From birth until their teens, children’s pediatricians will ask a LOT of questions to make sure each child is reaching their developmental milestones, living in a happy and healthy home environment, and eating and sleeping regularly. A lot of these questions may seem standard, but some will elicit a few eyebrow raises from mom and dad.
And while a new baby may still keep most parents on their toes, after just a few months of life, his or her sleeping and eating habits will become predictable and their physique will become more like a little person and less like a newborn.
But still, with all the things one may believe they have come to know, understand, and anticipate as a parent, there are at least one million more things that doctors look out for that we as parents are unaware of.
Some questions a pediatrician asks may seem ridiculous and unimportant, even hard to follow or even remember given that most days are spent caring for a child, but the wrong answer to one of those questions can be life-threatening for an infant. Here are 15 things pediatricians want to know that parents should not brush off and why.
15 Is He Smiling?
It's crazy to think that something as simple as smiling can help identify how well your baby is developing.
Pediatricians typically ask whether or not your baby is smiling at appointments during their first year of life.
Neonatal smiling occurs from birth to one month of age and shows no emotions. These smiles are spontaneous and often occur while the baby is drowsy or during REM stages of sleep. Baby smiles are subcortical, meaning they are a reaction from the brain, and will actually decrease with maturity. And, contrary to popular belief, baby smiles have nothing to do with gas.
Any time between six to 10 weeks in when your child's pediatrician will ask if you've witnessed your baby's first smile. That's because, at that age, your baby’s brain is developing, her vision is improving and she can recognize your face. Your baby will likely respond to noises first, such as music or a parent's voice. She or he will then respond to a combination of objects or images and sounds. And lastly, as your baby grows he or she will be able to smile from visual stimulation alone.
Your doctor will know what to look for if your baby is still not smiling by three months. According to the Mayo Clinic, not smiling by a certain age, usually between four and six months, can be a sign that your baby may be autistic. Seek advice from a medical professional if your six month old baby has not reached the smiling milestone.
14 Is She Cooing?
That indistinct babble, high-pitched noises, and long cooing are actually your baby's way of communicating and the first steps he or she may be taking to develop actual speech.
During your baby's first several weeks, any communication is mainly through crying. But around 8 weeks, there's a lot of activity that begins to take place in the brain's front temporal lobe (the brain's speech center) that lets your baby coo. "I often half-jokingly say that if she has a social smile, can follow movement with her eyes and can coo, it means she has the ability to go to college, since there's so much that has to be working right in the brain for these things to occur," says Dr. Stein, director of developmental pediatrics of Rady Children's Hospital, San Diego.
Babies who coo use the back of their throat to create vowel sounds. As a parent, you can encourage your baby to coo by talking to them and narrating your life.
Here's a stellar example: "First we're going to take a bath, then we're going to put our pajamas on and get ready for bed. How does that sound?". However, don't expect your baby to coo on command. Babies at around 3 months of age are still developing the ability to communicate and coo. If your baby still does not spontaneously coo by 3 months hearing tests may need to be performed as that could be an indication of inner ear problems, brain developmental issues, or autism.
13 How Long Does It Take Her To Eat?
This question always made me roll my eyes. Every breastfeeding group, forum, and mother will tell you to never watch the clock while breastfeeding.
It makes each feeding feel like an eternity and if your baby stops before it's "time" it can lead to tons of anxiety for mom.
Yet, this remains a very routine question for pediatricians to ask. "Knowing an estimate of how long a baby is eating at the breast helps determine whether or not good breastfeeding practices are being developed," explained Dr. Benjamin, pediatrician at Brooklyn's medical clinic.
As babies age, they may spend less time on the breast since they have figured out how to get milk out more quickly. Younger babies may need to spend more time and be fed on both sides since they have yet to get the hang of it.
A pediatrician will also ask about the frequency you feed your baby.
Medical professionals of La Leche League say that for babies under six months of age, milk should be the main food source. Since breast milk is easy to digest, mothers should not go more than four-hour intervals of feeding a baby, because all of the milk a baby would have eaten previously will have been easily absorbed by that time. Telling your pediatrician how often and how long you feed your baby will allow them to gauge whether or not your baby is eating enough and could be the explanation behind weight gain, weight loss, or failure to meet weight milestones.
12 How Many Ounces Is He Getting?
Much like the question pediatricians ask about breastfed babies, regarding the amount of time they eat, pediatricians will ask parents of bottle-fed babies how many ounces their child is drinking. Whether your baby is formula fed or fed breastmilk from a bottle, most childcare experts will tell parents to follow a general rule of thumb regarding the amount of milk that should be given.
As a general rule: give 2.5 ounces for every pound your baby weighs in a 24 hour period.
Asking about the amount of milk our child is getting can help diagnose or rule out stomach and growth issues your little one may be having.
During your child's wellness visits try to be forthcoming about your baby's eating habits in order to help your doctor give your little one the best care. If your baby is formula fed different kinds of formula could cause different disorders in your child, so make sure to choose brands wisely and follow instructions when preparing formula. When preparing formula, be sure not to add more or less water than recommended.
According to BabyCenter, if formula is too diluted, your baby will be undernourished; formula that's too strong can dehydrate your baby. Cow's milk formula is the most common allergy trigger in infancy and can lead to colic (frequent bouts of crying), digestive difficulties, and blood-tinged stools. If these symptoms occur in your baby your pediatrician may request you switch formulas.
11 Just What Exactly Is She Eating?
For some moms, combination feeding is the best option. This means feeding your child both breastmilk and formula.
If mom isn't producing enough milk, needs extra sleep, wants to get dad more involved with feeding, or some other reason, combination feeding can be a great solution.
For pediatricians, knowing what a baby is eating can help to determine the quality of health of the baby. Because babies can develop milk allergies it is important to monitor your diet, Mom, as well as the type of formula you are giving your little one.
If you need to supplement your infant's diet with pumped breast milk and formula, they may be mixed together safely in the same bottle. At the Cincinnati Children's Center for Breastfeeding Medicine,
Medical director Dr. Geraghty recommends that you prepare several smaller 2 oz bottles in case your child doesn't finish. Once a baby sucks on a bottle, the remaining contents should be discarded.
As you initiate bottle-feeding, begin with the smallest nipple size, since a slow-flow one most closely mimics your own body. Many moms of twins find that it works best to nurse only one baby at each feeding and bottle-feed the other, alternating so that each child gets to nurse at every other feed. Make sure to keep your pediatrician in the loop, although your feeding schedule may seem like second nature.
10 Does He Follow You With His Eyes?
The ability for your baby to follow you with their eyes is one of the first milestones parents often notice. It may seem pretty cool to know your baby can follow you around with their eyes, but not important enough to write down.
The thing is, it's actually a pretty big deal. Not just because your baby is finally paying attention to you, and following you with her eyes, but also because it indicates that her neurological growth and ability to communicate are on track. When your baby follows you with their eyes, he or she is demonstrating that his or her brain is registering a familiar face. In a sense, it's like saying, "Hey, I know who you are."
Pediatricians will ask whether or not your baby is following you with their eyes by around the two-month check up mark. But don't fret if your little one is not there yet. Many babies reach their milestones at individual times, but if your little one still is not able to show signs of facial recognition and awareness by about three months many doctors would suggest vision testing to rule out eye disease. Then the next step would be to look for signs of attachment or behavioral problems.
9 Does She Focus On Your Face?
Pediatricians will ask you if your baby has focused on you with their eyes. This is a good determiner if you are bonding with your baby, but also this is a way for doctors to determine whether or not your baby's eyes are functioning properly. The pediatrician will conduct eye tests like examining the pupils to make sure they dilate when a light is turned off, those tests are important indicators that your baby's eyes are functioning as they should.
There are a few possible reasons why your baby has not held eye contact by a certain age. Pediatricians view three-months of age as a later, but still normal time for babies to begin making eye contact.
But after three months there may be a problem. If a baby is still not focusing on you with their eyes by their two-month check up, the most likely reason for no eye contact is that you're looking at the wrong times. "An infant needs to be in a quiet but alert mental state to respond in this way, and most of the time an infant is awake she's tired or hungry," says Dr. Stein. The lesson? Be patient, and keep your eyes open.
8 Does He Sleep At Night?
Babies are born with no sense of day and night, they basically have no internal clock. But as a baby gets older the American Academy of Pediatrics states that his or her brain begins producing melatonin, a natural sleep inhibitor that the human brain creates.
This is a good sign and should mean that your baby is sleeping more soundly through the night and on a more predictable schedule. Pediatricians will want to know if this is the case.
But as a baby’s brain continues to mature, they begin to cycle between deep and light sleep. Although early in life, typically before four months you were able to pass your sleeping baby from one set of arms to another without fear; your newborn quickly and easily entered into a deep sleep and it was easy for them to remain asleep.
As your child develops an adult-like pattern with cycles of light sleep and deep sleep, things change. Significantly. Your baby takes longer to get to sleep. And when they do fall asleep, they do not immediately enter deep sleep like they used to. This pattern is called sleep regression. Pediatricians will want to know if this is happening as well since this is a good indicator of your baby's brain development.
7 Does She Cry At The End Of The Day?
Another milestone is the fussy milestone. As babies grow older they will experience a period known as 'The Witching Hour.' The Mayo Clinic calls the time of day when a baby gets fussy for no reason on a regular basis, the witching hour.
The witching hour can occur in babies who cry for an extended period of time at any point in the day, but typically breakdowns happen in the evening after dinner, between 6 p.m. and 10 p.m.
That’s when babies are extra tired, but because their nervous system hasn’t fully matured, and they don’t know how to put themselves to sleep.
Your child's pediatrician will want to know if your baby is getting fussy around this time as a sort of baby right of passage. However, an overly fussy baby may be cause for alarm, if your baby does not calm down after an hour or so of their fussy spell or remains fussy for several days his or her doctor may have to rule out any medical conditions that may be causing your baby to cry.
In some cases, all the crying could be due to a protein allergy or intolerance. It could also be because of baby reflux.
And although it may seem like it will last forever, babies typically only have a hard time in the evenings for the first few months of life, according to Pampers.com most babies outgrow this phenomenon by about five months of age. So hang in there, parents.
6 Does He Hold His Head Up?
At birth, your baby has little control over his or her head because his motor skills and neck muscles are fairly weak. He'll develop this crucial skill little by little during the first year of life.
Pediatricians will determine where your baby is in their muscle development by asking questions like, "Can your baby hold his or her head up on their own while you hold him/her?" A delay in this ability could mean a delay in all later movement, like sitting up and walking. Your baby should be able to lift his or her head when he or she is about a month old and hold it up when placed in a sitting position at around 4 months. His or her neck muscles and head control should be strong and steady by 6 months.
You don't have to do much to encourage the development of head control, but you do have to be careful until it's well established. Trying pull and sit exercises or tummy time are great ways to build up your baby's neck strength.
In rare cases, babies can develop head lag, or underdeveloped neck muscles. Head lag can be due to low birth weight, premature birth, or other cerebral injuries. Head lag can lead to difficulty in posture and make it hard for your baby to support herself. If by the time your baby is four months old, you notice that she’s having a hard time keeping her head in line with her body be sure to schedule a checkup to make sure her muscles are developing properly.
5 Does She Raise Her Chest When She's On Her Belly?
Another indicator of strength and development is your baby's ability to pull his or her self up when they are placed on their stomach. The exercise parents do for their children is commonly known as tummy time. However, it is common for babies to dislike tummy time, especially if they suffer from colic or acid reflux.
Pediatricians recommend practicing tummy time several times a day, by putting the baby on his or her tummy frequently while awake for at least 3 to 5 minutes at a time. This will help your baby gain the head control he or she needs.
Your baby's ability to lift his or her head is also it’s crucial in keeping him or her from developing a flat head from lying on her back too often, finding a proper balance to establish good posture and the ability to walk.
Mom, Jelisse praises tummy time, "a two and a half months I placed my baby on their stomach and played with him during tummy time. He was so fascinated with watching his sister. He skipped the crawling stage and was walking at 8 months. "
4 What Side Does He Sleep On?
The American Academy of Pediatrics recommends that healthy infants be placed on their backs for sleep. Putting your baby to sleep on his back decreases his chance of sudden infant death syndrome (SIDS), which is responsible for more infant deaths in the United States than any other cause during the first year of life. Pediatricians will want to know if you put your baby to sleep on their side, back, or tummy to rule out a risk for SIDS, and to gauge how their stomach is growing.
As your baby gets older and his or her stomach grows, your baby will be able to go for a longer time between feedings.
Actually, more than 90 percent of babies sleep through the night by three months.
Most infants are able to last this long between feedings when they reach 12 or 13 pounds, so if you have a very large baby, he or she may begin sleeping through the night even earlier than three months. As encouraging as this sounds, don’t expect the sleep struggle to end all at once. Most children swing back and forth, sleeping beautifully for a few weeks, or even months, then returning abruptly to a late-night wake-up schedule.
3 Are You Going Back To Work?
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Going back to work after a new baby can be extremely difficult, for both parents and the baby. Decisions about who will watch the baby, how the baby will be fed, and what that means for the entire family should be carefully discussed and decided upon.
And for your baby's pediatrician, they want to know what this means as well. If you exclusively breastfed your baby will now have to transition to bottles if you are planning to return to work, if you are formula feeding but have been the sole person giving your child bottles, now they need to get comfortable taking a bottle from someone else.
Does the person you are entrusting your child know how to pace feed? These are all questions your pediatrician will want to know as to determine what sort of attachment or eating issues your baby may develop.
During the going back to work process, be kind to yourself. Don't try to overdo it. If you are breastfeeding begin stocking up on milk several weeks before your return to work. Pump while at work in normal intervals that you would be feeding your baby. The transition can be hard for everyone, but with a little patience, it can be made easier.
2 Do You Take Her Out Of The House?
"This question is a lot more to gauge how new parents are adjusting to parenthood," Dr. Benjamin explained. As a new mother or father, it can be scary to take your new baby outside.
What about the germs? What about the other people? What if the baby cries? What if the baby needs changing and you're in the middle of a store?
With all the what ifs it is important to remember that as a new parent although you may encounter a lot of firsts, you are certainly not the first to ever parent a child. But an unwillingness to risk encountering these firsts or having a lack of interest or extreme fear of taking your baby outside can be a sign of depression. If you are experiencing symptoms of depression it is important that you seek out professional help.
Your child's pediatrician may also ask about your daily routines and how often you take your child out of the house just to get an idea of what type of bacteria your baby may be exposed to in order to have a better idea of what illnesses, if any, they need to look out for during their check-ups and wellness visits.
1 How Many Diapers Does He Soil Per Day?
I don't know about other parents but I really try not to count how many diapers I go through in a day. The thought of throwing away something that is so expensive, so frequently, depresses me.
This is why when my son's pediatrician asks me how many diapers he goes through, I respond with a sigh.
But, this question is actually very important. Knowing how many soiled diapers your baby goes through is an excellent indicator of how their digestive system is working, or not working, whether or not the milk they are eating is providing nutrients for them, and if something needs to be changed.
Some babies will have several small loose stools every day, while others will only have 1 or 2 larger stools a day or even every 2 or 3 days. For breastfed babies, breastmilk is very easy to digest, and as your baby grows it is not uncommon to notice less frequent dirty diapers. This will happen for two reasons, first, the colostrum (first milk) is now gone from your milk,
And secondly, mom's milk will change several times throughout the breastfeeding journey, including when your baby may be going through some growth spurts, and their need for proteins for growth and neurodevelopment is greater, your milk will change to reflect this need, meaning fewer diapers. It is not uncommon for some exclusively breastfed babies to go for up to 7 days without having a dirty diaper.
For formula-fed babies, the diaper count will differ. Since formula obviously does not change depending on the developmental stage of the baby, diaper count should remain relatively consistent throughout the first six months of life, although the color and texture may vary depending on the baby. A pediatrician will want to know how your baby's digestive system is breaking down the formula and if there is a need for a change.
References: Pampers.com, Mayo Clinic, Baby Center, American Academy of Pediatrics, and interviews with Pediatricians