Querida,

In my part of the USA (see below), healthy newborns are routinely seen by the
pediatrician or pediatric nurse practitioner at 2 weeks of age (sometimes
sooner, depending on HCP), at 1 month, and then almost monthly for the first
year.  This schedule is certainly not the law, but based on the American
Academy of Pediatrics immunization recommendations (DPT at 2, 4, and 6 months,
etc) and tradition.  This is the financial bread and butter of a pediatric
practice.  And these HCPs have a wealth of knowledge to share concerning
infant feeding, toilet training, child rearing, et cetera.  (Tongue firmly in
cheek here!)  My pediatrician didn't make much money on my children, as they
only went for the shots.  They never have been sick enough to require any
other kind of visit (Breastfed, you know.)   :-)

Even though most towns have well-baby clinics, staffed by nurses, which offer
free immunizations, the majority of parents take their infants to private
practices.  Before the advent of HMOs (health maintenance organizations), most
insurance did not pay for these well-baby check-ups.  When my now 10 year old
went for his pre-kindergarten physical (required by law in my state) at age 5,
the bill for the examination, immunizations, and lead screening came to $275.!
That's not chicken feed. (American idiom meaning of little worth.)

My 2 sons still go for annual physicals because they are required in order to
play sports in school.  Again, the school system, by law, will provide these
physicals at no charge, but most people go to private HCPs.  This is due, in
part, to the fact that HMOs, now the insurance providers for the majority of
Americans, pay for well-baby and annual check-ups with only a small co-pay
(usually $5. or $10.) by the patient.

There is patch work system of clinics for indigent people and those people
without insurance.  (In the USA, there is no national health insurance
program, but services are provided to the poor if they know where to go and
can figure out how to do the paperwork. WIC is one such program often
discussed on Lactnet, providing nutritional support for women, infants, and
children.  Medicaid provides medical care.)  These clinics also see infants at
frequent intervals, though probably not monthly.

I'm sure this is more than you wanted to know, Querida.  We do have a
tradition of focusing on weight gain in infants here in the US.  Most mom's
keep track of monthly weights on charts in their baby books.  (Guilty as
charged!)

Kim

Kim Block RNC, MSN, IBCLC
Westfield, New Jersey, USA  (suburb of New York City)
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