Your Child's Checkup: 1 Month

What to Expect During This Visit

Your doctor and/or nurse will probably:

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

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

Feeding. Infants should be fed when they seem hungry. At this age, breastfed babies will eat about 8–12 times in a 24-hour period. Formula-fed infants consume about 24 ounces a day. Burp your baby midway through feedings and at the end.

Peeing and pooping. Infants should have about 6 wet diapers a day. The daily number of poopy diapers varies, but most breastfed babies will have 3 or more. Around 6 weeks of age, breastfed babies may go several days without a bowel movement. Formula-fed babies have at least 1 bowel movement a day. Tell your doctor if you have any concerns about your infant's bowel movements.

Sleeping. Infants this age sleep about 14 to 17 hours a day, including several daytime naps. Breastfed babies may still wake often to eat at night, while bottle-fed infants may sleep for longer stretches.

Developing. By 1 month of age, babies should:

• focus and follow objects (especially faces)
• respond to sound by quieting down, blinking, turning the head, startling, or crying
• still hold arms and legs in a flexed position, but start to extend legs more often
• move arms and legs equally
• lift the head briefly when on the stomach
• have strong newborn reflexes:
  • 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 and then curls them in when startled

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

4. Do screening tests. Your doctor will review the newborn 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.

6. Because postpartum depression is common, your baby’s doctor may ask you to fill out a depression screening questionnaire.

Looking Ahead

Here are some things to keep in mind until your baby's next routine checkup at 2 months:

Feeding

1. Continue feeding whenever your baby is hungry. Pay attention to signs that your baby is full, such as turning away from the breast or nipple and closing the mouth. Between 6 and 8 weeks, your baby may be hungrier due to a growth spurt.
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. Continue to burp your baby midway through and at the end of feedings.
5. If you breastfeed:
   • If you haven't yet, you can pump and store breast milk for future use.
   • If breastfeeding is going well, it's OK to give a bottle or pacifier. You might need to have someone else offer the bottle if your little one rejects it when you try.
   • Continue to take a prenatal vitamin or multivitamin daily.
   • Ask your doctor about vitamin D drops for your baby.
6. If you formula-feed:
   • Give your baby iron-fortified formula.
   • Follow the formula package's instructions when making and storing bottles. Do not add extra water to your baby’s formula.
   • 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 ask others to do the same. Avoid people who may be sick.
2. Hold your baby and be attentive to their needs. You can't spoil a baby.
3. Sing, talk, and read to your baby. Babies learn best by interacting with people.
4. Give your baby supervised "tummy time" when awake. Always watch your baby and be ready to help if they get tired or frustrated in this position.
5. It's normal for infants to have fussy periods. But for some, crying can be excessive, lasting several hours a day. If an otherwise well baby develops colic, it usually starts when they’re around 3 weeks old, peaks around 6 weeks, and improves by 3 months.
6. Call your doctor if your baby has a fever of 100.4ºF (38ºC) or higher, taken in your baby’s bottom. Call the doctor if your baby is acting sick. Don't give medicine to an infant younger than 2 months old without talking to your doctor first.
7. 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.
8. 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):
   • Always place your baby to sleep on a firm, flat mattress on their back, and not on the stomach or side, in a crib or bassinet without any crib bumpers, blankets, quilts, pillows, or plush toys.
   • Breastfeed your baby, if possible.
   • 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.
   • Avoid overheating by keeping the room temperature comfortable. Dress your baby for the room temperature and don't overbundle. Don't cover your baby's head while they're sleeping. Watch for signs of overheating, such as sweating or feeling hot to the touch.
   • Consider putting your baby to sleep sucking on a pacifier. If your baby rejects the pacifier, don't force it. If the pacifier falls out during sleep, you don't have to replace it. If you're breastfeeding, wait until breastfeeding is established before introducing the pacifier.
   • Don’t let your baby fall asleep on a product that isn’t specifically designed for sleeping babies, such as a sitting device (like a car seat), a feeding pillow (like the Boppy pillow), or an infant lounger (like the Dock-a-Tot, Podster, and Bummzie).
   • Don’t use products or devices that claim to lower the risk of SIDS, such as sleep positioners (like wedges or incliners) or monitors that can detect a baby’s heart rate and breathing pattern. No known products can actually do this.
   • Make sure that all sleep surfaces and products you use to help your baby sleep have been approved by the U.S. Consumer Product Safety Commission (CPSC) and meet federal safety standards.Consider putting your baby to sleep sucking on a pacifier.
2. Don't smoke or use e-cigarettes. Don't let anyone smoke or vape around your baby.
3. Always put your baby in a rear-facing car seat in the backseat. Never leave your baby alone in the car.
4. Keep all cords, wires, and toys with loops or strings away from your baby.
5. While your baby is awake, don't leave your little one unattended, especially on high surfaces or in the bath.
6. Never shakeyour baby — it can cause bleeding in the brain and even death. If you are ever worried that you will hurt your baby, put your baby in the crib or bassinet for a few minutes. Call a friend, relative, or your health care provider for help.
7. 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.