Find out what to expect at this well-baby checkup. Download a printable version of our 4-month checkup worksheet to take with you. You may want to read through the questions and jot down answers beforehand.
What the doctor will do
Weigh and measure your baby
You'll need to undress your baby completely for weighing. The doctor weighs your baby, measures length and head circumference, and plots the numbers on a growth chart.
The chart enables you to see how your baby compares with other children the same age. But it doesn't matter whether he's in the 5th or the 95th percentile, as long as his rate of growth is steady from one visit to the next.
Do a complete physical
- Heart and lungs: Uses a stethoscope to listen for any abnormal heart rhythms or breathing problems.
- Eyes: Checks for signs of congenital eye conditions and other problems. May also check for blocked tear ducts and discharge.
- Ears: Looks for signs of infection and observes how your baby responds to sound.
- Mouth: Looks for signs of thrush (an oral yeast infection) and any signs of emerging teeth.
- Head: Checks the soft spots (fontanels) and the shape of your baby's head. Also checks to see if your baby's head is developing a flat spot.
- Body: Checks your baby's reflexes and muscle tone, and examines his skin for rashes. Puts the baby on his tummy to check his head control.
- Belly: Presses gently on the abdomen to check for a hernia or any enlarged organs.
- Genitals: Opens your baby's diaper and checks for signs of infection.
- Hips and legs: Moves your baby's legs around to look for problems in the hip joints.
Give your baby her shots
Your baby will receive the DTaP, Hib, polio, pneumococcal vaccines (combined in two shots) and the rotavirus vaccine (given orally).
An assistant may administer the vaccines. This is usually done at the end of the appointment so you can have some privacy afterward to comfort your baby.
Address any other concerns
Your doctor will recommend giving vitamin D drops to breastfed babies. (Babies who drink 17 to 32 ounces of formula a day are getting enough vitamin D.)
The doctor will address any health concerns (such as how to deal with constipation, colds, and the flu), ask you some questions (see below), and help you understand what's normal at this age.
Questions the doctor may ask:
- How's your baby sleeping? Your baby's sleep may be falling into a more predictable routine with three to four daytime naps and a longer nighttime sleep interval of six hours or more.
- When, how, and how often is your baby eating? Some babies aren't ready for solids quite yet – 4 to 6 months is the recommended time – but it can't hurt to talk to the doctor about it now. Ask the doctor how and when you should begin, and whether your baby needs any extra vitamins.
- What are your baby's bowel movements like? Soft feces are best, but color can vary. If your baby has ever passed frequent, smelly, watery, mucus-streaked stools, it's probably diarrhea. Ask the doctor about the best way to treat it.
- Can your baby roll over one way or sit with support? Both of these are skills that your baby will begin to develop around now, though she probably won't be able to roll over in both directions or sit without support until around 6 months of age.
- Can your baby do a mini-pushup? This skill is typical for 4-month-olds and shows that their physical development is on track. If your baby is still having difficulty controlling or lifting her head, let the doctor know.
- What sounds does your baby make? Your baby's language skills may include babbling, squealing, and even laughing. She's probably smiling at you even more now, too, sometimes even before you smile at her, and her mouth is getting quite active – exploring objects, drooling, and blowing bubbles. If your baby is making fewer sounds than she did before, tell the doctor.
- How are your baby's motor skills? Your baby may now reach for and grab things. She may also be able to bring her hands together in front of her. If she uses one hand more than the other, mention it to the doctor. She should also be kicking with both legs and bouncing on them when held upright above your lap or the floor. If she holds her legs straight a lot of the time, tell the doctor.
- Have you noticed anything unusual about your baby's eyes or the way she looks at things? At every well-baby visit, the doctor should check the structure and alignment of the eyes and your baby's ability to move them correctly.
- How's your baby's hearing? If your baby doesn't turn toward sounds, be sure to tell the doctor. The sooner potential hearing problems are investigated, the sooner they can be treated.
- Find out what's in store for you the 6-month doctor visit.
- View and print a clean copy of the 4-month doctor visit worksheet.