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 several 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 16 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 (startle response): throws out arms and legs and then curls them in when startled

3. Perform 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. Update immunizations. Immunizations can protect babies from serious childhood illnesses, so it’s important that your child receive 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 next routine visit at 2 months:

Feeding

1. Continue to feed your baby on demand (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 introduce solids or juice, and don’t put cereal in your baby’s bottle unless directed by your doctor.
3. Continue to burp your baby midway through and at the end of feedings.
4. If you breastfeed:
   • You may now begin pumping and storing breast milk for future use.
   • If breastfeeding is well established, it’s OK to introduce a bottle or pacifier.
   • If you plan on going back to work, introduce the bottle in the next few weeks to get your baby used to bottle-feeding.
   • Continue to take a prenatal vitamin or multivitamin daily.
   • Ask your doctor about vitamin D drops for the baby.
5. 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 newborn.
3. 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.
4. 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.
5. Use fragrance-free soaps and lotions.
6. Call your doctor if your baby has a fever or is acting sick. Don’t give medication to an infant younger than 2 months old without consulting a 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. TV viewing (or other screen time, including computers) can interfere with the brain development of young children. Therefore, TV is not recommended for those under 2 years old.

Safety

1. To reduce the risk of sudden infant death syndrome (SIDS):
   • 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 let anyone else smoke around your baby.
3. Always put your baby in a rear-facing car seat in the backseat.
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.