The 4-month visit is a time to show off your beautiful baby. Dress him up for the visit and celebrate how far you've come together! Your 4-month-old will sit in your lap and give strangers a wary stare before he tries a smile or a sound to get them to talk to him. Then he'll beam brightly and charm everyone around him. He's curious about the whole event and probably won't protest too much at the exam ... it usually goes smoothly. Enjoy everyone enjoying him.
He will get a lot of immunizations at this visit, so remember to bring his immunization card. Let everyone know if your health insurance has changed, or if you don't have health insurance for your child.
At this visit, your provider will probably:
- Weigh and measure your baby. Click here to see our growth chart.
- Measure your baby's head.
- Give your baby his second round of immunizations (probably DTaP, Hib, and IPV). Click here to see our immunization chart.
- Answer any questions you may have about child care and transitions in care.
- Give you some insight into your baby's development, temperament, and behavior.
- Discuss ways to help your baby develop good sleep habits.
Your provider will want to know:
- Has your baby seen another health care provider since the last visit? If so, why? What was the outcome of that visit, and were any medications or treatments prescribed?
- Does your baby get up on his hands when he's on his tummy?
- Roll from his tummy to his back? Some babies can roll the other way, too.
- Make babbling sounds, squeal, or laugh?
- Reach and grab for things, or at least try to? Does he grab his own hands?
- Hold a rattle or small toy?
- Notice you and follow you across the room with his eyes?
- Recognize your voice?
- Put his hands together in the middle?
- Sit up with support?
- Put objects in his mouth, blow bubbles, or drool?
- Sleep longer at night?
- Smile at you before you smile at him?
Although every baby develops in a slightly different way, most babies are close to doing most of these things. Report what your baby is up to now, and what things on this list he's still working on accomplishing.
Talk It Over
Your health care provider wants to know more than just the numbers. Don't be afraid to take this time to ask your provider anything at all about your baby. For example:
- Discuss your baby's eating habits. If you think he's ready for solid foods, ask about it. Most babies don't need solid food before they're 6 months old, but your baby may be different. Get instructions on how to begin if you are advised to start.
- Talk about your baby's sleep habits. Your provider may have some tips on how to set up a sleep ritual that will help your baby settle himself and sleep through the night.
- Many mothers are already back at work when their babies are 4 months old. Discuss your child care arrangements and any troubles or concerns you may have.
- Have you made any changes in your home or family life? Let your provider know. These always have an impact on the baby.
- If you don't have health insurance, say so. There are special insurance programs for children. Don't be caught without!
- If you aren't enjoying your baby at this time, tell your provider. Whatever is interfering with your enjoyment needs and deserves prompt attention.
- If you haven't gone out of the house without the baby by this time, it's time to do so. If you're not comfortable leaving the baby for brief periods, then your provider will want to help explore your concerns and feelings.
- Some babies are so social at this age that they seem to want to wean from the breast. If this seems to be happening, bring it up now.
- Your baby should be moving toward two to three naps within a 24-hour period. If he's not moving in that direction, bring it up at this visit.
There are additional issues of special concern to both you and your provider. Let your provider know if your baby:
- Doesn't seem to notice things unless they're very close to him, or doesn't follow you with his eyes from across the room.
- Makes no sounds or fewer sounds than before.
- Notices sounds less than before or doesn't turn to sounds, particularly your voice. This could be just the way he is or it could be a sign of hearing loss.
- Uses one hand more than the other. Babies should be using both hands equally at this age.
- Doesn't kick with both feet or keeps his legs straight most of the time.
- Doesn't lift up his head when he's on his tummy.
- Keeps his hands closed and/or doesn't grab things.
- Doesn't put things in his mouth.
- Doesn't roll over.
- Can't bear weight on his legs or bounce when held upright.
- Still feels wobbly or loose when held or has a hard time controlling his head.
You should leave this visit:
- Happy that you're one step closer to full immunization.
- Confident that you can manage fevers and minor health complaints.
- With a plan for dealing with your baby's sleep and feeding needs.
- Proud of your child's growth and gains in development.
- Glad to have gotten the help you need to care for your child.
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