Well Child Care, 1 Month

PHYSICAL DEVELOPMENT

A 1-month-old baby should be able to lift his or her head briefly when lying on his or her stomach. He or she should startle to sounds and move both arms and legs equally. At this age, a baby should be able to grasp tightly with a fist.

EMOTIONAL DEVELOPMENT

At 1 month, babies sleep most of the time, indicate needs by crying, and become quiet in response to a parent's voice.

SOCIAL DEVELOPMENT

Babies enjoy looking at faces and follow movement with their eyes.

MENTAL DEVELOPMENT

At 1 month, babies respond to sounds.

IMMUNIZATIONS

At the 1-month visit, the caregiver may give a 2nd dose of hepatitis B vaccine if the mother tested positive for hepatitis B during pregnancy. Other vaccines can be given no earlier than 6 weeks. These vaccines include a 1st dose of diphtheria, tetanus toxoids, and acellular pertussis (also called whooping cough) vaccine (DTaP), a 1st dose of Haemophilus influenzae type b vaccine (Hib), a 1st dose of pneumococcal vaccine, and a 1st dose of the inactivated polio virus vaccine (IPV). Some of these shots may be given in the form of combination vaccines. In addition, a 1st dose of oral Rotavirus vaccine may be given between 6 weeks and 12 weeks. All of these vaccines will typically be given at the 2-month well child checkup.

TESTING

The caregiver may recommend testing for tuberculosis (TB), based on exposure to family members with TB, or repeat metabolic screening (state infant screening) if initial results were abnormal.

NUTRITION AND ORAL HEALTH

  • Breastfeeding is the preferred method of feeding babies at this age. It is recommended for at least 12 months, with exclusive breastfeeding (no additional formula, water, juice, or solid food) for about 6 months. Alternatively, iron-fortified infant formula may be provided if your baby is not being exclusively breastfed.

  • Most 1-month-old babies eat every 2 to 3 hours during the day and night.

  • Babies who have less than 16 ounces of formula per day require a vitamin D supplement.

  • Babies younger than 6 months should not be given juice.

  • Babies receive adequate water from breast milk or formula, so no additional water is recommended.

  • Babies receive adequate nutrition from breast milk or infant formula and should not receive solid food until about 6 months. Babies younger than 6 months who have solid food are more likely to develop food allergies.

  • Clean your baby's gums with a soft cloth or piece of gauze, once or twice a day.

  • Toothpaste is not necessary.

DEVELOPMENT

  • Read books daily to your baby. Allow your baby to touch, point to, and mouth the words of objects. Choose books with interesting pictures, colors, and textures.

  • Recite nursery rhymes and sing songs with your baby.

SLEEP

  • When you put your baby to bed, place him or her on his or her back to reduce the chance of sudden infant death syndrome (SIDS) or crib death.

  • Pacifiers may be introduced at 1 month to reduce the risk of SIDS.

  • Do not place your baby in a bed with pillows, loose comforters or blankets, or stuffed toys.

  • Most babies take at least 2 to 3 naps per day, sleeping about 18 hours per day.

  • Place babies to sleep when they are drowsy but not completely asleep so they can learn to self soothe.

  • Do not allow your baby to share a bed with other children or with adults who smoke, have used alcohol or drugs, or are obese. Never place babies on water beds, couches, or bean bags because they can conform to their face.

  • If you have an older crib, make sure it does not have peeling paint. Slats on your baby's crib should be no more than 2 3⁄8 inches (6 cm) apart.

  • All crib mobiles and decorations should be firmly fastened and not have any removable parts.

PARENTING TIPS

  • Young babies depend on frequent holding, cuddling, and interaction to develop social skills and emotional attachment to their parents and caregivers.

  • Place your baby on his or her tummy for supervised periods during the day to prevent the development of a flat spot on the back of the head due to sleeping on the back. This also helps muscle development.

  • Use mild skin care products on your baby. Avoid products with scent or color because they may irritate your baby's sensitive skin.

  • Always call your caregiver if your baby shows any signs of illness or has a fever (temperature higher than 100.4° F (38° C). It is not necessary to take your baby's temperature unless he or she is acting ill. Do not treat your baby with over-the-counter medications without consulting your caregiver. If your baby stops breathing, turns blue, or is unresponsive, call your local emergency services.

  • Talk to your caregiver if you will be returning to work and need guidance regarding pumping and storing breast milk or locating suitable child care.

SAFETY

  • Make sure that your home is a safe environment for your baby. Keep your home water heater set at 120° F (49° C).

  • Never shake a baby.

  • Never use a baby walker.

  • To decrease risk of choking, make sure all of your baby's toys are larger than his or her mouth.

  • Make sure all of your baby's toys are labeled nontoxic.

  • Never leave your baby unattended in water.

  • Keep small objects, toys with loops, strings, and cords away from your baby.

  • Keep night lights away from curtains and bedding to decrease fire risk.

  • Do not give the nipple of your baby's bottle to your baby to use as a pacifier because your baby can choke on this.

  • Never tie a pacifier around your baby's hand or neck.

  • The pacifier shield (the plastic piece between the ring and nipple) should be 1½ inches (3.8 cm) wide to prevent choking.

  • Check all of your baby's toys for sharp edges and loose parts that could be swallowed or choked on.

  • Provide a tobacco-free and drug-free environment for your baby.

  • Do not leave your baby unattended on any high surfaces. Use a safety strap on your changing table and do not leave your baby unattended for even a moment, even if your baby is strapped in.

  • Your baby should always be restrained in an appropriate child safety seat in the middle of the back seat of your vehicle. Your baby should be positioned to face backward until he or she is at least 2 years old or until he or she is heavier or taller than the maximum weight or height recommended in the safety seat instructions. The car seat should never be placed in the front seat of a vehicle with front-seat air bags.

  • Familiarize yourself with potential signs of child abuse.

  • Equip your home with smoke detectors and change the batteries regularly.

  • Keep all medications, poisons, chemicals, and cleaning products out of reach of children.

  • If firearms are kept in the home, both guns and ammunition should be locked separately.

  • Be careful when handling liquids and sharp objects around young babies.

  • Always directly supervise of your baby's activities. Do not expect older children to supervise your baby.

  • Be careful when bathing your baby. Babies are slippery when they are wet.

  • Babies should be protected from sun exposure. You can protect them by dressing them in clothing, hats, and other coverings. Avoid taking your baby outdoors during peak sun hours. If you must be outdoors, make sure that your baby always wears sunscreen that protects against both A and B ultraviolet rays and has a sun protection factor (SPF) of at least 15. Sunburns can lead to more serious skin trouble later in life.

  • Always check temperature the of bath water before bathing your baby.

  • Know the number for the poison control center in your area and keep it by the phone or on your refrigerator.

  • Identify a pediatrician before traveling in case your baby gets ill.

WHAT'S NEXT?

Your next visit should be when your child is 2 months old.