Well-Child Visit Guidelines for 2-Week Old Infants

Feeding Assessment

• The American Academy of Pediatrics recommends asking 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
• For breastfeeding mothers, assess whether lactation support is needed based on these observations 1
• Ask about any difficulties with feeding, including infant fussiness during feeds or maternal concerns about milk supply 1

Elimination Patterns

• Obtain historical evidence of adequate stool and urine patterns to confirm sufficient hydration and feeding 1
• 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
• 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 2
• Confirm that newborn metabolic screens were completed and review any outstanding results 1
• Ask about any hospitalizations, emergency visits, or illnesses since discharge 2

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 2
• Ask specifically: "Does anyone who provides care for your child smoke?" to assess tobacco exposure 3
• Inquire about exposure to electronic nicotine delivery systems (vaping) 3

Environmental and Safety Concerns

• Ask about housing conditions, including water damage or mold problems 2
• Inquire about exposure to toxic substances or drugs in the home 2
• 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

• 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, such as asking detailed questions about concerning events, breathing problems, or reflux symptoms 2
• Ask about any recent exposure to infectious illness, particularly upper respiratory illness or pertussis 2

Common Pitfalls to Avoid

• Remember that parents may use different terminology for tobacco products, so clarify what "smoking" means to include vaping and other nicotine delivery systems 3