Definition A well baby visit is a routine physical exam. It is performed on a newborn, infant, toddler or young child. This exam has several purposes. One goal is to evaluate a child's physical growth and development. This can help healthcare providers find and address problems early. Another goal is to educate parents on normal development. Regular exams also provide the opportunity for the child to get immunizations on the recommended schedule.
Childhood is a stage of physical and mental development. Providing the proper healthcare and guidance helps a child have a positive future. The chances of illness can be reduced with good preventive care. Problems can be detected and treated early.
What is the information for this topic? A well baby visit involves a number of standard procedures.
The American Academy of Pediatrics (AAP) recommends well baby exams on the following schedule:
within 24 hours of birth
2 to 4 days old, if a baby was discharged less than 48 hours after delivery
2 to 4 weeks old
2 months old
4 months old
6 months old
9 months old
12 months old
At each exam:
The healthcare provider evaluates the child's head circumference, height and weight. These figures are plotted on a growth chart, and the body mass index, or BMI, can be determined. The provider can then monitor the child's growth on each visit in comparison to the last visit. This is important in order to make sure that a child is growing normally.
The provider will feel the soft spots on the top and the back of the baby's head. The soft spot on the back of the head usually closes between the ages of 2 to 5 months. The spot on the top of the head closes by 18 months.
The baby's eyes, ears, and mouth will be examined for irregularities. The provider will also look for signs of infection and teeth coming in.
The healthcare provider will listen to the child's lungs, chest, heart and abdomen. The abdomen will be pressed gently to feel the internal organs.
The baby's reflexes, hearing and vision may be evaluated. This will depend on the baby's age.
The genitals will be examined for abnormalities. The provider will also look for lumps, swelling, tenderness or signs of infection.
The baby's legs will be rotated and gently pulled apart to check for hip dysplasia, congenital hip dislocation, or other hip abnormalities.
When the child can walk the healthcare provider will evaluate the child's gait for problems with leg alignment.
During the well baby visit, the provider will also inquire about the child's development. During the baby's first year, the provider will ask if the child sitting up, rolling over, pulling himself or herself to a standing position. Other developmental milestones will also be discussed. These include questions the provider will ask about:
bottle or breastfeeding
bowel movements
eating
crying
playing
cooing
babbling
following people with the eyes
These visits also give the caregivers an opportunity to ask the provider questions. Typical topics include how the baby is doing, what to expect in the future, what to do in cases of illness, and other concerns caregivers may have.
Another very important part of the well baby visit is the routine immunizations. These are crucial for preventing life threatening illnesses. The AAP's recommendations for immunizations are as follows:
Between birth and 2 months: the first hepatitis B shot of a 3 shot series is given.
At 2, 4, and 6 months: the diphtheria, pertussis and tetanus, or DPT, vaccine is given. The polio vaccine will also be given, although the third dose may be given any time between 6 and 18 months old. The child will also receive the haemophilus influenzae type b, or Hib, vaccine. The second hepatitis B shot may be given between 2 and 4 months, followed by the third immunization, which is given between 6 to 18 months.
Between 9 and 12 months: screening test for lead in the baby's blood may be done.
Between 12 to 15 months: measles, mumps and rubella, or MMR, vaccine will be given. The baby will also get the third Hib shot if necessary.
Between 12 to 18 months: vaccine for chickenpox called the varicella zoster virus vaccine will be given. The fourth DPT vaccine is given at least 6 months after the third vaccine was given.
Author: Eileen McLaughlin, RN, BSN Reviewer: Lama Rimawi, MD Last Updated: 06/29/00 Contributors Potential conflict of interest information for reviewers available on request
