So, you went to the hospital and have now returned with a brand new addition to your family! Congratulations! Very soon you will need to go visit the pediatrician - below is important information as well as some tips that can help with your first visit.
When should the first pediatrician visit occur?
Most parents pick a pediatrician before they have their baby. This may be the physician for older children in your family, or you may find this person through family or friend referral, or even the Pediatrician you were “assigned” and grew to love in the hospital. Even if you’ve met and “interviewed” this person, the first visit can be a little nerve-wracking. The American Academy of Pediatrics (AAP) recommends that the first visit occur at 3-5 days of your baby's life, and should occur even earlier if your physician has significant concerns. You should ask the doctor you see in the hospital when this visit should occur. To make sure you can get the baby in for an appointment at a time that works for your family, try to schedule this appointment while you're still in the hospital.
Getting ready for the first visit
Keep in mind that babies come with a lot of "equipment"...strollers, blankets, car seats, bottles, diapers... make sure that you leave at least an hour to gather all of this up before you even think about heading out for your first few appointments. And, while most pediatricians will have changing materials, it's best to be sure you pack up some diapers and changing materials for your appointment.
What to bring to your first appointment
Be sure to bring your hospital discharge paperwork to your first visit. This lets your pediatrician know important facts such as if your child got their first Hepatitis B vaccine in the hospital, his or her birthweight and other important information about both Mom's and baby's health during the pregnancy. It also will detail any delivery events or exam findings noted by that first doctor who saw your baby. This helps cue the doctor who will be seeing the baby on a more long-term basis into any concerning findings that may need to be followed up after your baby is discharged from the hospital.
With a new baby at home, questions are likely to come up on a daily basis. And, you may have quite a few questions you’d like to ask your pediatrician at these first couple of visits. To ensure that you remember to ask everything you’d like answered, it may help to make a list to bring to your appointment. Parents are often overwhelmed at these first visits, and they can seem like a whirlwind. So, if you bring a pad of paper and pen, you can also jot down the answers to be sure you remember what you’ve been told.
Oftentimes, there isn’t time to cover a full family history of disease at that first visit with your new pediatrician. But, while in the comfort of your own home, and during these first few months of life, it may be worthwhile to think about your family history ahead of time (and write it down)… it helps the doctor know possible diseases or problems your child is at risk for, at present, or in the future.
Pictures are worth a thousand words
Finally, a picture is worth a thousand words. A video is worth even more. If you have any concerns about your baby, take a picture or video and bring it to your doctor appointment. Even if the picture is on your cell phone, that’s better than nothing! By the time you come to see the doctor, the rash you were worried about may have disappeared, or the behavior your infant was demonstrating may not happen in the doctor’s office...so if you can show either a picture or video to your pediatrician, the pediatrician will be much more likely to be able to judge if it is abnormal and requires further testing, or if (hopefully) you can rest assured.
What will happen during this visit
In addition to answering your questions, the pediatrician will likely “fill in the blanks” and give you advice on what to expect, feeding, stooling, skin care, sleep and safety… much of what’s provided in our articles. They will also let you know of worrisome signs that may show up in these first couple of weeks, such as what qualifies as a fever (typically higher than 100.4 F rectally) and when you should even check the temperature, what sort of “spit up” is normal (e.g. a little “dribbling” is okay but it should never be projectile or “shooting”). If these aren’t made clear to you at the visit, you should ask about these. Even if you don’t think you have questions right now, you may wish you’d asked them after you get home and before your next visit.
Your paperwork from the hospital will indicate if any vaccines were given in the hospital (usually your child's first Hepatitis B shot is given in the hospital). If, for some reason, your infant did not receive the first Hepatitis B vaccine in the hospital, your child will likely need this at his or her first visit.
The pediatrician you see as your child’s primary caregiver may not be the one you saw in the hospital right after birth, so your new pediatrician will likely want to do a full exam and history for the child. They’ll examine things such as their muscle tone, look for any rashes, and evaluate the infant for congenital anomalies such as limb defects. The doctor will want to be sure they have good pulses (especially in the groin area to screen for heart/vessel anomalies), that their hips are stable, their eyes and spine look okay (e.g. no spinal dimples which can be a sign of spinal cord problems if the doctor can’t see the bottom of the skin in the dimple), and to be sure they demonstrate the appropriate neurologic reflexes. Also, they will check the genitalia to make sure they look normal. If your child was circumcized, the pediatrician may check to be sure it’s healing okay.
The first visit with your baby to see the pediatrician can be exciting and scary all at the same time. The above information is to help make this first visit smooth. Barring any significant concerns, your next visit will typically be right around when the child is 10 days to 2 weeks old. The American Academy of Pediatrics (AAP) recommends that this second visit occur “by one month of age”. It may be best to make this appointment before you leave the office so that you can ensure this timeslot works for your new family and that you get to see the same doctor.
American Academy of Pediatrics. Recommendations for Preventive Pediatric Health Care. 2010.