What to expect at your baby’s 4 months checkup

Weigh and measure your baby : You need to undress your baby completely so that she can be weighed. Her length and head circumference will also be taken and plotted on a growth chart. This chart enables them to compare your baby with other children the same age. It doesnt really matter if your child is on the 5th or 90th percentile, as long as she is growing steadily.

Complete physical : The doctor will do the following :

• check your baby lungs and heart. He will use a stethoscope to check for any abnormal heart rhythms and breathing problems
• check the ears for any infection and how the baby responds to sound. The eye  of your baby will be checked for any congenital eye problem and other problems. He may also check for blocked tear duct
• he will check the shape of your baby’s head . This is a good time to catch the development of a flat spot on the baby’s head. The soft spot ( fontanelle) on your baby’s head will also be evaluated
• he will look out for signs of thrush in your baby’s mouth and any signs of teething
• he will press gently on the your baby’s belly to check for any enlarged organs or abdominal hernia
• the doctor will check your baby’s reflexes and muscle tone. He will also check for any rash on the baby’s skin.
• he will open your baby’s diaper and check for signs of infection
• he will move your baby’s legs around to look for signs of hip problems

Immunization : Your baby will receive the following shot

• DTaP
• Hib
• polio
• pneumococcal vaccines
• rotavirus ( this is given orally )

Your doctor will recommend giving  vitamin D supplement drops to breastfed babies. Babies who drink 17 to 32 ounces of formula a day are getting enough vitamin D.

He will also address and any questions and concerns you may have.

Some of the questions your doctor may ask you include the following :

1. How is your baby sleeping : Your baby’s sleep pattern is now predictable. She has about 3 to 4 daytime naps . Her nigh sleep interval is now longer . She can sleep for about 6 hours at a time
2. Your baby’s bowel movement : Soft stools are the best. The color of the stool can vary. However if baby  passes frequent , smelly , watery stool with streaks of mucus, it could be diarrhea. You have to notify your doctor.
3. How well is your baby eating :  4 to 6 months is the recommended time for solid foods in babies. However it doesnt hurt to talk to your doctor about it now.  Ask him when and how to feed your baby solids foods . You should also inquire if your baby needs any extra vitamins
4. Development : It is common for babies at this age to do the following :
   • coo in responds to you
   • hold her head and chest up while supporting herself on her arms or on her tummy
   • bring her hands together infront of her chest
   • reach for and grab things
   • possibly roll from front to back
   • bring toys to the mouth
   • smile, laugh and squeal

You have to know that children grow at different rates. If you  have concerns about your child’s development, talk to your pediatrician.