What questions should be asked during a 2-week infant well-child visit?

Questions to Ask During a 2-Week Infant Well-Child Visit

At the 2-week well-child visit, focus your questions on feeding patterns, elimination, sleep, jaundice assessment, family adjustment, and screening for maternal postpartum depression, as these are the critical areas for identifying early problems in newborns. 1

Feeding Assessment

• Ask specifically about breastfeeding technique by observing position, latch, and swallowing to ensure adequate nutrition, as feeding problems are common in the first weeks of life 1
• Inquire about feeding frequency and duration for both breast and formula-fed infants 2
• Ask about any difficulties with feeding, including infant fussiness during feeds or maternal concerns about milk supply 1
• For breastfeeding mothers, assess whether lactation support is needed based on these observations 1

Elimination Patterns

• Obtain historical evidence of adequate stool and urine patterns to confirm sufficient hydration and feeding 1
• Ask parents to describe the frequency, color, and consistency of stools 2
• Inquire about the number of wet diapers per day (should be at least 6-8 by this age) 1

Jaundice and General Health

• Assess the infant's general health, hydration status, and degree of jaundice visually and through parental report 1
• Ask if parents have noticed any yellowing of the skin or eyes 1
• Inquire about the infant's activity level and alertness 2
• Ask about any new problems or concerns since hospital discharge 1

Sleep and Safety

• Ask about sleep patterns, including where the infant sleeps and sleep position 1
• Reinforce that infants should be placed on their back to sleep and inquire about current sleep practices 1
• Ask specifically about co-sleeping practices, as this should be avoided 1
• Verify appropriate use of car safety seats and clarify that these should only be used for travel, not for positioning in the home 1

Birth and Newborn History

• Review birth history including gestational age, birth weight, and any complications 1
• Confirm that newborn metabolic screens were completed and review any outstanding results 1
• Ask about any hospitalizations, emergency visits, or illnesses since discharge 1

Family and Social Environment

• Screen for maternal postpartum depression, as this is a critical component of the 2-week visit 1
• Assess the quality of mother-infant attachment and details of infant behavior 1
• Ask about family structure and who is providing care for the infant 1
• Inquire about family stressors, support systems, and access to needed resources 1
• Ask specifically: "Does anyone who provides care for your child smoke?" to assess tobacco exposure 1
• Inquire about exposure to electronic nicotine delivery systems (vaping) 1

Environmental and Safety Concerns

• Ask about housing conditions, including water damage or mold problems 1
• Inquire about exposure to toxic substances or drugs in the home 1
• Screen for potential trauma or concerning events by asking: "Has anything scary or concerning happened to you or your child since the last visit?" 3
• For families with identified risk factors, ask about history of domestic violence, mental illness in caregivers, or substance abuse 1

Medical History and Follow-up

• Review any medications or supplements the infant is receiving 2
• Confirm plans for ongoing health care maintenance and verify the family has a method for obtaining emergency services 1
• Ensure immunization schedule is understood and planned 1
• Schedule or confirm the next well-child visit to maintain continuity of care 1

High-Risk Screening Questions

For infants with specific risk factors, additional questions are warranted:

• For infants with any concerning events (brief resolved unexplained events), ask detailed questions about the event: Was the infant breathing? What was the skin color? How did it stop? 1
• For premature infants (born <37 weeks), ask about breathing problems, noisy breathing, or snoring 1
• For infants with reflux symptoms, obtain detailed information about frequency and management 1
• Ask about any recent exposure to infectious illness, particularly upper respiratory illness or pertussis 1

Common Pitfalls to Avoid

• Do not rely solely on asking "Do you have any concerns?" as an open-ended question—many parents, especially first-time parents, may not know what concerns to raise 4
• Physicians often overestimate the time they spend discussing safety issues and their direct involvement in communicating information, so be intentional about covering key topics 4
• Remember that parents may use different terminology for tobacco products, so clarify what "smoking" means to include vaping and other nicotine delivery systems 1
• Ensure adequate visit time, as shorter visits are actually associated with better adherence to health supervision recommendations when structured appropriately 5