Well-child visits

What to Ask at Every Well-Child Visit: A Physician Dad's Checklist, Birth to 15 Months

By Rajesh Harrykissoon, MD
Physician · Board-certified in sleep medicine and pulmonology · Published September 8, 2026

I spend my working life on the physician side of the exam table. In the ICU, nobody schedules fifteen minutes with me — the problems arrive already urgent. So it was a strange experience to sit in the parent chair at our daughter's well visits and watch the clock work against me the way it works against my own patients' families: the visit ended, the door closed, and half of what Paula and I meant to ask was still on my phone.

Here is what I eventually understood, and what this article is for: a well-child visit is not an open conversation. It is a tightly engineered protocol with a small, precious pocket of unstructured time at the end. If you know what the protocol already covers, you can spend that pocket on the questions only you can raise — and those are the ones that change care.

How the visit actually runs

Every US pediatrician's checklist descends from one document: the Bright Futures/AAP Periodicity Schedule, which maps out — visit by visit — the history, measurements, physical exam, screenings, immunizations, and anticipatory guidance your child is due for. The Bright Futures Guidelines define what happens inside each of those boxes.

In a 15-to-20-minute visit, that protocol consumes most of the time: interval history, growth plotted against the curve, a head-to-toe exam, whatever screening instrument is due, vaccines, and the guidance script for the next stage. Your unstructured questions land in the last three minutes, and they get triaged in the order you raise them.

So the single most useful habit I can give you: lead with your most important question, not your first chronological one. "She does this thing with her left eye" beats "how was her weight?" — the weight was already plotted, and the eye question is the one the protocol will not surface on its own.

The newborn visit (first days, and the 3–5 day check)

What is being checked: weight against birth weight, jaundice, feeding, the newborn screening results, and hearing. The Periodicity Schedule anchors the first outpatient visit at 3–5 days precisely because weight, bilirubin, and feeding problems declare themselves in that window.

Five questions worth the time:

  1. What percentage of birth weight has she lost, and what is the plan if the trend continues?
  2. Did she pass the newborn hearing screen in both ears — and if not, when exactly is the follow-up? The benchmark is 1-3-6: screened by 1 month, diagnosed by 3, intervention by 6. Do not let a "refer" result drift.
  3. Where is her bilirubin relative to the treatment threshold, not just "a little jaundiced"?
  4. How many wet diapers and stools per day should we count, and what number should make us call?
  5. Who do we call at 2 a.m., and what does your practice consider after-hours-worthy?

Insider note: ask for numbers, not adjectives. "Down six percent, trending fine" is a plan. "She looks good" is a mood.

The 1-month visit

What is being checked: weight trajectory back to and past birth weight, feeding, and — this surprises many parents — the parent. The AAP recommends maternal depression screening at the 1-, 2-, 4-, and 6-month visits, because the baby's chart is also, for a while, the mother's.

Five questions:

  1. Is her weight gain on trajectory, and has she regained birth weight?
  2. Is this crying pattern normal in timing and volume, or something more? (The evening cluster is real and has a shape — the newborn witching hour.)
  3. What should nights look like right now, and what is a realistic stretch of sleep? (Newborn day-night confusion)
  4. Is spit-up at this volume reflux worth treating, or laundry?
  5. What should we have figured out by the 2-month visit?

Insider note: when the depression screen comes — on paper or in conversation — answer it honestly. It is not a test of fitness. It is the one moment the system deliberately checks on the parents, and pediatricians can only act on what you tell them.

The 2-month visit

What is being checked: growth, developmental surveillance, and the first large vaccine set per the CDC/ACIP child immunization schedule. Note the distinction the AAP itself draws: what happens at every visit is developmental surveillance — informed watching — while formal screening with a validated instrument comes later, at 9, 18, and 30 months.

Five questions:

  1. Which vaccines is she getting today, and can I have the record updated before we leave?
  2. What is normal after shots — fussiness, sleep, low-grade fever — and what crosses the line into a call?
  3. Is her head shape developing normally, and are we doing enough tummy time to protect it?
  4. She smiles at us now — what social milestones should appear before the 4-month visit?
  5. Nights are still hard — is her day-night rhythm on track? (Day-night confusion)

Insider note: book 2-month visits for the morning when you can. If there is a post-vaccine fussy stretch, you want it landing at home in the evening, not starting at bedtime.

The 4-month visit

What is being checked: head control, social engagement, early rolling, growth, and the second vaccine set.

Five questions:

  1. Is her head control where it should be when you pull her to sitting?
  2. She is starting to roll — what has to change about the sleep setup today, not next month?
  3. What readiness cues for solid food should we watch for between now and six months?
  4. Our sleep is collapsing — is a structured night-shift split reasonable at this age? (The split-night system)
  5. What would make you want to see her before the 6-month visit?

Insider note: ask the solids question now, at four months, not at six. The readiness cues — sitting with support, head steady, losing the tongue-thrust reflex, reaching for your plate — appear on their own schedule, and knowing them in advance beats retrofitting them at the next visit.

The 6-month visit

What is being checked: growth, the third vaccine set, solids and iron, and the final scheduled maternal depression screen. Bright Futures anticipates an iron/anemia risk conversation here because stored fetal iron runs down around this age.

Five questions:

  1. How should we sequence first foods, and which iron sources matter most for a baby like ours?
  2. Do her feeding pattern and our family history put her at risk for anemia — will she need the hemoglobin check at 9 or 12 months?
  3. First teeth are coming — when does she need fluoride, and when a dentist?
  4. What does normal sleep architecture look like now, and is night-weaning reasonable to discuss?
  5. What is the plan if a food causes a reaction — what do we watch, what do we do, who do we call?

Insider note: this is the last visit where anyone officially asks how the parents are doing. If the honest answer is "not well," say it here. After six months, the system stops asking, and you become the only one who will raise it.

The 9-month visit

What is being checked: the first formal developmental screening with a validated instrument — ASQ-3, PEDS, or similar — plus a hemoglobin screen where risk warrants, growth, and a home-safety conversation that suddenly matters because she moves now.

Five questions:

  1. How did she actually score on the developmental screen — which domains were strong, and which are we watching?
  2. If a domain is borderline, what is the plan: recheck at 12 months, or refer now?
  3. Does she need the hemoglobin test today, given her diet and our history?
  4. She is pulling to stand — what are the two or three childproofing priorities you see families miss?
  5. Separation anxiety has arrived — what is normal, and what would concern you?

Insider note: if the office sends the ASQ ahead of the visit, fill it out at home over a normal day, not in the waiting room from memory. It is a screening instrument, not a quiz — rushed answers cost you the one data point the visit is built around.

The 12-month visit

What is being checked: the birthday vaccine set — MMR, varicella, hepatitis A, and boosters per the CDC schedule — plus universal hemoglobin and a blood lead risk assessment: universal testing for Medicaid-enrolled and refugee children, risk-based for everyone else.

Five questions:

  1. Should she get an actual blood lead test, or just the risk questionnaire — and what about our housing answers changes that?
  2. Live vaccines today — what reactions can appear, and on what delay?
  3. How do we transition from formula or breast milk to whole milk, and how much is too much?
  4. She is not walking yet — where is the boundary of normal, and when would you refer?
  5. What should her words and gestures look like by 15 months?

Insider note: answer the lead questionnaire about your actual house, not your ideal one. Pre-1978 paint, a recent renovation, well water, an older bathtub — these are exactly the answers that convert "risk assessment" into the test that catches something.

The 15-month visit

What is being checked: vaccine catch-up, language and social milestones — words, pointing, responding to her name — and the dental home and fluoride varnish conversation.

Five questions:

  1. Is her word count and pointing where it should be, and what specifically should appear by 18 months?
  2. Are we caught up on every vaccine, and can I see the record to confirm?
  3. When does fluoride varnish start here, and does she need a dentist visit before age two?
  4. Tantrums have arrived — what is developmentally normal, and what would you want to hear about?
  5. What does the 18-month visit screen for, and what should we track between now and then?

Insider note: that last question has a specific answer worth knowing in advance — the 18-month visit brings the autism-specific screen (M-CHAT-R/F). If you have a concern about eye contact, name response, or pointing, raise it at 15 months. Do not sit on it waiting for the formal screen; AAP policy is explicit that surveillance concerns act on their own, at any visit.

The vaccine conversation, from the physician side

I give difficult medical news for a living, and I can tell you the conversations that go well share a structure: a specific question, asked early, without an ambush.

If you have a vaccine question, three moves keep the visit productive:

  1. Name the specific concern, not the category. "I read about febrile seizures after MMR — how do you think about that risk?" is answerable in two minutes. "I have concerns about vaccines" is not, and it converts your last three minutes into a standoff.
  2. Ask schedule questions before vaccine day. If you are behind and need a catch-up plan, or you want to understand why two vaccines are given together, raise it at the prior visit or through the portal. Decisions made calmly beat decisions made with a crying baby on the table.
  3. Bring the record. If your child has vaccines from another practice, urgent care, or another country, bring documentation. Pediatricians can only build a catch-up plan from what they can see.

Your pediatrician wants your questions answered — the visit just has to be built so there is room for the answer.

Walk in with data, not vibes

Here is the difference between "I think she was fussy on Wednesday?" and a one-page log of feeds, sleep, medications, and milestones: the first is a feeling the pediatrician must decode, the second is a dataset she can act on inside the fifteen minutes. Interval history is the single largest consumer of visit time — hand it over in thirty seconds and you have bought back minutes for your actual questions.

Bring the data with you. Track feeds, sleep, medications, and milestones in Usha Care Guide and export a one-page summary for the visit. It is free and private. Start your family's guide — free

When not to wait for the next visit

Everything above assumes a healthy child on a scheduled cadence. Some things do not wait for the calendar. Call the same day — or go in — for:

  • Dehydration signs: markedly fewer wet diapers, no tears, a sunken soft spot, dry mouth.
  • Feeding refusal beyond a single bad day in a young infant.
  • Hard to wake, limp, or a cry that sounds wrong and will not settle.
  • Working to breathe: ribs pulling in with each breath, grunting, nostrils flaring, or a sustained fast breathing rate — this is my own field, and it is chronically under-called by parents at night.
  • Fever of 100.4°F (38°C) or higher, taken rectally, in a baby under 3 months — this is an immediate call, at any hour, full stop.
  • Loss of a milestone she previously had. Plateaus get watched; regressions get seen. CDC's developmental monitoring guidance and AAP surveillance policy both treat regression as a now-question, not a next-visit question.

When in doubt, call. Pediatric practices staff their phones for exactly this, and no good pediatrician resents the call that turned out to be nothing.

The printable

Every visit section above fits on one page: the five questions, what will be screened, and blank lines for the questions only you can know to ask. The full set — newborn through 15 months — is a single printable page below, free, no email required. Print the section for the visit you have coming, put it in the diaper bag, and hand your pediatrician the gift every clinician quietly loves: a parent who knows what the visit is for.

Printable master checklist: the well-child visit question sheets — one page per visit from the newborn check through 15 months, each with the five questions, what will be checked, and blank lines for your own. Free, no email required. Print the whole set or just the page for your next visit.

Frequently asked questions

What are the well-child visit ages in the first 15 months?

Newborn (3–5 days), 1, 2, 4, 6, 9, 12, and 15 months, per the AAP/Bright Futures Periodicity Schedule. The 18-month visit follows as the next major screening milestone.

What screenings happen at the 9-month checkup?

The first formal developmental screening with a validated instrument (commonly the ASQ-3), plus a hemoglobin check where risk warrants, per AAP policy and Bright Futures.

When does the pediatrician screen for autism?

Autism-specific screening with the M-CHAT-R/F is recommended at the 18- and 24-month visits. Concerns raised by parents or surveillance at any visit should be acted on without waiting for those ages.

How do I bring up a vaccine concern without an argument?

Ask a specific question early in the visit, ideally raised before vaccine day. Named concerns get real answers; broad ones get scripts. The live CDC schedule is the reference your pediatrician is working from.

Should I ask for a blood lead test at the 12-month visit?

Children enrolled in Medicaid and refugee children should be tested; for everyone else, testing follows a risk assessment covering housing age, renovations, and water. Answer it about your actual home.

Related reading: The Newborn Witching Hour: Why Babies Cry at Dusk — and Why It Isn't Colic — the evening crying window behind the crying question at the 1-month visit; Newborn Day-Night Confusion: A Sleep Physician's Guide to Flipping the Switch — what to expect when you ask what nights should look like; and The Split-Night System — a physician's shift schedule so both parents keep getting real sleep between visits.

Sources

Medical disclaimer. This article is for general education only and is not medical advice, diagnosis, or treatment. Reading it does not create a physician-patient relationship. I am board-certified in pulmonary and sleep medicine — not a pediatrician or obstetrician — and I write here as a physician and a parent. Always consult your own pediatrician about your baby, and never delay care because of something you read here. If you think you or your child may be having a medical emergency, call 911. Full details in the site Terms of Use & Medical Disclaimer.

Hand your pediatrician a dataset, not a guess

Usha Care Guide is free, private, and built by the physician who wrote this guide. Log feeds, sleep, medications, and milestones in seconds, and walk into every well visit with the interval history already written.

Start your family's guide — free