Four Month Check-Up
Your pediatrician will ask you questions about the previous two months, how your baby is doing overall and address any concerns you may have. He or she will ask you questions about developmental milestones your baby may have reached by four months, such as if she is sleeping through the night, rolling over, if she can follow an object from side to side, is exploring things with her hands and mouth, and if she is babbling or making noises other than crying.
Be ready to describe a typical day with your baby, how active he or she is, what developmental milestones he or she has achieved since the last appointment, how much he eats, and how many diapers you go through on a typical day. Don't be afraid to ask the pediatrician lots of questions; in fact according to Sharon L. Busey, M.D., assistant professor of pediatrics at the Medical College of Wisconsin, "Parents should come to visits armed with any questions or concerns they have about their child. The well-baby visit is a good opportunity to address questions that the parent [may have.]" Never leave the office feeling uncertain or uncomfortable about the answers your doctor has given you; he or she is there for you.
The doctor will then physically examine your baby, which includes measuring your baby's length, height, weight (the average four-month-old has doubled his or her birth weight), and head circumference. Head circumference is an indirect measure of your baby's brain growth, so the pediatrician will make sure growth is steady and continuous between check-ups. He or she will probably plot all of your baby's measurements on a growth chart; however, try not to compare your baby with others. It is more important that your baby show consistent growth from month to month, rather than how much he weighs or how long he is at a particular check-up. Throughout the first year, your doctor will also watch the soft spots on your baby's head; the one at the front of your baby's head may take up to two years to fully close.
The standard physical examination also includes the following:
Ears - Your pediatrician will look for evidence of fluid or infection, as well as make sure your baby's hearing is normal.
Eyes - The doctor will shine a bright light in front of your baby's face to catch his or her attention, and check for any signs of infection or impaired vision.
Skin - Your doctor will examine your baby's skin for various conditions, including birthmarks and rashes.
Mouth - Your pediatrician will check your baby's mouth for signs of infection, such as oral thrush, and for teething progress.
Heart and lungs - The doctor will listen to your baby's heart and breathing with a stethoscope.
Abdomen - Your pediatrician will press gently on your baby's abdomen to check for any enlarged or abnormal organs.
Genitalia - Your doctor will examine your baby's genitalia to look for any unusual lumps, tenderness or signs of infection. Hips and Legs - The doctor will move your baby's legs to check for dislocations or other problems. When your baby begins to walk, the doctor will make sure her legs and feet are aligned properly.
Your baby will get the next set of immunizations at this visit, which will probably include DTaP (diphtheria, tetanus, pertussis), HiB (Haemophilus influenza type B), and IPV (polio). The doctor may also test your baby's blood for anemia, particularly if he or she was born prematurely.