Newborn Checkups in Japan: The Schedule & What to Expect at Each Visit

May 31, 2026 Maternity Prep Navigator Editorial ~15 min read

After your baby arrives, a structured series of health checkups begins — designed to monitor growth, development, and overall wellbeing during the critical early years. For foreign parents in Japan, navigating these appointments can feel daunting: the notices arrive in Japanese, the venues and formats differ from what you may be used to, and it is not always clear which checkups are free and which require payment. This guide explains the standard checkup schedule, what is generally observed at each visit, the difference between publicly subsidized and self-pay checkups, and practical tips for attending as a non-Japanese speaker. Your baby's checkup records are kept in the Boshi Techo (Maternal and Child Health Handbook) — bring it to every appointment.

1. Overview of Japan's infant checkup system

Japan has a nationwide system of infant and child health checkups (nyuuyouji kenshin / 乳幼児健診) that runs from birth through early childhood. The purpose of the system is to monitor physical growth and developmental progress, identify any concerns early, and provide guidance to parents on feeding, sleep, and child-rearing. The system is administered at the municipal level, meaning each city, ward, town, or village organizes and subsidizes checkups for residents.

Two important laws underpin the system:

• Mother and Child Health Act (母子保健法 / boshi hoken-hou): Article 12 requires all municipalities to conduct health examinations for children aged 1 year 6 months and 3 years. These two checkups are legally mandated, and in practice are provided to residents at no cost (the municipality bears the cost).
• In addition to these legally required checkups, most municipalities voluntarily provide subsidized checkups at other ages — most commonly at around 1 month, 3 to 4 months, 6 to 7 months, and 9 to 10 months — as part of their public health programs. The exact ages, number of visits, and whether they are fully free or require a small co-payment differ depending on where you live.

2. Free vs. self-pay checkups: which is which

Understanding which checkups are covered by public funds — and which require out-of-pocket payment — helps you plan ahead. The general picture across Japan is as follows, though local differences exist:

3. The checkup schedule: visit by visit

The following table summarizes the standard checkup timing used across Japan. Remember that municipalities may adjust the exact age windows, combine checkups, or offer additional checkups beyond this list.

Invitation letters or notices for municipal checkups are sent by post to your registered address. If you miss a notice or are unsure of the schedule, contact your public health center or city office. Missing a checkup is not a legal offence, but attendance is strongly encouraged as a way to monitor your child's wellbeing.

4. What is generally observed at each visit

Each checkup is different in focus depending on the baby's age, but all visits typically include measurement of weight (taijuu), height or length (shinchou), and head circumference (toui), as well as a general physical observation and a questionnaire for parents. The following gives a general picture of what tends to be observed at each stage. Note that the exact items, and how they are assessed, vary by municipality and by individual clinic or health center. The items described here are general observation areas — they are not diagnostic criteria. If you have any concerns, speak with your pediatrician (shounika no isha) or the public health nurse (hokenshi) at the checkup.

1-month checkup (around 1 month after birth)

This checkup is typically conducted at the hospital or clinic where your baby was born. Both the mother and baby are usually seen at this visit. General items commonly observed include:

• Baby's weight, length, and head circumference — checking that growth is progressing since birth.
• General physical observation — skin condition, umbilical cord healing, fontanelle (the soft spot on the head), eyes, mouth, and reflexes.
• Feeding — whether breastfeeding or formula feeding is going well, and whether the baby is gaining weight adequately.
• Mother's postnatal recovery — this may include an examination of the mother's physical recovery, discussion of any postnatal concerns, and mental wellbeing screening in some facilities.

3-to-4-month checkup (san-shi-ka-getsu kenshin)

This checkup is often a group checkup (shuudan kenshin) held at the public health center, though some municipalities organize it through designated clinics. General items commonly observed include:

• Weight, length, and head circumference — plotting on the growth chart in the Boshi Techo.
• Neck control (kubi suwari) — observation of whether the baby can hold their head up steadily when held upright or placed on the tummy. This is a commonly observed developmental milestone at this age, though the timing of development varies among individual babies.
• Ability to follow a moving object with the eyes (visual tracking).
• Responses to sound.
• Hip joint observation — screening for hip dysplasia may be included at this age in some areas.
• Parent questionnaire about the baby's daily routine, feeding, and any concerns.

6-to-7-month checkup

Where offered by the municipality, this checkup is typically an individual clinic appointment (kobetsu kenshin). General items commonly observed include:

• Weight, length, and head circumference.
• Observation of sitting ability — whether the baby can sit with support, or independently.
• Hand use and reaching — whether the baby reaches for objects and transfers them between hands.
• Hip joint observation (may be repeated or continued from earlier).
• Introduction of solid foods (weaning / rinyuu shoku) — guidance on when and how to start, if not already begun.
• Parent questionnaire.

9-to-10-month checkup

Where offered, this checkup is typically an individual clinic appointment. General items commonly observed include:

• Weight, length, and head circumference.
• Observation of movement — whether the baby is crawling, pulling to stand, or cruising along furniture. Development of these skills varies considerably among babies of the same age.
• Fine motor observation — pincer grip (picking up small objects between thumb and forefinger).
• Social and communicative responses — response to name, babbling, gestures such as waving or pointing.
• Progression of solid foods.
• Parent questionnaire.

18-month checkup (1歳6か月健診 / issai roku-ka-getsu kenshin)

This is one of the two legally mandated checkups and is typically a group checkup held at the public health center. It involves a more detailed assessment than the earlier checkups. General areas commonly covered include:

• Weight, height, and head circumference.
• Walking — observation of whether the child is walking independently.
• Language development — observation of whether the child uses words with meaning. The public health nurse or doctor may ask about how many words the child uses; the timing of language development varies considerably among children.
• Dental check — observation of the baby teeth that have emerged.
• Social and emotional development — observation of how the child interacts, plays, and responds.
• Parent questionnaire covering daily routines, eating, sleep, and any concerns.
• Guidance sessions — many municipalities include brief group sessions on nutrition, tooth-brushing, or child development as part of this checkup.

3-year checkup (3歳健診 / san-sai kenshin)

This is the second legally mandated checkup and typically involves the most comprehensive assessment in the infant checkup schedule. General areas commonly covered include:

• Weight, height, and head circumference — compared against growth charts.
• Vision and hearing screening — simple tests are often included at this age. If a more detailed test is needed, a referral to a specialist clinic may be made.
• Language and communication development — more extended observation of vocabulary, sentence use, and comprehension.
• Dental check — condition of the baby teeth.
• Social and behavioral development — how the child plays, follows simple instructions, and interacts with others.
• Urine test — some municipalities include a simple urine test at the 3-year checkup (a urine collection kit may be sent in advance).
• Parent questionnaire and consultation with public health nurse.

5. Group checkups vs. individual clinic checkups

Japan's infant checkup system uses two main formats, and knowing which format applies to each checkup will help you prepare:

The 18-month and 3-year checkups are almost universally group checkups in Japan, as the guidance sessions and consultation components work better in that format. Earlier checkups (6-to-7-month, 9-to-10-month) are more often individual clinic appointments, though this varies by municipality.

For group checkups at the public health center, the notification letter from the municipality will tell you the date, time, and location. If the assigned date does not work for you, contact the public health center to reschedule — it is generally possible to change to another available date.

6. Useful English phrases for checkup appointments

The following phrases may be helpful when communicating with medical staff or public health nurses at checkup appointments. In many areas, especially outside major cities, English-speaking staff may not be available — a translation app pointed at written text or used for speech translation can be very useful.

7. Tips for non-Japanese-speaking parents

Attending health checkups in a language you are not fully comfortable with adds an extra layer of stress to an already busy time. The following practical tips may help.

Before the checkup

• Check whether multilingual support is available. Some public health centers have staff who speak English or other languages on certain days, or can arrange an interpreter. Contact the center in advance — often by phone or via the city office — to ask about available language support.
• Prepare a written list of concerns. Write down any questions or observations you have about your baby's development, feeding, or sleep in English, then use a translation app to prepare a Japanese version. Having it in writing means you can show it to the doctor or nurse directly.
• Bring the Boshi Techo and all documents sent by the municipality. The checkup notice and any forms sent with it are important — bring them even if you cannot read them. Staff will know how to use them.
• Download a translation app. Apps with camera-based translation (pointing the camera at Japanese text to get an instant translation) are practical for reading notices, questionnaire forms, and the checkup record pages filled in by the doctor.

At the checkup

• Ask for things to be written down. If a staff member gives you verbal instructions or findings that you are not able to follow fully, show them the phrase from the table above: 「要点を書いていただけますか？」 (Could you please write down the key points?). Written Japanese is often easier to translate later than spoken Japanese.
• Do not leave without understanding any follow-up actions. If the doctor or nurse mentions a referral, a follow-up appointment, or anything that requires action on your part, make sure you understand what it is before you leave — or bring a bilingual friend or interpreter if possible.
• Check what has been written in the Boshi Techo. After the checkup, look at the pages that have been filled in. If anything is unclear, you can use a translation app at home to read the notes, and follow up at the next appointment.

Finding support

• Many city and ward offices have international resident support desks with multilingual staff who can help you navigate municipal services, including health checkups.
• Some municipalities have a hokenshi (public health nurse) who makes home visits to new parents — these visits are an opportunity to ask questions in a less formal setting. Ask your public health center if this is available in your area.
• For more on subsidy programs that may cover checkup costs for your baby, see our article on Baby Medical Coverage in Japan: Free or Subsidized Healthcare for Your Newborn.

8. FAQ

My baby is a foreign national. Are they still entitled to free infant checkups?

The legally mandated 18-month and 3-year checkups are provided by municipalities to children registered as residents, regardless of nationality. Children registered in the municipality's resident registry (juuminhyou) are generally eligible for municipal public health services. If you are unsure of your child's registration status or eligibility, confirm with your city or ward office.

We moved to a different city after my baby was born. How do we get checkup notices in our new area?

When you register your change of address at the new municipality's city or ward office, ask about the infant checkup schedule for your new area. The public health center in your new municipality will take over your baby's checkup management. Bring your Boshi Techo — it holds all the checkup records from the previous area and the new staff will use it as the basis for continuing your baby's health record.

I missed a scheduled checkup. What should I do?

Contact your local public health center as soon as possible. In most cases, it is possible to reschedule, particularly for group checkups where dates are offered periodically. For the legally required 18-month and 3-year checkups, municipalities make particular efforts to ensure all children can attend — do not hesitate to reach out if you missed the original date.

The questionnaire form sent with the checkup notice is entirely in Japanese. How do I fill it in?

Use a translation app to read the form. Many checkup questionnaires follow a standard format with yes/no questions about feeding, sleep, developmental milestones, and any concerns. If you cannot complete the form before the checkup, bring it to the appointment and ask a staff member for help at the reception desk. Showing the phrase 「日本語があまり話せません」(I do not speak Japanese well) will alert staff that you need assistance.

Can I bring my baby to a regular pediatrician instead of the public health center for the group checkups?

For the legally required 18-month and 3-year checkups, the format and venue are determined by your municipality — these are usually group checkups at the public health center. However, if you attend the prescribed municipal checkup and also wish to have an additional check with your regular pediatrician, that is always an option. For checkups that your municipality offers as individual clinic checkups (kobetsu kenshin), the designated clinic list is provided by the municipality — confirm which clinics are included before booking.