4 Month Visit
Development
Your baby is now smiling and laughing, cooing, and making “raspberries.” He/she can follow and object with their eyes and responds to their own name. They may voluntarily grab objects placed near their hands. Watching mobiles is a great pastime at this age! Continue tummy time each day – they will be holding their head high and possibly rolling over. Drooling and putting objects in their mouth is normal at this age and not necessarily a sign of teething. Most infants’ first tooth erupts between 6 and 10 months.
Feeding your Baby
Click here to find out about introducing solids to your infant.
Elimination Questions
Based on your child’s diet, stools can vary. Breast – fed infants will have yellow, soft, seedy stools; whereas formula fed infants will have stools that are brown to green. At this age, it is normal to have between several stools per day to several per week. Grunting and pushing during a bowel movement is normal. Call our office if stools become hard, dry or if there is no stool for more than three days.
Sleeping
Always place baby on his/her back to sleep! Encourage good sleep behavior – keep night time feedings quiet so as not to encourage night feedings. When the baby is acting tired, lie him/her down in a crib in a quiet, dark room. Rocking to sleep, feeding to sleep, or using a pacifier to lull baby to sleep may interfere with the baby learning to fall asleep on their own. The baby should be sleeping 4 – 8 hour stretches at night.
Skin Care
Beware diaper rash! Use a barrier cream, such as A&D Ointment or Aquaphor each diaper change to protect delicate skin. Treat redness or irritation with a white, zinc-based cream, such as Desitin or Triple Paste. Call the office if your child’s skin becomes very red, raw or shows any sign of discomfort. Bathe your child with a mild soap.
Safety Concerns at this Age
- Chances of falling are greater because of increased mobility. Don’t leave your baby unattended on a changing table, bed, couch or other elevated surfaces.
- Your baby can grab objects for swallowing of chocking.
- Never leave the baby alone in the bath, no matter how shallow the water!
- Continue to place your child in an infant car seat, rear facing.
- Do not use a wheeled walker – these can cause serious injury.
Today’s Immunizations
Today’s vaccines are: DTaP (diphtheria, tetanus, pertussis), Rotavirus, HiB, Pneumococcal, and Polio. As with any vaccine, low grade fever (below 101°), irritability and pain at the injection site are common side effects. You can give your child acetaminophen (Tylenol) for pain and fever, and use cold compresses for comfort. Call our office if your child has a fever over 101° rectally, becomes very pale or limp, or cries inconsolably for longer than 3 hours.