Things you should know about Infant Well-Child visits

By Phumeza Msikinya, MD

Everyone needs to be proactive with their health by having a well visit at least once a year. However, for infants, it is important to have those visits more often. The American Academy of Pediatrics recommends at least nine well visits in the first three years, in fact.

Four or five of those visits should ideally take place during baby’s first year. What should parents anticipate for those evaluations? Here are some general guidelines for four of them.

Four months

At this well visit, the caregiver will want to know about smiling and laughing, babbling and cooing. Does your child smile? Respond to loud noises? Reach for toys? Other milestones for this age:

  • Looks at caregivers
  • Enjoys playing with others
  • Copies some sounds
  • Follows objects with eyes
  • Has good head control
  • May be able to roll from tummy to back
  • Receives second doses of Rotavirus, DTap, Hib, PCV13 and IPV.

Babies this age should still avoid solid foods, water and juices. Breast milk or iron-fortified formula are still the ideal.

Six months

At this well visit, the caregiver will want to know about your child’s social interactions with caregivers. Does the child recognize familiar faces and friends? Is he/she stringing words together? Beginning to recognize names? Rolling over and standing with help? Other milestones for this age:

  • Explores with eyes and mouth
  • Touches reflection in the mirror
  • Bangs and shakes toys
  • Rocks back and forth, may sit briefly
  • May receive third doses of Hepatitis B, Rotavirus, DTap, PCV13 and IPV.

Babies this age should be able to begin eating single ingredient foods. But they should avoid honey, peanuts, tree nuts, fish and shellfish.

Nine months

At this well visit, the caregiver will want to know more about social interactions, such as whether there’s a fear of strangers, whether the baby is able to follow the parent’s gaze, if whether the child seeks familiar caregivers for comfort. Other milestones include:

  • Repeating consonants and vowels
  • Copies sounds and gestures
  • Understands “no” and “come here”
  • Looks for things after they fall
  • Crawls, sits and beginning to pull up to stand
  • May receive third doses of Hepatitis B, IPV and seasonal influenza.

Continue to introduce single ingredient foods, but limit the size of bits to avoid choking.

Twelve months

At this well visit, the caregiver will want to know if the child is waving goodbye, imitating behavior, playing “peek-a-boo” or “pat-a-cake” and handing things to you. Generally the fear of others peaks at about this age. Other milestones include:

  • Speaking a few words and babbles
  • Copying more sounds and gestures
  • Follows simple directions
  • Uses objects like drinking cups correctly
  • Points to desired objects
  • Pulls to stand and may take independent steps
  • May receive third doses of Hepatitis B, HIB and IPV, first dose of MMR, Varicella, Hepatitis A and seasonal influenza.

For nutrition, three balanced meals with two to three snacks a day are common; you may introduce whole milk.

Of course babies vary some in progressing through these steps. Be sure to talk to your family doctor or pediatrician if you have questions or concerns.


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