Chapter 2 – Health Check-ups

Once discharged from the birth center, if everything is normal, the baby transitions from the care of the neonatologist to that of the freely chosen pediatrician, also known as the family pediatrician. This is a specialist who works under agreement with the National Health Service and sees young patients in their clinic. Almost all of their services are free of charge, with the exception of some certificates, out-of-hours visits, and tests not covered by the collective agreements between pediatricians and the Regions.

All children residing in our country are entitled to the assistance of a family pediatrician from birth until the age of 14, after which care is transferred to a general practitioner. Between ages 6 and 14, parents can choose to make this transition earlier. In rare cases, due to the need for continuity of care in the presence of chronic illnesses, a child may continue to see a pediatrician until the age of 16.

To register a newborn with the National Health Service and choose a family pediatrician, parents must go to the local health authority (ASL) with the child’s tax code (codice fiscale) and choose a pediatrician from the list available at the ASL office. To speed up the process, it is advisable to evaluate the available options before birth and request assignment as soon as possible after delivery.

From the time of discharge, the family pediatrician becomes the primary point of reference for new parents. They turn to the pediatrician not only in case of health issues with the newborn but also for regular health check-ups.

A key part of the family pediatrician’s job involves health check-ups (also known as “well-child visits”)—a series of approximately ten scheduled appointments from birth to age 14. These appointments monitor the child’s growth, health status, and progress in motor, cognitive, and social development, and help prevent or promptly identify any potential illnesses. The first five appointments, as established by the national agreements, are concentrated in the first year of life, when changes and developmental milestones occur more rapidly: at 1 month, 2–3 months, 4–6 months, 7–9 months, and 10–12 months. Further appointments are scheduled at 15–18 months, 2–3 years, 5–6 years, 8–10 years, and 11–13 years. Some Regions provide an even greater number of check-ups.

At each visit, the pediatrician examines the child from head to toe, checks weight and height, and measures head circumference up to age two. They assess vision, hearing, motor skills, and social interaction. During the early check-ups, the Barlow-Ortolani maneuver is repeated. Many pediatricians also prescribe a screening ECG at 4–5 weeks of life. Each appointment is also an opportunity to talk with the parents, answer their questions, clarify concerns, relieve anxieties, and encourage the adoption of a healthy lifestyle.