Quick answer: Baby’s first pediatrician check-up — typically at 3–5 days in the UK (midwife home visit) or 2–3 days to 2 weeks in the US (first office visit) — can feel overwhelming when you’re sleep-deprived and still learning your b
Baby’s first pediatrician check-up — typically at 3–5 days in the UK (midwife home visit) or 2–3 days to 2 weeks in the US (first office visit) — can feel overwhelming when you’re sleep-deprived and still learning your baby. Here’s exactly what happens and what questions to have ready.
What the Pediatrician or Midwife Looks For
The newborn examination is a head-to-toe assessment covering: Weight: Compared to birth weight to assess feeding adequacy. A loss of up to 10% from birth weight in the first 3–5 days is normal. Jaundice: Visual assessment of skin and eye color; transcutaneous bilirubinometer check if clinically indicated. Feeding: Questions about frequency, duration, latch (if breastfeeding), amounts (if formula), and nappy output. Head: Fontanelle (soft spot) tension — a bulging fontanelle can indicate raised intracranial pressure; a very sunken one may indicate dehydration. Head shape (some molding and asymmetry is normal from birth). Eyes: Red reflex check — a red-orange reflection confirms the lens is clear and no tumor or cataract is present. This is a critical check. Heart: Auscultation for heart murmurs. Murmurs are common in newborns — most are innocent (benign) and resolve spontaneously. Hips: Ortolani and Barlow tests for developmental dysplasia of the hip (DDH) — checking that the hip joint is well-formed and stable. Tone and reflexes: Moro (startle), rooting, sucking, grasp, stepping, and Babinski reflexes. Genitalia: In boys, confirming both testes are descended. Spine: Checking for sacral dimples, skin abnormalities, or spine deformities.
The Heel-Prick Newborn Screening Test
The newborn bloodspot screening test (heel-prick or Guthrie test) is performed at 5 days in the UK (or 2–3 days in the US). A few drops of blood are collected from the heel and dried on a card to screen for multiple rare but serious conditions: Phenylketonuria (PKU) — inability to process the amino acid phenylalanine; requires a special diet from birth to prevent intellectual disability. Congenital hypothyroidism — thyroid hormone deficiency; highly treatable with early diagnosis. Cystic fibrosis. Sickle cell disease and other hemoglobin disorders. Medium-chain acyl-CoA dehydrogenase deficiency (MCADD) — a fatty acid metabolism disorder. In the US, the panel screens for 30+ conditions varying by state. Results typically come back within 6–8 weeks.
Newborn Hearing Screening
Automated otoacoustic emission (AOAE) or automated auditory brainstem response (AABR) hearing tests are offered to all newborns — typically before hospital discharge or at the first home visit. The test is quick (10–15 minutes), painless, and identifies hearing loss early enough for intervention to prevent speech and language delays. If the initial test doesn’t give a clear result (common in newborns due to fluid in the ear canal), a follow-up test is arranged — this is not cause for alarm.
Questions to Ask at the First Appointment
- Is the weight loss/gain trajectory normal for us specifically?
- Are there any concerns from the physical examination I should know about?
- When should I be worried about jaundice?
- How many wet and dirty nappies should I expect per day this week?
- What’s the plan if breastfeeding is difficult — who should I contact?
- When is our next scheduled appointment?
- What symptoms should prompt an emergency call or visit?
Frequently Asked Questions
My baby’s fontanelle is pulsing — is that normal?
Yes — you can often see or feel the fontanelle pulsing in time with the heartbeat. This is completely normal and simply reflects blood flow through the vessels beneath the membrane. A fontanelle that bulges significantly when baby is upright and calm (not crying) warrants evaluation. A slightly sunken fontanelle in an otherwise well baby is usually normal.
The doctor found a heart murmur — how worried should I be?
Most newborn murmurs are innocent (functional) and reflect normal blood flow through the transitioning cardiovascular system — the ductus arteriosus (a vessel that bypasses the lungs in the womb) takes several days to close fully, and this transition creates sounds. The majority resolve without any intervention. Your pediatrician will tell you whether further evaluation (an echocardiogram) is needed or whether watchful waiting is appropriate based on the murmur’s characteristics.
When should I take my baby to the ER vs. calling my pediatrician?
Go to the ER for: any fever (rectal temperature above 100.4°F / 38°C) in a baby under 3 months — always an emergency, no exceptions; difficulty breathing (ribs showing, nostrils flaring, skin pulling in at the throat, grunting); persistent inconsolable screaming (different from normal cry); blue or pale coloring around the lips; unresponsiveness or extreme limpness. Call your pediatrician for: feeding concerns, jaundice changes, rashes, normal-seeming illnesses, and non-urgent questions.
Related Reading
- Bringing baby home: the first 24 hours survival guide
- Jaundice in newborns: when to worry and when to relax
- Baby’s breathing: what’s normal, what’s not
Found this helpful? Sign up to the LylyMama newsletter for more honest, evidence-based parenting guides delivered to your inbox every week.
