Two-Week Checkup

Date ______________________________________

A.  MEASUREMENTS                   

Length _________________ in     (         %tile) 

Weight ___________ lb ___ oz    (          %tile) 

Head Size ______________ cm    (         % tile)

B.   FEEDING

Milk - Most full term infants will now be taking 20-26 oz. formula or breast milk over a 24 hour period. Usual feeding intervals are 3-5 hours. Most babies will not sleep all night until they weigh 14-18 lbs. If you feel your child is not tolerating his formula, please notify us so that we can help you choose the best formula for your baby. Please do not randomly change from formula to formula without checking with us first.

Holding your baby while you feed her is very important. Propping the bottle increases the danger of your baby choking, and it deprives her of contact with you, which is most important! Burp her halfway through feeding and also at the end of feeding. If she has more spitting than usual, try burping more frequently.

Water - Although routine water feedings are no longer recommended for most infants, it is occasionally recommended during the hot summer months or if the infant is experiencing constipation (very firm, hard stools). In those instances, offer water once or twice a day between feedings. City water may be given from the tap; well water should first be boiled.  Do NOT add sugar or syrup! Do not be concerned if infant does not take water; he will take it if needed.

Solids - Do not start feeding with cereal or other baby foods until your baby is six months of age.  Early introduction of solid foods increases the risk of food allergies, and also gives your baby more calories than she needs, contributing to problems of being overweight.

C. DEVELOPMENT

As a part of your infant's well-child visits, we will closely watch his development - the rate at which he learns to do new things.  Please remember that "average" ages for specific motor, speech, and social skills are only approximations and may have wide ranges. Normal children may learn some skills early, some at the "average" age, and some later. The guidelines which we describe are only to give you an idea of what to expect. You will be promptly advised if we feel that your child's development is not normal.

D. IMMUNIZATIONS AND LABORATORY STUDIES

As long as your baby received the Hepatitis B vaccine in the hospital, there are no vaccines today.

E. GENERAL CARE AND GUIDANCE

(1) VITAMINS AND IRON - Extra amounts of vitamins D are recommended until your baby is one year old, at which time we recommend a multivitamin.  However, if your infant takes one of the commercially available formulas, it is  not necessary to give additional vitamins since extra amounts have been added to these milks by the manufacturer. Although breast milk does contain some vitamins, the amount is variable. We therefore recommend a vitamin supplement in nursing babies until they are weaned; additional iron is not necessary.

(2) FLUORIDE - To prevent tooth decay, a fluoride supplement is currently recommended by the American Dental Association for all children, starting with appearance of the first tooth (approx. age 4-6 mo.) through the full maturation of adult teeth (in adolescence). Most city water supplies have fluoride supplement. If, however, your home uses well water, you may need a prescription for fluoride drops, but it is necessary to test your well water first since some well water contains natural fluoride. Please continue to have the prescription refilled until 3 years of age at which time we will substitute a single fluoride tablet once daily. Exclusively breast fed infants will also be provided a fluoride supplement once the first tooth appears, as breast milk contains inadequate fluoride. You should be careful not to give more than the recommended dose, because too much fluoride can be harmful to the teeth. 

(3) FEVER - All fevers greater than 100.4 degrees rectally during the first six months should be reported to us. This is especially important in the first two months, as small infants do not tolerate illnesses as well as older children. Instructions for fever medications are contained in a separate instruction sheet.

(4) SPITTING - Many babies spit small amounts of milk and food after feedings and occasionally between feedings. Usually the amounts lost are insignificant and do not affect the child's growth or indicate a serious problem. However, repeated vomiting of large amounts and any forceful vomiting should be reported to us immediately.

(5) CRADLE CAP - Shampoo daily if crusts of cradle cap appear. Massage scalp with mineral oil or petroleum jelly to loosen scale, then scrub scalp gently - including soft spot - with wash cloth or soft brush.  If regular shampoo doesn't help, a selenium containing product, such as Selsun Blue, may help.

(6) DIAPER RASH - Change more frequently and bathe diaper area gently with damp cloth after each soiling. Diaper wipes can increase the irritation and should be avoided. Apply any of the available diaper ointments. For persistent rashes leave your baby out of diapers as much as possible for 2-3 days. If area still fails to clear or if blisters are found, we may need to see her in the office.

(7) PACIFIERS – The most recent research indicates that infants who use pacifiers may have added protection against Sudden Infant Death Syndrome (SIDS).  However, pacifier use past six months of age has also been recognized as a contributing factor to recurrent ear infections.

 F. REMINDERS AND PRECAUTIONS

(1) Siblings: Allow older brothers and sisters to assist you in caring for the new baby. Let him be "their baby" also. In addition try to spend a few minutes every day with each older child on a one-to-one basis while baby is asleep.

(2) Falls: Avoid leaving baby unattended on dressing tables, counter fops, beds, or sofas. Falls are very common at this age.      

(3) Burns: Turn water heater to less than 120° F (warm) to help prevent burns. Also, do not drink hot liquids near your baby or warm bottles in a microwave.

(4) Car Seats: Babies must ride rear-facing until 20 lbs AND at least 1 year of age, by law, but it is much safer to keep them rear-facing even longer to prevent spinal cord injuries which easily occur with crashes when a baby faces forward. NEVER place your baby in the front seat of a car.  For more information, visit http://www.buckleupnc.org/.

(5) Sleep Position: Sleeping on back is best to help prevent SIDS.  However, keep your child upright after feedings, and encourage "tummy time" to help prevent flattening of the head.

(6) Routines: Hold your baby often, speak to him frequently, and try to maintain a relaxed home atmosphere. When possible, establish a regular routine for feeding, bathing, sleeping, and play but avoid being overly rigid. When questions or problems arise, allow us to help you with them. A relaxed, calm, unworried family is the most important single ingredient to good infant care.

For additional safety tips, visit http://www.aap.org/healthtopics/safety.cfm

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

We will see your infant at one month of age to check for adequate weight gain and to provide the second Hepatitis B vaccine.  The next complete well baby checkup is at two months of age.  Your baby will receive several vaccines at that office visit. 

Last modified: Monday February 16, 2015