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Pediatric Health Maintenance 4 Months quick look
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This chart rates treatment options according to general effectiveness, ease of use,
side effects and safety.
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Check infant for normal coordination and strength to make sure that the nervous system is developing properly
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Not available
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By four months of age babies should reach out and grasp object and play with hands. Babies should coo to parents, smile and laugh.
Check that the baby has head control and can lift the body with the arms when lying on the stomach. Check reaching and grasping skills and language/social interaction
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Full physical exam, and comparing height to a growth chart to see if growth is normal
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Physician should pay particular attention to: checking for hip abnormalities (hip dysplasia), heart murmurs, and overall evidence of good health/good care.
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Full physical exam, and comparing height to a growth chart to see if growth is normal
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Blood test (called blood counts) for infants at risk for anemia
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Excellent
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Infants who were premature or who are on a low-iron formula are at higher risk of anemia.
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Blood test (called blood counts) for infants at risk for anemia
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Other screening tests
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There are not any particular lab or other screening tests that are recommended at this interval other than the routine physical exam.
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Other screening tests
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DTaP (diptheria/tetanus/pertussis vaccine), IPV (Inactivated poliomyelitis vaccine), HIB (Haemophilus influenza type b vaccine), PCV (pneumoccocal vaccine), RotaTeq (rotavirus vaccine)
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Excellent
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The second injections of these vaccinations are given at 4 months: diptheria/tetanus/pertussis vaccine; polio vaccine; H. influenza vaccine; pneumococcal vaccine; rotavirus vaccine (by mouth). The most common side effects from these vaccines are pain around the area of injection and fever.
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DTaP (diptheria/tetanus/pertussis vaccine), IPV (Inactivated poliomyelitis vaccine), HIB (Haemophilus influenza type b vaccine), PCV (pneumoccocal vaccine), RotaTeq (rotavirus vaccine)
Severe reactions due to these immunizations are rare and most of these are due to allergic reactions. DTaP (diptheria/tetanus/pertussis vaccine) can rarely cause a nerve problem called brachial neuritis. RotaTeq (rotavirus vaccine) is given by mouth. Physicians must give parents vaccine information statements to inform them of the risks of any vaccine. These statements are available at: http://www.immunize.org/vis/. Experts recommend that all babies receive these vaccines except those who have had a severe reaction to these vaccinations in the past, or who are allergic to an ingredient in the vaccine. (see information in the vaccine information statement at http://www.immunize.org/vis/).
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Discuss introducing solids between 4-6 months, sleep habits, age-appropriate toys.
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When starting solid foods, parents should first give iron-fortified cereal. Babies should sleep through the night by 4 months. Toys should not have small parts that are choking hazards. Steps should be taken to childproof the home.
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Discuss introducing solids between 4-6 months, sleep habits, age-appropriate toys.
New foods should be introduced one-at-a-time, watching carefully for allergic reactions. Further information on food allergies can be found at the website of the National Institute of Allergy and Infectious Disease of the National Institutes of Health at:
http://www3.niaid.nih.gov/topics/foodAllergy/understanding/children.htm
The American Academy of Pediatrics Committee on Nutrition adds the following recommendations:
When the time comes to wean your baby to solid foods, the ACAAI recommends that children in atopic families (that is, families with a history of allergies) be weaned slowly. Here are four principles to keep in mind:
1. Recommendations released in January 2008 by the AAP now recommend that solid foods not be introduced before four to six months of age, but that the timing of introducing common allergens (such as dairy, eggs, and nuts) is no longer believed to have an impact on a child's later probability of developing allergic diseases.
2. The ACAAI recommends that even foods with a low likelihood of causing allergies (like simple fruits, vegetables, and less allergenic grains) be introduced one at a time, and not be combined until parents are sure that each individual ingredient is well-tolerated. Parents should note, however, that "stage 2" and "stage 3" commercial baby foods -- even from organic and natural manufacturers -- may include unexpected grains or fillers. Always check ingredient labels.
3. The ACAAI recommends that fruits and vegetables be introduced in their cooked form, as many of them are less allergenic when cooked.
4. Parents concerned about keeping track of which foods their infants can tolerate might consider making a food log during the period in which their child is being introduced to new foods.
Finally, parents should keep in mind that no matter how many precautions they take, there is no proven way to prevent food allergies in any particular child. These steps are simply believed to be good practices for reducing the risk of developing food allergies over large populations of children.
Childproofing includes plugging electrical outlets and removing dangling electrical cords. Plastic bags, balloons, medications, and poisonous substances should not be within reach. Stairs should have gates to prevent falls. A good website with excellent childproofing recommendations is: http://www.cpsc.gove/cpscpub/pubs/grand/12steps/12steps.html
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NOTE: Just because a drug or combination of drugs can cause a
symptom does not mean it is actually causing your symptom. Symptoms can be caused by
medical conditions as well. Make sure that your physician is aware of any symptoms you
are experiencing so he/she can work with you to determine the cause. Please DO NOT STOP
MEDICATIONS without first consulting a physician since doing so could be hazardous to
your health.
DISCLAIMER: Please note that the information DoubleCheckMD.com provides is intended
to help individuals to work with their medical professionals and is for educational purposes
only. It does not constitute medical or healthcare advice and serves to supplement, not
substitute for, the expertise and judgment of a healthcare professional. In all cases
individuals should consult with a physician before taking any action based on DoubleCheckMD
feedback including, but not limited to ceasing taking any drug, changing diet or commencing or
discontinuing any course of treatment. The information provided by DoubleCheckMD.com is not
intended to cover all possible uses, directions, precautions, drug interactions or adverse
effects, nor should it be construed to indicate that the use of a particular drug is safe,
appropriate or effective.
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