WHAT YOU NEED TO KNOW:

What is a well child visit? A well child visit is when your child sees a healthcare provider to prevent health problems. It is a different type of visit than when your child sees a healthcare provider because he is sick. Well child visits are used to track your child's growth and development. It is also a time for you to ask questions and to get information on how to keep your child safe. Write down your questions so you remember to ask them. Your child should have regular well child visits from birth to 17 years.

What development milestones may my baby reach by 1 month? Each baby develops at his own pace. Your baby may have already reached the following milestones, or he may reach them later:

• Focus on faces or objects, and follow them if they move
  
  
• Respond to sound, such as turning his head toward a voice or noise or crying when he hears a loud noise
  
  
• Move his arms and legs more, or in response to people or sounds
  
  
• Grasp an object placed in his hand
  
  
• Lift his head for short periods when he is on his tummy

What can I do to help my baby grow and develop?

• Put your baby on his tummy when he is awake and you are there to watch. Tummy time will help your baby develop muscles that control his head. Never leave your baby when he is on his tummy.
  
  
• Talk and play with your baby. This will help you bond with your child. Your voice and touch will help your baby trust you.
  
  
• Help your baby develop a healthy sleep-wake cycle. Your baby needs sleep to help him stay healthy and grow. Create a routine for bedtime. Bathe and feed your baby right before you put him to bed. This will help him relax and get to sleep easier. Put your baby in his crib when he is awake but sleepy.
  
  
• Find resources to help care for your baby. Talk to your baby's healthcare provider if you have trouble affording food, clothing, or supplies for your baby. Community resources are available that can provide you with supplies you need to care for your baby.

What can I do when my baby cries? Your baby may cry because he is hungry. He may have a wet diaper, or be hot or cold. He may cry for no reason you can find. Your baby may cry more often in the evening or late afternoon. It can be hard to listen to your baby cry and not be able to calm him down. Ask for help and take a break if you feel stressed or overwhelmed. Never shake your baby to try to stop his crying. This can cause blindness or brain damage. The following may help comfort him:

• Hold your baby skin to skin and rock him, or swaddle him in a soft blanket.
  
  
• Gently pat your baby's back or chest. Stroke or rub his head.
  
  
• Quietly sing or talk to your baby, or play soft, soothing music.
  
  
• Put your baby in his car seat and take him for a drive, or go for a stroller ride.
  
  
• Burp your baby to get rid of extra gas.
  
  
• Give your baby a soothing, warm bath.

How should I lay my baby down to sleep? It is very important to lay your baby down to sleep in safe surroundings. This can greatly reduce his risk for SIDS. Tell grandparents, babysitters, and anyone else who cares for your baby the following rules:

• Put your baby on his back to sleep. Do this every time he sleeps (naps and at night). Do this even if he sleeps more soundly on his stomach or on his side. Your baby is less likely to choke on spit-up or vomit if he sleeps on his back.
  
  
• Put your baby on a firm, flat surface to sleep. Your baby should sleep in a crib, bassinet, or cradle that meets the safety standards of the Consumer Product Safety Commission (CPSC). Do not let him sleep on pillows, waterbeds, soft mattresses, quilts, beanbags, or other soft surfaces. Move him to his bed if he falls asleep in a car seat, stroller, or swing. He may change positions in a sitting device and not be able to breathe well.
  
  
• Put your baby to sleep in a crib or bassinet that has firm sides. The rails around your baby's crib should not be more than 2⅜ inches apart. A mesh crib should have small openings less than ¼ of an inch.
  
  
• Put your baby in his own bed. A crib or bassinet in your room, near your bed, is the safest place for your baby to sleep. Never let him sleep in bed with you. Never let him sleep on a couch or recliner.
  
  
• Do not leave soft objects or loose bedding in his crib. His bed should contain only a mattress covered with a fitted bottom sheet. Use a sheet that is made for the mattress. Do not put pillows, bumpers, comforters, or stuffed animals in his bed. Dress your baby in a sleep sack or other sleep clothing before you put him down to sleep. Avoid loose blankets. If you must use a blanket, tuck it around the mattress.
  
  
• Do not let your baby get too hot. Keep the room at a temperature that is comfortable for an adult. Never dress him in more than 1 layer more than you would wear. Do not cover his face or head while he sleeps. Your baby is too hot if he is sweating or his chest feels hot.
  
  
• Do not raise the head of his bed. Your baby could slide or roll into a position that makes it hard for him to breathe.

What can I do to keep my baby safe in the car?

• Always place your child in a rear-facing car seat. Choose a seat that meets the Federal Motor Vehicle Safety Standard 213. Make sure the child safety seat has a harness and clip. Also make sure that the harness and clips fit snugly against your child. There should be no more than a finger width of space between the strap and your child's chest. Ask your healthcare provider for more information on car safety seats.
  
  
• Always put your child's car seat in the back seat. Never put your child's car seat in the front. This will help prevent him from being injured if you get into an accident.

How can I keep my baby safe at home?

• Never leave your baby in a playpen or crib with the drop-side down. Your baby could fall and be injured. Make sure that the drop-side is locked in place.
  
  
• Always keep 1 hand on your baby when you change his diaper or dress him. This will prevent him from falling from a changing table, counter, bed, or couch.
  
  
• Keeping hanging cords or strings away from your baby. Make sure there are no curtains, electrical cords, or strings, hanging in your baby's crib or playpen.
  
  
• Do not put necklaces or bracelets on your baby. Your baby may be strangled by these items.
  
  
• Do not smoke near your baby. Do not let anyone else smoke near your baby. Do not smoke in your home or vehicle. Smoke from cigarettes or cigars can cause asthma or breathing problems in your baby. Ask your healthcare provider for information if you currently smoke and need help to quit.
  
  
• Take an infant CPR and first aid class. These classes will help teach you how to care for your baby in an emergency. Ask your baby's healthcare provider where you can take these classes.

What can I do to prevent my baby from getting sick?

• Do not give aspirin to children under 18 years of age. Your child could develop Reye syndrome if he takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin, salicylates, or oil of wintergreen. Do not give your baby medicine unless directed by his healthcare provider. Ask for directions if you do not know how to give the medicine. If your baby misses a dose, do not double the next dose. Ask how to make up the missed dose.
  
  
• Wash your hands before you touch your baby. Use an alcohol-based hand sanitizer or soap and water. Wash your hands after you change your baby's diaper and before you feed him.
  
  
• Ask all visitors to wash their hands before they touch your baby. Have them use an alcohol-based hand sanitizer or soap and water. Tell friends and family not to visit your baby if they are sick.

What can I do to help my baby get enough nutrition?

• Continue to take a prenatal vitamin or daily vitamin if you are breastfeeding. These vitamins will be passed to your baby when you breastfeed him.
  
  
• Breast milk gives your baby the best nutrition. It also has antibodies and other substances that help protect your baby's immune system.
  
  
• Feed your baby breast milk or formula that contains iron for 4 to 6 months. Do not give your baby anything other than breast milk or formula. Your baby does not need water or other food at this age.
  
  
• Feed your baby when he shows signs of hunger. He may be more awake and may move more. He may put his hands up to his mouth. He may make sucking noises. Crying is normally a late sign that your baby is hungry.
  
  
• Breastfeed or bottle feed your baby 8 to 12 times each day. He will probably want to drink every 2 to 3 hours. Wake your baby to feed him if he sleeps longer than 4 to 5 hours. If your baby is sleeping and it is time to feed, lightly rub your finger across his lips. You can also undress him or change his diaper. Your baby may eat more when he is 6 to 8 weeks old. This is caused by a growth spurt during this age.
  
  
• Prepare and heat formula as directed. Follow directions on the package. Ask your baby's healthcare provider if you have questions about how to prepare his formula.
  
  
• If you are breastfeeding, wait until your baby is 4 to 6 weeks old to give him a bottle. This will give your baby time to learn how to breastfeed correctly. Have someone else give him his first bottle. Your baby may need time to get used the bottle's nipple. You may need to try different bottle nipples with your baby. When you find a bottle nipple that works well for your baby, continue to use this type.
  
  
• Do not prop a bottle in your baby's mouth or let him lie flat during feeding. This may cause him to choke. Always hold the bottle in your baby's mouth with your hand.
  
  
• Your baby will drink about 2 to 4 ounces of formula at each feeding. Your baby may want to drink a lot one day and not want to drink much the next.
  
  
• Your baby will give you signs when he has had enough to drink. Stop feeding him when he shows signs that he is no longer hungry. He may turn his head away, seal his lips, spit out the nipple, or stop sucking. Your baby may fall asleep near the end of a feeding. If this happens, do not wake him.
  
  
• Burp your baby between feedings or during breaks. Your baby may swallow air during breastfeeding or bottle-feeding. Gently pat his back to help him burp.
  
  
• Your baby should have 5 to 8 wet diapers every day. The number of wet diapers will let you know that your baby is getting enough breast milk. Your baby may have 3 to 4 bowel movements every day. Your baby's bowel movements may be loose if you are breastfeeding him. At 6 weeks, breastfed infants may only have 1 bowel movement every 3 days.
  
  
• Wash bottles and nipples with soap and hot water. Use a bottle brush to help clean the bottle and nipple. Rinse with warm water after cleaning. Let bottles and nipples air dry. Make sure they are completely dry before you store them in cabinets or drawers.
  
  
• Get support and more information about breastfeeding your baby.
  • American Academy of Pediatrics
    141 Northwest Point Boulevard
    Elk Grove Village , IL 60007-1098
    Phone: 1- 847 - 434-4000
    Web Address: http://www.aap.org
    
  • La Leche League International
    957 North Plum Grove Road
    Schaumburg , IL 60173
    Phone: 1- 847 - 519-7730
    Phone: 1- 800 - 525-3243
    Web Address: http://www.lalecheleague.org
    

How do I give my baby a tub bath? Use a baby bathtub or clean, plastic basin for the first 6 months. Wait to bathe your baby in an adult bathtub until he can sit up without help. Bathe your baby 2 or 3 times each week during the first year. Bathing more often can dry out his delicate skin.

• Never leave your baby alone during a tub bath. Your baby can drown in 1 inch of water. If you must leave the room, wrap your baby in a towel and take him with you.
  
  
• Keep the room warm. The room should be warm and free of drafts. Close the door and windows. Turn off fans to prevent drafts.
  
  
• Gather your supplies. Make sure you have everything you need within easy reach. This includes baby soap or shampoo, a soft washcloth, and a towel.
  
  
• If you use a baby bathtub or basin, set it inside an adult bathtub or sink. Do not put the tub on a countertop. The countertop may become slippery and the tub can fall off.
  
  
• Fill the tub with 2 to 3 inches of water. Always test the water temperature before you bathe your baby. Drip some water onto your wrist or inner arm. The water should feel warm, not hot, on your skin. If you have a bath thermometer, the water temperature should be 90°F to 100°F (32.3°C to 37.8°C). Keep the hot water heater in your home set to less than 120°F (48.9°C). This will help prevent your baby from being burned.
  
  
• Slowly put your baby's body into the water. Keep his face above the water level at all times. Support the back of his head and neck if he cannot hold his head up. Use your free hand to wash your baby.
  
  
• Wash your baby's face and head first. Use a wet washcloth and no soap. Rinse off his eyelids with water. Use a clean part of the washcloth for each eye. Wipe from the inside of the eyes and out toward the ears. Wash behind and around your baby's ears. Wash your baby's hair with baby shampoo 1 or 2 times each week. Rinse well to get rid of all the shampoo. Pat his face and head dry before you continue with the bath.
  
  
• Wash the rest of your baby's body. Start with his chest. Wash under any skin folds, such as folds on his neck or arms. Clean between his fingers and toes. Wash your baby's genitals and bottom last. Follow instructions on how to wash your baby boy's penis after a circumcision.
  
  
• Rinse the soap off and dry your baby. Soap left on your baby's skin can be irritating. Rinse off all of the soap. Squeeze water onto his skin or use a container to pour water on his body. Pat him dry and wrap him in a blanket. Do not rub his skin dry. Use gentle baby lotion to keep his skin moist. Dress your baby as soon as he is dry so he does not get cold.

How do I clean my baby's ears and nose?

• Use a wet washcloth or cotton ball to clean the outer part of your baby's ears. Do not put cotton swabs into your baby's ears. These can hurt his ears and push earwax in. Earwax should come out of your baby's ear on its own. Talk to your baby's healthcare provider if you think your baby has too much earwax.
  
  
• Use a rubber bulb syringe to suction your baby's nose if he is stuffed up. Point the bulb syringe away from his face and squeeze the bulb to create a vacuum. Gently put the tip into one of your baby's nostrils. Close the other nostril with your fingers. Release the bulb so that it sucks out the mucus. Repeat if necessary. Boil the syringe for 10 minutes after each use. Do not put your fingers or cotton swabs into your baby's nose.

How do I care for my baby's eyes? A newborn baby's eyes usually make just enough tears to keep his eyes wet. By 7 to 8 months old, your baby's eyes will develop so they can make more tears. Tears drain into small ducts at the inside corners of each eye. A blocked tear duct is common in newborns. A possible sign of a blocked tear duct is a yellow sticky discharge in one or both of your baby's eyes. Your baby's pediatrician may show you how to massage your baby's tear ducts to unplug them.

How do I care for my baby's fingernails and toenails? Your baby's fingernails are soft, and they grow quickly. You may need to trim them with baby nail clippers 1 or 2 times each week. Be careful not to cut too closely to his skin because you may cut the skin and cause bleeding. It may be easier to cut his fingernails when he is asleep. Your baby's toenails may grow much slower. They may be soft and deeply set into each toe. You will not need to trim them as often.

How can I care for myself during this time?

• Go for your postpartum checkup 6 weeks after you deliver. Visit your healthcare provider to make sure you are healthy. Take care of yourself so you have the energy to care for your baby. Talk to your obstetrician or midwife about any concerns you have about you or your baby.
  
  
• Join a support group. It may be helpful to talk with other women who have babies. You may be able to share helpful information with one another about caring for your baby.
  
  
• Begin to plan your return to work or school. Arrange for childcare for your baby. Ask your baby's healthcare provider if you need help finding childcare. Make a plan for how you will pump your milk during the work or school day. Plan to leave plenty of breast milk with adults who will care for your child.
  
  
• Find time for yourself. Ask a friend, family member, or your partner, to watch the baby. Do activities that you enjoy and help you relax.
  
  
• Ask for help if you feel sad, depressed, or very tired. These feelings should not continue after the first 1 to 2 weeks after delivery. They may be signs of postpartum depression. Talk to your healthcare provider so you can get the help you need.

Call 911 for any of the following:

• You feel like hurting your baby.
  
  

When should I seek immediate care?

• Your baby's abdomen is hard and swollen, even when he is calm and resting.
  
  
• You feel depressed and cannot take care of your baby.
  
  
• Your baby's lips or mouth are blue and he is breathing faster than usual.

When should I contact my baby's healthcare provider?

• Your baby's armpit temperature is higher than 99°F (37.2°C).
  
  
• Your baby's rectal temperature is higher than 100.4°F (38°C).
  
  
• Your baby's eyes are red, swollen, or draining yellow pus.
  
  
• Your baby coughs often during the day, or chokes during each feeding.
  
  
• Your baby does not want to eat.
  
  
• Your baby cries more than usual and you cannot calm him down.
  
  
• You feel that you and your baby are not safe at home.
  
  
• You have questions or concerns about caring for your baby.

What do I need to know about my baby's next well child visit? Your baby's healthcare provider will tell you when to bring him in again. The next well child visit is usually at 2 months. Contact your baby's healthcare provider if you have questions or concerns about his health or care before the next visit. Your baby may get the following vaccines at his next visit: hepatitis B, rotavirus, DTaP, HiB, pneumococcal, and polio.

CARE AGREEMENT:

You have the right to help plan your baby's care. Learn about your baby's health condition and how it may be treated. Discuss treatment options with your baby's caregivers to decide what care you want for your baby.