4 months old
The 4-month Check-up
If you weren’t scheduled an appointment during month three, you’re probably anxiously awaiting this upcoming check-up. Maybe not for the immunizations (which, unfortunately, will resume this month), but to finally ask the list of questions you’ve been stockpiling. The doctor will probably do the same type of physical exam as your last visit – checking your baby’s abdomen, joints, ears, etc. – as well as a developmental assessment, largely relying on your observations. If there’s anything you’ve been worrying about, now is the time to ask. Also make sure to have a pen handy to jot down your baby’s new measurements, as well as any immunizations, medications, test results or recent illnesses.
Write a list of questions ahead of time, especially if they’ve been building up for a month. Besides unique developmental and health concerns, you also might want to inquire about:
- When to start solids and what to begin with;
- Immunization side effects and how to treat them;
- When/if to stop using a pacifier;
- How much your baby should be sleeping; and
- Any recommendations you might need for childcare or other local services.
If you missed our tips on how to make your check-ups run smoothly, read it now.
And because problems can arise before and after your doctor’s appointment, don’t forget to familiarize yourself on the symptoms and warning signs that warrant an immediate call to the doctor or emergency room.
Bowel Movements and Digestion
You’ll notice a reduction in your baby’s bowel movement frequency (if you haven’t already) as your baby’s digestive system matures and solid foods are introduced. Even if you decide to stick to a purely liquid diet for a few more months, you might notice that the six bowel movements your baby had yesterday have turned into maybe one – or none – today. Of course, digestive habits will vary, but don’t be too concerned about this sudden drop. Unless your baby is straining to pass hard, pellet-size stools, it’s most likely not constipation. On the other hand, if you notice watery, green stools – possibly with blood or mucus – then it sounds like your baby has diarrhea.
Also, keep in mind that symptoms of tend to peak at around four months, characterized by:
- Inconsolable crying, often sounding like he or she is in pain
- A large amount of spit-up and drool
- Projectile vomit
- Little to no weight gain
- Difficulty sleeping
- Gagging while eating
- Back arching, leg curling or other signs of abdominal pain
- Excessive burping and/or hiccupping
- A chronic cough, which often leads to respiratory problems
- Constant ear infections
The doctor might recommend adding rice cereal to your baby’s bottle (always get the green light before doing this), or giving medication to reduce or neutralize your baby’s stomach acid. Most will outgrow this heartburn-like condition and the symptoms aren’t likely to get worse than they are right now. Until then, follow our advice on how to help relieve reflux.
Now that your baby is secreting less waste, cloth and hybrid diapers might be more manageable for those cringing at the landfill contribution of and chemical-filled plastic in disposables. Before you write off cloth as messy and high maintenance, there are plenty of new options that eliminate some of the hassle. And if your baby has been experiencing painful diaper rash, trying a different diapering option might be helpful.