Infant Health Checkups in Japan: The Municipal Kenshin System

See how Japan's city-run checkups for babies and toddlers work, when they happen, what they cover, and how families from overseas can use them.

Published October 19, 2026 at 10:42 AM JST | By Tokyo Paul

Quick answer: Japan's municipal infant checkups (nyuyoji kenshin) are free health and development checks that local governments offer at set ages. Two are required by law, at about 1 year 6 months and 3 years, and most cities also hold one at around 3 to 4 months. Parents are notified by mail and bring the Maternal and Child Health Handbook. Schedules vary by city, so check locally.

What kenshin means for young children

Kenshin is the Japanese word for a health checkup, and nyuyoji kenshin refers to the checkups for babies (nyuji) and young children (yoji). They are run by local governments through public health centers or by medical institutions that contract with the city. The purpose is broad: to follow growth, notice anything that may need support, and give parents a chance to ask questions from trained staff.

The system is built around a shared timetable. Instead of waiting for a problem, families receive an invitation for each stage, and the city keeps track of who has attended. City guidance for foreign residents encourages parents to attend each checkup offered, and Hamamatsu's English page, for example, describes its checkups at city-entrusted clinics as free of charge.

The main schedule by age

A typical sequence begins soon after birth. A first checkup around one month is usually done at the hospital where the baby was born. The next is often at 3 to 5 months, held at a public health center or a local clinic; the exact month depends on the city. Many cities also offer a checkup in the latter part of the first year, with the timing set by each local government.

The two checkups defined in law come next: the 18-month checkup (1 sai 6 kagetsu ji kenshin) and the 3-year checkup (3 sai ji kenshin). The first is generally held when the child is between 1.5 and 2 years old, and the second between 3 and 4. A dental checkup at age 2, and a checkup at age 5 in some places, are also offered. Preschool checkups before elementary school entry round out the list.

What happens at the checkup

At a public health center, the visit often starts with reception and the handing in of a questionnaire. Staff measure height, weight and head size, and a doctor does a physical exam and talks with parents about development. Hearing and vision are looked at for older toddlers, and the 3-year checkup includes a dental exam. Nutritionists, public health nurses and sometimes childcare counselors are available for individual consultation.

Examples from city websites show the pattern. Hamamatsu's English page lists a checkup at 3 to 5 months and another from 9 months up to the first birthday, both at contracted clinics, then a group checkup at 18 to 20 months with an interview, measurements, a physical exam and a dental exam, a dental checkup at age 2, and a 3-year checkup. The format is similar across Japan even when the venues differ.

The Maternal and Child Health Handbook

The Boshi Kenko Techo (Maternal and Child Health Handbook) is the record that ties the system together. Parents receive it from the municipal office when they register a pregnancy. Doctors and nurses write in it at checkups, and parents note milestones and vaccinations. It is brought to every visit, along with any questionnaire the city sends.

Families often keep the handbook until the child grows up. It is meant for every family registered in the city, including foreign residents who register their pregnancy. If a handbook was not issued, or a translated edition would help, the city office is the place to ask. The same handbook is used at vaccination appointments and many clinic visits, so it is worth keeping in the bag you carry for the child.

How the invitation and booking work

Parents are normally notified by mail or by a checkup slip close to the right month. The notice states the date, place and what to bring. Some checkups at clinics require booking an appointment, and some cities bind vouchers for clinic checkups into the handbook. Hamamatsu, for example, uses handbook vouchers for its checkups at about 4 months and 10 months, which take place at contracted clinics.

Practical rules are common and sensible: some cities ask that only one guardian attend with each child, and families are asked to stay home if the child or someone in the household has a fever or cough. Parents often bring a bag for used diapers and dress the child in clothes that are easy to remove. Rules and dates vary, so check the current notice for your city.

Tips for overseas families

Families who move to Japan should register their address first, since the city sends notices to the registered address. Many cities have a support center for families with children, under names that vary from place to place, which serves as a main point of contact from pregnancy through early childhood. Translation tools or a local international exchange association can also help if Japanese is difficult.

Bring any vaccination records from abroad, because staff may ask about them. Questions are welcome, and staff are used to parents who want to check typical development. If a family prefers an interpreter, it is worth asking the city office ahead of time, since some cities offer multilingual information or interpreter support. Differences from the schedule at home are normal and are not a cause for worry. Some parents write their questions in the handbook beforehand so that nothing is forgotten in a busy session, and a short list in Japanese or English both work well with staff.

What the checkups do and do not replace

The kenshin system covers general development and health guidance. Vaccinations and illness visits happen at medical institutions, and some vaccinations are free of charge under local rules. A checkup is not a diagnosis visit, and a parent who is concerned between appointments can see a pediatrician or contact the local public health center.

This guide shares general cultural information and published guidance, not professional advice; for a child's health, talk with a pediatrician or local clinic. Costs and ages are set by each municipality and can change, so confirm the current schedule on the city website or at the ward office. Missing a session is not the end of the road: city health centers commonly offer make-up dates or can advise on the next step, so call the number on the notice rather than skipping the checkup altogether. Staff are generally glad to hear from families who need a different date or an interpreter.

Frequently Asked Questions

Are infant checkups in Japan really free?

The main municipal checkups are generally free for residents. Hamamatsu's English page notes that the city pays for its clinic infant checkups and the age-2 dental checkup. Some optional extras, such as fluoride treatment in some cities, may charge, so check your own city's notice.

Which checkups are required by law?

The 18-month checkup (about 1.5 to 2 years old) and the 3-year checkup (about 3 to 4 years old) are the two defined by law, and cities must offer them. Many cities also provide checkups at around 3 to 4 months and other ages. Dates and venues vary by municipality.

Can foreign residents use the system?

Yes. Residents registered with a municipality, including foreign residents, can receive notices and a Maternal and Child Health Handbook. Staff at city offices or local family support centers can explain options, and some cities provide multilingual materials. Registering your address is the first step.

Want to go deeper? Tokyo Paul's book Japanese Parenting Secrets That Create Calm, Independent Children is available on Amazon.

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More guides from Tokyo Paul: Children's Dental Care in Japan: Fluoride, Checkups and Daily Habits, Boshi Techo: Japan's Maternal and Child Health Handbook Explained and Celebrating Babies in Japan.