From the Guidelines
An 8-week well-child check should include a comprehensive physical examination, growth measurements, developmental assessment, and preventive care interventions, with special attention to hip stability and eye health, as indicated by the most recent guidelines 1. The visit begins with measuring weight, length, and head circumference, plotting these on growth charts to ensure appropriate development.
- A complete physical examination follows, examining all body systems with special attention to:
- Hip stability to screen for developmental dysplasia, using tests such as the Ortolani and Barlow tests, as recommended by the American Academy of Pediatrics 1.
- Eye health, including assessment of eye alignment, structural features of the eyes and ocular adnexa, and parental observations on the overall quality of the child’s vision, as outlined in the pediatric eye evaluations preferred practice pattern 1. Developmental milestones should be assessed, including social smiling, following objects visually, and beginning to lift the head when prone.
- Vaccinations are a critical component, typically including the second doses of:
- DTaP (diphtheria, tetanus, acellular pertussis)
- IPV (inactivated polio vaccine)
- PCV13 (pneumococcal conjugate)
- Hib (Haemophilus influenzae type b)
- Rotavirus vaccines Hepatitis B may be given if not administered previously.
- Common anticipatory guidance includes discussing:
- Feeding patterns (breast milk or formula requirements of approximately 2-3 ounces every 2-3 hours)
- Sleep safety (back sleeping position, avoiding co-sleeping)
- Prevention of sudden infant death syndrome
- Normal developmental progression Screening for postpartum depression in the mother is also important as it can affect infant care.
- Parents should be educated about:
- Normal crying patterns
- Strategies for soothing, as colic often peaks around this age The visit provides an opportunity to address parental concerns and strengthen the doctor-family relationship during this critical developmental period, as emphasized by the most recent guidelines 1.
From the Research
Necessary Procedures for an 8-Week Well-Child Check Appointment
- History taking: Focus on feeding, stooling, and sleeping patterns 2
- Physical examination: Comprehensive assessment to evaluate normal development and identify any abnormalities 2, 3
- Vaccination administration: Review and update immunizations as appropriate, and address vaccine hesitancy 2, 4
- Screening for critical congenital heart disease, genetic conditions, hearing, hyperbilirubinemia, and neonatal opioid withdrawal syndrome 2
- Screening for postpartum depression in mothers of infants up to six months of age 4
- Assessment of infant growth and development, including trends in weight, length, and head circumference 2, 4
- Counseling on infant nutrition, including breastfeeding and introduction of solid foods 2, 4
- Discussion of safety measures, such as rear-facing car seats, water safety, and avoiding infant walkers 2, 4
- Education on normal infant sleep patterns and safe sleep practices 2
Additional Interventions
- Screening for social determinants of health and offering community resources to address identified needs 2
- Providing age-appropriate guidance and answering caregivers' questions 4
- Discussing the importance of vitamin D and iron supplementation for infants 2
- Reviewing and updating immunization schedules, including co-administration of vaccines such as pneumococcal conjugate and rotavirus vaccines 5