After you go home, your baby will need to see his or her doctor several days later. There are also a number of other medical issues that your baby may need to follow-up for.
First Doctor’s Visit
Your baby will need to be seen within 2-3 days of discharge from the hospital. This is a standard recommendation for all babies. If your baby has any conditions such as jaundice, low birth weight or feeding problems, then she may need to be seen sooner, in 1 or 2 days. Someone at the hospital should tell you when your baby needs to be seen if it is sooner than 2-3 days. Be sure to schedule this visit as soon as possible.
Your pediatrician should be able to see sick children and newborns within one day or the same day you call.
The main reason for the 2-3 day visit is to check the baby’s weight and feeding status and to evaluate the baby for jaundice. Also, some heart problems and other conditions do not show any symptoms during the first 24-48 hours of life. In the recent past, babies and moms would stay in the hospital for 3-4 days and the baby would be monitored in the hospital. Now, moms and babies go home in 1-2 days and the baby is at home when some of these conditions start to show symptoms. This visit could be one of the most important your baby will have with the pediatrician. Be sure to bring your baby’s discharge paperwork.
Next visits
After the first visit, your baby may need to be seen again in 1-2 days to recheck weight. Many babies are still losing weight at 2-3 days old and don’t start gaining weight until 4-5 days old. If you are breastfeeding and/or this is your first baby, then it is especially important to be sure your milk comes in and the baby starts to gain weight.
Other babies at higher risk, such as late preterm infants or babies with jaundice or higher risk of jaundice, will need close follow-up.
After your baby is feeding well and gaining weight, the next scheduled visit is usually between 2-4 weeks of age. Different pediatric offices handle their schedule for the first 1-2 months a little differently.
For the rest of the check-up schedule and overview of the first year, see Your Newborn’s Health.
Lactation consult
Many mothers and babies would benefit from seeing a lactation consultant in the first week. However, many do not seek care until a minor problem causes a more serious issue. We recommend that all first-time breastfeeding moms and all mothers and babies at higher risk see a lactation consultant the first week. See the Breastfeeding section of this handbook for more information on risk factors for breastfeeding problems.
Other followup your baby may need
Jaundice
Depending on your baby’s risk level of developing jaundice, your baby may need to follow-up with a pediatrician 1 day after discharge instead of the standard 2-3 days. Your baby may also need a bilirubin test in 1-2 days after discharge. If your baby was treated for jaundice with phototherapy in the hospital, your baby may need to have the bilirubin level checked the next day. The hospital staff should inform you of when follow-up is needed.
Hearing screening
If your baby does not pass the hearing test in the hospital, it should be repeated sometime in the next 2 weeks. Usually, this can be done at the hospital. If it is still abnormal, then your baby will need further testing.
Newborn screening
If there are any abnormalities on one of the tests in your baby’s newborn screening, you will be contacted for further testing. It is vital that the hospital has your correct contact information, and that you follow-up with your pediatrician. Sometimes the test has to be repeated because of an error on the blood samples on the form. Babies with low birth weight will also need to have the test repeated at one month of age. Your pediatrician should arrange this.
Breech babies
Babies who were breech at time of delivery OR anytime in the third trimester are at increased risk of developmental dysplasia of the hip (DDH), a condition in which the hip joint is too loose. If left untreated, it can cause the hips not to develop properly. It is easily treated.
Pediatricians check babies’ hips for this condition in the hospital and for about the first 9 months of life at routine well visits. However, since breech babies are at increased risk, current guidelines recommend a hip ultrasound or x-ray in the first few months of life to screen for the condition. Your baby’s pediatrician will need to order this test, which is usually done around 4-6 weeks of life. Some guidelines distinguish between the risk for males vs. females, so talk to your baby’s doctor. IF your pediatrician is not caring for your baby in the hospital, then you will need to tell your baby’s doctor that your baby was breech.
Heart murmur
If your baby was checked for a heart murmur or other heart condition in the hospital, it is likely that your baby will need to follow-up in a few weeks. The cardiologist should let you know what follow-up is necessary.
Enlarged kidneys during pregnancy
If your baby had enlarged kidneys on prenatal ultrasounds that lasted during the third trimester, then further testing may be needed. It is recommended in most cases to wait until after discharge for your baby to have a kidney ultrasound, which means that your pediatrician will need to arrange this test. If your baby’s pediatrician is not the one caring for your baby in the hospital, then you need to be sure to tell your baby’s doctor about your pregnancy history.
Other conditions
- Babies with cleft lip and/or palate will need a referral to the craniofacial clinic at Children’s Healthcare of Atlanta.
- Babies with club foot or possible hip dysplasia will need to see a pediatric orthopaedic specialist.
- Babies with extra fingers or toes will need to see a pediatric surgeon.
- Babies with nerve injury to the arm (brachial plexus injury) will need to see the brachial plexus clinic at Children’s Healthcare of Atlanta (CHOA).