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Home / Parenting, Kids & Teens / Quick guide to your infant’s first pediatrician visits

Quick guide to your infant’s first pediatrician visits

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Frequent checkups with a health care provider are an important part of your baby’s first few years. These checkups — often called well-child visits — are a way for you and your child’s health care provider to keep tabs on your child’s health and development, as well as spot any potential problems. Well-child visits also give you a chance to discuss any questions or concerns you might have and get advice from a trusted source on how to provide the best possible care for your child.

The benefit of seeing your child’s provider regularly is that each visit adds critical information to your child’s health history. Over time, you and the provider will get a good idea of your child’s overall health and development.

In general, the provider will be more attentive to your child’s pattern of growth over time, rather than to specific one-time measurements. Typically what you’ll see is a smooth curve that arcs upward as the years go by. Regularly reviewing your child’s growth chart can also alert you and the provider to unexpected delays in growth or changes in weight that may suggest the need for additional monitoring.

Each health care provider does things a bit differently, but here’s what will generally be on the agenda during your first well-child exams.

Body measurements

Checkups usually begin with measurements. During first-year visits, a nurse or your baby’s health care provider will measure and record your baby’s length, head circumference and weight.

Your child’s measurements will be plotted on his or her growth chart. This will help you and the provider see how your child’s size compares with that of other children the same age. Try not to fixate on the percentages too much, though. All kids grow and develop at different rates. In addition, babies who take breast milk gain weight at a different rate than do babies who are formula-fed.

Keep in mind that a child who’s in the 95th percentile for height and weight isn’t necessarily healthier than a child who’s in the fifth percentile. What’s most important is steady growth from one visit to the next. If you have questions or concerns about your child’s growth rate, discuss them with your child’s provider.

Physical exam

Your child’s health care provider will give your child a thorough physical exam and check his or her reflexes and muscle tone. Be sure to mention any concerns you have or specific areas you want the doctor to check out.

Here are the basics of what providers commonly check for during an exam:

• Head — In the beginning, your child’s health care provider will likely check the soft spots (fontanels) on your baby’s head. These gaps between the skull bones give your baby’s brain plenty of room to grow in the coming months. They’re safe to touch and typically disappear within two years, when the skull bones fuse together. The health care provider may also check baby’s head for flat spots. A baby’s skull is soft and made up of several movable plates. If his or her head is left in the same position for long periods of time, the skull plates might move in a way that creates a flat spot.
• Ears — Using an instrument called an otoscope, the health care provider can see in your child’s ears to check for fluid or infection in the ears. The provider may observe your child’s response to various sounds, including your voice. Be sure to tell the provider if you have any concerns about your son’s or daughter’s ability to hear or if there’s a history of childhood deafness in your family. Unless there’s cause for concern, a formal hearing evaluation isn’t usually needed at a well-child exam.
• Eyes — Your child’s health care provider may use a flashlight to catch your child’s attention and then track his or her eye movements. The provider may also check for blocked tear ducts and eye discharge and look inside your child’s eyes with a lighted instrument called an ophthalmoscope. Be sure to tell the provider if you’ve noticed that your child is having any unusual eye movements, especially if they continue beyond the first few months of life.
• Mouth — A look inside your baby’s mouth may reveal signs of oral thrush, a common, and easily treated, yeast infection. The health care provider might also check your baby’s mouth for signs of tongue-tie (ankyloglossia), a condition that affects the tongue’s range of motion and can interfere with a baby’s oral development as well as his or her ability to breast-feed.
• Skin — Various skin conditions may be identified during the exam, including birthmarks, rashes, and jaundice, a yellowish discoloration of the skin and eyes. Mild jaundice that develops soon after birth often disappears on its own within a week or two. Cases that are more severe may need treatment.
• Heart and lungs — Using a stethoscope, your child’s health care provider can listen to your child’s heart and lungs to check for abnormal heart sounds or rhythms or breathing difficulties.
• Abdomen, hips and legs — By gently pressing a child’s abdomen, a health care provider can detect tenderness, enlarged organs, or an umbilical hernia, which occurs when a bit of intestine or fatty tissue near the navel breaks through the muscular wall of the abdomen. Most umbilical hernias heal by the toddler years without intervention. The provider may also move your child’s legs to check for dislocation or other problems with the hip joints, such as dysplasia of the hip joint.
• Genitalia — Your child’s care provider will likely inspect your son’s or daughter’s genitalia for tenderness, lumps or other signs of infection. The provider may also check for an inguinal hernia, which results from a weakness in the abdominal wall.

For girls, the doctor may ask about vaginal discharge. For boys, the provider will make sure a circumcised penis is healing well during early visits. The provider may also check to see that both testes have descended into the scrotum and that there’s no fluid-filled sac around the testes, a condition called hydrocele.

Your child’s provider will likely ask you about your child’s eating habits. If you’re breastfeeding, the provider may want to know how often you’re feeding your baby during the day and night and whether you’re having any problems. If you’re pumping, the provider may offer suggestions for managing pumping frequency and storing breast milk. If you’re formula-feeding, the provider will likely want to know how often you feed and how many ounces of formula your baby takes at each feeding. In addition, the provider may discuss with you your baby’s need for vitamin D and iron supplements.

Bowel and bladder function

In the first few visits, your child’s health care provider will likely also ask how many wet diapers and bowel movements your baby produces a day. This information offers clues as to whether your baby is getting enough to eat.

Sleeping status

Your child’s health care provider may ask you questions about your child’s sleep habits, such as your regular bedtime routine and how many hours your child is sleeping during the day and night. Don’t hesitate to discuss any concerns you may have about your child’s sleep, such as getting your baby to sleep through the night. Your child’s provider may also help you figure out how to find rest for yourself, especially in the early baby months.

Development

Your child’s development is important, too. The health care provider will monitor your child’s development in the following five main areas.

• Gross motor skills — These skills, such as sitting, walking and climbing, involve the movement of large muscles. Your child’s health care provider may ask you how well your baby can control his or her head. Is your baby attempting to roll over? Is your baby trying to sit on his or her own? Is your child starting to walk or throw a ball? Can your toddler walk up and down steps?
• Fine motor skills — These skills involve the use of small muscles in the hand. Does your baby reach for objects and bring them to his or her mouth? Is your baby using individual fingers to pick up small objects?
• Personal and social skills — These skills enable a child to interact and respond to his or her surroundings. Your child’s health care provider may ask if your baby is smiling. Does your baby relate to you with joy and enthusiasm? Does he or she play peekaboo?
• Language skills — These skills include hearing, understanding and use of language. The health care provider may ask if your baby turns his or her head toward voices or other sounds. Does your baby laugh? Is he or she responding to his or her name?
• Cognitive skills — These skills allow a child to think, reason, solve problems and understand his or her surroundings. Your child’s provider might ask if your baby can bang together two cubes or search for a toy after seeing you hide it.

Vaccinations

Your baby will need a number of scheduled vaccinations during his or her first years. The health care provider or a nurse will explain to you how to hold your baby as he or she is given each shot. Be prepared for possible tears. Keep in mind, however, that the pain caused by a shot is typically short-lived but the benefits are long lasting.

Your child’s provider may talk to you about safety issues, such as the importance of placing your baby to sleep on his or her back and using a rear-facing infant car seat as long as possible.

Questions and concerns

During your son’s or daughter’s checkups, it’s likely that you’ll have questions, too. Ask away! Nothing is too trivial when it comes to caring for your baby. Write down questions as they arise between appointments so that you’ll be less likely to forget them when you’re at your child’s checkup.

Also, don’t forget your own health. If you’re feeling depressed, stressed-out, run-down or overwhelmed, describe what’s happening. Your child’s provider is there to help you, too.

Before you leave the health care provider’s office, make sure you know when to schedule your child’s next appointment. If possible, set the next appointment before you leave the provider’s office. If you don’t already know, ask how to reach your child’s provider in between appointments. You might also ask if the provider has a 24-hour nurse information service. Knowing that help is available when you need it can offer peace of mind.

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What To Expect From Baby's First Pediatrician Visit

Pediatricians may be the next best thing to a handbook for newborns., by sharon brandwein.

Whether it’s your first baby or your third, bringing a new life into the world is no easy feat. The parenting journey is long, and having your own little “village” will help you navigate any bumps in the road. But with everything that your support network of friends and family can do, they can’t do it all.

Babies may not come with handbooks, so that’s where your pediatrician comes in. Not only can they, too, offer the support you need, but they’re also there to answer questions about whether or not a poop is normal and crayons in noses (it happens, folks).

Every parent wants to give their baby a healthy start in life, and doing so begins with your baby’s first pediatrician visit, also known as a well baby visit. In what will be the first of many, your baby’s doctor will check in on your little one soon after they’re discharged from the hospital to ensure everything is on track. During this visit, the doctor will not only examine your baby from tip to toe, but they’ll also take the time to answer questions, dispense some sage advice and allay any lingering fears you may have.

When Do Newborns Have Their First Doctor Appointment?

“Your newborn’s appointment should be within 1-2 days after discharge from the hospital,” says Dr. Emily Wisniewski, a pediatrician with Mercy Family Care Physicians . “Some babies can wait a little bit longer, 3-5 days even, provided there were no concerns about feeding, significant weight loss, or jaundice. But otherwise, you [and your baby] should be checked on soon after discharge to make sure your baby is growing and feeding well.”

It’s worth noting that after your baby’s initial visit to the pediatrician, the American Academy of Pediatrics (AAP) recommends well-baby visits at the following intervals for the first two years of your baby’s life.

How Far in Advance Do I Need to Schedule the First Baby Checkup?

Schedules can vary widely from doctor to doctor. If you’re concerned about getting an appointment, consider calling ahead (before your due date) to get a better idea of how busy your preferred pediatrician will be. There’s no harm in being proactive and scheduling your appointment in advance.

What Will Happen During My Newborn’s First Doctor Appointment?

Wisniewski tells Babylist that doctors and nurses cover a lot of ground during the first visit to the pediatrician.

“We get to know the family—especially if they are new to the practice or a first-time parent—and ask questions about feeding, peeing and pooping, safety in the home—regarding safe sleep, smoke detectors/guns in the home and other family members in the home,” she says. “We also will do a postpartum depression screening to check in on parents as well as baby.” In addition to the baby’s physical exam, Wisniewski says doctors will often leave time to “address any questions or concerns the parents have.”

What Will My Baby’s First Physical Exam Look Like?

Once you’ve filled out any required paperwork, the nurse will probably be the next person you see. Ahead of the doctor’s exam, the nurse will weigh and measure your baby. He or she will then chart your baby’s measurements on a growth chart that shows what percentile your baby is measuring. Beyond length and weight, the nurse will also measure the circumference of your baby’s head.

Incidentally, your baby will need to be naked to get the most accurate measurements. So, you’ll want to bring an extra diaper —but more on that later.

After the nurse has all the measurements and numbers plotted, the pediatrician will examine your little one from head to toe. This includes:

Checking Your Baby’s Head: Your doctor will palm your baby’s head to check for a still-soft fontanel, which you may know as the soft spot. Your baby’s head circumference should increase by about 4 inches within their first year, and the soft spots on their skull are designed to accommodate that growth. However, if they close up too quickly, that could be cause for concern.

Checking Their Neck and Collarbone: The doctor will feel your baby’s bones along the neck and collarbone to check for any breaks or fractures that occurred during delivery.

Rolling Your Baby’s Hips: Pediatricians often roll babies’ hips to look for any signs of hip dysplasia. Incidentally, they will do this at every well-baby visit until your little one takes their first steps.

Testing Your Baby’s Reflexes: During this visit and four to follow, your pediatrician will assess your baby’s Moro reflex (also known as the startle reflex). Typically, the Moro reflex test simulates falling. It involves placing the baby face up on a soft padded surface, lifting their head slightly above their body, then gently letting it fall into the doctor’s hand. The doctor is looking for your baby to extend their arms and draw them back quickly (what all of us do when we feel like we’re falling).

In addition to the Moro reflex, your pediatrician will also check your baby’s rooting reflex as well as their sucking reflex. To check the rooting reflex, they will touch or stroke your baby’s cheek to gauge whether or not baby automatically turns their head to that side and opens their mouth. To check the sucking reflex, the doctor will place a gloved finger in your baby’s mouth to see whether they start sucking.

Checking Their Femoral Pulse: Pediatricians typically check the baby’s pulse via the femoral artery. A weak femoral artery pulse could be a sign of a heart condition.

Checking Genitalia: During your baby’s first trip to the pediatrician (and every visit that follows), your pediatrician will check on the development of your baby’s genitalia. In this case, they’re looking for signs of infection from circumcisions, following up on undescended scrotums or labial adhesions.

Examining the Umbilical Stump: Doctors will also check on how the umbilical stump is healing and offer some guidance for care until it falls off on its own—usually within 1-3 weeks after birth.

What Questions Will the Pediatrician Ask?

Throughout the physical exam, your baby’s doctor will ask questions about your child’s feeding patterns, elimination and sleep schedule. Their questions will likely focus on the following topics:

• Feeding Patterns/Schedule: While you don’t necessarily need to keep a food diary, you should be prepared to communicate how often and how well your baby eats. This is also a good opportunity to share any questions or concerns you have about feeding baby.
• Baby’s Digestive System: Peeing and pooping are indicators of overall health so expect your provider to ask questions about baby’s digestive system. They’ll want to know how many wet diapers your baby has each day, how often they’re pooping, as well as the color and consistency of their poop.
• Sleeping Patterns: Your baby’s doctor will also check in on how your baby is sleeping , and they’ll likely go over safe sleeping guidelines.

Will My Baby Be Vaccinated During Their First Visit to the Pediatrician?

Baby’s first official checkup and first immunization will take place at the hospital. Typically, baby won’t get any shots during their first visit to the pediatrician, but Wisniewski notes, “If your baby did not receive the Hepatitis B vaccine in the hospital (usually given prior to discharge), then your infant should receive this at their first pediatrician appointment.”

What Should I Bring With Me to the First Checkup?

The short answer here is simply to bring your diaper bag . Remember that you’ll need to remove baby’s clothing and diaper for the nurse to take their measurements and get an accurate weight. So, it’s a good idea to bring along a blanket and a fresh diaper.

Wisniewski also suggests bringing the discharge summary of your baby’s hospital stay. “It helps the doctor know what happened in the hospital and if any follow-up is needed (like checking for jaundice),” she says.

What Questions Should I Ask the Doctor at My Baby’s First Appointment?

While your baby’s pediatrician will ask plenty of questions about your baby’s general health, this is also the time for you to ask any and all questions you may have about your newborn.

Common questions that new parents often have include:

• How do I know if my baby ate enough ?
• What should I do if my baby is not drinking enough breast milk ?
• Should I give supplements to my baby?
• How can I store my breast milk?
• How can I help my baby latch on to my breast?
• What’s the best way to soothe or care for sore nipples?
• How many naps should my baby take?
• How many hours a day should my baby sleep ?
• Is it okay if I wake up my baby to eat?
• How can I help my baby to stay asleep?
• Is it safe for my baby to s leep on their back ?
• How can I try to avoid sudden infant death syndrome?
• Where should my baby sleep?
• When will my baby sleep through the night?

Helpful hint: Keep a digital note or write down all the questions you have for your baby’s doctor. There’s a lot of ground to cover on your baby’s first visit to the doctor, and if your little one is fussing or crying for the duration, you can easily become flustered and forget your questions. Keeping an actual note is the best way to ensure you walk out of the appointment with all your questions answered. But don’t worry! This is a routine visit, and your pediatrician is here to guide you through it all.

Sharon Brandwein

Sharon Brandwein is a Certified Sleep Science Coach and a freelance writer. She specializes in parenting, health, and of course, all things sleep. Sharon’s work has also appeared on ABC News, USAToday, Parents, and Forbes. When she’s not busy writing, you might find her somewhere curating a wardrobe for her puppy.

Family Life

AAP Schedule of Well-Child Care Visits

Parents know who they should go to when their child is sick. But pediatrician visits are just as important for healthy children.

The Bright Futures /American Academy of Pediatrics (AAP) developed a set of comprehensive health guidelines for well-child care, known as the " periodicity schedule ." It is a schedule of screenings and assessments recommended at each well-child visit from infancy through adolescence.

Schedule of well-child visits

• The first week visit (3 to 5 days old)
• 1 month old
• 2 months old
• 4 months old
• 6 months old
• 9 months old
• 12 months old
• 15 months old
• 18 months old
• 2 years old (24 months)
• 2 ½ years old (30 months)
• 3 years old
• 4 years old
• 5 years old
• 6 years old
• 7 years old
• 8 years old
• 9 years old
• 10 years old
• 11 years old
• 12 years old
• 13 years old
• 14 years old
• 15 years old
• 16 years old
• 17 years old
• 18 years old
• 19 years old
• 20 years old
• 21 years old

The benefits of well-child visits

Prevention . Your child gets scheduled immunizations to prevent illness. You also can ask your pediatrician about nutrition and safety in the home and at school.

Tracking growth & development . See how much your child has grown in the time since your last visit, and talk with your doctor about your child's development. You can discuss your child's milestones, social behaviors and learning.

Raising any concerns . Make a list of topics you want to talk about with your child's pediatrician such as development, behavior, sleep, eating or getting along with other family members. Bring your top three to five questions or concerns with you to talk with your pediatrician at the start of the visit.

Team approach . Regular visits create strong, trustworthy relationships among pediatrician, parent and child. The AAP recommends well-child visits as a way for pediatricians and parents to serve the needs of children. This team approach helps develop optimal physical, mental and social health of a child.

More information

Back to School, Back to Doctor

Recommended Immunization Schedules

Milestones Matter: 10 to Watch for by Age 5

Your Child's Checkups

• Bright Futures/AAP Recommendations for Preventive Pediatric Health Care (periodicity schedule)

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What to Expect at Your Baby’s First Pediatrician Visit

Nervous about your baby's first pediatrician visit? Here's what to expect, from paperwork to meeting the doctor, plus tips for making the visit easier for you and your baby.

Your baby should have their first well-baby visit at the pediatrician's office three to five days after birth, according to the American Academy of Pediatrics (AAP). After that, you'll be going in for checkups every few months over the course of the first year.

Since your baby's first pediatrician visit might be the first time your newborn leaves home, it's natural to feel some trepidation. But remember that this visit is often empowering and informative for new parents. Read on to learn what to expect during your baby's first pediatrician visit, from exams to vaccinations, as well as tips for timing and preparation.

There Will Be Paperwork

Be prepared to fill out paperwork when you arrive. Remember to pack the following:

• Your ID and health insurance card
• Information about your newborn's discharge weight
• Any complications during pregnancy or birth
• Your family's medical history

Knowing that your older child has asthma or your parents have diabetes, for example, focuses your pediatrician's attention on likely problems, says Christopher Pohlod, DO , assistant professor of pediatrics at Michigan State University's College of Osteopathic Medicine.

The Nurse Will Do Some Exams

A nurse will probably handle the first part of your baby's exam. They'll do the following:

• Weigh your naked baby on a scale
• Extend their limbs to measure height and width
• Use a tape measure to determine the head circumference

According to the AAP, it's normal for babies to lose weight after birth (up to 10% of their body weight). But they'll generally gain it back within a couple of weeks.

You'll Get to Know the Doctor

The pediatrician will examine your baby, educate you about their health, and answer any questions. One of the biggest components of the first pediatrician visit is developing a relationship with your child's new doctor. They will be a source of information, support, and troubleshooting in the many years to come.

They'll Check Your Baby's Neck and Collarbone

At your baby's first pediatrician visit, a health care provider will feel along your baby's neckline to check for a broken collarbone during the physical exam. That's because some babies fracture their clavicle while squeezing through the birth canal.

If your pediatrician finds a small bump, that could mean a break is starting to heal. It will mend on its own in a few weeks. In the meantime, they may suggest pinning the baby's sleeve across their chest to stabilize the arm so the collarbone doesn't hurt.

They'll Check Your Baby's Head

A pediatrician will also palm your baby's head to check for a still-soft fontanel. They will do this at every well visit for the first one to two years.

Your baby's head should grow about 4 inches in the first year, and the two soft spots on their skull are designed to accommodate that rapid growth. But if the soft spots close up too quickly, it can lead to a condition called craniosynostosis, which is when the tight quarters can curb brain development, and your child may need surgery to fix it.

They'll Check Your Baby's Hips

The doctor will roll your baby's hips to check for signs of developmental hip dysplasia, a congenital malformation of the hip joint that affects 1 in every 1,000 babies. You can expect this exam starting at your baby's first pediatrician visit and every visit until your baby can walk.

"The exam looks completely barbaric," says Vinita Seru, MD , a pediatrician in Seattle. "I tell families what I'm doing so they don't think I'm trying to hurt the baby."

If your pediatrician feels a telltale click from the hips, they'll order an ultrasound. Luckily, when dysplasia is found early, treatment is simple: The baby wears a pelvic harness for a few months.

They'll Check Your Baby's Reflexes

To check for a Moro reflex, a health care provider startles your baby. For the first 3 or 4 months, whenever something startles your infant, they'll fling their arms out as if they're falling. It's an involuntary response that shows your baby is developing normally.

This exam starts at the first pediatrician visit and continues through the first four well-child visits. A health care provider might also check whether your little one grasps a finger or fans their toes after you touch their foot.

They'll Check Your Baby's Pulse

By pressing the skin along the side of the baby's groin, a health care provider checks for your baby's pulse in the femoral artery, which runs up from your baby's thigh. Your pediatrician wants to see if the pulse is weak or hard to detect on one or both sides as that may suggest a heart condition.

You can expect this exam at the first pediatrician visit and all baby well visits. Around 1 in 125 babies are diagnosed with a heart defect every year in the US. This check is a simple way to screen for problems, says Dr. Seru: "When a heart condition is caught early, it can increase the likelihood of a good recovery."

They'll Check Your Baby's Genitalia

Starting at the first pediatrician visit and every well-baby visit after that, a health care provider will check your baby's genitals to ensure everything looks normal.

In about 1 to 3% of babies with testicles, the testicles don't descend into the scrotum before birth. While the problem usually corrects itself by 3 to 4 months of age, your doctor will keep an eye on things to see if your baby needs surgical assistance in the future. They will also check for signs of infection if your baby has been circumcised .

In babies with vulvas, it's not uncommon to find labial adhesions. Although the labia should open up over time, adhesions can shrink the vaginal opening and make your baby more prone to urinary tract infections (UTIs) . "If we know that they're there when your baby has a high fever, we look for a UTI first," says Melissa Kendall, MD , a pediatrician in Orem, Utah.

They'll Ask About Your Baby’s Feeding Patterns

The doctor will want information about your baby's feeding patterns. You don't need to keep super-detailed records, but you should have a general idea of the following:

• How often your baby is eating
• How long they feed (if nursing)
• How much they consume (if bottle-feeding)

This is an excellent time to raise concerns or questions about latching, formula brands, and other feeding issues.

They'll Check Your Baby’s Digestive System

You should have a general idea of how often you change your baby's diapers each day. If your doctor knows the consistency, frequency, and color of your baby's poop , they can better assess their digestive system and nutrient absorption.

They'll Ask About Your Baby's Sleeping Patterns

A health care provider will also probably inquire about sleeping patterns at your first pediatrician visit. They'll also make sure you're following safe sleep practices to help reduce the risk of sudden infant death syndrome (SIDS).

They'll Review the Childhood Vaccination Schedule

Hospitals usually give babies their first dose of the hepatitis B vaccine shortly after birth, but if your baby was born at home or at a birth center, they might receive it at their first pediatrician visit.

Most vaccinations start when your baby is 2 months old, and a health care provider might review the vaccine schedule with you so you're prepared for the many vaccines your baby will receive in the months ahead.

There Will Be Time for Questions

You will cover a lot of ground during your baby's first pediatrician visit. Ask the doctor to slow down, repeat, or clarify information if needed. It's also wise to come prepared with any questions you have.

Here are some examples:

• Is this behavior normal?
• Is my baby eating enough?
• Should their stool look like that?
• When should I schedule the next appointment?
• What should I expect in the next few days and weeks?

When you have a written list of talking points, you won't worry about your mind going blank if your baby starts to fuss, says Dr. Pohlod.

You'll Schedule Your Next Appointment

The lineup of well-baby checkups during the first year includes at least a half dozen more pediatrician visits.

Recommended Baby Checkup Schedule

Here is a quick-glance list of what ages the AAP recommends that your child be seen for well-child pediatrician visits through their second year:

• 3 to 5 days old
• 1 month old
• 2 months old
• 4 months old
• 6 months old
• 9 months old
• 12 months old
• 15 months old
• 18 months old
• 24 months old

At first glance, the recommended number of checkups may seem like a lot. But trust the process: This schedule was designed to closely monitor your baby's growth and development to ensure their health and well-being.

The checkups, depending on the age of your baby, will include measurements, sensory screening, and developmental health, which include social, behavioral, and mental health. It will also include vaccinations, oral health, and advice for parents and caregivers.

Frequent appointments with your baby's health care provider are also the best way to get personalized expert answers to your questions about your baby. Ultimately, it's important to be comfortable with your doctor, and seeing them frequently in the first year helps you develop a relationship you may have for years to come.

When you schedule your next appointment, ask about the office's hours of operation, billing policies, and how after-hours communication works. Keep the doctor's phone number handy, and be informed of what to do and who to contact in an emergency or when you have a question.

Tips for Your Baby's First Pediatrician Visit

Leaving the house with a newborn isn't easy, and it can be especially stressful when you're on a timetable (like when you're trying to make it to a scheduled appointment). But your baby's first pediatrician visit doesn't have to be super stressful. Here are some tips for smooth sailing:

• Plan your time. Ask for an appointment during the least busy part of the day. You can also see if a health care provider has specific time slots dedicated to seeing newborns. Expect the visit to take about 25 minutes, but plan for waiting and setbacks as well.
• Bring a support person. Consider bringing your partner or another caregiver to your baby's first doctor appointment. Two people can more effectively care for the baby, remember the doctor's advice, and recall questions you plan to ask.
• Dress your baby with the exam in mind. Since the doctor will examine your baby's entire body, dress them in easy-on, easy-off clothing or even just a diaper and comfortable blanket if weather permits.
• Be prepared, but pack light. Definitely bring a change of clothes, extra diapers, wipes, pacifiers, feeding supplies, and other necessities, but try not to overpack. Ultimately, "warmth, cuddling, loving, and reassuring voices are more helpful than a stuffed animal" at a newborn exam, says Brian MacGillivray, MD, a family medicine specialist in San Antonio.
• Wait in the car, if you can. If you attend the appointment with another person, send them inside to fill out paperwork while you wait in the car with the baby. This limits your newborn's exposure to germs. Some offices even have systems in place that allow you to fill out the paperwork online, wait in your car, and receive a call or text when it's time to go in.
• Keep your distance from others. If you must sit in the waiting room, have your baby face the corner. According to  Mary Ellen Renna, MD , a pediatrician from Jericho, New York, the chances of catching sickness are lower if you maintain a 3-foot radius from others.

AAP Schedule of Well-Child Care Visits . American Academy of Pediatrics . 2023.

Weight Loss . The American Academy of Pediatrics . 2020.

Clavicular Fractures in Newborns: What Happens to One of the Commonly Injured Bones at Birth? . Cureus . 2021.

Facts About Craniosynostosis . Centers for Disease Control and Prevention . 2023.

Developmental Dislocation (Dysplasia) Of the Hip (DDH) . American Academy of Orthopaedic Surgeons . 2022.

Moro Reflex . StatPearls . 2023.

A five (5) chamber heart (Cor Triatriatum) in Infancy: A rare congenital heart defect .  Niger Med J . 2013.

Undescended Testicles: What Parents Need To Know . American Academy of Pediatrics . 2022.

Periodicity Schedule . American Academy of Pediatrics . 2023.

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Your New Baby's Well-Child Check-Up Schedule (and What to Expect)

Introduction

Well-baby visits are a staple of every new parent’s life. From the day they are born throughout their first year, your baby will have several wellness visits to ensure that they are healthy, happy, and reaching developmental milestones. 

Well-baby visits are vital for immunizations, healthcare, and support from your pediatrician. At Juno Pediatrics, we love establishing relationships with parents that last throughout their baby’s childhood. From newborn through adulthood, Juno is there for every step along the way. 

In this guide, we will explore new-baby visits in-depth, including what to expect, when to schedule them, and how to give your little one the best care possible.

What Are Well-Baby Visits? 

Also known as well-child check-ups, these appointments are pivotal points in their development and healthcare. From the day your baby is born, doctor’s visits will become a regular part of your life. A baby’s first year is filled with trips to the pediatrician where parents can ask questions, get advice and address any concerns they may have. 

In addition to spotting any issues or developmental warning signs, parents can seek out advice on common concerns, such as how to soothe teething, when to expect their baby to start walking, weaning, and breastfeeding. 

Bear in mind that well-child visits are different from additional doctor’s appointments you may need. For example, if your baby falls ill, is injured or you are concerned about something, you can schedule additional evaluations outside of their well-visit schedule. 

Well-Baby Visit Schedule 

Each baby receives a well-baby check-up at 2-5 days,1 month, 2 months, 6 months, 9 months, and 12 months from their birth date. You can, of course, also schedule additional appointments to address any concerns with your pediatrician. 

Remember that well-visits aren’t just for your baby — they are meant to help you, too! There are many parenting milestones you will reach your baby’s first year. From feeding to sleeping, walking to teething, the team at Juno Pediatrics is here to help you nurture your little one every step of the way. 

The First Check-Up: 2-5 Days

The first visit is also important to establish a baby’s feeding habits. All babies lose weight after birth, and it is critical to make sure that the baby is within a healthy range of weight loss and maintains adequate hydration while they learn to eat. Sometimes, a newborn needs assistance with latching onto the breast or learning to take a bottle, which the doctor can address and assist with.

Some babies become jaundiced , a condition caused by too much bilirubin in the bloodstream. This is a yellow substance produced by red blood cells as they break down and accumulate in the baby’s skin.  This will be closely monitored with physical exams and bloodwork if necessary. If your baby had feeding issues or jaundice at birth, you may have daily visits from birth until their condition improves.

If you have a home birth, then your baby should visit the doctor one to two days after entering the world.  This is important because an infant needs vital exams within the first 48 hours of life. Certain tests that were not done at your home birth will be done at this visit, including taking a sample of the baby’s blood for a Newborn Screen. This metabolic screening during this early check-up ensures that your newborn’s body systems are all functioning as they should.

Depending on how your baby is growing and feeding, you will have a weight check between your first and second well-child visits. At this exam, your pediatrician will take your baby’s measurements and start to build their health record. They will address subjects like regular feedings, sleep schedules, and skills like diaper changing and swaddling. 

This visit is the perfect time to establish a connection with your baby’s doctor. They are here for you, so don’t hesitate to ask all your questions, share any concerns and be honest about how you’re feeling. 

Many new parents struggle in the early days, and if you’re feeling overwhelmed, your pediatrician can help. 

The Second Visit: 1 Month

Your baby will grow rapidly throughout its first four weeks of life. You don’t have to schedule this well-visit on the exact 1-month date but aim to make it during the milestone week. 

From birth, babies will typically gain 1 ounce every day for the first 30 days. By the time they reach 1-month old , most will have gone through two small but rapid growth periods and gained at least 2 additional pounds. 

During their 1-month well-visit, the doctor will begin by checking your baby’s vital signs and taking their measurements. Then, the doctor will check in with you and how you’re feeling. They can offer tips and suggestions on how to nurture your baby’s development through play, tummy time and reading. 

Through feeding, playing, cuddling, and rest, your baby will develop according to their own body. If they have a condition that will affect their health and development, the pediatrician will discuss this in detail and give you advice on what to look for. 

The Third Check-Up: 2 Months

At the 8-week mark, your baby will be far more alert than when they were born. The average 2-month old is more visually engaged and able to look at an object for several seconds as well as watch you when you move. 

At the beginning of this and every visit, your baby’s vital signs measurements will be taken and documented. Your pediatrician will review how they are eating, voiding, stooling, and sleeping.  In addition, your pediatrician will review their development and milestone and give you guidance on what to expect for the next two months before their next checkup

This visit is also the time to start immunization. At the 2-month well-visit, your infant will obtain 4 vaccines and be protected against 8 serious bacterial and viral diseases. 

The following vaccines are administered at the 2-month visit, and comprises the first set of their primary series:

Hepatitis B

Diphtheria/Tetanus/Pertussis (DTaP) 

Haemophilus influenzae type b (Hib) 

Pneumococcal (PCV)

Polio (IPV) 

Rotavirus (RV)

Be sure to voice any concerns or questions you have about vaccines and immunization with your pediatrician. Many parents who never second-guessed immunization can become anxious after they have a baby. They will discuss everything you need to know, listen to how you feel and answer your questions. 

At Juno Pediatrics , we are committed to providing the highest level of care and protection, and toward that goal, we ensure that all of our patients are vaccinated on schedule and on time.  You can find more on our approach to pediatric vaccines on our website . Your pediatrician will be there to answer any and all questions along the way.

The Fourth Check-Up: 4 Months

Four-month-olds are smiling, cooing babies, reaching for toys and your hair, looking around, and holding their heads up with more stability. 

The care assistant will take your baby’s vitals and measurements, as usual, review how the child is doing, answer your questions, and let you know what to expect in the coming two months.  Additionally, at this visit, we will start discussing introducing solid foods to your baby, a fun new adventure!

Your infant will also receive his second set of vaccines, the exact same one they received at the 2-month visit.  This is the second of three of their primary series vaccines.

The Fifth Check-Up: 6 Months

The half-year mark is a major milestone in a baby’s life. Their personality will have emerged and begun to shine through as they engage more with you, their family, and the world around them. By this age , they may begin to sit on their own, enjoy looking at their reflection in mirrors and show emotional responses to others. 

Your pediatrician will take your baby’s vitals and measurements as usual, then discuss some of the 6-month-old milestones to expect. If you are worried about your baby’s development, the doctor will listen intently and offer reassurance and guidance.

If your baby is not mobile, does not sit up or hold things, does not laugh or smile, or does not respond to its caretakers, then make sure you bring these issues up with your doctor. 

The final 4 vaccines of the primary series will be administered at this visit by the pediatrician. During flu season, your baby is eligible to receive its first influenza vaccine. This is administered to children in 2 doses roughly 1 month apart. 

The Sixth Check-Up: 9 Months

A 9-month-old is curious, adventurous, and always interested in the world around them. They will be eating solid foods 2-3x a day in addition to breast milk and formula and are starting to express their independence. At this stage , most babies are very vocal and have some ability to move. 

They will have a range of emotional expressions from deep frowns to big, happy smiles. They can also express anger and frustration more clearly, so it will be easier to differentiate their cries and understand their feelings. 

Your pediatrician will ensure the baby’s growth is on par with their sex and age. Then, they will begin to discuss their oral hygiene, as your baby may have a tooth erupted. . If you are concerned about any developmental delays, they can be addressed during this time.

Lack of emotional response, limited eye contact, infrequent mobility, and poor motor skills can indicate an issue that the doctor should know about. They can address these concerns and, if need be, refer you and your baby to a specialist. 

Bear in mind that every baby is unique, and some children reach milestones later without having any major conditions.

The Seventh Check-Up: 1 Year

As you celebrate your child’s first year of life, your pediatrician will offer advice on how to nurture them through late infancy into early toddlerhood. Over the next year, they will experience many changes to their cognitive, mental, and emotional development.

Your baby’s personality will emerge even more from this point forward, especially as they become more mobile, taking first steps, and communicative, saying first words and phrases.

At the 12-month-old check-up , your baby will undergo a blood test that checks lead level and hemoglobin screening, which checks for anemia . 

The 1-year mark is also time for babies to receive the following vaccines:

Measles, Mumps, and Rubella (MMR)

Chickenpox (varicella)

Hepatitis A 

Their final boosters of DTaP and Hib vaccines will be given at their 15-month check-up, and their final Hepatitis A vaccine and PCV vaccine will be completed at the 18-month visit.

Your Baby’s Health Journey Starts Here

At Juno, we provide comprehensive healthcare for the entire family. Our medical team includes board-certified pediatricians who take the time to listen to your experiences, hear your concerns, and ensure your baby gets the highest quality care. If you are looking for a long-term practice to nurture your baby, schedule an appointment with Juno Pediatrics today .

The Basics: Overview

Babies need to go to the doctor or nurse for a “well-baby visit” 6 times before their first birthday.

A well-baby visit is when you take your baby to the doctor to make sure they’re healthy and developing normally. This is different from other visits for sickness or injury.

At a well-baby visit, the doctor or nurse can help catch any problems early, when they may be easier to treat. You’ll also have a chance to ask any questions you have about caring for your baby.

Learn what to expect so you can make the most of each well-baby visit.

The Basics: Well-Baby Visits

How often do i need to take my baby for well-baby visits.

Babies need to see the doctor or nurse 6 times before their first birthday. Your baby is growing and changing quickly, so regular visits are important.

The first well-baby visit is 2 to 3 days after coming home from the hospital, when the baby is about 3 to 5 days old. After that first visit, babies need to see the doctor or nurse when they’re:

• 1 month old
• 2 months old
• 4 months old
• 6 months old
• 9 months old

If you’re worried about your baby’s health, don’t wait until the next scheduled visit — call the doctor or nurse right away.

The Basics: Child Development

How do i know if my baby is growing and developing on schedule.

Your baby’s doctor or nurse can help you understand how your baby is developing and learning to do new things — like smile or turn their head to hear your voice. These are sometimes called “developmental milestones.”

At each visit, the doctor or nurse will ask you how you’re doing as a parent and what new things your baby is learning to do. 

The Basics: 2 Months

By age 2 months, most babies:.

• Lift their head when lying on their stomach
• Look at your face
• Smile when you talk to them
• React to loud sounds

See a complete list of milestones for kids age 2 months .

The Basics: 4 Months

By age 4 months, most babies:.

• Bring their hands to their mouth
• Make cooing sounds
• Hold toys that you put in their hand
• Turn their head to the sound of your voice
• Make sounds when you talk to them

See a complete list of milestones for kids age 4 months .

The Basics: 6 Months

By age 6 months, most babies:.

• Lean on their hands for support when sitting
• Roll over from their stomach to their back
• Show interest in and reach for objects
• Recognize familiar people
• Like to look at themselves in a mirror

See a complete list of milestones for kids age 6 months . 

The Basics: 9 Months

By age 9 months, most babies:.

• Make different sounds like “mamamama” and “bababababa”
• Smile or laugh when you play peek-a-boo
• Look at you when you say their name
• Sit without support

See a complete list of milestones for kids age 9 months . 

What if I’m worried about my baby’s development? 

Remember, every baby develops a little differently. But if you’re concerned about your child’s growth and development, talk to your baby’s doctor or nurse. 

Learn more about newborn and infant development .

Take Action: Get Ready

Take these steps to help you and your baby get the most out of well-baby visits.

Gather important information.

Take any medical records you have to the appointment, including a record of vaccines (shots) your baby has received and results from newborn screenings . Read about newborn screenings .

Make a list of any important changes in your baby’s life since the last doctor’s visit, like:

• Falling or getting injured
• Starting daycare or getting a new caregiver

Use this tool to  keep track of your baby’s family health history .

What about cost?

Under the Affordable Care Act, insurance plans must cover well-child visits. Depending on your insurance plan, you may be able to get well-child visits at no cost to you. Check with your insurance company to find out more.

Your child may also qualify for free or low-cost health insurance through Medicaid or the Children’s Health Insurance Program (CHIP). Learn about coverage options for your family.

If you don’t have insurance, you may still be able to get free or low-cost well-child visits. Find a health center near you and ask about well-child visits.

To learn more, check out these resources:

• Free preventive care for children covered by the Affordable Care Act
• How the Affordable Care Act protects you and your family
• Understanding your health insurance and how to use it [PDF – 698 KB]

Take Action: Ask Questions

Make a list of questions to ask the doctor..

Before the well-baby visit, write down 3 to 5 questions you have. Each well-baby visit is a great time to ask the doctor or nurse any questions about:

• How your baby is growing and developing
• How your baby is sleeping
• Breastfeeding your baby
• When and how to start giving your baby solid foods
• What changes and behaviors to expect in the coming months
• How to make sure your home is safe for a growing baby

Here are some questions you may want to ask:

• Is my baby up to date on vaccines?
• How can I make sure my baby is getting enough to eat?
• Is my baby at a healthy weight?
• How can I make sure my baby is sleeping safely — and getting enough sleep?
• How can I help my baby develop speech and language skills?
• Is it okay for my baby to have screen time?
• How do I clean my baby’s teeth?

Take a notepad, smartphone, or tablet and write down the answers so you can remember them later.

Ask what to do if your baby gets sick.

Make sure you know how to get in touch with a doctor or nurse when the office is closed. Ask how to reach the doctor on call, or if there’s a nurse information service you can call at night or on the weekend.

Take Action: What to Expect

Know what to expect..

During each well-baby visit, the doctor or nurse will ask you about your baby and do a physical exam. The doctor or nurse will then update your baby’s medical history with all of this information.

The doctor or nurse will ask questions about your baby.

The doctor or nurse may ask about:

• Behavior — Does your baby copy your movements and sounds?
• Health — How many diapers does your baby wet each day? Does your baby spend time around people who are smoking or using e-cigarettes (vaping)?
• Safety — If you live in an older home, has it been inspected for lead? Do you have a safe car seat for your baby?
• Activities — Does your baby try to roll over? How often do you read to your baby?
• Eating habits — How often does your baby eat each day? How are you feeding your baby?
• Family — Do you have any worries about being a parent? Who can you count on to help you take care of your baby?

Your answers to questions like these will help the doctor or nurse make sure your baby is healthy, safe, and developing normally.

Take Action: Physical Exam

The doctor or nurse will also check your baby’s body..

To check your baby’s body, the doctor or nurse will:

• Measure height, weight, and the size of your baby’s head
• Take your baby’s temperature
• Check your baby’s eyes and hearing
• Check your baby’s body parts (this is called a physical exam)
• Give your baby shots they need

Learn more about your baby’s health care:

• Read about what to expect at your baby’s first checkups
• Find out how to get your baby’s shots on schedule

Updated At: 03/30/2023 02:03:26 PM

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What to Expect At A Well Child Visit

Going to the doctor with your new baby may feel scary—but we’re here to help! Here’s what to expect at a well child visit (plus, a checklist of everything to bring along).

What is an early well child visit?

It’s early check-in with your baby’s pediatrician to make sure they are healthy and seeing all signs of typical development. It is a great place to ask questions, detect and treat any delays, and help parents feel best prepared to care for their child.

When should a well-baby visit take place?

First and foremost, follow the instructions of your doctor. They will let you know when visits should take place for your baby.

The American Academy of Pediatrics (AAP) recommends that most babies have their first doctor visit when they are 3 to 5 days old. After that, the AAP recommends well-baby visits in the first year at 1, 2, 4, 6, 9, and 12 months. See the list of check-in ages here .

What should you plan to discuss?

The doctor will be checking in on your child’s health, development, and overall well-being. Therefore, doctors will ask questions about their development and functioning.

• They will make sure baby is doing activities such as Tummy Time , remaining calm during diaper changes, etc.
• They will make sure baby is sleeping safely and getting enough sleep .
• They will check in on your child’s motor function .
• They will ask about your child’s feeding
• They may ask you if you’ve noticed any delays or issues in your child’s day-to-day activities. You can always visit our age pages to read about the milestones and abilities your child should reach- -and any signs of delay. If there’s something you want to bring to your child’s healthcare provider sooner than their next well-child visit, you can make an appointment at any time.
• They will be checking in on you as well, to make sure you’re informed on how to best care for your baby, so don’t be afraid to ask them questions about your baby’s care.

Remember that early intervention is key to prevention of further delays and complications—so it is always best to tell the doctor if you’ve seen anything concerning, or if your child is having trouble reaching a certain milestone. If something seems delayed or if you think your child might need extra help, trust your instincts and ask your doctor for their input!

Watch this video to learn more!

Your well-baby visit checklist

Before the visit:.

• Print out and review the Pathways.org Ability and Milestone Checklists . Check your baby to see if they are meeting their developmental milestones.
• If there are any that they are not meeting, just make a note of it! Just be sure to ask your doctor about it at the visit.
• Speak to any caregivers for your baby to see if they have noticed anything in your child that should be brought up to the doctor.

For the visit:

• Your baby needs to be there, as well as at least 1 parent. Your doctor will have questions about how your baby is doing, so it’s recommended that the parent present can accurately answer those questions.
• Bring your checklists with in case any questions come up about their abilities and milestones.
• Bring a pen and notebook, to write down any important information.
• Write down any questions you may have and bring them with the doctor.

Want to learn more about baby’s development and track their milestones?

Download the free pathways.org baby milestones app .

Track your child’s milestones here!

• 0-3 month milestones
• 4-6 month milestones
• 7-9 month milestones
• 10-12 month milestones
• 13-18 month milestones
• 19-24 month milestones
• 2-3 year milestones

Related Resources

When To Use Swaddles and Sleep Sacks

Do The “Sleep Switch” Every Night to Help Prevent Plagiocephaly

Doctor Visits

Make the Most of Your Child’s Visit to the Doctor (Ages 1 to 4 Years)

Take Action

Young children need to go to the doctor or nurse for a “well-child visit” 7 times between ages 1 and 4.

A well-child visit is when you take your child to the doctor to make sure they’re healthy and developing normally. This is different from other visits for sickness or injury.

At a well-child visit, the doctor or nurse can help catch any problems early, when they may be easier to treat. You’ll also have a chance to ask questions about things like your child’s behavior, eating habits, and sleeping habits.

Learn what to expect so you can make the most of each visit.

Well-Child Visits

How often do i need to take my child for well-child visits.

Young children grow quickly, so they need to visit the doctor or nurse regularly to make sure they’re healthy and developing normally.

Children ages 1 to 4 need to see the doctor or nurse when they’re:

• 12 months old
• 15 months old (1 year and 3 months)
• 18 months old (1 year and 6 months)
• 24 months old (2 years)
• 30 months old (2 years and 6 months)
• 3 years old
• 4 years old

If you’re worried about your child’s health, don’t wait until the next scheduled visit — call the doctor or nurse right away.

Child Development

How do i know if my child is growing and developing on schedule.

Your child’s doctor or nurse can help you understand how your child is developing and learning to do new things — like walk and talk. These are sometimes called  “developmental milestones.”

Every child grows and develops differently. For example, some children will take longer to start talking than others. Learn more about child development .

At each visit, the doctor or nurse will ask you how you’re doing as a parent and what new things your child is learning to do.

Ages 12 to 18 Months

By age 12 months, most kids:.

• Stand by holding on to something
• Walk with help, like by holding on to the furniture
• Call a parent "mama," "dada," or some other special name
• Look for a toy they've seen you hide

Check out this complete list of milestones for kids age 12 months .

By age 15 months, most kids:

• Follow simple directions, like "Pick up the toy"
• Show you a toy they like
• Try to use things they see you use, like a cup or a book
• Take a few steps on their own

Check out this complete list of milestones for kids age 15 months.

By age 18 months, most kids:

• Make scribbles with crayons
• Look at a few pages in a book with you
• Try to say 3 or more words besides “mama” or “dada”
• Point to show someone what they want
• Walk on their own
• Try to use a spoon

Check out this complete list of milestones for kids age 18 months . 

Ages 24 to 30 Months

By age 24 months (2 years), most kids:.

• Notice when others are hurt or upset
• Point to at least 2 body parts, like their nose, when asked
• Try to use knobs or buttons on a toy
• Kick a ball

Check out this complete list of milestones for kids age 24 months . 

By age 30 months, most kids:

• Name items in a picture book, like a cat or dog
• Play simple games with other kids, like tag
• Jump off the ground with both feet
• Take some clothes off by themselves, like loose pants or an open jacket

Check out this complete list of milestones for kids age 30 months .

Ages 3 to 4 Years

By age 3 years, most kids:.

• Calm down within 10 minutes after you leave them, like at a child care drop-off
• Draw a circle after you show them how
• Ask “who,” “what,” “where,” or “why” questions, like “Where is Daddy?”

Check out this complete list of milestones for kids age 3 years . 

By age 4 years, most kids:

• Avoid danger — for example, they don’t jump from tall heights at the playground
• Pretend to be something else during play, like a teacher, superhero, or dog
• Draw a person with 3 or more body parts
• Catch a large ball most of the time

Check out this complete list of milestones for kids age 4 years . 

Take these steps to help you and your child get the most out of well-child visits.

Gather important information.

Bring any medical records you have to the appointment, including a record of vaccines (shots) your child has received.

Make a list of any important changes in your child’s life since the last doctor’s visit, like a:

• New brother or sister
• Serious illness or death in the family
• Separation or divorce
• Change in child care

Use this tool to  keep track of your child’s family health history .

Ask other caregivers about your child.

Before you visit the doctor, talk with others who care for your child, like a grandparent, daycare provider, or babysitter. They may be able to help you think of questions to ask the doctor or nurse.

What about cost?

Under the Affordable Care Act, insurance plans must cover well-child visits. Depending on your insurance plan, you may be able to get well-child visits at no cost to you. Check with your insurance company to find out more.

Your child may also qualify for free or low-cost health insurance through Medicaid or the Children’s Health Insurance Program (CHIP). Learn about coverage options for your family.

If you don’t have insurance, you may still be able to get free or low-cost well-child visits. Find a health center near you and ask about well-child visits.

To learn more, check out these resources:

• Free preventive care for children covered by the Affordable Care Act
• How the Affordable Care Act protects you and your family
• Understanding your health insurance and how to use it [PDF - 698 KB]

Ask Questions

Make a list of questions you want to ask the doctor..

Before the well-child visit, write down 3 to 5 questions you have. This visit is a great time to ask the doctor or nurse any questions about:

• A health condition your child has (like asthma or an allergy)
• Changes in sleeping or eating habits
• How to help kids in the family get along

Here are some questions you may want to ask:

• Is my child up to date on vaccines?
• How can I make sure my child is getting enough physical activity?
• Is my child at a healthy weight?
• How can I help my child try different foods?
• What are appropriate ways to discipline my child?
• How much screen time is okay for young children?

Take a notepad, smartphone, or tablet and write down the answers so you remember them later.

Ask what to do if your child gets sick. 

Make sure you know how to get in touch with a doctor or nurse when the office is closed. Ask how to get hold of the doctor on call — or if there's a nurse information service you can call at night or during the weekend. 

What to Expect

Know what to expect..

During each well-child visit, the doctor or nurse will ask you questions about your child, do a physical exam, and update your child's medical history. You'll also be able to ask your questions and discuss any problems you may be having.

The doctor or nurse will ask questions about your child.

The doctor or nurse may ask about:

• Behavior — Does your child have trouble following directions?
• Health — Does your child often complain of stomachaches or other kinds of pain?
• Activities — What types of pretend play does your child like?
• Eating habits — What does your child eat on a normal day?
• Family — Have there been any changes in your family since your last visit?

They may also ask questions about safety, like:

• Does your child always ride in a car seat in the back seat of the car? 
• Does anyone in your home have a gun? If so, is it unloaded and locked in a place where your child can’t get it?
• Is there a swimming pool or other water around your home?
• What steps have you taken to childproof your home? Do you have gates on stairs and latches on cabinets?

Your answers to questions like these will help the doctor or nurse make sure your child is healthy, safe, and developing normally.

Physical Exam

The doctor or nurse will also check your child’s body..

To check your child’s body, the doctor or nurse will:

• Measure your child’s height and weight
• Check your child’s blood pressure
• Check your child’s vision
• Check your child’s body parts (this is called a physical exam)
• Give your child shots they need

Learn more about your child’s health care:

• Find out how to get your child’s shots on schedule
• Learn how to take care of your child’s vision

Content last updated February 2, 2024

Reviewer Information

This information on well-child visits was adapted from materials from the Centers for Disease Control and Prevention and the National Institutes of Health.

Reviewed by: Sara Kinsman, M.D., Ph.D. Director, Division of Child, Adolescent, and Family Health Maternal and Child Health Bureau Health Resources and Services Administration

Bethany Miller, M.S.W. Chief, Adolescent Health Branch Maternal and Child Health Bureau Health Resources and Services Administration

Diane Pilkey, R.N., M.P.H. Nursing Consultant, Division of Child, Adolescent, and Family Health Maternal and Child Health Bureau Health Resources and Services Administration

You may also be interested in:

Take Care of Your Child's Teeth

Get Your Child’s Vision Checked

Healthy Snacks: Quick Tips for Parents

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Premature baby, baby products, have a baby, baby health, how to prepare your baby for doctor’s visits – challenges and tips.

Written by Gayathri Lakshminarayanan

Gayathri Lakshminarayanan

Gayathri’s passion for writing had its foundation at the very early stages of her life when she was on her college editorial board and also won several awards for writing events and book review competitions. She combines her corporate experience with her writing skills and her experience as a homemaker makes her an empathetic contributor in the parenting domain . Her shift from full-time accounting professional to a homemaker gave her career a new direction.

Why Do You Need to Take Your Baby to the Doctor During Their First Year?

Challenges parents face when taking baby for doctor’s visits, top 10 tips to prepare your baby for doctor’s visits, faq’s.

1. Other Crying Babies

2. your baby’s separation anxiety , 3. fear of the injection pain, 4. the doctor, 6. parents’ anxiety, 7. overcrowding, 8. hunger or soiled diapers.

1. Time the Visit Well

2. do not make the baby wait for too long, 3. keep the baby busy during waiting time, 4. carry their favorite toy along, 5.  plan to go out after the checkup, 6. do not get stressed about doctor’s visits, 7. explain the purpose of the visit, 8. prepare to breastfeed, 9. always carry the diaper bag, 10. avoid last-minute hurry, 1. at what ages do you take your baby to the doctor, 2. why is it important to take the babies for regular visits to the doctor, 3. what is the duration of a regular baby visit, advantages of saffron during pregnancy.

Saffron is the dried stigma of Crocus Sativus flower, i.e. the thread-like part at the centre which contains pollen.

Gayathri Lakshminarayanan,CA, B.Com

Gayathri’s passion for writing had its foundation at the very early stages of her life when she was on her college editorial board and also won several awards for writing events and book review competitions. She combines her corporate experience with her writing skills and her experience as a homemaker makes her an empathetic contributor in the parenting domain . Her shift from full-time accounting professional to a homemaker gave her career a new direction. Read more.

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• Published: 04 April 2024

The infant–doctor relationship: an examination of infants’ distress reactions in the presence of a doctor

• Motonobu Watanabe 1 , 2 ,
• Masaharu Kato 1 ,
• Yoshi-Taka Matsuda 1 , 3 ,
• Kosuke Taniguchi 1 , 4 &
• Shoji Itakura 1  

Scientific Reports volume  14 , Article number:  7968 ( 2024 ) Cite this article

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• Medical ethics
• Paediatric research
• Paediatrics

Fear of doctors is a common source of distress among infants; however, the underlying sources of this distress are unknown. To investigate the doctor-infant relationship, the behaviors of 61 healthy infants (176–617 days old) were observed in a simulated examination room. Their behaviors and electrocardiograms were recorded. Two groups of infants were analyzed: those who cried and those who did not. When an experimenter dressed in the doctor’s attire entered the room, all 9 infants who were crying (14.8% of all infants) stopped crying, all infants gazed at the experimenter, and their mean heart rate (HR) decreased. After the auscultation started, 29.5% of all infants cried, and the HRs of infants who cried were higher than those of infants who did not cry. During the auscultation, 80.0% of infants who cried averted from the experimenter, while 34.4% of infants who did not cry. Within 5 s of gazing at the stethoscope, the number of infants who cried increased from 3 to 12, and their mean HR also increased. Our findings suggest that the fear of doctors is not due to the appearance of doctors but rather to specific actions performed by doctors, such as auscultation. Infants may regard a doctor’s appearance as a source of interest. Furthermore, a stethoscope is a possible trigger for infants’ crying. These behavioral observations suggest the potential for patient-centered care for infants.

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Introduction

Infants often cry, fuss, and refuse medical procedures when visiting a doctor 1 , 2 , 3 , and these behaviors represent medical distress, referred to as “fear of doctors.” A common belief is that infants are afraid of doctors; however, the mechanisms underlying these behaviors are unknown. Infant crying not only makes medical care difficult, but also may exacerbate cyanosis and other symptoms 4 , 5 . When providing medical care, pediatricians must develop a rapport with infants quickly to avoid distressing them 6 , 7 . Communication is the most common “procedure” in medicine 8 .

Forms of medical distress, such as those related to needle procedures, are often considered mild; however, for certain children, this distress is far from benign 9 . Moreover, anxiety-inducing experiences, such as being hospitalized and receiving medical care, can affect physical growth, personality, and emotional development 1 . These negative experiences in childhood may lead not only to medical fear but also to the avoidance of medical care as an adult 10 , 11 . Despite these problems, the medical care field often neglects to consider children's thoughts and emotions. Health care providers have a moral and ethical obligation to discuss health and illness with child patients, just as they do with adults 8 .

Recently, patient-centered care has played an increasing role in building partnerships between patients and healthcare professionals 12 , 13 , 14 , 15 , 16 . However, regarding pediatric patients, most studies have focused on family-centered care 17 , 18 , 19 . Few reports have examined patient-centered care in childhood, particularly in infancy. One reason for this lack of reports may be that infants have limited communication skills and cannot convey their specific wishes. An assessment is needed to determine whether family-centered care truly leads to positive experiences for children 20 . With respect to patient-centered care for infants, we propose that examining the factors underlying the fear of doctors is critical.

A meaningful approach is for pediatricians to elucidate the cause of infants’ crying during medical procedures. Many studies have used questionnaires to show that the visual perceptions of doctors reflect children’s comfort levels 6 , 21 , 22 . In addition, children’s self-reported distress is significantly associated with their attitudes toward healthcare 23 . However, little is known about how infants (at a preverbal age) feel about doctors or healthcare. Hyson observed young children of different ages during routine visits to a doctor’s office and described the effects of age and time period or situation on negative emotions 24 . However, certain problems exist with the methods used in Hyson’s study. One problem is that the conditions were uncontrolled because the observations occurred in a real-world medical setting. Another problem is that all the results were based solely on the judgment of one examiner’s observations every 30 s and lacked objective video data 24 . Infants may change their responses to physicians every second during an examination. Therefore, we need to expand upon previous research by including more detailed identifications of facial expressions and behaviors on a second-by-second basis. Moreover, the use of images alone is a limitation, and it is necessary to consider other indicators. Even when analyzing video recordings, coders are limited in their ability to understand infants' ever-changing facial expressions. In addition, it is assumed that there may be cases in which it is difficult to make judgments regarding the interpretation of facial expressions. Therefore, we measured HR as another indicator because electrocardiography (ECG) provides a physiological indicator that captures aspects of the emotional response to stimuli, such as activation of the autonomic nervous system. Heart rate has been considered to be an index of emotion. For example, a deceleration in HR is considered a measure of interest or attention, whereas an acceleration in HR is regarded as an indicator of fear 25 , 26 , 27 .

The current study investigated the doctor-infant relationship by focusing on infant reactions to determine a method for examining infants without provoking crying. The study was designed to analyze the differences between two groups: those who cried and those who did not. We obtained fine-grained distinctions by coding the video footage taken during a physical examination. The infants’ facial expressions and gazes recorded in the video were coded at 0.2 s intervals. Additionally, HR analyses were adopted to examine the transition of infants’ emotions as a method other than facial expression surveys. We hypothesized that the infants’ HRs would fluctuate with the scenes, even if their expression did not change. The questions addressed in this study were as follows:

Are infants afraid of doctors if a doctor appears and approaches them? We hypothesized that the infants’ crying could be attributed to the doctor’s approach and relative distance from the doctor. If infants are afraid of doctors, they may cry or avert their gaze from a doctor as soon as they see a doctor, and their HR will be accelerated.

What type of scene during a medical examination causes infants to start crying? We divided the consultation process into three scenes. Scene 1: An experimenter wearing a white coat enters the room after knocking on the door and approaches the infant (first contact scene). We investigated whether the medical distress of infants was due to the approach of doctors in Scene 1. On the other hand, if infants are interested in doctors, they may look at the experimenter without crying and their HR may decelerate. Scene 2: The experimenter sits down on a chair and interviews the infant’s mother (interview scene). We needed to ascertain whether the infants’ distress had been relieved or worsened during the interviews. We postulated that maternal engagement with the doctor would dampen alarms and infants would gaze at the experimenter with their HR decelerated in Scene 2. Scene 3: The experimenter takes a stethoscope out of his pocket and places it on the infant's chest (auscultation scene). We needed to explore whether infants cry due to medical practices such as auscultation. We also paid attention to the infants’ gaze and HR before and after auscultation.

What triggers infant crying? To further understand whether there were particular aspects of the scenes that triggered infant crying, we analyzed video data before and after infants cried. A more detailed analysis of the scene confirmed what factors caused the crying. We investigated what infants were watching and how their HR changed before crying in particular.

What individual factors are associated with infant distress? We investigated whether factors in an infant’s life and temperament were associated with fear of doctor. The infants’ temperament was measured using the Infant Behavior Questionnaire (IBQ) 28 . Rothbart et al. defined temperament as constitutionally based individual differences in reactivity and self-regulation 29 . Reactions to doctors may be related to infants' individual temperaments, especially their ability to self-regulate. The independent variables associated with the infants’ crying were assessed using a stepwise multivariate logistic regression model. We added the IBQ data to the results of a stepwise logistic regression analysis.

Here, to examine the fear of doctors in infancy, we reproduced the medical examination situation and examined the behaviors of infants who cried or did not cry.

Changes in facial expressions during each scene

The infants’ facial expressions were coded to examine whether the infants were afraid of the doctor and when they started crying. During the experiment, 28 infants cried, while 33 infants did not cry (Table 1 ). We analyzed how many infants cried from 5 s before to 10 s after the event in each scene (Fig.  1 ). In the first contact scene, nine infants (14.8% of all infants) cried 2 s before the experimenter entered the room. The infants stopped crying when the experimenter entered the room and approached them, and no infants cried at 5 s. The percentage of crying infants tended to be less than 10% in the interview scene. According to the analysis of infants’ facial expressions in the auscultation scene, the number of crying infants increased by approximately two-fold when the experimenter began the examination. Of the 28 infants who cried in this study, 21 cried from 5 s before to 10 s after auscultation. Moreover, 18 infants (29.5%) cried from 7 to 9 s after auscultation, the maximum value obtained in the experiment. This number decreased to 7 infants (11.7%) who cried for 5 s after the experimenter left the room (Supplementary Fig. S1 ).

Changes in facial expressions during each scene. The time course of changes in the percentages of infants who cried in each scene is shown. The changes in facial expressions from 5 s before to 10 s after the event in each scene are shown. The 0-s time points are the times when the experimenter knocked on the door in the first contact scene, was seated in the interview scene, and placed a stethoscope on the infant’s chest in the auscultation scene.

Changes in HR during each scene

We divided the infants into two groups (those who cried and those who did not cry) and compared the mean HRs between the groups during each scene (Fig.  2 a). Due to missing data and noise, in the HR analysis we had to exclude data for 6 infants in the group that cried and 8 infants in the group that did not cry. Therefore, in the three scenes the numbers of included infants who cried and did not cry were 22 and 25, respectively. We conducted a series of hierarchical multiple regression analyses using generalized least squares methods with an autoregression structure (Supplementary Table S1 ).

Changes in the infants’ HRs, gazes, and looking time during each scene. ( a ) The scene-related HR time courses in the two groups of infants (those who cried and those who did not cry) at each scene are shown. The changes in HR values refer to the HR relative to 0 s (delta HR). The results show the mean values for each group at each time point with the sample-by-sample intertrial SEM (vertical lines). ( b ) The percentages of infants who gazed at the experimenter in the two groups. Infants whose gazes were unable to be coded were excluded. In the scene without an experimenter, which occurred before he entered (the time before the 0-s time point), we counted the number of infants who gazed in the direction of the entrance door. ( c ) The proportion of the total looking time directed to the experimenter was averaged across all trials of the scenes for each successive 1-s time bin from 5 s prior to each scene until 10 s after the scene. Time 0 is indicated here with a vertical dashed line. The symbols with error bars plotted in each time bin represent the average data and standard errors.

For the first contact scene, we examined the goodness of fit of the statistics when autoregressive variables were included as covariates (i.e., HR ~ intercept vs. HR ~ intercept + autoregression) and found that the goodness of fit was significantly better when autoregressive variables were included as covariates (χ 2 (1) = 7680.44, p < 0.001). We then compared the goodness of fit of Model 0a, the intercept model with autoregressive covariance, with Model 1a, which adds two main effects (time course and two groups) to Model 0a (i.e., HR ~ intercept + autoregression vs. HR ~ time + group + autoregression). The results showed that the goodness of fit of Model 1a was significantly higher (χ 2 (2) = 14.29, p < 0.001). Furthermore, a comparison of the goodness of fit between Model 1a and Model 2a (i.e., HR ~ time + group + autoregression vs. HR ~ time * group + autoregression), in which the interaction effect was added to Model 1a, showed no significant change in goodness of fit (χ 2 (1) = 0.78, p = 0.376). Thus, an effect of time course or two-group interaction was not observed. Model 1a showed that the main effect of time course was significant and that HR decreased with time (beta = -0.40, p < 0.001). On the other hand, the effects in these two groups were not observed.

For the interview scene, the intercept model with autoregressive variables (Model 0a: HR ~ intercept + autoregression) was chosen because it showed a better fit than the intercept model without the variables (Model 0: HR ~ intercept; χ 2 (1) = 8235.13, p < 0.001). Model 1a (HR ~ time + group + autoregression) fit significantly better than Model 0a (χ 2 (2) = 9.28, p = 0.010), while the difference in the goodness of fit between Model 1a and Model 2a (HR ~ time * group + autoregression) was marginally significant (χ 2 (1) = 3.81, p = 0.051). Therefore, Model 1a was analyzed. The results indicated that the HRs of infants who cried were higher than those of infants who did not cry (beta = − 3.73, p = 0.014). The effect of the time course was marginally significant (beta = 0.22, p = 0.059).

During the auscultation scene, the intercept model with autoregressive variables (Model 0a: HR ~ intercept + autoregression) showed better goodness of fit than the intercept model (Model 0: HR ~ intercept; χ 2 (1) = 10,123.98, p < 0.001). The goodness of fit of Model 1a (HR ~ time + group + autoregression) was not significantly different from that of Model 0a (χ 2 (2) = 4.51, p = 0.105), while the goodness of fit of Model 2a (HR ~ time * group + autoregression) was significantly better than that of Model 0a (χ 2 (3) = 10.13, p = 0.018) and Model 1a (χ 2 (1) = 5.60, p = 0.018). Model 2a was chosen and indicated a significant effect of time course (beta = 0.51, p = 0.042) and interaction (beta = − 0.82, p = 0.017), while the effect on the two groups was not significant. The time course was centered at the median (2.5 s after the event) and at the value of the ¾ quartile deviation (6.25 s after the event) to analyze the simple slope. Both approaches indicated that the HRs of the infants who cried were significantly higher than those of the infants who did not cry after the event (betas < − 5.70, p < 0.028).

After the experimenter left the room (Supplementary Fig. S2a , Supplementary Table S1 ), the intercept model with autoregressive variables (Model 0a: HR ~ intercept + autoregression) showed a better fit than the intercept model without the variables (Model 0: HR ~ intercept; χ 2 (1) = 5132.25, p < 0.001). Model 1a (HR ~ time + group + autoregression) had a better fit than Model 0a (χ 2 (2) = 20.54, p < 0.001), while the goodness of fit of Model 2a (HR ~ time * group + autoregression) was not significantly different from that of Model 1a (χ 2 (1) = 1.87, p = 0.171). Model 1a showed a significant effect on the two groups (beta = 3.10, p = 0.030) and time course (beta = − 0.72, p < 0.001). The results indicated that the HR of the infants who did not cry was higher than that of the infants who cried and that the HR decreased with time.

Moreover, when the relative HRs in all scenes were compared with the baseline values (i.e., HR at 5 s before the first contact scene) (Fig.  3 ), the first contact and the interview scenes showed no significant differences in HR between the two groups (Supplementary Table S1 ). For the auscultation scene, the intercept model with autoregressive variables was chosen (Model 0a: HR ~ intercept + autoregression) because it showed a better fit than the intercept model without the variables (Model 0: HR ~ intercept; χ 2 (1) = 12,343.50, p < 0.001). A comparison of the goodness of fit among the models revealed that Model 1a (HR ~ time + group + autoregression) was a marginally better fit than Model 0a (χ 2 (2) = 5.84, p = 0.054). Model 2a (HR ~ time * group + autoregression) was a significantly better fit than Model 0a (χ 2 (3) = 8.99, p = 0.029). Model 2a indicated that the HRs of infants who cried were higher than those of infants who did not cry (beta = − 9.00, p = 0.044). The effect of time course was not significant (beta = 0.46, p = 0.145), and the interaction was marginally significant (beta = − 0.76, p = 0.075).

Comprehensive analysis with the measure before the event serving as the baseline. The baseline was defined as the HR 5 s before the first contact (5 s before the start of the experiment). Figure shows the HR time courses in the two groups. The changes in HR values in all scenes refer to the HR measured 5 s before the first contact scene. The symbols with error bars plotted in each time bin represent the average data and standard errors.

Changes in infants’ gazes and looking time during each scene

We coded the infants’ gazes at the experimenter in each scene (Fig.  2 b). Three infants in the group who cried and one infant in the group who did not cry were excluded from the analysis because their gazes could not be coded from the video data. Therefore, the numbers of included infants who cried and did not cry were 25 and 32, respectively. During the time when the experimenter was not present (i.e., before he entered the room or after he left), we counted the number of infants who gazed in the direction of the entrance door.

In the first contact scene, fewer than 20% of the infants in each group gazed at the entrance door 1 s before the experimenter entered. However, infants in both groups began to gaze at the experimenter at 0 s, and all infants gazed at the experimenter within 4.6 s after he entered. For the looking time of the first contact scene, we examined whether the intercept model fit was changed by autoregressive variables (i.e., Model 0: looking time ~ intercept vs. Model 0a: looking time ~ intercept + autoregression) and found that the model with autoregression variables displayed a significantly better fit (χ 2 (1) = 978.05, p < 0.001; Fig.  2 c, Supplementary Table S2 ). We compared the goodness of fit of Model 1a (looking time ~ time + group + autoregression) with Model 0a to investigate the effects of the two groups (infants who cried and those who did not cry) and time course and found that Model 1a displayed a significantly better fit (χ 2 (2) = 127.48, p < 0.001). Model 2a (looking time ~ time * group + autoregression), however, did not exhibit a significantly better fit than Model 1a (χ 2 (1) = 1.44, p = 0.230). Model 1a indicated that infants in both groups were more likely to look at the experimenter after he entered the room (beta = 0.06, p < 0.001), and infants who did not cry tended to look at the experimenter for a longer time (beta = 0.09, p = 0.067).

For the looking time of the interview scene, Model 0a (looking time ~ intercept + autoregression) showed a better goodness of fit than Model 0 (looking time ~ intercept; χ 2 (1) = 394.81, p < 0.001). Model 1a (looking time ~ time + group + autoregression) exhibited a marginally better fit than Model 0a (χ 2 (2) = 5.06, p = 0.080), and Model 2a (looking time ~ time * group + autoregression) was not a significantly better fit than either Model 0a or 1a (vs. Model 0a: χ 2 (3) = 5.08, p = 0.166; vs. Model 1a: χ 2 (1) = 0.01, p = 0.909). Therefore, neither the effects of the two groups nor the time course affected the viewing time.

No significant between-group differences were detected in the interview scene. However, during the auscultation scene, the percentage of infants who gazed at the experimenter in the group who cried was lower than that of the group who did not cry. At 3.6 s after auscultation started, 80.0% of infants who cried averted from the experimenter, whereas 34.4% of infants who did not cry. For looking time in the auscultation scene, Model 0a (looking time ~ intercept + autoregression) displayed a significantly better fit than Model 0 (looking time ~ intercept; χ 2 (1) = 432.04, p < 0.001). Model 1a (looking time ~ time + group + autoregression) fit significantly better than Model 0a (χ 2 (2) = 17.06, p < 0.001), while Model 2a (looking time ~ time * group + autoregression) did not fit significantly better. Model 1a indicated that infants who did not cry looked at the experimenter longer than infants who cried (beta = 0.12, p = 0.043), and the looking time at the experimenter decreased over time in both groups (beta = − 0.02, p < 0.001).

When the experimenter left, 88.0% of the infants who cried and 93.9% of the infants who did not cry gazed at the experimenter (Supplementary Fig. S2b ). At 3.8 s after the experimenter left the room, 68.0% of the infants who cried gazed at the doorway through which the experimenter had exited, while the percentage of infants who did not cry decreased to 24.2%. For the looking time in the scene of leaving, Model 0a (looking time ~ intercept + autoregression) showed better goodness of fit than Model 0 (looking time ~ intercept; χ 2 (1) = 457.91, p < 0.001; Supplementary Fig. S2c ). Model 1a (looking time ~ time + group + autoregression) showed a significantly better fit than Model 0a (χ 2 (2) = 39.48, p < 0.001), and Model 2a (looking time ~ time * group + autoregression) had a significantly better fit than Model 1a (χ 2 (1) = 5.04, p = 0.025). The regression analysis of Model 2a showed that the main effect of time course (beta = − 0.03, p = 0.009) and the interaction were significant (beta = − 0.03, p = 0.025). We examined the median (at the time of the event) and the value of the ¾ quartile deviation (2.5 s after the event) of the time course to test for a simple slope and found no difference between the two groups in the time spent looking at the experimenter up to the time of the event. However, the infants who cried were more likely to gaze at the doorway than those who did not cry after the experimenter left the room (beta = − 0.15, p = 0.051).

Association with the stethoscope

We analyzed the behaviors of 28 infants before and after crying to determine which factors triggered their crying. Twenty-three (82.1%) of the infants who cried and 30 (90.9%) of the infants who did not cry began to watch the stethoscope before, during, or after auscultation. Within 5 s of gazing at the stethoscope, the number of infants who cried increased from 3 to 12 (Fig.  4 a).

Association with the stethoscope. ( a ) The number of infants who cried before and after gazing at the stethoscope is shown. ( b ) The time course of the changes in HR (delta HR) before and after gazing at the stethoscope is shown. Infants who did not gaze at the stethoscope and whose HR data had noise or defects in each scene were excluded. The results show the mean values for each group at each time point with the sample-by-sample intertrial SEM (vertical lines).

We examined whether the time course of HR before and after gazing at the stethoscope differed between the two groups (those who cried and those who did not cry) (Fig.  4 b, Supplementary Table S3 ). The intercept model with autoregressive variables (Model 0a: HR ~ intercept + autoregression) showed better goodness of fit than the intercept model without the variables (Model 0: HR ~ intercept; χ 2 (1) = 8119.86, p < 0.001). Although no significant difference in goodness of fit was found between Model 0a and Model 1a (HR ~ time + group + autoregression; χ2(2) = 4.47, p = 0.107), Model 2a (HR ~ time * group + autoregression) had a significantly better fit than Model 0a (χ2(3) = 9.64, p = 0.022). Therefore, Model 2a was chosen as the optimal model. Model 2a indicated a significant effect of time course (beta = 0.43, p = 0.031) and interaction (beta = − 0.61, p = 0.022), while the effect of the two groups was not significant. To conduct the analysis of simple slopes, the time course was centered at the median (2.5 s after the event) and at the value of the ¾ quartile deviation (6.25 s after the event), both of which indicated that the HRs of the infants who cried were significantly higher than those of the infants who did not cry after gazing at the stethoscope (after 2.5 s: beta = − 3.57, p = 0.035; after 6.25 s: beta = − 5.84, p = 0.003). Thus, the HR of infants who cried was significantly higher than that of infants who did not cry as time elapsed.

Logistic regression analysis

We used stepwise logistic regression analysis to determine crying triggers based on the infants’ profiles (Table 2 ). Previous experience crying at a doctor consultation was significantly associated with crying (OR, 15.09; p < 0.001). Low birth weight was also associated with crying; however, the association was not significant (OR, 1.00; p = 0.037). According to the results from the regression model, none of the other variables analyzed, including age and IBQ score, were significant.

We examined the relationship between doctors and infants, focusing on infants’ reactions. In this study, four conclusions were drawn. (1) All of the infants gazed at an experimenter dressed in doctor’s attire without crying when he appeared and approached them. (2) Among the three scenes, most infants cried during the auscultation scene. (3) The number of infants who cried increased immediately after the experimenter used a stethoscope. (4) Infants’ crying was associated with a history of crying at doctor consultations.

The first goal was to show that infants were not afraid of the experimenter when he appeared and approached them during the first contact scene. The infants stopped crying at the moment they recognized the experimenter’s appearance. Similar to the infants who did not cry, the HRs of the infants who cried decreased, and they gazed at the experimenter after he entered the room. Most studies have focused on children’s perceptions of physicians’ attire 6 , 21 , 22 . Based on our results, the doctor’s appearance does not explain why the infants cried at the doctor’s office.

Second, of the 28 infants who cried, 21 infants cried during the auscultation scene, particularly immediately after the auscultation began. Moreover, these infants averted their gazes from the experimenter, and their HRs were faster than those of the infants who did not cry. We propose two possible explanations for this finding: infants may simply fear medical procedures, including auscultation, or infants may regard an experimenter as a doctor when he or she starts an examination. Based on these results, the fear elicited in infants by doctors is due to the doctor’s actions, such as performing examinations, and is not related to the doctor’s appearance.

Third, by performing a behavioral analysis before and after crying, we found that the stethoscope was a potential trigger of the infants’ crying behaviors. We did not test whether the appearance of a stethoscope would scare the infants; therefore, no definitive conclusion can be drawn. However, in a real doctor’s office, infants are unlikely to cry immediately upon seeing a stethoscope when it is not in use (e.g., when it is placed on the desk or hanging on a doctor’s shoulder). A more likely explanation might be that the doctor handling the stethoscope by the doctor or the doctor’s action with a stethoscope becomes scary for infants during the process of the examination.

Fourth, logistic regression analysis revealed that infants with a history of crying at doctor consultations tended to cry in the present study. This finding indicates that our study effectively reproduced the hospital environment. Previous reports suggest that the fear of doctors might be due to an infant’s past experiences at doctors’ offices 1 , 30 , 31 . The results of the above logistic regression indicated that to further elucidate infants’ fear of doctors, it is necessary to investigate infants’ past experiences with medical institutions. On the other hand, the results from the regression analysis indicated that no other factors, including infant age or IBQ score, were associated with infant crying. To assess the possibility that fear of doctors appears in infants of different ages, infants across a wide age range (176–617 days of age) were analyzed. However, the present experiment did not show that the infants’ ages were associated with their crying. A study that included older children suggested effects of age on negative emotions during pediatric examinations 24 . Future research should examine older infants or toddlers to establish the effect of children’s age on responses to doctors. Fear from the IBQ domain, which assesses distress in response to a novel social or physical object, was not a significant factor in the current regression model. If all domains were also examined, the relationship with temperament might have become clearer. Alternatively, using the IBQ-Revised (IBQ-R), which has been used as a measure of infant self-regulation, could have shown individual differences 32 .

Our results revealed other between-group differences, except in the auscultation scene. First, the infants who cried were more likely to gaze at the doorway than those who did not cry after the experimenter left the room. The infants who cried tended to maintain their attention on the experimenter even if the experimenter was not visible, whereas the infants who did not cry were likely to lose interest in the experimenter as soon as he left the room. In addition, the HR of infants who cried was significantly lower than that of infants who did not cry after the experimenter left the room. Thus, the experimenter had a greater effect on the emotions of the infants who cried, suggesting that the fear of doctors had already formed in the memories of the infants who cried. This research also has the potential to explore aspects of infant self-regulation. Analysis of the gaze and HR of the group that cried after leaving suggested a possible response during the “recovery” phase after stressor removal. Infants who cried may not have fully recovered from the stress even after the experimenter left, perhaps because they were not able to self-regulate completely. On the other hand, infants who did not cry may have been better able to regulate their behavior, or perhaps they did not perceive the experimenter as a stressor.

Second, significant differences were observed in the results of the HR analysis during the interview scene: the HRs of the infants who cried were higher than those of the infants who did not cry. Although further research is needed, maternal engagement with doctors may influence the heart rate of infants during interviews. Unlike in the auscultation scene, simultaneous differences in the HR and the looking time results were not observed in the interview scene. These results suggest that gaze is different from HR as an indicator and might identify differences that are not present in HR values. The measurement of infants’ gazes may provide additional information on other factors, such as their interests, cognitions, and emotions 33 , 34 , 35 , 36 , which is essential for patient-centered care 37 , 38 , 39 , 40 .

This research highlighted that a doctor’s examination can act as a mild stressor for infants. These findings are consistent with the literature on infant development, especially as they relate to how infants self-regulate 32 , 41 , 42 . Self-regulatory processes can be observed on multiple levels, including the physiological, attentional, emotional, cognitive, and interpersonal domains of functioning 29 , 43 , 44 , 45 . The Face-to-Face Still-Face Paradigm suggested a relationship between heart rate and emotional reactivity to a stressor 46 . Overcoming the fear of doctors can be thought of as the process of developing self-regulatory abilities through various maturation processes, including the autonomic nervous system.

This study investigated infants’ responses to a doctor to shift the perspective of infant medical care from family-centered to patient-centered care. Medical care requires both family-centered and patient-centered care; however, little is known about patient-centered care in infancy because infants do not have verbal skills and cannot convey their specific wants, unlike their parents. Our approach aims to address the challenge of investigating less-known patient-centered care for infants. Our findings have implications for pediatric healthcare and clinical practice, as follows: (1) an infant’s first impression of a doctor is favorable, (2) medical procedures may cause fear in infants, (3) opportunities to build relationships with infants occur during the time before the medical examination, and (4) doctors should avoid showing infants medical instruments such as stethoscopes before they are comfortable with examinations. For example, it might be worth considering auscultating an infant’s back at the beginning so that the infant does not pay attention to the stethoscope. If these proposed recommendations are considered for routine pediatric care, patient-centered care for infants may become more practical for social implementation.

Our study has several limitations. First, our research replicated the first visit to an unfamiliar doctor. Infants exhibit different behaviors when they consult with their own physicians, and reports indicate that past medical experiences influence infant behaviors 47 , 48 . Second, our results may not be widely available in a sufficiently timely manner to achieve patient-centered care for infants soon. However, we documented one way of approaching such care and accumulated evidence by observing infant behaviors rather than by testing interventions. Patient-oriented research must be based on both patient observations and heterogeneity studies rather than the identification of the best intervention for each individual patient 39 . Furthermore, the age range was limited in our research, and it is necessary to expand the scope to include older patients. Future studies should investigate more and broader samples by age to examine developmental changes. Additionally, we believe that there are potential confounding factors and alternative explanations that could not be shown in our exploration. For example, this study could be extended by considering measurements of infant and maternal HR variability, aspects of attachment, maternal mental health, a detailed assessment of the marital relationship, parental attitudes, and medical experiences. It is essential to address these limitations and consider them in future research efforts.

Conclusions

The aim of the present study was to examine infant-doctor relationships, focusing on infants’ reactions during examinations. Based on our findings, the fear of doctors among infants is due to specific actions, such as auscultation, performed by a doctor. Another major finding was that infants are not afraid of the doctor’s appearance but rather show interest in the doctor. Furthermore, we found that a stethoscope is a possible trigger for infants’ crying. These findings provide insights that are applicable to addressing infants’ fear of doctors or healthcare. Beyond family-centered care, the present study advances the establishment of patient-centered care for infants. Based on behavioral observations of infants, this study suggests the potential for infant-centered care.

Participants

From December 13, 2011, to July 19, 2016, 69 healthy full-term infants were recruited through various methods, including announcements in local magazines, the internet, and participant referrals. Among the infants who participated, 61 (33 females [54.1%]; mean age [standard deviation: SD], 377.0 [110.3] days) were included in the analysis. Infants with a wide age range (aged 176–617 days) were analyzed to assess the possibility that fear of doctors appeared in infants of various ages. Eight infants were examined and then excluded for one of the following reasons: the infant was not sufficiently controllable to participate in the experiment (infant refusal) (n = 5), the infant had previously been seen by the experimenter as a patient (not seen for the first time) (n = 2), and data were not recorded due to a technical error (n = 1). Table 1 lists the demographic characteristics of the participants according to the Infant Questionnaire for Research (see Table 3 ). We classified the infants into two groups (those who cried during the experiment and those who did not cry).

Ethics approval

Written informed consent was obtained from the infants’ parents prior to their participation. The study was conducted in accordance with the principles of the Declaration of Helsinki, and the study design was approved by the ethics committee of Doshisha University (#1354-1). All experiments were completed within 5 min to minimize the burden on the infants. Furthermore, we prioritized the infants’ condition and stopped the survey soon after the infants expressed being unwell or refused to participate.

Experimenter and procedure

Our experimenter was a pediatrician who provided daily medical care in a hospital near the laboratory. All participants met him for the first time during the study because we aimed to observe the infants’ behaviors while interacting with a new doctor, thus excluding biases associated with previous consultations. In accordance with standard attire, the doctor wore a white coat and had a stethoscope in his pocket.

We planned to observe daily medical examinations of the infants. Thus, the experiments were conducted in a simulated consultation room in our laboratory. We used partitions and arranged the seats to resemble an examination room as much as possible (Fig.  5 ). In this experiment, we intended to confirm whether the fear of doctors was attributed to the doctor’s approach and the relative distance from the doctor. Therefore, a laboratory setup was devised to observe the extent to which infant behavior changed under the conditions of alarm introduced by the doctor’s arrival and approach 49 , 50 , 51 . The mother and infant were brought to the simulated consultation room, where they waited for the doctor to enter. The mother sat on a chair against the back wall, and her infant sat in a floor seat (Bumbo®, Bumbo International Trust, Pretoria, South Africa) on her lap. We used a Bumbo seat because we needed to exclude the effects of maternal touch and contact 52 . We recorded the infants with a digital video camera (Panasonic AG-DVX1008).

Experimental procedure in a simulated consultation room. A mother and an infant were introduced to a simulated consultation room, and they waited there for the doctor to enter. The following experimental procedure was used: Scene 1: An experimenter wearing a white coat enters the room after knocking on the door and approaches the infant (first contact scene). Scene 2: The experimenter sits down on a chair and interviews the infant’s mother (interview scene). Scene 3: The experimenter takes a stethoscope out of his pocket and places it on the infant's chest (auscultation scene). After the three scenes, the experimenter leaves the room (dotted arrow). An ECG recorder was placed behind the partitions. The digital video camera was covered with a black cloth such that the infant did not pay attention to it, but this figure does not show that process.

The experiment was constructed in three scenes (Fig.  5 ).

Scene 1: An experimenter wearing a white coat entered the room after knocking on the door and approached the infant (first contact). The moment of knocking was defined as the 0-s time point in Scene 1.

Scene 2: The experimenter sat down on a chair and interviewed the infant’s mother (interview). The moment of being seated was the 0-s time point in Scene 2.

Scene 3: The experimenter removed a stethoscope from his pocket and placed it on the infant’s chest (auscultation). The time of stethoscope placement was defined as the 0-s time point in Scene 3.

The observation period from 5 s before the scene to 10 s after the scene was considered to investigate infants’ responses in each scene. The 0-s time point indicated the start of the scene, and the observation started 5 s before the 0-s time point. We considered this time frame because in our review of initial data, we observed that infants may change their facial expressions every second once the doctor appears. After the three scenes, the experimenter left the room, and the experiment was complete. We also observed the infants’ behaviors before and after the experimenter left the room to determine the subsequent effects on the infants.

ECG measurements

ECG data were used as physiological indicators. We attached an ECG sensor (PolyTele® STS-1C, Nihonsanteku Co., Ltd., Osaka, Japan) to the infant’s chest and measured the infant’s HR to investigate the effect on the autonomic nervous system. During each experimental period, ECGs were recorded and displayed using Audacity® software version 1.3 or 2.0. The sampling rate was set to 8000 samples/s, and no filtering was applied. Using the elapsed time from one heart contraction to the next (RR interval), the HR was calculated in beats per minute (bpm) with our in-house program in MATLAB® between consecutive RR interval samples. HR artifacts were confirmed and removed by MATLAB and visual inspection. If artifacts could not be removed, the data were removed from the analysis. Due to missing data and noise, we had to exclude data for 6 participants in the group that cried and 8 participants in the group that did not cry in the HR analysis.

Video coding

The main outcome measures included the infants’ facial expressions and gazes as well as changes in their HRs. Two coders who were unaware of the study hypotheses identified the infants’ facial expressions and gazes. The facial expressions were coded as negative or not negative. Our criteria for defining negative facial expressions in infants were based on those described by Sullivan and Lewis 53 or Ikeda and Itakura 54 . The criteria included lowering of the brows, tight squeezing of the eye orbital muscles, and lateral stretching of the mouth 55 . We defined vocalization with a negative facial expression as crying. The infants’ gazes were coded as looking at the experimenter’s face or looking elsewhere. A fixation time of more than 0.2 s shown on the video image was considered the looking time. The coding reliability was calculated for all samples using Cohen’s kappa coefficient 56 . The percentages of intercoder agreement were 94.6% for the infants’ facial expressions and 87.7% for their gazes. Three infants in the group that cried and one infant in the group that did not cry were not included in the results because these cases could not be coded.

Infant questionnaire

We developed the Infant Questionnaire for Research, which consists of 15 questions, to collect data on infants’ background and temperament via mothers’ reports (Table 3 ). We investigated whether factors in an infant’s life, the mother-infant relationship, and the infant’s temperament were associated with fear of doctors. The variables included in the score were age, sex, gestational age, birth weight, family structure, the number of siblings, the level of shyness, the number of days since the last vaccination, medical consultation frequency, whether the infant attended a nursery school or cried at a doctor’s consultation, whether the doctor wore a white coat, and whether the infant followed his or her mother, cried when his or her mother left, or was breastfed 1 , 3 , 9 , 30 , 31 , 49 , 50 , 51 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 .

We also measured the infants’ temperaments using the Infant Behavior Questionnaire (IBQ) 28 . Although the IBQ is designed for infants aged 3–12 months, we used the IBQ items for all participants to directly compare their results using the same scale. The IBQ assesses six domains of infant temperament: fear, distress related to limitations, smiling and laughter, soothability, duration of orienting, and activity level. From six domains of the IBQ, we measured fear on a scale consisting of 16 items that assess distress in response to a novel, social, or physical object, such as a stranger. The IBQ score was included in the logistic regression analysis to determine the crying trigger based on the infant profile.

Data analyses

We classified the infants into two groups (those who cried during the experiment and those who did not cry), which served as a dependent variable, to examine the differences between infants who cried and those who did not cry. We analyzed the infants’ behavior by comparing the reactions before and after the stimulus in each scene. In addition to facial expressions, we examined changes in the following measures to determine which scene induced distress: HR, the percentage of time infants spent gazing at the experimenter, and the time spent looking before and after the event in each scene. Throughout all the scenes, we analyzed the infants and paid particular attention to the moments before and after they cried.

Analyses of HR: After the selection of HR trials 5 s prior to and 10 s after each scene, averaging was performed across each scene. The results showed scene-related HR time courses with a sample-by-sample intertrial standard error of the mean (SEM). For statistical analyses, we extracted the relative HR values every 0.2 s for a time interval of 15 s in each scene 65 , 66 . The changes in HR values refer to the relative HR from the 0-s time point. In addition, we compared HRs across the different scenes for each group. The baseline was defined as the HR 5 s before the first contact (5 s before the start of the experiment). The changes in HR values across the different scenes were also analyzed by referring to the relative HR from the baseline. We conducted a series of hierarchical multiple regression analyses using generalized least squares methods with an autoregression structure in each scene and the nlme package in R version 4.1.0 ( https://www.r-project.org ) to examine whether the HR time course differed between the two groups (i.e., infants who cried and those who did not cry). The model included HR as the dependent variable. The time course of a scene (at intervals of 0.2 s; centered at the event occurrence) was set as the continuous independent variable, and whether the infants cried or did not cry was set as the dummy independent variable. The time course of the scene and infant ID were set as the covariates for the time and grouping factors, respectively. A p value of < 0.05 was considered significant for all analyses. We compared the goodness of fit (AIC) between models using the likelihood ratio test to analyze the effect of independent variables. The models to be compared are described below. First, we examined whether the goodness of fit differed depending on whether the residuals included or did not include autoregression in the intercept model only to control for the effect of the time course. If the fit of a model including the autoregressive covariate was high, it was set as Model 0a. Otherwise, the autoregressive covariate was not included (Model 0). Model 1 (or Model 1a) was added to Model 0 (or Model 0a) to include the main effects of time course and whether the infant group cried or did not cry, and Model 2 (or Model 2a) was added to Model 1 (or Model 1a) to include the effect of the interaction.

We analyzed the changes in the infants’ gazes from 5 s before the scene to 10 s after each scene. Analyses of the percentages of the infants who gazed at the experimenter: The percentages of infants in the two groups that gazed at the experimenter in each scene were calculated every 0.2 s and were displayed as a time series. Analyses of looking time: The proportion of the total looking time directed to the experimenter was averaged across all trials of the scenes for each successive 1-s time bin from 5 s prior to 10 s after the event of each scene 67 . For looking time, a linear model with an autoregression structure fit was also run. The analysis procedure was similar to that for HR except that the dependent variable was set as the looking time and the time course was set at intervals of 1 s.

We analyzed the contributions of the predictor variables to determine the effects of individual differences. The independent variables associated with the infants’ crying were assessed using a stepwise multivariate logistic regression model with R. The data were obtained using the Infant Questionnaire for Research and the IBQ (Table 1 ). We performed a logistic regression analysis to estimate the odds ratios and 95% confidence intervals (CIs) for the risk of crying. A p value < 0.05 was considered significant for all analyses.

Consent to participate

Written informed consent was obtained from the infants’ parents prior to their participation.

Consent for publication

Verbal informed consent was obtained from all individual participants to publish nonidentifying information collected during the experiment.

Data availability

All data generated or analyzed during this study were included in this published article and its supplementary information files (Supplementary Data 1) .

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Acknowledgements

We would like to thank Yukuo Konishi, the first director of the Center for Baby Science, for contributing to the study’s conception and providing the laboratory. We are also grateful to the infants who participated in this study and their families, the staff, and Yasuyuki Kawanishi, who supported the data collection.

This work was funded by Japan Society for the Promotion of Science (Grant nos. JP25460639 and JP24600028).

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Motonobu Watanabe, Masaharu Kato, Yoshi-Taka Matsuda, Kosuke Taniguchi & Shoji Itakura

Department of Pediatrics, NHO Minami Kyoto Hospital, Joyo, Kyoto, Japan

Motonobu Watanabe

Department of Child Studies, Shiraume Gakuen University, Kodaira, Tokyo, Japan

Yoshi-Taka Matsuda

Department of Psychology, Kyoto University of Advanced Science, Ukyo-ku, Kyoto, Japan

Kosuke Taniguchi

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Study concept and design: M.W. and M.K. Data collection: M.W. Funding acquisition: M.W. and Y.M. Statistical analysis: M.W., Y.M., and K.T. Writing — original draft preparation: M.W. Writing — review and editing: M.W. and S.I. Analysis and interpretation of data: All authors. All authors read and approved the final manuscript.

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Correspondence to Motonobu Watanabe .

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Watanabe, M., Kato, M., Matsuda, YT. et al. The infant–doctor relationship: an examination of infants’ distress reactions in the presence of a doctor. Sci Rep 14 , 7968 (2024). https://doi.org/10.1038/s41598-024-58677-5

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Discovered in a tree after her Gaza home was destroyed, Baby Unknown finds a new family with her doctor

Days old and desperately thin, Baby Malak didn’t even have a name when she was taken to the Emirati Hospital in Gaza’s southernmost city of Rafah . Her family was presumed dead, so medics called her “Unknown.”  

Today, the chubby 6-month-old is the star of the wards where her de-facto guardian, Amal Abu Khatleh, 32, works as a pediatrician. As Abu Khatleh carries Malak — which means angel in Arabic — around the facility, other members of the staff lean in for a kiss and a cuddle. 

“We had a lot of catastrophic stories because of the war that affected us, but the one that affected me most is Malak’s,” Abu Khatleh told an NBC News crew in Rafah late last month. Other children had their parents with them, she added, but Malak “did not and her name was ‘Unknown.’” 

Malak was found in a tree near her family’s ruined home in central Gaza, apparently flung into the branches by a strike, which killed the rest of her relatives in November. 

Shortly after she was taken to Al-Shifa Hospital in northern Gaza for treatment, Dr. Nasser Bolbol, head of the neonatal unit, told NBC News that based on her umbilical cord, he believed Malak was just 2 days old. 

Bolbol added that he and his colleagues thought she had been caught by an angel, providing inspiration for her name. “When I see this baby with no family members, I feel so sad. Very sad,” he said, standing next to her incubator.  

With power outages on the increase, supplies dwindling and battles between Israeli forces and Palestinian militants getting increasingly closer to the hospital, Malak was evacuated to the Emirati Hospital, along with 30 other premature babies.    

Israel, which recently completed a second weekslong operation at Al-Shifa, has long maintained that Hamas was using the complex as a base — which both Hamas and doctors at the hospital have denied.

Abu Khatleh first met Malak when she began treating her after the baby was transferred to the facility in her home city. 

After two of the other babies were taken in by their relatives and the rest were transferred to Egypt for further treatment, only Malak remained, alone, with no family and no name.  

“I was really moved and got so close to her,” Abu Khatleh said, adding that after seeking and being granted permission by the Gaza Health Ministry, she took Malak “home with me and promised to make it up to her after what she has been through.” 

Since then, she said, her family had been helping her raise Malak and the hospital provided her with milk and diapers. Although she was worried that Malak’s development might have been stunted during her two months in an incubator, she said she “tried to make her communicate with my sister’s kids and thank God she did.” Malak, she added, “is great now healthwise and socially.” 

The family bonding also provided much needed companionship for Malak, who is one of at least 17,000 children in Gaza who are unaccompanied or separated from their families, according to a recent estimate from the United Nations Children’s Fund, or UNICEF. 

So many children have been orphaned in the six months since Hamas’ Oct. 7. attacks and Israel’s subsequent ground invasion of Gaza, that doctors now use a chilling new acronym — WCNSF, for "wounded child, no surviving family."

Abu Khatleh said her family has embraced her new role as a single mom and they treat Malak “as one of their own.” 

“ When I told my parents, they got very excited about the idea and told me it’s no problem. ‘She’s going to be a daughter of ours and we’ll take care of her,’ they said … I leave her with my sister and she takes care of her. Everyone treats her as if she is their biological daughter,” she added. 

Quite what the future holds is unclear. 

Israeli Prime Minister Benjamin Netanyahu has repeatedly threatened to launch a major ground operation in Rafah, which is home to more than half of Gaza’s 2.3 million people, many of them displaced from other parts of the besieged and bombarded enclave.

He has repeatedly stated that a ground assault on the city is necessary to destroy the military and governmental capabilities of Hamas, reiterating the goals of the war triggered by the militants’ Oct. 7 attack that killed 1,200 people and led to some 240 being kidnapped. 

Even as the United States continues to supply Israel with military hardware , President Joe Biden has repeatedly warned against launching a military incursion into the city, fearing it could dramatically increase the death toll in the enclave. More than 33,000 people have been killed in Gaza since Oct. 7, according to health officials in the enclave, although many more bodies are thought to be buried under the rubble of destroyed buildings.   

Dr. Mohammad Salama, head of the neonatal unit where Abu Khatleh works, said that there was no shortage of prospective adopters for the babies under his care but that finding people who could keep the orphaned children safe was proving difficult. 

Giving the babies away is also emotionally hard, he said. “Already, we have this bond between us and the babies. I feel like a father, not like a doctor,” he added.

Adoption by strangers is relatively rare in the Middle East , and extended family networks usually take care of children who have lost their parents. But UNICEF says that families under extreme pressure to provide food and shelter for their own children may be reluctant to take on more.

Malak, Salama said, was “one of us, one of our team.”

Cradling Malak in her lap, Abu Khatleh said she was still checking to see if there were any surviving relatives.

“Concerning Malak’s future with me, I’ve left this issue to God,” she said.

Mo Abbas is a London-based multimedia producer for NBC News.

Erin McLaughlin is an NBC News correspondent.

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How to find a pediatrician for your baby

Your relationship with your child's pediatrician is an important one – it could last for 18 years! Here's everything to consider as you search for the best doctor for your baby.

What is a pediatrician?

When to find a pediatrician, how to find a pediatrician, what to consider when choosing your baby's doctor, do all babies have a pediatrician, how to set up a pediatrician before your baby is born.

Choosing the right physician for your baby is an important decision: You'll be visiting the doctor's office at least six times in the first year for routine well-baby visits alone. It's easy to feel overwhelmed by the choice, but with a little homework and legwork, you should be able to find a pediatrician you like and trust.

Pediatricians are physicians who look after children. In addition to completing medical school, pediatricians have an additional three or more years of training about children and the illnesses that often affect them. Focusing on children's health and practicing with kids each day makes pediatricians experts on children's medical issues, development, and behavior.

As a new parent, you'll be seeing your baby's pediatrician often. Babies visit the doctor for at least six scheduled visits during their first year of life. During these visits, your pediatrician and their staff will monitor your baby's progress, track their growth , and administer vaccines. Your baby will also see their pediatrician as needed – for example, if they're sick with a respiratory infection or earache .

Most pediatricians are certified by the American Board of Pediatrics. In order to get board certification, pediatricians must take a comprehensive exam that shows their knowledge and skill. When you're researching physicians online, you'll be able to see if a pediatrician you're considering is board certified.

Ideally, start looking for a physician three to four months before your baby is due. Making a decision well before labor and delivery allows for an informed, well-considered choice. You have plenty of time to find out if your preferred practices are taking new patients, and to keep looking if they're not. It also gives you the time you'll need to narrow down your choices and meet with pediatricians by phone or in person.

Some parents know which physician or practice they want for their baby before they even conceive. But many start the search during pregnancy and arrive at a decision when they're seven or eight months along.

You can ask your ob-gyn or midwife for recommendations, for starters. Also, check your health insurance provider's website to see which physicians are covered by your health plan.

The American Academy of Pediatrics (AAP) offers  referrals to certified practitioners Opens a new window  on its HealthyChildren.org website. Certification by the American Board of Pediatrics (ABP) means that the physician has finished the required medical education and training, completed an accredited residency program, and passed the board exam in pediatrics.

Be sure to ask your local contacts – friends, relatives, neighbors, and co-workers with kids – for recommendations. People look for different things in physicians, and what's most important for you may not even be on someone else's radar. So rather than just gathering a list of names, try asking some probing questions of whoever makes the recommendation, such as:

• How does your child respond to the physician?
• Does the physician seem to enjoy working with children?
• Does the physician know about the latest medical advances?
• Does the physician welcome questions?
• Does the physician take time to discuss problems and listen to your concerns?
• If it's a group practice, do you know and like the other physicians, PAs, and NPs?
• Is the office staff patient and helpful?
• How long do you usually have to wait?
• Is the waiting room pleasant and kid-friendly?
• Is parking convenient?
• Is there anything you don't like or wish was different about your child's physician or their practice?
• Are you able to get last-minute appointments when your child is sick?
• Does the office return your calls promptly? How do they handle after-hours calls?

The answers you get can help narrow your list to the handful of physicians who seem most promising.

Before going a step further, make sure all the physicians you're considering are taking new patients and will accept your health insurance. And although this might seem unnecessarily cautious, it's wise to check with your state medical board to find out whether any physician you're interested in has been disciplined for wrongdoing.

Next, look over your list and note which physicians have convenient locations and office hours. The best physician in your area can lose their luster if their office is hard to get to (imagine driving across town at rush hour with a sick and miserable child).

The next step is visiting your top prospects at their offices, if you choose. A face-to-face meeting isn't required, but it may be helpful in showing you whether this doctor has the warmth, sensitivity, and professionalism you're seeking.

Most offices will accommodate your request for an interview with the physician, although some practices charge for it. (If this is the case, find out ahead of time whether your insurance company will pay for the meeting. Some will if it's billed as an office visit.)

Arrive with specific questions about the topics that are most important to you. Here are some questions to consider asking the physician:

• Which hospital are you affiliated with?
• Will you (or someone else in the practice) see my newborn in the hospital, or will the first contact be an office visit?
• What hours are you available to see patients?
• How does your office handle telephone inquiries? Does it set aside specific times for parents to call in with questions, or is there an open advice line during office hours? And if staff members handle the inquiries, do they dispense their own advice or relay the physician's?
• Do you accept and answer questions by email, text, portal, or chat? Offer video visits?
• How long does it take to get a non-emergency appointment?
• How are appointments handled for children who are sick? Is there good chance your child will get to see their own physician?
• Are there separate well-baby and sick-baby waiting rooms?
• What happens if my child gets sick after hours? When you're not on call, who covers? (Some physicians send patients to urgent care clinics, for example, while others will meet you at the office even at night.)
• Do you have a subspecialty or an area of interest? Do you work with a team of specialists if your child needs additional care?
• How does the practice handle payments, billing, laboratory charges, and insurance claims?
• What are your views on topics such as breastfeeding, immunizations, and different parenting styles? Are you open to – and supportive of – other opinions and approaches?

Pay attention to such intangibles as the physician's style. Do you want a doctor who offers choices and lets you decide which one works best for you – or would you be more comfortable with one who gives a lot of direction? Also, take note of the overall atmosphere of the office. Is it clean, warm, and inviting? Is the staff friendly and welcoming?

Not all babies see a pediatrician. Some parents prefer a family practitioner, a physician specializing in family medicine who can treat the whole family, from birth to old age. One advantage these parents point to is that the family practitioner will be well versed in health issues that pertain to your entire family (genetic diseases, for example). Plus, family providers can be convenient, since they can treat both you and your child. Overall, they provide many of the same services as pediatricians, including well-child visits, vaccines, and advice when your baby is sick.

In addition to a pediatrician or family practitioner, your child might see other medical providers for both routine care and sick visits. Nurse practitioners (NP) and physician assistants (PA) are both medical professionals who typically work under a physician's supervision.

If your pediatrician is part of a teaching hospital, you may also see resident physicians. These are physicians who have finished medical school but are undergoing on-the-job training, known as a residency.

Finally, if your baby has a medical condition, they may see a specialist. These are physicians who have additional training in specific areas, like the eyes, the cardiovascular system, or behavioral health. They'll work with your pediatrician to provide care for your baby.

Once you've picked a pediatrician (or family physician), ask them about the process for establishing your baby as a new patient. Oftentimes, there's not much you need to do before birth. After birth, it's important to contact your insurance company about adding your baby to your plan .

The hospital will ask you for your physician's name when you check in, and many hospitals notify the physician when your baby's born. Some physicians visit newborns in the hospital (or send another doctor from the practice) while others will see you when you bring your baby in for the first office visit. Oftentimes, you'll be asked to set up this visit before you leave the hospital.

In many instances, the hospital's pediatrician or neonatologist will take care of newborns until they're discharged – either instead of or in addition to the babies' own physician. But before you know it you'll see your own pediatrician for your baby's first visit, and you'll be happy to know you did the leg work ahead of time to find a doctor you trust.

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BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies .

American Academy of Pediatrics. 2020. A Pediatricians' Training. https://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/Pages/A-Pediatricians-Training.aspx Opens a new window [Accessed January 2023]

American Academy of Pediatrics. 2022. Finding a Pediatrician. https://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/Pages/Finding-a-Pediatrician.aspx Opens a new window . [Accessed January 2023]

American Academy of Pediatrics. 2020. How to Choose A Pediatrician. https://www.healthychildren.org/English/family-life/health-management/Pages/How-To-Choose-A-Pediatrician.aspx Opens a new window [Accessed January 2023]

Boston Children's' Hospital. 2021. Ten Questions To Ask When Choosing A Pediatrician. https://answers.childrenshospital.org/choosing-pediatrician-alliance/ Opens a new window [Accessed January 2023]

Seattle Children's' Hospital. Choosing a Doctor for Your Child Opens a new window [Accessed January 2023]

University of Iowa Stead Family Children's' Hospital. 2013. Pediatric Providers Opens a new window . [Accessed January 2023]

Kelly Burch is a freelance journalist covering health, entrepreneurship, family, and more. She's passionate about bringing complex topics to life through stories that are easy to read and informative. Burch lives in New Hampshire with her husband and two young daughters. When she's not at her desk, you'll find her kayaking or hiking in the wilderness around her home. Burch is currently writing a book about traveling around the United States in an RV with her family for seven months.

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The life and music of Amy Winehouse, through the journey of adolescence to adulthood and the creation of one of the best-selling albums of our time. The life and music of Amy Winehouse, through the journey of adolescence to adulthood and the creation of one of the best-selling albums of our time. The life and music of Amy Winehouse, through the journey of adolescence to adulthood and the creation of one of the best-selling albums of our time.

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Woman says doctors misdiagnosed her with cancer after undergoing weeks of chemotherapy

COLLEGE STATION, Texas ( KBTX /Gray News) - A Texas woman is sharing her life-changing experience after she says she was misdiagnosed with cancer.

Lisa Monk said in 2022 her life took an unexpected turn when she sought medical attention for what she suspected were kidney stones causing her stomach pains.

But this visit kicked off a difficult medical journey she said challenged her physically, emotionally and financially.

According to Monk, a routine CT scan initially confirmed her suspicion of kidney stones, but it also revealed something far more alarming — a mass on her spleen.

In January 2023, Monk underwent surgery to remove the spleen mass, expecting to receive a diagnosis and begin treatment for her condition.

However, a series of events followed that she said turned her world upside down.

“They said I had clear cell angiosarcoma, which is a blood-type cancer,” Monk said.

The wife and mother of two said doctors in the Houston area delivered the gut-wrenching prognosis of just 15 months left to live.

Monl said she embarked on a grueling journey of chemotherapy and hospitalizations as she fought what she believed to be a battle against cancer.

But in April 2023, a twist of fate revealed a startling truth. Monk said the hospital had made a grave error.

During a routine follow-up appointment, a nurse practitioner stumbled upon the misdiagnosis. It was revealed that Monk never had cancer in the first place.

“I underwent a total of two rounds of chemotherapy and the Friday before I went in for my third round, I went to visit my doctor and just again, a routine appointment, just checking in before we go in for round three,” Monk said. “The nurse practitioner was reading my file and talking to me, asking me about all my symptoms, all the nausea and vomiting and all the things that come with chemo.”

Monk added, “She just suddenly stopped talking and she got a horrified look on her face. She said she had to get the doctor real quick. She ran out of the room, left me alone for about 15 minutes and the doctor came back in and told me that I never had cancer.”

According to Monk, the facility gave her a report showing that she was cancer-free.

“They had ordered a second pathology, it’s their policy to do their own in-house. So, when they did that, that was the result. My spleen was just going to rupture. I had blood vessel activity in my spleen and that was all it was. It was never cancer,” Monk said.

Monk said what’s even more frustrating is knowing that the mistake could have been avoided after additional lab work was done.

“It was dated a whole month prior. I had received an entire second round of chemotherapy two weeks after they had received the second pathology report,” she said.

The mother of two said she had to deal with the psychological trauma of the misdiagnosis and the financial strain of medical bills.

“It wasn’t just me that went through all of this. I am a mom, I’m a wife, I’m a sister, a daughter, a friend,” Monk said. “My children were preparing for my death. I was writing goodbye letters to them for the graduations that I wouldn’t be at, the babies that I would never see, and the weddings that I would never attend.”

While relieved not to have cancer, Monk doesn’t want anyone else to go through the unnecessary medical procedures and emotional journey.

In the aftermath of her ordeal, Monk has shared her story on social media, shedding light on the critical issue of diagnostic mistakes in the healthcare system.

“It makes you wonder how many other mistakes are out there. How many times has someone been misdiagnosed or how many reports are sitting in someone’s inbox not being read because the doctors are too busy or there’s too many tests being run?” Monk said. “I don’t think that I can change the world because frankly, I don’t think I’m that special. But maybe I change their policies.”

According to Monk, the doctor or the hospital has not taken accountability for what she and her family have gone through.

“They told me congratulations. They never said we’re sorry that you went through this. We’re sorry that your family went through this,” she said.

Monk said the entire situation has been a roller coaster of emotions.

“I’ve never been so relieved and angry at the same time,” Monk said. “We still have a lot of healing to do. Physically I’m still healing from chemo and it’s hard to get those answers because there’s no research out there on people like me.”

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• Entertainment

Country singer Lisa McHugh forced to cancel more gigs on ‘doctor’s orders’

Country singer Lisa McHugh has confirmed that she is pulling out of more gigs on the advice of doctors.

Lisa, who is  pregnant with her second child, previously had to pull out of performing at Nathan Carter’s Cavan gig on Easter Sunday due to health issues.

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Struggling with a bout of illness over the past few weeks, Lisa has been encouraged by doctors to take more time off at home to rest.

Taking to Instagram on Friday morning, Lisa said she was ‘so disappointed’ to have to cancel her weekend appearances after some ‘more hospital visits’.

‘Since my last post, I’ve been following doctors’ orders but unfortunately, things haven’t improved much or enough to allow me to do much or go back to work yet

‘With more hospital visits since I’ve been advised to do nothing but rest in the hope that things begin to improve soon,’ she said.

Lisa added: ‘So, unfortunately, I won’t be able to perform at the Willow Bridge School fundraiser tonight with Nathan Carter and the others or Wexford Opera House tomorrow with Derek Ryan.

‘I’m so disappointed as I was really looking forward to them but I just have to listen to the professionals and spend as much time in bed as possible. Hope everyone attending has a great time and see you somewhere soon.’

Sadly for fans of her Downtown Radio NI show, Lisa revealed that she won’t be on that either as she thanked her fans for their ongoing support.

‘Thanks so much for all the well wishes [over] the last few weeks, every one of them is greatly appreciated,’ she said.

Lisa and her husband Nathan Khan already share an adorable  son, Milo , who they welcomed to the world back in 2022.

Sharing a ‘life update’ in February with her legion of adoring fans, Lisa revealed the good news that she, Nathan and Milo will have a new addition to their family later in the year.

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