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Four Month Well Visit

The baby may be rolling over now but do not worry if they don’t until the next month or so.   The normal range for this is quite large.  The baby should be rolling by 6 months. If all the development of the baby is normal but 1 thing is late, then the baby is normal but has just one thing delayed. That is OK and if you read the two-month-visit page, sooner is not necessarily better. 

You should start using a spoon to feed your baby. It is still OK to put cereal in the bottle or feeders. If you are still only breast feeding, keep it up. Babies only require breast milk or formula for the first 6 months and do not require cereal.  We will start the veg. & meats at 6 months. Only give rice or oatmeal cereal.  Apple and bananas are OK. You also can give non-citric acid juices like apple, pear or prune.

There is a tremendous increase in saliva, drooling and chewing.  It still is not teething although few babies will have teeth now.  The later the teeth erupt then the teeth are usually stronger.   The increase in swallowed saliva and the increase in physical activity will cause more spitting up of milk in this age so do not worry.  

They also will have bonded with the parent and cry when they leave the room. They will bond most with the person who does most of the feedings. The other parent will get their feelings hurt when the baby cries when the other parent leaves but this is the normal bonding to the baby’s parent. This is not spoiled. You do not spoil them till 9 months or older when they through a temper tantrum for a cookie and the parent gives in to it. Crying when the parent leaves is bonding to the parent.  Go ahead and leave if just for a minute and call from the other room to reassure them.  

You will see the baby have a desire to be more upright, and stand more. It is an instinct to be upright erect like a human and not horizontal like animals. They will be trying to sit up straight instead of lying back in the seats. (abdominal crunches!)  It is all right to sit them in an infant activity center propped up by pillow or blanket safely.  It won’t hurt their back or legs.  Careful with walkers so they do not go down steps or get into trash, etc. that can harm them.  Jumping seats that hang are OK but again be careful. 

They may go outside but careful of too much sun or of bug bites. They can burn in the shade by indirect light reflected off objects. (Previously called wind burn. Wind does not burn, it cools you. It was the reflected indirect light.) They can go swimming for a short time.  Their body temperature changes quickly so make it only a few minutes.  Take their body temp after swimming and be sure it is not below 97 degrees.  Some parents have left water in the hose in the sun and then add that hot water to a small rubber wadding pool.  That way the water isn’t so cold.

They are getting cute now. It is OK to put pierced earrings in their ears. I haven’t seen one get infected yet. Do it this year or as a teenager. But definitely have fun with the baby.  This is a great age before they enter “terrible twos”. 

Dr. Knapp