Well-child visits with the pediatra: what to expect

0-12 months · Healthcare · Reviewed 20 June 2026 · All articles

One of the most reassuring structures available to families after a baby is born is the network of scheduled well-child visits provided through the SSN (Servizio Sanitario Nazionale). These visits, delivered by a free-choice paediatrician known as the pediatra di libera scelta, track your baby's growth, development, and health at regular intervals from birth through to the start of primary school at age six. Understanding how the system works, what you are entitled to, and what happens at each visit makes these appointments far more productive and far less stressful.

Choosing your baby's pediatra

The pediatra di libera scelta is a paediatrician who contracts with the SSN to provide primary care for children from birth until the age of fourteen. The "libera scelta" (free choice) element means that you, as a parent, have the right to choose which registered paediatrician you register with, from the list maintained by your local ASL (Azienda Sanitaria Locale). This is one of the SSN's defining features: you are not assigned a doctor but actively choose one.

To register your baby, you visit the ASL office in your municipality. You will typically need the baby's birth certificate or the declaration from the birth registration, your tessera sanitaria, and proof of residence. Registration should ideally happen within the first few weeks after birth, so that your baby is enrolled before their first scheduled visit at fifteen days. The service is fully covered by the SSN at no cost for all registered residents, including non-Italian nationals with a valid permit of stay (permesso di soggiorno).

When choosing a pediatra, practical factors include: whether the practice is near your home, the opening hours for phone consultations (which matter enormously in the early weeks), whether the pediatra accepts same-day appointments for acute illness, and whether there is cover during holidays. Many families also ask friends or their local mamma community for recommendations, since the relationship with a pediatra is a long one.

The well-child visit schedule: birth to six years

The schedule of well-child visits is set by the Societa Italiana di Pediatria (SIP) and the Ministero della Salute, and is followed by paediatricians across the SSN. The schedule for the first year is intensive, reflecting the speed of development and the importance of early detection of any concerns.

At birth (before hospital discharge): A full neonatal examination including weight, length, head circumference, heart and lung auscultation, hip examination, and Apgar score assessment. The newborn metabolic screen (Guthrie test or heel prick test) is performed on day two or three, screening for phenylketonuria, congenital hypothyroidism, cystic fibrosis, and a growing number of metabolic conditions.

At 15 days: The first post-discharge visit. Weight regain is assessed (babies typically lose up to ten percent of birth weight and should be back to birth weight by ten to fourteen days). Breastfeeding support, jaundice follow-up if relevant, and a check on the umbilical cord. This is also a key visit for identifying any parental concerns in the very early weeks.

At one month: Full physical examination, growth measurements, feeding assessment. The pediatra checks for developmental red flags including response to sound and visual tracking. First guidance on safe sleep and posture.

At three months: Growth, development (social smile, head control), feeding, and the first vaccine visit under the PNPV schedule. Vaccines at this visit typically include hexavalent (diphtheria, tetanus, pertussis, polio, hepatitis B, Haemophilus influenzae type b), pneumococcal, meningococcal C, and rotavirus.

At six months: Growth, weaning readiness assessment, development (sitting support, transferring objects, babbling). Second vaccine doses are given at this visit for vaccines on a two-dose schedule.

At nine months: Growth, development (crawling, pincer grasp beginning, stranger anxiety), weaning progress, sleep patterns, dental care introduction.

At twelve months: Full development review including standing, first words, and social development. Final doses of some vaccines, and introduction of the MMR (morbillo, parotite, rosolia) and varicella vaccines. Discussion of toddler nutrition and transition from breast or formula.

After the first year, scheduled visits continue at eighteen months, twenty-four months, three years, four to five years, and five to six years, covering the preschool development period. At each visit, growth is plotted on standardised charts, developmental milestones are assessed, and parental questions are addressed.

What is assessed at each visit

Well-child visits follow a consistent assessment framework across all ages. Growth is the foundational measure: weight, length (or height once standing), and head circumference are plotted on the child's personal growth chart, which is kept in the libretto sanitario del bambino. A single measurement rarely tells a complete story; it is the trend over time that matters. A child consistently tracking on the second centile is behaving differently from one who has fallen from the fiftieth to the second centile in two visits.

Developmental screening uses a combination of structured observation and parental report. The pediatra will ask what the baby can do, observe directly, and use validated tools at certain ages. In Italy, the SIP has endorsed the use of the Ages and Stages Questionnaires (ASQ) at key visits as a standardised way to identify developmental delay early. If a concern is identified, the pediatra will usually offer a follow-up visit and, if needed, a referral to the relevant specialist service under the SSN (neuropsychiatria infantile for developmental concerns, for example).

The libretto sanitario is the central document of all these assessments. It travels with the child and records every visit, every vaccination, and any referrals or diagnoses. It is required for enrolment in nido and scuola materna, where the vaccine schedule must be up to date.

Vaccines covered under the SSN

Italy's Piano Nazionale di Prevenzione Vaccinale (PNPV) sets out which vaccines are mandatory and which are recommended and offered free of charge. The current schedule, based on the PNPV 2023-2025, includes mandatory vaccines against diphtheria, tetanus, pertussis, polio, hepatitis B, Haemophilus influenzae type b, measles, mumps, rubella, and varicella. These must be administered for a child to enrol in state education under the law introduced in 2017 (the Lorenzin decree).

In addition to mandatory vaccines, the SSN offers a range of recommended vaccines at no cost: pneumococcal, meningococcal C, meningococcal ACWY, meningococcal B (offered at two months in most regions), rotavirus, and HPV (offered at eleven years). The exact availability of recommended vaccines can vary slightly by region, since health is a shared competence between the central government and the regions.

Vaccine appointments are typically scheduled as part of the well-child visit calendar, or at dedicated vaccination clinics run by the ASL. Parents receive a schedule in writing at birth registration. If a vaccine is missed or delayed, the pediatra can advise on catch-up schedules.

Getting the most from your visits

The most productive well-child visits happen when parents arrive prepared. Keeping a note of questions as they arise between visits, rather than trying to remember them in the waiting room, is a simple habit that many families find transforms the usefulness of each appointment. Common topics include feeding (breastfeeding questions are common in the first months; weaning and portion sizes come up later), sleep, behaviour, development milestones, and what symptoms warrant an acute visit rather than a wait-and-see approach.

The pediatra is also the right person to ask about services beyond the scheduled visit. Referrals to speech therapy, physiotherapy, dietetics, and child neuropsychiatry are all available via the SSN on the pediatra's recommendation. Knowing that this gateway exists means you do not need to first diagnose a problem yourself; it is enough to describe what you are observing and let the pediatra assess whether a referral is warranted.

If you disagree with your current pediatra's approach, or if the relationship is not working, you can change to a different pediatra on the SSN list. This is your right under the libera scelta principle, and it does not require any explanation. The new pediatra can access the relevant history from the libretto sanitario.