Healthy infants should be seen by their doctor often during the first year of life. Preventive health care visits (also called well-child visits) typically take place within a few days after birth or by 2 weeks of age and at 1, 2, 4, 6, and 9 months of age. During these visits, the doctor uses age-specific guidelines to monitor the infant's growth and development and asks the parents questions about various developmental milestones (see table Developmental Milestones From Birth to Age 12 Months). Tests are sometimes done, and during many visits, the doctor vaccinates the infant against various illnesses (see Childhood Vaccination Schedule).
Health care visits also allow the doctor to educate the parents about eating, sleeping, behavior, child safety, nutrition, exercise, and good health habits. In addition, the doctor advises the parents what developmental changes to expect in their infant by the next visit.
Examination
The infant's length and height, weight, and head circumference are measured at every visit. The doctor examines the infant for various abnormalities, including signs of hereditary disorders or birth defects.
The eyes are examined, and vision is tested. Infants who were born very prematurely (before the completion of 32 weeks of development in the uterus) usually need more frequent eye examinations by an eye specialist to look for retinopathy of prematurity, which is an eye disease that occurs when infants are born before the blood vessels in their eyes are fully developed and may result in blindness, and for the development of refractive errors, which result in blurring of vision. These disorders are more common among infants who were born very prematurely.
The doctor checks the infant’s hips for signs that the hip joints are loose or dislocated (developmental dysplasia of the hip). The doctor checks the infant's teeth, if they are present, for cavities and the mouth for thrush, which is a common yeast infection among infants.
The doctor also examines the heart, lungs, abdomen, arms and legs, and genitals.
Screening
Screening tests are done to assess whether infants are at risk of certain disorders.
Blood tests are done to detect anemia, sickle cell disease, and exposure to lead.
Hearing tests are done shortly after birth to determine whether an infant has a hearing disorder or hearing loss (see Newborn Screening Tests) and are repeated later if new concerns about the infant's hearing develop (see also Hearing Impairment in Children).
Infants are screened for tuberculosis (TB) risk factors with a questionnaire at all well-child visits, usually beginning in infancy. Risk factors include exposure to TB, being born in or having traveled to areas of the world where TB is common (countries other than the United States, Canada, Australia, and New Zealand and Western and North European countries), having a family member with TB, and having parents or close contacts who are recent immigrants from an area where TB is common or who have recently been in jail. Those with risk factors usually have tuberculosis screening tests done.
Safety
At these visits, the doctor gives parents age-appropriate safety guidelines.
The following safety guidelines apply to infants from birth to age 12 months:
Use a rear-facing car seat and place it in the back seat of the vehicle.
Set the hot water heater to 120° F or less.
Prevent falls from changing tables and around stairs.
Place infants on their back to sleep on a firm, flat mattress for every sleep, do not share a bed, and do not place pillows, bumper pads, nonfitted sheets, stuffed animals or other toys, quilts, comforters, or weighted or loose blankets in the crib. (See also sidebar Safe to Sleep: Reducing the Risk of SIDS.)
Do not give infants foods and objects that can cause choking or be inhaled into the lungs.
Do not use baby walkers.
Place safety latches on cabinets and cover electrical outlets.
Remain alert when watching infants in the bathtub or near a pool or any body of water and when they are learning to walk.
Image courtesy of the Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (Transportation Safety Resources). This guidance from the CDC is for the United States, and regulations may differ in other countries.
Image courtesy of the Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (Transportation Safety Resources). This guidance from the CDC is for the United States, and regulations may differ in other countries.
Image courtesy of the Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (Transportation Safety Resources). This guidance from the CDC is for the United States, and regulations may differ in other countries.
Image courtesy of the Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (Transportation Safety Resources). This guidance from the CDC is for the United States, and regulations may differ in other countries.
Image courtesy of the Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (Transportation Safety Resources). This guidance from the CDC is for the United States, and regulations may differ in other countries.
Image courtesy of the Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (Transportation Safety Resources). This guidance from the CDC is for the United States, and regulations may differ in other countries.
Image courtesy of the Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (Transportation Safety Resources). This guidance from the CDC is for the United States, and regulations may differ in other countries.
Image courtesy of the Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (Transportation Safety Resources). This guidance from the CDC is for the United States, and regulations may differ in other countries.
Nutrition and exercise
For infants, recommendations for nutrition are based on age. The doctor can help parents weigh the benefits of breastfeeding versus formula-feeding and give guidance regarding solid foods.
Parents should provide infants with a safe environment they can roam in and explore. Outdoor play should be encouraged from infancy.
Screen time (for example, television, video games, cell phones and other handheld devices, and noneducational computer time) may result in inactivity and obesity. Limits on the time a child spends using devices with screens should start at birth and be maintained throughout adolescence.
