Your Child's Checkup: 1 Month

What to Expect During This Visit

Your doctor and/or nurse will probably:

1. Check your baby's weight, length, and head circumference and plot the measurements on the growth charts.

2. Ask questions, address any concerns, and offer advice about how your baby is:

Feeding. Infants should be fed when they seem hungry. At this age, breastfed babies will eat about eight to twelve times in a 24-hour period. Formula-fed infants consume about 24 ounces a day. Burp your baby midway through feedings and at the end.

Peeing and pooping. Infants should have about six wet diapers a day. The number of poopy diapers varies, but most breastfed babies will have three or more. Around 6 weeks of age, breastfed babies may go several days without a bowel movement. Formula-fed babies have at least one bowel movement a day. Tell your doctor if you have any concerns about your infant's bowel movements.

Sleeping. Infants this age sleep about 14 to 17 hours a day, including 4 or 5 daytime naps. Breastfed babies may still wake often to eat at night, while bottle-fed infants may sleep for longer stretches.

Developing. By 1 month of age, babies should:

• focus and follow objects (especially faces)
• respond to sound by quieting down, blinking, turning the head, startling, or crying
• still hold arms and legs in a flexed position, but start to extend legs more frequently
• move arms and legs equally
• lift the head briefly when on the stomach
• have strong newborn reflexes:
  • rooting and sucking: turns toward, then sucks breast/bottle nipple
  • grasp: tightly grabs hold of a finger placed within the palm
  • fencer's pose: straightens arm when head is turned to that side and bends opposite arm
  • Moro reflex (startle response): throws out arms and legs and then curls them in when startled

3. Do a physical exam with your baby undressed while you are present. This will include an eye exam, listening to your baby's heart and feeling pulses, examining the belly, and checking the hips.

4. Do screening tests. Your doctor will review the screening tests from the hospital and repeat tests, if needed. If a hearing test wasn't done then, your baby will have one now.

5. Update immunizations. Immunizations can protect infants from serious childhood illnesses, so it's important that your baby get them on time. Immunization schedules can vary from office to office, so talk to your doctor about what to expect.

Looking Ahead

Here are some things to keep in mind until your baby's next routine checkup at 2 months:

Feeding

1. Continue to feed your baby when he or she is hungry. Pay attention to signs that your baby is full, such as turning away from the breast or nipple and closing the mouth. Between 6 and 8 weeks, your baby may be hungrier due to a growth spurt.
2. Don't give solid foods or or juice.
3. Don't put cereal in your baby's bottle unless directed to by your doctor.
4. Continue to burp your baby midway through and at the end of feedings.
5. If you breastfeed:
   • If you haven't yet, you can now pump and store breast milk for future use.
   • If breastfeeding is well established, it's OK to introduce a bottle or pacifier. You might need to have someone else offer the bottle if your little one rejects it when you try.
   • Continue to take a prenatal vitamin or multivitamin daily.
   • Ask your doctor about vitamin D drops for the baby.
6. If you formula-feed:
   • Give your baby iron-fortified formula.
   • Follow the formula package's instructions when making and storing bottles.
   • Don't prop bottles or put your baby to bed with a bottle.
   • Talk to your doctor before switching formulas.

Routine Care

1. Wash your hands before handling the baby and avoid people who may be sick.
2. Hold your baby and be attentive to his or her needs. You can't spoil a baby.
3. Sing, talk, and read to your baby. Babies learn best by interacting with people.
4. Give your baby supervised "tummy time" when awake. Always supervise your baby and be ready to help if he or she gets tired or frustrated in this position.
5. It's normal for infants to have fussy periods, but for some, crying can be excessive, lasting several hours a day. If a baby develops colic, it usually starts in an otherwise well baby at around 3 weeks, peaks around 6 weeks, and improves by 3 months.
6. Call your doctor if your baby has a fever or is acting sick. Don't give medicine to an infant younger than 2 months old without talking to your doctor first.
7. It's common for new moms to feel tired and overwhelmed at times. But if these feelings are intense, or you feel sad, moody, or anxious, call your doctor.
8. Talk to your doctor if you're concerned about your living situation. Do you have the things that you need to take care of your baby? Do you have enough food, a safe place to live, and health insurance? Your doctor can tell you about community resources or refer you to a social worker.

Safety

1. To reduce the risk of sudden infant death syndrome (SIDS):
   • Let your baby sleep in your room in a bassinet or crib next to the bed until your baby's first birthday or for at least 6 months, when the risk of SIDS is highest.
   • Always place your baby to sleep on a firm mattress on his or her back in a crib or bassinet without any crib bumpers, blankets, quilts, pillows, or plush toys.
   • Avoid overheating by keeping the room temperature comfortable.
   • Don't overbundle your baby.
   • Consider putting your baby to sleep sucking on a pacifier.
2. Don't smoke or use e-cigarettes. Don't let anyone smoke or vape around your baby.
3. Always put your baby in a rear-facing car seat in the backseat. Never leave your baby alone in the car.
4. Keep all cords, wires, and toys with loops or strings away from your baby.
5. While your baby is awake, don't leave your little one unattended, especially on high surfaces or in the bath.
6. Never shake your baby — it can cause bleeding in the brain and even death.
7. Avoid sun exposure by keeping your baby covered and in the shade when possible. Sunscreens are not recommended for infants younger than 6 months. However, you may use a small amount of sunscreen on an infant younger than 6 months if shade and clothing don't offer enough protection.

These checkup sheets are consistent with the American Academy of Pediatrics (AAP)/Bright Futures guidelines.