A Rundown of an Infant Well-Child Checkup at 1 Month Old
Feeding and Elimination
- Continue feeding on demand – will average 2-4 ounces every 3-4 hours if bottle-feeding or 15min on each breast every 2-4 hours if breastfeeding (usually taking 20-27 oz. per day).
- No solids or infant cereal until 4-6 months.
- Changes in stooling patterns are normal, it is a problem only if the stool is very hard to pass or running out of the diaper, if blood is noted in the diaper, if the baby is fussy all of the time, if the baby is losing weight, or if going less than once every five days.
- You baby should still be having between 5-8 wet diapers a day.
- Continue vitamin D supplementation until three months for formula fed infants or six months for breastfed infants.
- Average weight gain is initially 2 pounds per month.
- Birth weight is doubled at 4-5 months and tripled at 1 year of age.
General Care and Common Concerns
- The baby can have a bath every 2-4 days once the umbilical stump has fallen off – use an infant bathtub and infant soap to prevent over drying of skin.
- It is ok to use a moisturizer, like Eucerin, for dry skin on an as needed basis.
- Cradle cap – yellow scales attached to the scalp and may be seen on eyebrows. Apply baby shampoo to the baby’s scalp and leave on scalp for 5 minutes, massage into scalp using a baby brush then rinse. After the bath is complete, apply baby oil to the scalp to keep it moisturized.
- Tear duct obstruction – continuously watery eye without swelling or redness of eye or swelling of eyelid. Massage the duct with clean hands to help drainage by gently taking your finger and placing it on the inn edge of the eyebrow and massaging to the corner of the inner eye. Bring your baby in to be seen if the discharge becomes yellow or thick.
- Colic – unexplained crying that usually occurs in bouts when the baby is well fed, dry, and healthy. It usually starts between 3-6 weeks and generally resolves by 3-4 months of age. It is not due to bad parenting and there is no medicine to give. Various soothing techniques like cuddling, rocking, vibrating bounce chairs have been helpful.
- This is a great time to introduce “tummy-time” – this enables the baby to develop strong neck and trunk muscles. A great way to start is to lie on your back and hold the baby on your chest facing you. Gently turn their head from one side to the other and as the baby gains strength, they will achieve this task on their own.
- More awake
- Will follow bright lights and sounds
- Moves all extremities equally
- Startles to loud sounds
When to Call Us
- Fever – a fever in a baby is a temperature greater than 100.4 (38C) rectally. If the baby is unusually fussy, not eating or drinking like usual, or sleeping more than usual, you may take the temperature rectally. Because of the baby’s immature immune system, the baby needs to be evaluated immediately in the emergency department if the temperature is greater than 100.4
- A drastic change in eating, elimination, or behavior pattern.
- 2 months – Pentacel, Hib, PCV13, RotaTeq
- 4 months – Pentacel, Hib, PCV13, RotaTeq
- 6 months – Pentacel, Hib, PCV13, RotaTeq
- 9 months – None or previously missed vaccines
- 12 months – MMR, Varicella, Hep A
- 15 months – PCV13, Hib
- 18 months – DTaP, Hep A
- 24 months – None or previously missed vaccines
- Annually – Influenza (optional)
- Pentacel: DTaP, Hib, and IPV
- DTaP: Diptheria, Tetanus, and Pertussis
- Hep B: Hepatitis B
- Hib: Haemophilus Influenza Type B
- IPV: Polio (inactivated virus)
- PCV13: Pneumococcal Pneumonia
- MMR: Measles, Mumps, Rubella
- Hep A: Hepatitis A
- Varicella: Chicken Pox
- Rotateq: Rotavirus (oral vaccine)
**All vaccines are preservative free (no thimerosal)
**Hep A > age 5 years if at risk, mandatory <5 years
**MCV4/PPSV > 2 years if at high risk