What to Expect at an Infant Well Check at 4 Months Old

Is your child ready for their well check at four months old? Infant and toddler well-child visits ensure that the child is developing appropriately, has reached expected milestones and has acquired the necessary immunizations. But with so many changes happening at this age, what does a well check involve? Let’s find out what you can expect from a visit to our Cumming pediatric office.

A baby at an infant well check appointment being checked by the doctor

An Overview of a Well-Child Visit at 4 Months

Your child is developing quickly at four months old, and you’ll undoubtedly have many questions for your pediatrician. Before attending the infant well-check appointment, review the following milestones and changes to take full advantage of your visit.

Feeding Guidelines for a 4-Month-Old Infant

  • The baby is usually eating between 4-8 ounces every 3-4 hours. Breastfed babies are usually feeding every 3-4 hours. The actual amount the baby is eating will depend on their weight so there is no “right number of ounces.”
  • Stool patterns may vary but should still be semi-soft and passed easily.
  • Solid foods for babies are not really solid at all. The first solid food is usually semi-liquid rice cereal. Start with infant rice cereal. Mix ½ to 1 tbsp. of cereal with formula or water. Offer this once a day for 3-5 days, slowly increasing the amount as tolerable. Then introduce barley, oat, wheat and lastly, mixed cereal. Allow 3-5 days between introductions of each new food. This allows time to observe for any allergic reactions like hives, trouble breathing, vomiting or diarrhea.
  • Research does not support introducing solid food to promote longer periods of sleep. Your baby will be able to sleep for extended periods only when he has reached the right level of developmental maturity and is capable of comforting himself when awake and not hungry.
  • No solids in bottles. Don’t let well-intentioned advice lead you astray. Regular pediatric checkups for newborns and infants allow you to assess the accuracy of advice you may have heard from others. For instance, while information and tips from friends and family could sound reasonable, you can always check with your pediatrician if you’re not sure.
  • Start the meal with solids – save the bottle until your baby has finished eating the solids. They will be hungriest at the start of the meal and more willing to try new foods. Remember, in the beginning, solid foods are an addition to – not a replacement for – breast milk or formula.
  • American Academy of Pediatrics recommends that honey not be given to infants younger than 12 months. Honey has been associated with infant botulism, an illness that can be fatal.

General Care at 4 Months Old

  • Before a child is mobile is a great time to start baby-proofing the house. Consider plugging outlets and locking up cleaning supplies, medications, weapons or objects of safety concerns. Obtain a fire extinguisher, and check all fire and carbon monoxide alarms.
  • Your baby is more active, so be extra careful with hot foods and drinks when your baby is in your lap. They are often stronger than they look. They also love putting everything in their mouth, so it is important to keep small items like marbles, coins and batteries out of their reach.
  • Start a bedtime routine with your baby (i.e. bath time, reading books, lullabies), and put your baby in the crib when they are almost asleep. This will help your baby learn how to self-soothe and fall asleep on their own.

A 4-Month-Old Baby’s Developmental Milestones

  • The baby is probably cooing, smiling and laughing. They like to hold and regard their own hands. During tummy time, they like to raise their upper body using their arms and roll over from stomach to back.
  • Games like pat-a-cake and peek-a-boo are great ways to enforce object permanence and teach the baby beginner social skills.
  • Facial expressions and voice intonations you use when you are playing with them teach them the normal flow and rhythm of language. Talk to the baby as much as possible. Telling them seemingly mundane things like “I am changing your diaper now” is important to their language development.
  • When eating your child may move their head forward to reach a spoon when hungry, swipe food toward the mouth when hungry, turn their head away from the spoon when full and get distracted or notice surroundings more when full.
  • The baby is probably sitting with help or support and pushing up on their arms with straight elbows when on their tummy.
  • At this age, a child may push food out of the mouth with the tongue, move pureed food forward and backward in the mouth with the tongue to swallow and will probably recognize a spoon and hold their mouth open as it approaches.

Suggested Immunizations at 4 Months Old

  • Immunizations are a critical part of the baby’s well-being. Immunizations protect us from illnesses that have historically caused significant illness and death in children. Multiple studies are completed on the importance and safety of vaccines before they are added to the state’s mandatory list. Particular information on each vaccine is available on our website. The vaccines that are administered at the 4-month visit are the following.
    Pentacel – Vaccinates against diphtheria, pertussis, tetanus, haemophilus influenza type B and polio. These bacteria and viruses can cause severe respiratory infections, meningitis, epiglottitis, some ear infections, lockjaw and paralysis.
    PCV13 – Vaccinates against pneumococcal bacteria. This bacteria can cause meningitis, pneumonia and some ear infections.
    Rotateq – An oral live vaccine that vaccinates against bacteria that can cause severe diarrhea.
  • You may give a dose of Tylenol to alleviate any discomfort from the shot administration – this can be given to the baby before you come in for the visit. Common side effects from these vaccines include fussiness, fever (usually less than 102 degrees) and mild redness or swelling at the injection site. Use of Tylenol for greater than 72 hours to control fever or fever greater than 102 with increased irritability warrants a call to the office.

Cumming-Based Pediatrician’s Office for Well-Child Checkups

At Vickery Pediatrics, we provide well-child visits and sick care treatment for children from newborns through their transition into adulthood. Our team of pediatric professionals is here to assist families in places like Cumming, Buford, Dawsonville, Gainesville, Johns Creek, Sugar Hill, Suwanee and Forsyth County. Call (678) 990-2501 or request an appointment now.

 

 

 

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