Find a Kinderarzt before birth. Free U-checks U1 to U7a, newborn screenings, and the daily vitamin D and fluoride tablet.
Who looks after you and your baby?
- Hebamme: visits daily for the first 10 days, then as needed until your baby is 12 weeks old (longer for feeding questions or on a doctor's request). Paid by statutory insurance (§ 24d SGB V).
- Kinderarzt: the first regular appointment is usually the U3 at 4–5 weeks.
- Warning signs, do not wait: see a doctor right away if your newborn drinks poorly, vomits, has trouble breathing, looks pale or bluish, has red sticky eyes, a red or weeping belly button, or strongly yellow skin.
No Kinderarzt taking new patients?
Start asking practices during pregnancy. If none has space:
- Call 116 117, use the 116117 app or book online. With statutory insurance, the appointment service also books Kinderarzt appointments, with no referral and no code (KBV).
- The U-checks count as planned appointments: the service arranges them within 4 weeks, without a code (Verbraucherzentrale). Book early, so the check-up still falls into its time window.
- At the first appointment, ask whether the practice can take your baby on as a regular patient.
- The official doctor search on 116117.de can filter practices by foreign language (KBV).
- Until you have a practice, your Hebamme looks after your baby in the first weeks. When your baby is ill and practices are closed, call the on-call service 116 117; in an emergency 112.
The U-checks
The U-checks (Vorsorgeuntersuchungen) are free and recorded in the yellow booklet (Gelbes Heft). Keep to the time windows (kindergesundheit-info, G-BA Children's Guideline).
- U1 – right after birth: breathing, heartbeat, skin colour, reflexes.
- U2 – day 3–10: full examination of all organs, usually still in hospital.
- U3 – week 4–5: growth, reflexes, hearing, feeding, hip ultrasound, vaccination advice.
- U4 – month 3–4: movement, hips, eyes and hearing.
- U5 – month 6–7: motor skills, grasping, hearing and vision (including squinting).
- U6 – month 10–12: sitting, crawling, standing, first words, teeth.
- U7 – month 21–24: language, fine motor skills, body control.
- U7a – month 34–36: language, behaviour, allergies, weight, teeth.
Newborn screenings in the first days
- Vitamin K drops: given at U1, U2 and U3 to prevent rare but dangerous bleeding, because newborns have very little vitamin K.
- Hearing test: a quick, painless test offered by every birth clinic. Early detection matters because language develops from birth.
- Pulse oximetry: a light sensor on the foot measures oxygen in the blood to detect rare critical heart defects, ideally 24–48 hours after birth.
- Heel-prick blood test (extended newborn screening): a few drops of blood taken on day 2–3 are tested for rare hormonal, metabolic and genetic conditions, such as an underactive thyroid, cystic fibrosis, spinal muscular atrophy (SMA) and sickle cell disease. If the result is normal, you will not be contacted (G-BA Children's Guideline).
- Hip ultrasound: at the U3, to detect hip dysplasia (affects about 2–3 in 100 babies).
Vitamin D, fluoride and iodine
Your Kinderarzt usually prescribes these tablets at the U2 or U3.
Vitamin D
Baby → Vitamin D → Strong bones
- Why: builds strong bones and prevents rickets.
- Not in milk or food: breast milk, formula and baby food do not provide enough.
- Sun is not enough: from November to February the sun in Germany is too weak; sun through a window does not help.
- How much: one tablet a day with 400–500 IU, usually from about day 8.
- Until when: the first birthday; babies born in autumn or winter until the following spring (Gesund ins Leben).
Fluoride and first teeth
Fluoride strengthens tooth enamel and protects against decay. Since 2021, paediatricians, dentists and midwives share one recommendation:
- Until the first tooth: a combined tablet with vitamin D and 0.25 mg fluoride every day.
- From the first tooth to age 1, choose one option:
- Keep the combined tablet and brush without toothpaste or with fluoride-free toothpaste, or
- Switch to a vitamin D tablet without fluoride and brush up to twice a day with a rice-grain-sized amount of toothpaste containing 1,000 ppm fluoride.
Even if your child swallows that small amount, it stays within safe limits (Gesund ins Leben). Brushing is mainly about removing plaque; avoid brushing straight after meals.
Fluoride in water and salt
Use fluoridated table salt at home. A few regions have higher fluoride in tap water (above 0.3 mg/l): in that case, if you prepare formula with it, give vitamin D without fluoride. Your local water supplier can tell you the value.
Iodine
Iodine is needed for the thyroid and for healthy growth and development. Formula already contains enough. Breastfed babies get iodine through breast milk, so the mother needs enough (see Breastfeeding). When buying baby food jars, choose ones with added iodine (Gesund ins Leben).
Stool colour
In the first weeks, hold the stool colour chart from the yellow booklet (7 numbered shades) next to the nappy in daylight.
- Normal
- See a doctor within 24 hours
- Very pale, whitish or clay-coloured stool: shade 5, 6 or 7 on the chart
- It can be a sign of a rare liver disease (biliary atresia) that needs treatment in the first weeks
See the chart: yellow booklet, page 15 (G-BA, PDF, German) · background: G-BA on the stool colour card.
Spitting up
- Normal
- Small amounts of milk after feeds
- Your baby gains weight and seems content
- See your Kinderarzt soon
- Forceful vomiting in a gush, especially in the first 3 months
- No weight gain
- Cries a lot and cannot be soothed, or seems in pain while drinking
- Unusually sleepy, limp or pale
- Noticeably fewer wet nappies
- Green (bile) or bloody milk
- Urgent: 116 117 or 112
- Very drowsy
- Signs of drying out: dry mouth, few wet nappies
- Call the on-call service 116 117; in an emergency 112
More: Kinderärzte im Netz: spitting up · Kinderärzte im Netz: vomiting (German).
Sources
Official German sources, most of them in German.