4 Month Visit

November 02,2022

At Peninsula Pediatrics, we don’t just help your children when they’re sick; we help them, and your whole family, stay well all the time.

Four month olds are just delightful. They are interactive, smiling and just a lot of fun to be around. Your little one is smiling, cooing and may have started laughing. They are excited to see you when you come into a room. The fussiness of infancy will have decreased and hopefully you are getting some more sleep!

Pre-visit Questionnaire

Before your visit, you will receive a link to the following questionnaires 

Edinburgh Postpartum Depression Screen:  At Peninsula Pediatrics, we care deeply about the health of your entire family unit. Ten to twenty percent of women experience postpartum depression or anxiety in the postpartum period. This can be hard to talk about. By screening all our patients, we are trying to eliminate any stigma and provide you with the opportunity to discuss your feelings in a nonjudgmental setting. ALL Peninsula Parents receive this questionnaire at the 5 week, 2,4, and 6 month visits. To learn more about postpartum depression/anxiety click here. 

PEDS-DM: This questionnaire is a standardized developmental screening that you will receive at all your little one’s well visits from ages 5 weeks to 5 years.

At this visit you should expect your child to

  • Have their weight, length, and head circumference measured
  • Have a complete physical exam

Immunizations

The 2,4, and 6 month vaccines are identical. They are what is called your child’s primary series. 

Pentacel-This vaccine protects against  DTap, Polio and haemophilus influenzae

Prevenar- This vaccine protects against Pneumococcal disease

Rotavirus- This is an oral vaccine that protects against Rotavirus.

Vaccine Reactions

Most babies do well after vaccinations. You may notice that your little one is having looser or greener stools for up to a week. There is no intervention needed. 

 A small percentage may develop fevers, fussiness or redness/swelling at the injection site. For redness or swelling, you can apply cool compresses to the area for soothing. For fussiness or fever (temperature above 100.4 F) you can give your little one some acetaminophen. All dosing in pediatrics is weight based. You can find the dosing chart here.

Vaccine reactions can last up to 72 hours after vaccination. If you have questions or concerns, please reach out to us.

Safety and parenting tips

  • At this age babies have started to gain the ability to self-soothe and can sleep for longer periods at night. Sleep education can begin around 4 months of age. Read more about age-appropriate sleep and options to lengthen your little one’s sleep periods overnight.
  • Many babies start to roll between 4-6 months of age. Your little one should always be placed to sleep on their back, if they roll to their tummy while sleeping, there is no need to go in and return them to their backs.
  • Most babies teeth between 6-10 months (3-18 months is normal,) all babie this age drool a lot and will bring things to their mouths. This is age appropriate behavior and nothing to be concerned with.
  • Babies this age are more aware and will respond to consistency and routines. This is a good time to start establishing a daily routine.
  • Babies this age will feed less frequently with anywhere between 6-10 feedings in 24 hours. Bottle fed babies will take anywhere between 26-36oz a day at this age.
  • Check out our starting solids guid
  • Car seats should remain in the back seat and rear facing
  • Your hot water heater should be set to below 120 degrees Fahrenheit to avoid burns. Babies this age grab at things, avoid carrying hot drinks or cooking when holding your baby.
  • Check out our baby proofing guide!

When is my little one’s next visit?

The next visit is in 2 months when your little one is 6 months old.

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