Well Child Visits

4 Month Visit

At this visit, your doctor will …

  • Check baby’s weight, length and head circumference.
  • Do a physical exam with your baby undressed while you are present.
  • Discuss baby’s development.
  • Address any concerns/questions you may have.
  • Immunizations: 4 Month scheduled vaccines ( see Immunization Schedule)(consider giving baby Tylenol just before this check up – see Medication Dosing Chart)

Feeding

  • For babies at 4 months of age, breast milk or formula is generally still the best food.
  • Typically, you should not introduce solid foods, juice or water until about 6 months. Be sure to talk with baby’s doctor before starting baby on any solids.
  • Babies this age should have several wet diapers a day and regular bowel movements. Some may poop every day; others may poop every few days. This is normal as long as stools are soft. Let your doctor know if they become hard, dry, or difficult to pass.

Breast Feeding

  • If still breastfeeding, that’s great! Begin to plan for pumping and storage of breast milk.

Formula Feeding

  • If formula feeding, safely prepare, heat and store formula. Hold baby while feeding, and avoid propping the bottle. Do not put baby to bed with a bottle.

Sleeping

  • At this age, babies sleep about 12 to 16 hours a day, with two or three daytime naps. Most babies have a stretch of sleep for 5 or 6 hours at night. Some infants, particularly those who are breastfed, may wake more often.
  • Now is a good time to lower baby’s mattress.

BACK-TO-SLEEP

(guidelines for reducing the risk of SIDS, Sudden Infant Death Syndrome)

  • Always place baby to sleep on his/her back
  • In your room in a bassinet or crib not in your bed
  • In crib which meets current safety standards: Bars should be no more than 2 3/8 inches apart. Allow no more than a width of 2 adult fingers between the crib mattress and frame. For full crib safety and standards visit www.cpsc.gov
  • Use a firm mattress without any bumpers, blankets, quilts, pillows, plush toys, ribbons or ties
  • Avoid overheating by keeping the room temperature comfortable
  • Consider putting your baby to sleep sucking on a pacifier

Routine Baby Care

General Care

  • Notice what helps to calm your baby: patting, rocking, talking, going for walks, sucking fingers or pacifier, etc.
  • Continue routines for feeding, sleeping, bathing and playing daily.
  • Keep baby out of the sun (sunscreen is not recommended before 6 months old).

Healthy Teeth

  • Some babies begin teething when they’re around 4 months old. If your baby has pain, use a cold teething ring. Talk to your doctor before giving acetaminophen for pain.
  • Make sure you are getting appropriate dental care twice per year. If your teeth are
    unhealthy, you could pass bacteria on to baby and possibly cause tooth decay.
  • Do not share cups or spoons with your baby, or use your mouth to clean baby’s pacifier.
  • Clean baby’s gums and teeth as soon as you see the first tooth. Use a soft cloth or toothbrush with a small smear (size of a grain of rice) of fluoride toothpaste.

Tips for mom

Take care of yourself:

  • Take time for yourself.
  • Spend time socially with your partner, family and friends.
  • Choose a mature, responsible caregiver or babysitter.
  • Be sure to let your doctor and/or baby’s doctor know if you are feeling anxious or overwhelmed.

Development

  • Interact with your baby! Singing, talking, and reading to your baby are great ways to help him/her learn.
  • Encourage active play: Offer child-safe mirror, floor gyms and colorful age-appropriate toys.
  • Learn what your baby likes and does not like.
  • Give your baby supervised “tummy time” when awake, and be ready to help if he or she gets tired or frustrated in this position.
  • Limit the amount of time your baby spends in an infant seat, bouncer, or swing.
  • Limit screen time for your baby. TV, videos, etc. aren’t recommended for babies this young.

By 4 months, it’s common for many babies to:

  • turn when they hear voices
  • smile, laugh, and squeal
  • “coo” in response to your “coos”
  • bring hands together in front of chest
  • reach for and grasp objects
  • have good head control when sitting
  • hold up head and chest, supporting themselves on arms, while on tummy
  • Roll from front to back

     * All babies develop at different rates, and meet developmental milestones differently.

Safety

Car Safety

  • Visit healthychildren.org for complete car seat guidelines provided by the American Academy of Pediatrics (AAP).
  • Make sure car seat is installed correctly (the Fire Department will check car seats for correct installation)
  • Make sure seat is rear-facing in the back seat, and never in the front seat with a passenger side airbag
  • Never leave baby alone in the car
  • Always wear a seat belt, and do not drive under the influence of alcohol or drugs

Child Safety Seat Inspection:
1-866-SEATCHECK (732-2432) or www.seatcheck.org

General Safety

  • Do not smoke/vape or allow others to smoke/vape around baby
  • Do not leave baby unattended
    • Never leave a baby alone with siblings or pets, in the bath, on a changing table, or any other raised surface.
  • Make sure your home’s water temperature is set to below 120º F
  • Do not carry or drink hot liquids while holding baby
  • Test baby’s formula temperature with your wrist
  • Keep small objects such as balloons, bags, toys from other children away from baby.
  • Never feed baby hard pieces of food such as raw carrots, hot dogs, grapes, apples, peanuts, and popcorn.
  • Do not use a baby walker as they are more likely to cause accidents.
  • The kitchen is a dangerous place. Avoid letting baby crawl in kitchen by using a playpen or high chair.

When to Call

Call Doctor

  • Fever: Rectal temperature below 96.8º or above 100.4º
  • If you suspect baby is not acting normal for any reason

What our parents say

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    Mom to Joey, Carsen, & Patrick

  • "I have been using this facility for 24 years. My own 2 children were patients and now my 2 grandchildren are patients. I think that speaks volumes about my confidence in this facility. Keep up the good work.”

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  • "Great staff! We have been several times during the COVID period, and we have gotten quick and excellent service. We love the text check in and waiting in the car.”

  • "Great service. Friendly staff. Excellent physicians!”

    Mom to Sophia & Victoria

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