight
• Check your child’s blood pressure
• Check your child’s vision
• Check your child’s body parts (this is called a physical exam)
• Give your child shots they need

Learn more about your child’s health care:

• Find out how to get your child’s shots on schedule
• Learn how to take care of your child’s vision

Content last updated February 2, 2024

Reviewer Information

This information on well-child visits was adapted from materials from the Centers for Disease Control and Prevention and the National Institutes of Health.

Reviewed by: Sara Kinsman, M.D., Ph.D. Director, Division of Child, Adolescent, and Family Health Maternal and Child Health Bureau Health Resources and Services Administration

Bethany Miller, M.S.W. Chief, Adolescent Health Branch Maternal and Child Health Bureau Health Resources and Services Administration

Diane Pilkey, R.N., M.P.H. Nursing Consultant, Division of Child, Adolescent, and Family Health Maternal and Child Health Bureau Health Resources and Services Administration

You may also be interested in:

Help Your Child Stay at a Healthy Weight

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The 2-Year-Old Checkup

Medical review policy, latest update:.

Medically reviewed to ensure accuracy.

The physical checkup

Developmental milestones, more about your toddler, 2-year-old vaccines, questions to ask your doctor.

Believe it or not, the time of frequent well-baby visits is coming to an end. After taking your child for another appointment around her half birthday (when she's 30 months old), you'll book a 3-year checkup . Trusted Source American Academy of Pediatrics AAP Schedule of Well-Child Care Visits See All Sources [3] From then on, it’s just a single yearly visit.

Updates history

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Doctor visit: The two-year checkup

You can expect your child's doctor to:

• Weigh and measure your child to make sure she's growing at a healthy rate .
• Check her heart and breathing.
• Check her eyes and ears.
• Measure your toddler's head size to keep track of her brain growth.
• Give your child any immunizations she missed at her previous checkups.
• Address any concerns about your child's health, including how to spot symptoms of ear infections , colds , and the flu .
• Answer any questions you may have about toilet training , discipline, or, if your child has brothers or sisters, sibling rivalry .
• Offer insight into your child's development , temperament, and behavior.
• Screen for anemia and lead poisoning with a blood test if your child has any risk factors.
• Ask about plans for preschool or organized activities.
• Watch your child walk to check her gait and coordination.

Questions the doctor may ask:

• How is your child sleeping? Most kids this age sleep about 11 hours at night and nap for about two hours during the day. Some kids may have given up naps altogether, preferring instead to sleep in one long nighttime stretch. If your child has been waking up with nightmares, tell your doctor. Nightmares and night terrors are common at this stage, but your doctor may suggest ways you can comfort your child.
• How is your child eating? Until now you may have been able to limit the amount of sugary foods your child eats, but as he spends more time around other kids – in daycare or at playdates, for example – he's probably becoming more interested in sampling junk food. If you find yourself constantly battling his sweet tooth, speak to the doctor, who may have some healthy snack suggestions for you or may be able to ease your concerns about your child's diet.
• How is toilet training going? Most kids have started toilet training at this point, although many haven't mastered it yet. Your doctor may have some advice on easing the transition out of diapers.
• Have you noticed anything unusual about the way your child walks? Many children walk knock-kneed at this age because their legs are still developing, but the problem usually resolves itself around age 7.
• Is your child physically active? By now a toddler has more control over his arms and legs, and is better coordinated overall. He should be able to kick a ball effortlessly, build block towers, climb furniture, jump, and walk up and down stairs. Make sure he has plenty of opportunities to move and explore.
• What new words is he learning? Most kids this age have discovered the word "why." Sometimes all he wants is an explanation, and other times he's merely trying to continue his conversation with you. His vocabulary is expanding, and he'll be trying out new words every day. The doctor may test your child's language abilities by asking him questions. Two-year-olds typically have a vocabulary of 50 to 100 words and are starting to put two words together.
• Does he respond to two-step commands? Two-year-olds are usually mature enough to understand and follow two-step directions such as "Go to your room and grab your bear" or "Go to Daddy and give him a hug." If your child doesn't follow your commands, or appears not to hear you , tell the doctor.
• What games does he like to play? The activities your child enjoys give the doctor insight into how he's developing. Many kids this age enjoy putting together simple puzzles, scribbling on paper, sorting objects by color, and filling and emptying boxes.
• Have you noticed anything unusual about your child's eyes or the way he looks at things? Learn about eye examinations and how to spot potential problems.
• Has he seen a dentist? The American Academy of Pediatrics recommends that children see a dentist after their first birthday. If your child hasn't been to the dentist yet, now is the time.

What's next?

• Find out what's in store for you at the 30-month doctor visit .

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Mother’s teenage partner caused baby’s death, Crown Court jury told

Carl alesbrook was aged 16 when he is alleged to have caused fatal brain damage by shaking four-month-old elijah shemwell..

A four-month-old baby was shaken to death by his mother’s 16-year-old partner after suffering rib and limb fractures and whiplash-type injuries, a court has heard.

Carl Alesbrook, now aged 19, is alleged to have killed Elijah Shemwell around seven weeks after meeting the child’s mother, India Shemwell, in November 2021.

Opening the case against Alesbrook at Derby Crown Court on Wednesday, prosecutor Vanessa Marshall KC said medical evidence showed Elijah suffered brain damage or subdural bleeding from shaking on at least three separate occasions, including New Year’s Day and January 2 2022.

Alesbrook, of Upper Greenhill Gardens, Matlock, denies murder and two counts of causing grievous bodily harm relating to alleged attacks on Elijah between November 18 2021 and January 2 2022, three days before his death at Nottingham’s Queen’s Medical Centre.

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Alleging that Elijah was injured when Alesbrook was left alone with the baby at Shemwell’s home in Acorn Drive, Belper, Derbyshire, Ms Marshall told jurors India had separated from the baby’s father but “remained emotionally and sexually involved” with him.

Ms Marshall told the jury: “Between the months of mid-November 2021 and early January 2022 Elijah Shemwell, only four-months-old, was left by his mother India Shemwell in this defendant Carl Alesbrook’s care.

“And rather than protect him, it is the prosecution’s case that instead, this defendant shook Elijah on at least two occasions, resulting in symptoms of brain damage or dysfunction and subdural bleeding, prior to a final shake on the 2nd of January, which caused catastrophic head injuries and his premature death a few days later.

“You will also hear members of the jury that in addition to the head trauma, this defendant caused rib and limb fractures to Elijah’s body, one to two days before his admission to hospital on the 2nd of January.”

The court heard that the evidence against Alesbrook includes numerous messages that the prosecution say “may well have caused this young defendant some understandable frustration at the uncertainty of the status of his relationship” with India.

Explaining the issues for the jury, the prosecutor added: “It may well be that it is not the cause of death which is the key issue in this case but rather who caused Elijah’s death.

“Because you will hear that when the defendant was interviewed by the police on several occasions after his arrest, that he denied inflicting any injuries on Elijah or harming him by shaking.”

India, aged 21 at the time death of her son’s death and now aged 23, was described by Ms Marshall as “a thoroughly inadequate mother” who both generally and specifically neglected Elijah and failed to seek prompt medical attention for him on both January 1 and 2.

But she added: “Whilst the prosecution heavily criticise Miss Shemwell for this neglect towards Elijah, it is not the prosecution’s case that she caused any of the injuries.”

After showing the panel a mobile phone video of Elijah allegedly struggling for breath shortly before his admission to hospital, the prosecutor said India dialled 999 at 10.33pm on January 2 and told the operator: “I’ve just come back from the shop and my four-month-old isn’t breathing very well and he’s gone pale and limp.”

The court was told that in the opinion of a consultant forensic pathologist, “in addition to shaking, there had been impacts to the face, either as the result of blows being delivered, or Elijah striking a surface.”

In short, the jury heard, the pathologist will say there is no plausible explanation for “the constellation of injuries present” other than from an assault.

Ms Marshall continued: “The prosecution is confident that a careful review of the evidence in this case puts this defendant alone with Elijah moments before the critical incidents… so as to make it inexplicable on the basis of coincidence that it was not this defendant who was responsible for causing Elijah’s injuries and death.”

The trial continues.

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