Your Child's Checkup: 3 to 5 Days

en españolLa revisión de su hijo cuando tenga entre 3 y 5 días

What to Expect During This Visit

The doctor and/or nurse will probably:

1. Check your baby's weight, length, and head circumference and plot the measurements on the growth charts.

2. Ask questions, address any concerns, and offer advice about how your baby is:

Feeding. Newborns should be fed when they seem hungry. Breastfed infants eat about every 1 to 3 hours, and formula-fed infants eat about every 2 to 4 hours. Your doctor or nurse watch you breastfeed and offer help with any problems. Burp your baby midway through a feeding and again at the end.

Peeing and pooping. Newborns should have about six wet diapers a day. The number of poopy diapers varies, but most newborns have 3 or 4 soft bowel movements a day. Tell your doctor if you have any concerns about your newborn's bowel movements.

Sleeping. A newborn may sleep up to 18 or 19 hours a day, waking up often (day and night) to breastfeed or take a bottle. Breastfed babies usually wake to eat every 1 to 3 hours, while formula-fed babies may sleep longer, waking every 2 to 4 hours to eat (formula takes longer to digest so babies feel fuller longer). Newborns should not sleep more than 4 hours between feedings until they have good weight gain, usually within the first few weeks. After that, it's OK if a baby sleeps for longer stretches.

Developing. In the first month, babies should:

• pay attention to faces or bright objects 8–12 inches (20–30 cm) away
• respond to sound — they may quiet down, blink, turn head, startle, or cry
• hold arms and legs in a flexed position
• move arms and legs equally
• lift head briefly when on stomach (babies should only be placed on the stomach while awake and under supervision)
• have strong newborn reflexes, such as:
  • rooting and sucking: turns toward, then sucks breast/bottle nipple
  • grasp: tightly grabs hold of a finger placed within the palm
  • fencer's pose: straightens arm when head is turned to that side and bends opposite arm
  • Moro reflex (startle response): throws out arms and legs, then curls them in when startled

3. Do a physical exam with your baby undressed while you are present. This exam will include an eye exam, listening to your baby's heart and feeling pulses, inspecting the umbilical cord, and checking the hips.

4. Do screening tests. Your doctor will review the screening tests from the hospital and repeat tests, if needed. If a hearing test wasn't done then, your baby will have one now.

5. Update immunizations. Immunizations can protect infants from serious childhood illnesses, so it's important that your baby get them on time. Immunization schedules can vary from office to office, so talk to your doctor about what to expect.

Looking Ahead

Here are some things to keep in mind until your next routine visit at 1 month:

Feeding

1. Continue to feed your baby when he or she is hungry. Pay attention to signs that your baby is full, such as turning away from the nipple or bottle and closing the mouth.
2. Don't give solid foods or juice.
3. Don't put cereal in your baby's bottle unless directed to by your doctor.
4. If you breastfeed:
   • Help your baby latch on correctly: mouth opened wide, tongue down, with as much breast in the mouth as possible.
   • Continue to take a prenatal vitamin or multivitamin daily.
   • Ask your doctor about vitamin D drops for your baby.
   • Don't use a bottle or pacifier until nursing is well established (usually about 1 month).
5. If you formula-feed:
   • Give your baby iron-fortified formula.
   • Follow the formula package's instructions when making and storing bottles.
   • Don't prop bottles or put your baby to bed with a bottle.
   • Talk to your doctor before switching formulas.

Routine Care

1. Wash your hands before handling the baby and avoid people who may be sick.
2. Keep the diaper below the umbilical cord so the stump can dry. The umbilical cord usually falls off in 10–14 days.
3. For circumcised boys, put petroleum jelly on the penis or diaper's front.
4. Give sponge baths until the umbilical cord falls off and a boy's circumcision heals. Make sure the water isn't too hot — test it with your wrist first.
5. Use fragrance-free soaps and lotions.
6. Hold your baby and be attentive to his or her needs. You can't spoil a newborn.
7. Sing, talk, and read to your baby. Babies learn best by interacting with people.
8. It's normal for infants to have fussy periods, but for some, crying can be excessive, lasting several hours a day. If a baby develops colic, it usually starts in an otherwise well baby around 3 weeks of age.
9. Call your baby's doctor if your infant has a fever or is acting sick, isn't eating, isn't peeing, or isn't pooping. Don't give medicine to an infant younger than 2 months old without talking to your doctor first.
10. It's common for new moms to feel tired and overwhelmed at times. But if these feelings are intense, or you feel sad, moody, or anxious, call your doctor.
11. Talk to your doctor if you're concerned about your living situation. Do you have the things that you need to take care of your baby? Do you have enough food, a safe place to live, and health insurance? Your doctor can tell you about community resources or refer you to a social worker.

Safety

1. To reduce the risk of sudden infant death syndrome (SIDS):
   • Breastfeed your baby.
   • Let your baby sleep in your room in a bassinet or crib next to the bed until your baby's first birthday or for at least 6 months, when the risk of SIDS is highest.
   • Always place your baby to sleep on a firm mattress on his or her back in a crib or bassinet without any crib bumpers, blankets, quilts, pillows, or plush toys.
   • Avoid overheating by keeping the room temperature comfortable.
   • Don't overbundle your baby.
   • Consider putting your baby to sleep sucking on a pacifier. If you're breastfeeding, wait until breastfeeding is established before introducing the pacifier.
2. Don't smoke or use e-cigarettes. Don't let anyone else smoke or vape around your baby.
3. Always put your baby in a rear-facing car seat in the back seat. Never leave your baby alone in a car.
4. While your baby is awake, don't leave your little one unattended, especially on high surfaces or in the bath.
5. Never shake your baby — it can cause bleeding in the brain and even death.
6. Avoid sun exposure by keeping your baby covered and in the shade when possible. Sunscreens are not recommended for infants younger than 6 months. However, you may use a small amount of sunscreen on an infant younger than 6 months if shade and clothing don't offer enough protection.

These checkup sheets are consistent with the American Academy of Pediatrics (AAP)/Bright Futures guidelines.