Why your baby needs so many doctor's appointments

Does it seem like there are a lot of doctor appointments for your new baby? All those checkups let the doctor get to know your baby.

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One week, two weeks. One month, two, four, six, nine, 12 months. You’ll see the doctor a lot during the first year of your baby’s life. Beginning at two months, well-baby visits usually coincide with scheduled immunizations. But there are other important reasons for regular baby doctor visits.

“The first two years of life are key in terms of development,” says Montreal paediatrician and Canadian Paediatric Society spokesman Denis Leduc. “If there are delays in achieving certain developmental milestones or if parents have any concerns about their child’s progress, these can be addressed quickly if we’re seeing the baby regularly.” Here’s what your doctor is looking for at all those visits:

Is the baby feeding well?
“We want to know about input and output,” says Leduc. “We want to know about feeding patterns for both breast- and bottle-fed infants. For breastfed babies, this involves the frequency and duration of feedings. For bottle-fed babies, we have guidelines for amounts and frequency of feedings according to age.” Leduc adds: “If a mom is experiencing any difficulties with breastfeeding, the earlier the doctor can refer her for breastfeeding support, the better.”

Is the baby growing well?
Your doctor will plot your baby’s weight, height and head circumference on a chart to track her rate of growth. Most babies will stay on a consistent curve, gaining weight and length at a steady rate. A deviation — growing more quickly or slowly — may indicate a problem. If, for instance, a baby’s rate of growth significantly slows, the doctor will be concerned that she isn’t getting enough calories or that she may not be absorbing enough nutrients.

Is the baby developing normally?
At each visit, your doctor will perform a complete examination of the baby, which includes checking his skull for abnormalities of shape and to make sure the fontanelles (soft spots) are closing up. Your baby will be screened for congenital dysplasia, a condition where the hips dislocate. In a young baby, the umbilicus will be checked. The physical examination should cover all of the systems, including heart and lungs, bones and joints, eyes, abdomen, nervous system, genitals and skin.

Your baby should be screened for hearing loss at birth (many provinces do this), and inquiries about hearing should continue at each doctor’s visit. As your baby grows, the doctor will ask you about his motor skills and how he’s sleeping, playing, using language and interacting with others. “I always ask if parents talk to the baby, and I encourage them to start reading early on,” says Leduc.

Do the parents have up-to-date safety information?
Your doctor may ask whether you’ve turned down the thermostat on the water heater to prevent burns, locked poisons in a high cupboard and have a proper car seat safely installed in your vehicle. The doctor will also discuss sleep. The Canadian Paediatric Society advises parents that for babies up to six months old, the safest place to sleep is in a government-approved bassinet or crib in the parents’ room. “If parents say they’re sharing their bed with the baby, we stress that this does increase the risk for SIDS, which can also be reduced by breastfeeding, not smoking, not drinking alcohol and not taking sedating drugs. Parents should also take precautions to make sure there’s no danger of the baby falling,” says Leduc.

How is the family coping?
Leduc talks with parents about how they’re dealing with crying. Are they finding it upsetting? Are they finding effective ways to soothe the baby? “If we have concerns, we can arrange for a visit with a public health nurse in the home,” says Leduc.

Are there any questions?
Leduc advises parents to write down any questions they have and begin the appointment by checking when would be the best time to ask them. “It’s incredible,” says Leduc. “About 90 percent of the time, the most important thing will be brought up as the visit is winding down.”

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