What to expect during a 1-Month-Old Physical?

Developmental Surveillance

  • Social Language and Self-Help
    • Periods of Wakefulness for feeding
  • Verbal Language
    • Cries with discomfort
    • Calms to adult voice
  • Gross Motor
    • Lifts head briefly 
    • Turns to the side
    • Reflexively moves arms and legs
  • Fine Motor
    • Keeps hands in a fist


  • History
    • Initial/Interval
  • Measurements
    • Length/Height and Weight
    • Head Circumference
    • Weight for Length
    • Blood Pressure
    • Newborn Blood
      • Range during which a service may be provided: 3-5 days – 1 Month – 2 Months
    • Vision
    • Hearing
      • Range during which a service may be provided: 3-5 days – 1 Month – 2 Months


  • Not Required
  1. Blood pressure measurement in infants and children with specific risk conditions should be performed at visits before age 3 years. 7) [Reference].  
  2. Instrument-based  screening may be used to assess risk at ages 12 and 24 months. [Reference]
  3. Verify results as soon as possible, and follow up, as appropriate.
  4. This assessment should be family-centered and may include an assessment of child’s social-emotional health, caregiver depression, and social determinants of health. [Reference]
  5. Screening should occur per. [Reference]
  6. At each visit, age-appropriate physical examination is essential, with infants totally unclothed and older children undressed and suitably draped. The extent of the physical examination is determined by both the reason for the visit and diagnostic considerations raised during the taking of the history.) [Reference].
  7. Every visit should be an opportunity to update and complete a child’s immunizations. [Reference
  8. Testing should be performed on the recognition of high-risk factors. Tuberculosis testing per recommendations of the AAP Committee on Infectious Diseases. 

1-Month-Old Anticipatory Guidance

Social Determinants of Health

◊Risks (living situation and food security, environmental tobacco exposure, intimate partner violence, maternal alcohol and substance use) 

◊Strengths and protective factors (family support)

  • Tell me about your living situation. Do you have the things you need for the baby? Are you worried about having enough money for food/infant formula?
    • Community agencies, WIC, and SNAP can help you with concerns about your living situation and having enough food.
  • Don’t use tobacco/e-cigarettes. Keep car/home free of tobacco smoke/e-cigarette vapor.
    • Call 800-QUIT-NOW (800-784-8669) for help quitting smoking.
  • Check home for mold, and radon; avoid using pesticides.
  • Do you always feel safe in your home? Has your partner ever hit, kicked, or shoved you, or physically hurt you or the baby? Would you like information on where to go or who to contact if you ever need help?
    • Ask for help if you are concerned about or have experienced violence from your partner or another significant person in your life.
  • You can also call the National Domestic Violence Hotline toll-free at 800 -799-SAFE (7233).
  • Don’t use alcohol/drugs.
  • Ask about community resources for child care.

Parent and family health and well-being

◊ Postpartum Checkup ◊ Maternal Depression ◊ Family Relationships

  • Finding good child care can help you feel confident about returning to work. I can provide information and resources.
  • Have a postpartum checkup.
  • Over the past 2 weeks, have you ever felt down, depressed, or hopeless? Over the past 2 weeks, have you felt little interest or pleasure in doing things?
  • Anxiety and Depression is common after birth
  • Getting enough sleep/physical activity and eating healthy help. 
  • Talk with me if feelings last more than 2 days
  • Find time for yourself, partner.

Newborn behavior and care

◊ Early Brain Development ◊ Adjustment to Home ◊ Calming ◊ When to Call (temperature taking) ◊ Emergency Readiness (CPR) ◊ Illness Prevention (handwashing, outings) ◊ Sun Exposure

  • Sing/talk/read to the baby; avoid TV and other digital media.
  • Help baby wake for feeding by patting/diaper change/undressing.
  • Calm baby with stroking head or gentle rocking.
  • What do you do to calm your baby? What do you do if that doesn’t work?
    • Never hit or shake baby.
  • What type of thermometer do you have? Do you know how to use it?
    • Take temperature rectally, not by ear or skin. 
  • Create an emergency preparedness plan (first aid kit, list of telephone numbers).
  • Wash hands often; avoid crowds.
  • Avoid the sun; use infant sunscreen.

Infant Behavior and Development

◊ Sleeping and Waking ◊ Fussiness and Attachment ◊ Media ◊ Playtime ◊ Medical Home After-Hours Support

  • Put baby in the crib awake/drowsy to help with transition; keep the room temperature comfortable.
  • Consider offering a pacifier.
  • Calm baby with stroking head or gentle rocking.
  • What do you do to calm your baby? What do you do if that doesn’t work?
    • Never hit or shake baby.
  • Avoid TV and other digital media with the baby.
  • Start “tummy time” when awake.
  • What type of thermometer do you have? Do you know how to use it?
    • Take temperature rectally, not by ear.
  • Call the office anytime with questions.
  • Wash hands often.

Nutrition and feeding

◊ Feeding Plans and Choices ◊ General Guidance on Feeding ◊ Breastfeeding Guidance ◊ Formula-Feeding Guidance 

  • How do you know if your baby is hungry? How do you know if your baby has had enough to eat?
    • Exclusive breastfeeding for about the first 6 months provides ideal nutrition supports best growth and development
    • The iron-fortified formula is recommended substitute
    • Recognize signs of hunger, fullness
    • Expect 6 to 8 wet cloth diapers per day or 5 to 6 wet disposable diapers
    • 3 to 4 stools per day; no extra fluids; 
    • Burp baby at natural breaks in feeding.
  • If breastfeeding: How is breastfeeding going? What concerns do you have about breastfeeding?
    • Feed every 1 to 3 hours daytime 
    • Every 3 hours at nighttime for 8 to 12 feedings in 24 hours
    • Give baby vitamin D (400 IU per day)
    • Mothers should continue prenatal vitamins with iron; eat a healthy diet (vegetables /fruit /whole grains/low-fat or nonfat dairy/fish/lean protein).
  • If formula feeding: 
    • Prepare/store formula safely
    • Feed 24 to 27 oz formula per day
    • Hold baby semi-upright; don’t prop the bottle.


◊ Car Safety Seats ◊ Heatstroke Prevention ◊ Safe Sleep ◊ Pets ◊ Safe Home Environment

  • Car Seat
    • Use a rear-facing car safety seat in the backseat
    • Never put the baby in the front seat of a vehicle with a passenger airbag
    • Keep the baby in a car safety seat at all times during travel.
  • Always use a seat belt; do not drive under the influence of alcohol or drugs.
  • Put baby to sleep on back; choose the crib with slats less than 2¾” apart; don’t use loose, soft bedding; have baby sleep in your room in own crib.
  • Keep a hand on baby when changing diaper/clothes; keep bracelets, toys with loops, and strings/ cords away from the baby.
  • Learn infant first aid/CPR; know emergency numbers; make an emergency plan.

Goals For 1 Month Check-up:

  • Be gentle and patient
  • Get more sleep
  • Make a budget
  • Leave your work at the office
  • Focus on self-care ◌ Meditate as a family
  • Find an outlet
  • “cell-free” zone
  • Spend more time with your partner
  • Take more baths
  • Have a girls’/boys’ night
  • Be more flexible
  • See your child for who they are
  • Teach your child to speak up
  • Help those less fortunate
  • Drink more water
  • Find 30 minutes a day of “me” time
  • Challenge yourself
  • Focus on experiences, not things
  • Make health a priority
  • Start—or finish—a degree
  • Inform yourself
  • Maintain balance
  • Laugh often
  • Cook dinner more frequently
  • Ask for help
  • Have designated “cheat” days
  • Stop having FOMO
  • Say “I love you” more often 

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