Sara Connolly, MD, FAAP, is a Board Certified Pediatrician who practices in Palm Beach County, Florida.
Your baby is 4 weeks old! Can you believe it? Even with the endless eating, sleeping, and pooping, your baby has done a lot of growing in a month. This is about the time your pediatrician will see your newborn for the 1-month check-up. Dr. Sara Connolly answers the questions most parents tend to ask during this first well baby visit.
Bundoo: Most babies will visit their pediatrician at 1 month for a check-up, if they haven’t already been into the doctor’s office. What are you looking for at the 1-month well baby check-up?
Dr. Sara Connolly: Pediatricians love to see babies at 1 month old! Depending on your office, your child may receive their second hepatitis B vaccination at this visit. In addition, there are many issues to discuss. Foremost in our minds is the opportunity to evaluate growth and feeding. For most mothers, breastfeeding is getting easier at this point, so we want to check in to make sure this is true for you and your baby. If not, we can help new moms stay committed to nursing. For both breastfed and formula-fed babies, we want to make sure the baby is gaining weight, growing longer, and that their head is growing well. By this time, there are often new questions about sleep, fussiness, rashes, and stooling patterns, so these can be addressed as well. Finally, we want to know that new families are doing okay. We ask about the adjustment to a new member of the household and how the mother is feeling.
Most babies receive their first Hepatitis B vaccine at birth, with a follow-up shot at 1 month. What would you say to a parent who was worried about this vaccine?
It is important to address any vaccine concerns parents have at each visit. While an infant typically receives Hepatitis B at the 1-month visit, they will receive several vaccines at the 2-month visit, so beginning this discussion early is best. Parents should feel free to bring up any concerns with the doctors. They should know that fever and soreness at the injection site are possible, and they should know what to do if they occur. They should know that the hepatitis B vaccine is a safe and effective cancer prevention vaccine as hepatitis B leads to liver cancer.
What questions should parents have for their doctors at the check-up?
Parents should ask about how well their child is gaining weight. They may want to discuss their baby’s stooling patterns as they can change dramatically between the first days after birth and now. If their baby is spitting up or uncomfortable with feeding, those issues should also be addressed. As families are usually beginning to leave the house more, they may want to ask about travel or how to prevent infections as they venture out into the world. If a family is struggling with bonding, depression, food insecurity, homelessness, or anxiety, be sure to tell the doctor. Parenting an infant is difficult, and there are many resources out there for people who are struggling, but we can’t always tell just by looking at you!
What’s the most common concern you hear from parents that they probably shouldn’t be worrying about at this point?
Parents are always worrying about frequency of stooling. Either they believe the baby is pooping too much or too little. Babies vary so much in how often they poop at this age, but often it is much less frequently than just a week or two ago, which is why they worry. If a baby is comfortable, eating well, and gaining weight, then how often they poop is unimportant. Some babies will stool three times a day or more, and some will not stool every day or even every other day. As long as when it comes, the poop is soft and like paste, then there is nothing to worry about.
Reviewed by Dr. Sara Connolly, May 2020