01
History
Prenatal/birth course; maternal blood type, HBsAg, HIV, STI and GBS results; medications/exposures; family history; feeding, elimination, sleep, safety and support.
Academy · Prevention · Pediatrics
Newborn
Preventive visit
A high-yield reference for birth hospitalization and the first check.
Verify newborn history, examination, universal screening, prophylaxis, feeding, discharge counseling, and individualized pathways without opening a full guideline document.
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Newborn visit — verify in 20–30 seconds.
Birth hospitalization plus first-week follow-up at 3–5 days. Routine and individualized care are separated deliberately.
02
Measure / examine
Weight, length, head circumference and WHO trajectory; vitals; complete newborn examination including red reflex, pulses, hips, cord, jaundice, tone and reflex symmetry.
03
Development / function
Surveil symmetric movement, primitive reflexes, sound response, brief fixation, state regulation, feeding cues and consolability. No routine formal developmental screen.
04
Universal screening
Bloodspot 24–48 h; hearing before discharge/by 1 mo; CCHD ≥24 h or before early discharge; TcB/TSB 24–48 h or before early discharge.
05
Immunization / prophylaxis
HepB by weight and maternal HBsAg pathway; RSV by season and maternal vaccination; IM vitamin K; erythromycin eye ointment.
06
Feeding / growth
Observed feeding before discharge and at 3–5 d; 8–12 feeds/24 h; assess output. Evaluate >7% loss by day 3–5 or >10% at any time.
07
Preventive counseling
Jaundice, fever/illness, ABC safe sleep, rear-facing car seat, cord care, hand hygiene, sick contacts and result follow-up.
08
Lifestyle counseling
Breast milk or iron-fortified formula, supervised awake tummy time, bonding/support, smoke-free care and avoidance of impaired caregiving.
09
Risk-based / individualized
Prematurity/<2,000 g, HBsAg positive/unknown, Rh-/type O, G6PD risk, substance exposure, home birth, abnormal screen, congenital anomaly, RSV history/season, vitamin K refusal and elective circumcision.
10
Follow-up
Confirm 3–5-day visit for weight, bilirubin and feeding reassessment; establish medical home and closed-loop screening-result follow-up.
Medical prevention
Examine, screen, immunize, provide prophylaxis, and identify illness early.
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Lifestyle prevention
Support feeding, safe sleep, awake play, relationships, and exposure avoidance.
RoutineRisk-basedHistory / timing dependentGuideline difference
Detailed reference · History
Start with the pregnancy, delivery, and first feeds.
Prenatal & birth
- Gestational age, delivery mode, ROM duration, maternal fever, meconium, Apgar scores
- Birth weight, complications and resuscitation
- Maternal blood/Rh, GBS, HIV, HBsAg, syphilis, gonorrhea and chlamydia results
- Pregnancy medications and maternal RSV vaccination timing
Family & newborn health
- Hemoglobinopathy, metabolic disorder, congenital heart disease, hearing loss
- Sibling jaundice requiring treatment; G6PD deficiency
- Current newborn concerns and 3–5-day follow-up plan
Feeding & elimination
- Breast/bottle method, frequency, duration, latch and milk-transfer signs
- Formula type, volume, preparation and storage
- Urination in first 24 hours; wet diapers and stool transition
Sleep, behavior & safety
- Sleep position, surface, location and caregiver plan
- Alertness, consolability, tone, movement and feeding cues
- Rear-facing car seat, smoke exposure, firearms, cord/circumcision care
Family / social environment
- Bonding, caregiver adjustment, postpartum-depression symptoms
- Supports, food/housing/transportation/financial needs
- IPV, substance use, prior child loss or protective-services involvement when relevant
Age-specific modifiers
- Home or birth-center birth and completion of hospital-based prevention
- Maternal HBsAg, HIV and Rh status
- Prenatal tobacco, alcohol, opioid, marijuana or other substance exposure
Detailed reference · Growth, examination & development
Confirm stability; establish the first trajectory.
Measurements
- Birth and follow-up weight
- Length
- Head circumference
- WHO charts, ages 0–24 months
- Evaluate >7% loss by day 3–5 or >10% at any time
General / neurologic
Color, tone, activity, cry, gestational-age assessment; Moro, suck, grasp, rooting and movement symmetry.
Head / eyes / ears
Fontanelles, sutures, molding, cephalohematoma/caput; red reflex and pupils; ear position, pits and tags.
Heart / lungs
Murmur, femoral pulses, respiratory effort/rate, retractions and grunting; pulse oximetry under CCHD screening.
Abdomen / genitalia / hips
Cord vessels, organomegaly, hernia; testes, hypospadias or ambiguity; Ortolani and Barlow maneuvers.
Spine / skin
Sacral dimples, tufts or masses; jaundice, birthmarks, rashes and skin integrity. Visual inspection alone is insufficient for bilirubin risk.
Developmental surveillance
Symmetric movement, flexion, head turn, reflexes, sound response, brief fixation, state changes, consolability and feeding cues.
Developmental red flags
Persistent hypotonia or hypertonia, absent or asymmetric primitive reflexes, seizure-like activity, poor feeding or suck, lack of response to auditory stimuli, or dysmorphic features warrant evaluation. Formal developmental screening is not routine at the newborn visit.
Detailed reference · Recommended screening
Universal first. Risk-based only when the history supports it.
Dried-bloodspot screening
Universal at 24–48 hours; exact disorders vary by state.
Timing, method & qualifiers
Follow the state program. Abnormal results require immediate state-protocol follow-up and confirmatory testing. Verify the current RUSP and state-specific panel rather than relying on a fixed condition count.
HHS/ACHDNC, state programs, ACOG 2019
Newborn hearing screening
Before discharge; no later than 1 month. OAE or automated ABR.
Timing, method & qualifiers
USPSTF Grade B. The supplied EHDI goal is diagnosis by 3 months and intervention by 6 months. Family history may warrant heightened follow-up.
JCIH, AAP, USPSTF Grade B
CCHD screening
Pre- and post-ductal pulse oximetry at ≥24 hours, or before an earlier discharge.
Timing, method & qualifiers
AAP 2025 algorithm: ≥95% at both sites to pass, with one retest after an initial failed screen.
AAP 2025 CCHD clinical report; RUSP
Predischarge bilirubin
TcB or TSB at 24–48 hours, or before an earlier discharge.
Timing, method & qualifiers
AAP 2022 KAS 5. Confirm TcB with TSB when within 3 mg/dL of the phototherapy threshold or TcB ≥15 mg/dL. Determine follow-up from the difference between the measured value and phototherapy threshold, not the prior risk-zone nomogram alone.
AAP 2022 hyperbilirubinemia guideline; KAS 5 recommendation
Blood type / DAT
For maternal type O, Rh-negative, or unknown blood type.
Timing, method & qualifiers
Cord-blood DAT is specified when maternal blood is Rh-negative or type O; heighten jaundice surveillance. Exact primary guideline details were not supplied.
Primary guideline details unavailable in the reviewed evidence
G6PD testing
Consider for specified ancestry, particularly with severe or unexplained jaundice.
Timing, method & qualifiers
The reviewed guidance identifies males of African, Mediterranean, Middle Eastern, or Southeast Asian descent. Exact timing and primary recommendation details were unavailable.
Primary guideline details unavailable in the reviewed evidence
Toxicology testing
For suspected prenatal exposure based on history or clinical signs.
Timing, method & qualifiers
Urine or meconium methods are described. Maternal substance use also triggers NAS surveillance and may alter hospitalization and social-work involvement.
Primary guideline details unavailable in the reviewed evidence
Maternal postpartum depression
Surveil now; institutional birth-hospital screening varies. Formal AAP screening starts at 1 month.
Timing, method & qualifiers
AAP periodicity: 1, 2, 4, and 6 months. Many institutions screen before discharge, but no formal universal AAP birth-hospitalization time point was identified. EPDS or PHQ-9 may be used.
AAP Periodicity Schedule; AAP 2025 MEB report; USPSTF 2016
Guideline difference
Universal predischarge bilirubin measurement
AAP 2022 recommends universal predischarge measurement under KAS 5. The reviewed USPSTF position is an I statement rather than a supporting universal recommendation. Preserve these positions separately.
Detailed reference · Immunization & medical prevention
Apply the weight, maternal-history, and seasonal pathways.
Hepatitis B — routine birth dose
Monovalent HepB within 24 hours for medically stable infants weighing ≥2,000 g.
Weight and maternal HBsAg pathways
- <2,000 g: give at chronological age 1 month or hospital discharge, whichever comes first.
- HBsAg positive: HepB + HBIG within 12 hours regardless of birth weight; post-vaccination serology at 9–12 months.
- HBsAg unknown: HepB within 12 hours; determine status promptly; give HBIG if positive or not determined within 48 hours.
RSV monoclonal antibody
Nirsevimab or clesrovimab; AAP states no product preference.
Season and maternal-vaccine pathway
- Born Oct–Mar: within 1 week, ideally during birth hospitalization.
- Born Apr–Sep: shortly before RSV season, optimally Oct–Nov.
- Generally not needed after maternal Abrysvo ≥14 days before delivery, except rare high-risk circumstances.
- Needed if maternal vaccine was not given, unknown, in a prior pregnancy, or <14 days before delivery.
Intramuscular vitamin K
>1,500 g: vitamin K1 1 mg IM within 6 hours. ≤1,500 g: 0.3–0.5 mg/kg IM. Document refusal and bleeding-risk counseling. No safe U.S. oral alternative is identified in the AAP statement.
Ocular prophylaxis
Erythromycin 0.5% ointment to both eyes within 24 hours; USPSTF Grade A and legally required in most U.S. states per the synthesis. It prevents gonococcal, not chlamydial, conjunctivitis. International recommendations differ.
Elective circumcision
Preference-sensitive, not universal. The AAP 2012 policy expired in 2017 and was not reaffirmed. Requires informed consent, sterile technique and adequate analgesia; contraindicated with hypospadias, ambiguous genitalia or medical instability.
Cord care & early detection
Keep the cord clean and dry. Identify anomalies, birth injury, jaundice, feeding problems, respiratory difficulty, abnormal tone/reflexes, or other illness; close the loop on every screening result.
DTaP, Hib, PCV, IPV, and rotavirus begin at 2 months rather than at birth in the reviewed schedule.
Detailed reference · Anticipatory guidance & lifestyle
Prepare the family for the first night home.
Medical and daily-life prevention meet in feeding assessment, safe sleep, early warning signs, and a confirmed follow-up plan.
Nutrition
Breast milk exclusively for about 6 months when breastfeeding; initiate within the first hour, use skin-to-skin and feed 8–12 times/24 h. Otherwise use iron-fortified formula with safe preparation. Observe breastfeeding before discharge and at 3–5 days.
Sleep
Supine every sleep; firm, flat, noninclined crib/bassinet with fitted sheet only; room-share without bed-sharing ≥6 months, ideally 12; no soft objects, overheating, head covering or home monitors for SIDS prevention.
Awake play
Begin supervised awake tummy time after discharge; increase toward 15–30 total min/day by 7 weeks (AAP Level A).
Relationships / emotional wellbeing
Promote skin-to-skin and bonding; assess caregiver stress, sleep deprivation, support and adjustment; normalize crying and discuss PURPLE Crying.
Exposure avoidance
No tobacco/nicotine in home or car (Level A). Avoid alcohol, marijuana, opioids and illicit drugs during breastfeeding or infant care; counsel against impaired caregiving.
Safety / when to seek care
Rear-facing car seat; not a sleep space outside travel. Rectal temperature ≥100.4°F (38°C) under 2 months is an emergency. Also address poor feeding, lethargy, breathing difficulty, persistent vomiting and reduced output.
Before discharge
Confirm the 3–5-day appointment for feeding, weight, and bilirubin reassessment; review jaundice, output, safe sleep, car-seat use, cord/circumcision care, hand hygiene, sick contacts, and how results will be communicated.
Detailed reference · When routine care changes
Exceptions and evidence should be visible, not buried.
Prematurity / <2,000 g
Alter HepB timing; use weight-based vitamin K; increase surveillance for jaundice, feeding difficulty and apnea; use corrected developmental age.
Maternal HBsAg positive / unknown
Use the HepB/HBIG pathways above and post-vaccination serology when maternal HBsAg is positive.
Maternal Rh-negative / type O
Cord-blood DAT and heightened jaundice surveillance.
Substance exposure
NAS surveillance, possible prolonged hospitalization, toxicology when indicated and social-work involvement.
Home or birth-center birth
Ensure bloodspot, hearing, CCHD, vitamin K, ocular prophylaxis and HepB completion. The evidence does not specify which items require repeat verification, so no repeat interval is operationalized here.
Abnormal screen / anomaly
Immediate state-protocol follow-up and confirmatory testing; alter discharge and specialty planning when needed.
RSV history / season
Maternal vaccine product/timing, birth season and rare high-risk circumstances determine infant antibody use.
Preference-sensitive care
Document vitamin K refusal counseling. Treat elective circumcision as individualized and respect contraindications.
Evidence conflicts retained
Do not silently merge these recommendations.
Ocular prophylaxis
AAP/USPSTF support routine U.S. use; Canadian guidance recommends against routine use in the described context; European positions vary.
Elective circumcision
Expired AAP statement supports availability, not universal use; European societies are described as disagreeing.
Developmental screening
AAP surveillance now and formal screening later vs USPSTF insufficient evidence for universal screening of asymptomatic children.
Postpartum-depression timing
AAP formal time points begin at 1 month; many hospitals screen before discharge.
Vitamin K route
AAP recommends IM only in the U.S.; international multidose oral regimens are described but not fully sourced.
Bilirubin
AAP recommends universal predischarge measurement; the reviewed USPSTF position is an I statement.
Primary sources used on this page
S1 · American Academy of Pediatrics
Preventive Pediatric Health Care / Periodicity Schedule
2017; rolling updates
S2 · AAP / Bright Futures
Guidelines for Health Supervision, 4th edition
2017
S3 · American Academy of Pediatrics
Management of Hyperbilirubinemia in Newborns ≥35 Weeks
2022
S4 · American Academy of Pediatrics
Updated CCHD Screening Algorithm
2025
S5 · American Academy of Pediatrics
Vitamin K and the Newborn Infant
2022
S6 · American Academy of Pediatrics
Sleep-Related Infant Deaths: Updated Recommendations
2022
S7 · American Academy of Pediatrics
Breastfeeding and the Use of Human Milk
2022
S8 · CDC / ACIP
Child and Adolescent Immunization Schedule
2025; addendum 2025-07-02
S9 · American Academy of Pediatrics
Prevention of RSV Disease in Infants and Children
2025
S10 · U.S. Food and Drug Administration
Clesrovimab approval
2025-06-27
S13 · U.S. Preventive Services Task Force
Ocular Prophylaxis for Gonococcal Ophthalmia Neonatorum
Grade A
S15 · American College of Obstetricians and Gynecologists
Newborn Screening and the Role of the Obstetrician-Gynecologist
2019
S17 · U.S. Preventive Services Task Force
Newborn hearing screening recommendation
Grade B
Direct source URLs were unavailable in the reviewed evidence, so references are identified by organization, title, and date rather than linked. Current state newborn-screening panels must be verified locally.
References & review
This clinician reference was last reviewed August 10, 2026. It is educational and does not replace individualized clinical care.
Evidence reviewed includes guidance from the American Academy of Pediatrics and Bright Futures, CDC/ACIP, USPSTF, HHS/ACHDNC, JCIH, ACOG, and FDA. Where recommendations differ, those differences are identified explicitly.