Here’s a breakdown of the recommended pediatric well-child visits and screening tests at each stage of development. This layout will walk you through each visit, the developmental checks, and the recommended screenings and immunizations. Additional screenings (such as allergy, genetic, and lab panels) would be added at the discretion of your pediatrician based on family history and findings at the time of exam. You can also click on the American Academy Of Pediatrics link at the end of this article that lists all additional screenings at each age.
Newborn Visit (3-5 Days After Birth)
Focus: General health, weight gain, feeding, and jaundice.
Screening Tests:
Newborn Metabolic Screening: Typically completed at the hospital; checks for metabolic, genetic, and hormonal conditions (e.g., PKU, hypothyroidism, cystic fibrosis, sickle cell disease).
Hearing Screening: Often done in the hospital with follow-up as needed.
Jaundice Screening: Visual check for yellowing of the skin or a blood test to measure bilirubin levels if jaundice is suspected.
Measurements: Weight, length, head circumference.
Immunizations: If not given in the hospital, the first dose of Hepatitis B vaccine is given.
1 Month Visit
Focus: Feeding, growth, sleep patterns, and parental concerns.
Screening Tests:
Growth Monitoring: Weight, length, and head circumference to ensure appropriate growth.
Developmental Milestones: Assessed informally, focusing on motor skills, tracking objects with eyes, and responsiveness to sounds.
Immunizations: Hepatitis B (if not given previously).
2-Month Visit
Focus: Growth, development, and immunization schedule initiation.
Screening Tests:
Developmental Screening: Observing motor skills (e.g., lifting head), cooing, and smiling.
Hearing and Vision: Observation of the baby’s response to sounds and tracking objects visually.
Measurements: Weight, length, head circumference.
Immunizations:
DTaP (Diphtheria, Tetanus, Pertussis)
IPV (Polio)
Hib (Haemophilus influenzae type b)
PCV13 (Pneumococcal)
Rotavirus (oral vaccine)
4-Month Visit
Focus: Continuation of growth and developmental checks.
Screening Tests:
Developmental Screening: Baby’s ability to roll over, hold head up, cooing, and making eye contact.
Hearing and Vision: Subjective observation by the pediatrician.
Measurements: Weight, length, head circumference.
Immunizations:
2nd doses of DTaP, IPV, Hib, PCV13, and Rotavirus.
6-Month Visit
Focus: Introduction of solid foods, growth, and development,
Screening Tests: Below and as needed for any delays or per AAP periodicity schedule.
Developmental Screening: Sitting with support, reaching for objects, and babbling.
Hearing and Vision: Observation and parental report, vision screening can begin via automated devices.
Measurements: Weight, length, head circumference.
Immunizations:
3rd doses of DTaP, IPV, Hib, PCV13, and Rotavirus.
Influenza vaccine (annually, starting at 6 months).
9-Month Visit
Focus: Growth, fine motor skills, social and emotional development.
Screening Tests: Below and as needed for any delays or per AAP periodicity schedule.
Developmental Screening: Crawling, pincer grasp, and responding to name.
Lead Screening: Especially for children in high-risk areas or older homes.
Vision and Hearing: Continued observation, vision screening device is not previously use.
Measurements: Weight, length, head circumference.
Immunizations: Catch-up vaccines if needed.
12-Month Visit (1 Year)
Focus: Growth, nutrition (whole milk introduction), and motor skill refinement.
Screening Tests: Below and as needed for any delays or per AAP periodicity schedule.
Developmental Screening: Walking, simple words, waving, pointing.
Hemoglobin Test: Checks for anemia (iron-deficiency anemia is common at this age).
Lead Screening: Mandatory in some regions, especially for high-risk children.
Vision and Hearing: Objective testing may start.
Measurements: Weight, length, head circumference.
Immunizations:
MMR (Measles, Mumps, Rubella)
Varicella (Chickenpox)
Hepatitis A (1st dose)
PCV13 (4th dose, if not already completed)
15-Month Visit
Focus: Behavior, emotional and social development, and communication skills.
Screening Tests: Below and as needed for any delays or per AAP periodicity schedule.
Developmental Screening: Speech development, walking independently, and feeding self.
Measurements: Weight and height.
Immunizations:
DTaP (4th dose)
Hib (booster, if needed)
Catch-up on any missed vaccines.
18-Month Visit
Focus: Language development and behavior.
Screening Tests: Below and as needed for any delays or per AAP periodicity schedule.
Autism Screening: Standardized tests like the M-CHAT (Modified Checklist for Autism in Toddlers).
Developmental Screening: Ability to walk well, use 15-20 words, and follow simple instructions.
Measurements: Weight and height.
Immunizations: Catch-up if necessary.
24-Month Visit (2 Years)
Focus: Growth, communication skills, and behavior.
Screening Tests: Below and as needed for any delays or per AAP periodicity schedule.
Autism Screening: Follow-up as necessary.
Developmental Screening: Combining two-word sentences, building towers, and beginning pretend play.
Lead Screening: Follow-up if previous results were elevated.
Vision Screening: Begin formal testing.
Measurements: Weight, height, BMI.
Immunizations: Catch-up if needed.
30-Month Visit
Focus: Further development of social and language skills.
Screening Tests: Below and as needed for any delays or per AAP periodicity schedule.
Developmental Screening: Building three- to four-word sentences, naming objects, and playing with peers.
Measurements: Weight and height.
Immunizations: None routinely recommended unless catch-up is needed.
3-Year Visit
Focus: School readiness, motor skills, and social interaction.
Screening Tests: Below and as needed for any delays or per AAP periodicity schedule.
Vision and Hearing: Objective vision testing and continued hearing assessment.
Developmental Screening: Speaking in sentences, drawing shapes, running, and climbing.
Measurements: Weight, height, BMI.
Immunizations: Catch-up if necessary.
Age 4 Years and Older (Annual Visits)
Focus: Growth, development, and school readiness.
Screening Tests: As needed for any delays or per AAP periodicity schedule.
Developmental Screening: Language, gross and fine motor skills, and behavior.
Vision Screening: Snellen eye chart testing begins.
Hearing Screening: Audiometry testing.
Blood Pressure Screening: Routine from age 3 onward.
Cholesterol Screening: Typically done once between ages 9-11 for children with family history of cardiovascular disease.
Behavioral Screening: Attention, hyperactivity, and emotional well-being.
Measurements: Weight, height, BMI.
Immunizations: Boosters for DTaP, IPV, MMR, Varicella, Tdap, HPV (starting at age 11-12), and meningococcal vaccines.
Additional Screening Tests Based on Risk Factors
- Tuberculosis (TB): Skin testing if child is at risk of exposure.
- STI Screening: For sexually active adolescents.
- Oral Health: Dental visits should start by 12 months.
- Depression Screening: Recommended starting at age 12 and continued yearly. Always consider screening earlier if there is a family history of anxiety or depression.
These well-child visits help ensure children meet developmental milestones, and early screening tests help catch potential health issues before they become serious. Regular pediatric visits also provide an opportunity for parents to ask questions and receive guidance on topics such as sleep, behavior, and safety.
Resources: https://downloads.
