Welcoming a new baby is a time of joy and excitement. But for many, especially new parents, it is also a time of anxiety and stress. At Summit Health, our pediatricians are here to guide you through the ups and downs of the newborn stage and answer your questions about common concerns like feeding, sleeping, and development.

Knowing what to expect at your newborn’s first pediatrician visit can help you stay organized and get the most out of your checkup. Babies should come in for their first appointment within two to three days of leaving the hospital. Sometimes the doctor may recommend you visit the pediatrician the day after discharge if your baby needs to be checked sooner.

“It is important to attend all scheduled visits throughout the first year of life and beyond,” says Catalina Scarfone, DO, a pediatrician at Summit Health. “There are many things that are reviewed and discussed according to the child's age and individual progress. As pediatricians, we can provide the most well-rounded care for children when working together with parents. Together, we can ensure good communication, adherence to visits and recommendations, and provide thorough education every step of the way.”

Prepare Ahead of Time

Taking a newborn out of the house can be overwhelming. Leave for the appointment 15 minutes early so you are not in a rush. Babies can be unpredictable—they may need to eat or have a diaper change—and this will give you plenty of time to organize yourself in the waiting area.

Ask your physician’s office if they have a separate newborn waiting room that keeps their tiniest patients isolated from older children who may be sick. If there is not a dedicated area, find a seat in the corner several feet away from other patients. It is also a good idea to keep the car seat covered while walking through public spaces.

“It is normal to feel worried about bringing your baby out in public during the pandemic,” says Erica Gennaro, MD, another pediatrician at Summit Health. “We try to group well visits together to prevent overlap with sick visits. The rooms are also thoroughly cleaned between patients. Parents should wear a mask and wash their hands before leaving the office.”

What to Bring to the Appointment

Parents should bring their discharge paperwork from the hospital as well as their insurance card. Remember to pack the diaper bag with all the essentials—a change of clothes, diapers, an extra bottle of formula if you are not breastfeeding, a pacifier if your baby uses one, and a blanket to put underneath your baby when the doctor is examining them on the table. Dress your bundle of joy in loose-fitting clothing that can be easily removed, such as a onesie.

Usually, pediatricians recommend bringing your partner or another caregiver; however, Dr. Scarfone explains that while COVID-19 protocols are in place, we are only allowing one caregiver to be in the room for the appointment. “We do ask the partner to call in, and some even choose to FaceTime so they can really be present for the visit,” she says.

Be Ready for Paperwork

Before you go into the exam room, the receptionist will ask you to fill out several documents. You will be asked about your pregnancy, delivery, and medical history. The pediatrician will want to know if there were any complications during your pregnancy or birth.

Checking the Essentials

A typical appointment lasts about 30 minutes. When you are called into the exam room, you will be asked to undress the baby. The nurse or medical assistant will then measure the baby’s weight, height, and head circumference. They will also check vital signs, including heart rate, respiratory rate, and temperature.

Dr. Gennaro encourages her patients to breastfeed during the appointment if it is helpful. “A common misconception is that we are uncomfortable with you breastfeeding in the room,” she says. “On the contrary, we encourage it. Breastfeeding keeps babies calm while we talk to you, and we want them to get the nutrition they need.”

The Doctor is In

The pediatrician will examine your baby thoroughly from head to toe, paying special attention to their skin, head, eyes, ears, nose, mouth/tongue, clavicles, heart, lungs, umbilical cord, belly, back, and extremities.​​ Dr. Gennaro says the most common problems they may find, and recommend further testing for, include jaundice (yellowing of the skin), heart murmurs, hip instability, or dimples at the base of the spine.

Your pediatrician will ask about the baby’s feeding schedule, along with wet and dirty diapers, and review safety measures such as umbilical cord care, use of car seats, and water temperature for bathing. Finally, if your baby did not have a hepatitis B shot at the hospital, they will administer one. Other vaccinations are not due until the baby is 2 months old.

Do not be alarmed if your infant has lost weight—it is perfectly normal. Most babies gain this weight back by their next checkup in two weeks. “A lot of the visit will be about feeding your baby and making sure that they are getting enough nutrition to grow,” describes Dr. Gennaro. “Your baby will be weighed, and the doctor will talk about how it compares to their weight at birth.”

Time for Questions

At the end of the appointment, there will be time to ask all your questions. Write down the questions you have for the doctor ahead of time. Some patients are nervous about speaking up at their first visit, but do not be shy. The pediatrician schedules in plenty of time to listen to your concerns—and every question is welcome!

“The most common misconception parents have is that we are annoyed by all of your questions. It is normal to be a little overwhelmed, tired, confused, and worried, but we are here to support you,” says Dr. Gennaro. “If we do not have enough time to answer your questions at the first visit, we can always schedule another in-person or virtual visit to talk more.”

Some of the most common questions new parents have include:

• Is my baby eating enough? Is spitting up normal?
• What can I do to get my baby on a regular sleep schedule?
• Is my baby’s behavior normal? What developmental milestones should I see in the coming weeks?
• How many times a day should I need to change my baby’s diaper? Does the baby’s stool look normal?
• Should I put anything on my newborn’s skin rashes?
• Why is their breathing so noisy?
• How do I care for my baby’s umbilical cord?
• When should I come back for an appointment?

In the first newborn visit haze, many parents forget what the doctor said by the time they get home. Bring a pen and paper with you and take notes. For your convenience, the physicians at Summit Health will also send you a summary of the appointment through the patient portal for you to reference.

Advice for Parents

Dr. Scarfone also recommends these helpful tips to help keep your baby healthy and safe.

• Monitor newborn's feedings. In the newborn period, it is important to ensure that the baby is feeding at least every 2 to 3 hours. They should be averaging 8-12 feedings in a 24-hour period. Watch for hunger cues such as rooting (turning head with mouth open), crying, or putting hands in their mouth. “Feedings at these times is what we refer to as 'on demand.' Ensuring adequate feedings, even if it means waking them up when they are sleeping in the first few days, will help ensure adequate nutrition and growth.” 
• Holding a baby too much will not spoil them. “It is impossible to spoil a newborn. Listen to your baby's cues and be attentive to their needs especially in the first few months.”
• Babies do not need daily baths: “We advise waiting to give baths until the umbilical cord has completely fallen off. You can keep the baby clean with warm water and wipes. Make sure the cord area remains as dry as possible. Once the cord falls off, daily baths can dry out the skin. Every other day or so is perfectly fine during this period.”
• Avoid co-sleeping. “We recommend against parents and infants sharing a bed because of the significantly increased risk of sudden infant death syndrome (SIDS). To reduce this risk, it is also advised that infants be placed on their back when they sleep.”

See You Next Time

The next appointment will depend on whether there is any need for follow-up, explains Dr. Scarfone. At this age, pediatricians are most concerned with the baby gaining enough weight. Most babies come back for their next visit at 2 weeks of age. Plan to see your pediatrician at least six times throughout the first year. 

“If the baby is losing weight, we will typically have you return in a few days or a week to monitor weight gain, or if the umbilical area was cauterized and needs to be monitored, that would be a weekly check as well,” explains Dr. Scarfone.