Newborns celebrate a lot of exciting firsts, but some of them aren't just milestones — they are important moments for the baby's health and future. That's the case for the first doctor's appointment. It can be intimidating for some moms and dads, especially since it's usually the first outing after coming home from the hospital and many parents are anxious to find out how they are doing with caring for their little one. But it's about so much more than that — making sure that the baby is growing and thriving and as healthy as possible.
Even though the newborn is only about a week old at this point, moms might be surprised at all the things that the baby can do. The doctor will test out reflexes, like grip and even taking some steps. And yes, the doctor will also get some clues on how things are going at home. Some of the questions might seem weird, but there are reasons for them that come down to the baby's health. The appointment can take a while, but that's because the doctor wants to be thorough and answer as many questions as possible.
Here are 20 surprising things pediatricians are looking for at the baby's first appointment.
We know that it seems early, but the pediatrician expects the baby to walk at his very first doctor's appointment. Most moms think that they won't need to talk about walking until the baby's first birthday or so, but the test often comes at the one week mark because babies have a natural reflex that the doctor needs to check.
The walking reflex doesn't mean that the baby will be able to stand. Instead, they should take steps when the doctor puts them upright on their feet. That will show that the baby's brain is developing normally — and the doctor won't worry about it again for a year or longer.
It doesn't take long for a newborn to grasp his mom's finger. In fact, it's a reflex that is present at birth and that the doctor will definitely check at the first doctor's appointment. If the baby has good muscle tone and age-appropriate control, it can be figured out just by his hands.
The examination will include the doctor putting his finger in the baby's hands, and the newborn should curl is own fingers tightly around them. The doctor can even lift up and the baby will go along with it. That's an instinct that can be telling, so it's always part of a first appointment exam.
A baby's soft spot is often something that scares the mom and dad. That's because it's a very vulnerable position on the baby's head where the skull isn't covering it. Moms don't like to touch the soft spot, but the pediatrician will examine it because it can say a lot about the baby.
First, a sunken soft spot can reveal if the baby is dehydrated and not getting enough nutrition. A swollen one can indicate an infection. And there are some conditions that can be revealed if the bones of the head aren't normal. That can all be revealed at the first doctor's appointment.
Doctors usually take a glance in the baby's mouth when they are born to make sure that the lip and the palate have formed correctly. But there are some other issues that might cause a problem a little later on and might be worth discussing at the first appointment.
For newborns who are struggling to breastfeed, doctors might notice a connective piece of skin that makes it harder for the baby's mouth to nurse. The ties can be below the tongue or at the top of the lip, and some babies have no problem with them, while others struggle more. The doctor might suggest a procedure to clip the tie to free up the tongue or the lip. It can usually be performed in the doctor's office and can change things as far as breastfeeding.
A newborn's sweet little pot belly is cute, but more importantly to the doctor, it can reveal some things about the baby's health. So a belly rub is always a part of the first exam and it's likely going to be a part of most of the other checkups as well.
A pediatrician can fell different parts when pushing a little on the baby's belly. That can include any obstruction in the intestines that could be a problem with going number two. It's also possible that the baby could have an umbilical hernia not long after the birth. Sometimes that resolves on its own, but the doctor will be on the lookout for the issue.
One of the most critical tests for the baby in the first week or two of life is all about the tone of the baby's skin. It's a big deal because jaundice is a very serious, and possibly fatal, issue, although it's really common in newborns in the very early days of life.
Some babies are diagnosed with jaundice before they leave the hospital, but if the baby leaves 24 or so hours after birth, they may not have the yellowish skin tone yet. Jaundice gets better the more the baby expels waste, so children should do well with nursing or feeding in the first week fair better. Severe jaundice can lead to brain damage or worse, so doctors definitely have the baby's best interest at heart when they check the skin tone.
The umbilical cord is a major deal during pregnancy, but most parents have it clipped in the moments after birth. Some choose to allow it to fall off naturally, but either way, there is a period of healing, and the doctor will make sure that is going well.
Doctors recommend that moms try to keep the area around the umbilical stump remains clean, but otherwise, they are told to try to avoid touching it. If the area has pus, oozing or a bad smell, that can be a sign of an infection. That needs to be treated right away, so the doctor will be sure to check.
The first pediatrician appointment isn't only about the baby. The doctor will also be keeping an eye out for the new mom, although she won't get a physical exam. Since new moms don't see their doctor until about six weeks after the birth, there has been an emphasis in recent years for the pediatrician to be more involved.
The baby's doctor is often the first person to pick up on issues of postpartum depression since they see the parent more than her own doctor. They ask about how the mom is coping in her role, and there may be questions about mental health in the forms that the mom fills out. It's important to be honest so that the mom can get help and be well while she cares for her baby.
One of the mom's most frequent duties in the first few weeks of life is to make sure that she changes baby's diaper. That can happen up to 10 or 12 times a day in the very beginning, so the doctor needs to make sure that the mom and dad know what they are doing.
On top of that, there can be issues with the baby's urinary and digestive systems that can take a few days to show up. The doctor needs to know about any problems producing urine or going number two so that the baby can be as healthy as possible, so that requires a check in the first appointment.
The doctor will listen to the baby's heart at pretty much every appointment ever, but that first office visit is a big test. That's because the most common birth defect for infants is something involving the heart, so the pediatrician will try his best to hear for any anomaly from the very beginning.
Heart defects can range from a very severe level that requires surgery within days of birth to small differences that might not be detected for years. Most of the time the big issues come up during the ultrasound, but doctors definitely have their eyes and ears out for any problem so that they can figure out treatment from the very beginning.
It might look like the baby's body is fully formed at birth, but the truth is that the hips are not yet fully developed. There are things that can go wrong at this point, so the pediatrician will move the baby's legs around at the hip joint to try to make sure that the hips are aligned properly so that the development can continue as normal.
A newborn might be diagnosed with a condition called hip dysplasia, which means at the legs move in and out of the joint. If the condition is caught early, there is treatment available so that the hips are secured so that the ball and socket joint develops properly. Early diagnosis is key, so the doctor will definitely check at the first appointment.
Of course, a new mom learns the baby's height and size just moments after birth, but that will happen again at the first doctor's appointment. All babies tend to go down in size a little after the birth, but it needs to turn around in a week or two, so the doctor is going to be tracking that growth chart very carefully in the beginning.
The height measurement might be more accurate in a week than right after birth. And a new statistic will be added, the baby's head circumference. It can be pointless to measure the head at birth because it changes shape to get through the birth canal, but most are back to normal within a week or two.
Before the appointment begins, moms have to fill out a lot of paperwork about the baby. There are also a lot of questions that might surprise the mom — about the home. Some people might think that those questions seem invasive and they don't understand why the age of the home has anything to do with the little one's health.
The questions can alert the doctor to test for issues such as lead poisoning or educate the parents about how to avoid other problems that could come if the baby spends a lot of time with another caregiver. A lot of these questions will be repeated at each appointment, just to make sure that the baby's home is safe.
A lot of moms think about what the baby is taking in through breastfeeding or bottles in the first week of life, but they might be surprised about what comes back out. Spit up is a part of life as a newborn mom, but it's still a good idea to discuss it with the doctor at the first doctor's appointment and later ones, if necessary.
While some spit up is normal, some babies have weak digestive systems that can cause the baby to have severe reflux. The baby might spit up half the bottle, which not only means a lot of laundries but possible problems with growth. There are some treatments that the doctor could recommend, so moms should bring up any issues at the baby's appointment.
At hospitals in the U.S., the baby's hearing is assessed before he leaves the hospital, but that isn't true with vision. Doctors can't tell much at the first doctor's appointment either, but they will still be certain to check out the baby's eyes very closely.
Newborns don't always track their eyes at that point, and it's normal for the baby to be cross-eyed. But there is still something about locking eyes with the baby that can help the doctor in determining health, including seeing how they react to light. Any infection can be noted, and the doctor will be on the lookout for any concerns.
Another big question for the doctor at the first appointment is about where and how the baby sleeps. That's because research and education about safe sleeping positions has greatly reduced the likelihood of Sudden Infant Death Syndrome, and doctors want to make sure that parents are aware of it.
Newborns should always sleep on their backs because of the possibility of suffocation on their bellies. In addition, doctors recommend taking everything out of a crib other than a firm mattress with a fitted sheet to reduce any other hazards. Doctors prefer if the baby shares a room with the parents, but not the bed. They will ask about that at the first appointment and advise the mom about how to be safe.
Doctors take a look in the baby's diaper area whether they are in need of a change or not. That's because they need to take a look at all of the baby's parts. It can be hard to get a good look in the first day or two of life because the area is swollen from the hormones that pass from mom to baby, but there are things to check.
Some babies have parts that are hard to distinguish and might require more information. Also, there could be differences like undescended area in a little boy's privates. Some of these things could resolve on their own, but the doctor will be on the lookout for anything that might require intervention.
Things are always a little different for little boys, since moms who chose to circumcise their little ones often decide to do it in the very beginning of life when the baby is most likely to feel less pain and not remember the surgery. It isn't as common as in the past, but many moms have religious, cultural or health reasons to go through the procedure.
For most newborn boys in the U.S., they have the procedure before they leave the hospital so the first doctor's appointment almost always includes a check. Moms usually don't have to do much to keep the area clean. But doctors will check for any signs of infection to make sure the area is healing properly in those first few weeks of life.
The doctor will be checking out the baby's little body for a portion of the visit, but the time is also about educating the parents. So a big portion of the appointment will be devoted to talking about the baby's schedule and answering the parents' questions about it.
Newborns sleep a lot, but they don't sleep for long periods of time. By the end of the first week, most parents are ready to ask about when the baby will sleep through the night. It's also imperative that the newborn eat every two hours to have enough nutrition to grow. That's definitely something the doctor will discuss so that the parents know how to properly care for their little one.
The biggest check in the first checkup is about the overall health of the newborn. The question—in a nutshell—is if the baby is thriving. That diagnosis is achieved if the little one is taking in enough food and growing, a feat that can be more difficult than most moms-to-be can imagine before the baby's arrival.
While most babies get smaller—as much as 10 percent—in the first week of life, the doctor wants to see the baby take a turn by the end of the first week. If the newborn is eating well, that should mean that he starts to bet bigger. If not, the doctor might have to step in and suggest formula or other treatments. All moms want their babies to thrive, so the first appointment is critical in meeting that big milestone.
Sources: Health Communities, Family Education, Rockford Pediatrics, Stanford Children's