Baby: Birth – 4m



The first 4 months of life is usually a healthy time because babies are born with lots of immunity they get from mom. (Breastfed babies get even more after birth). When babies this young do get sick, however, it can be more serious and more difficult to evaluate than similar illnesses in older children. Prevention is best. All babies should see the pediatrician at about 3 days, 2 weeks, 2 months and 4 months of age. Sometimes we may want to keep a closer eye on something and ask you to come in more frequently. These visits are not just for shots, but are times when we screen for a variety of subtle problems and are a good opportunity for you to learn more about your baby:

  • Your baby will get vaccines at the 2 and 4 month visits Always call if the baby gets a HIGH fever (more than 104°F) or is VERY irritable (not just fussy) after a vaccine. Very rarely, more serious side effects can occur, but the benefits of giving these vaccines outweigh the risks involved. If you want to know more about this, please refer to our office schedule, Immunizations – Protection for your Child
  • Washing hands with soap and water is the single most effective thing you can do to prevent the spread of colds and other infections to the baby.
  • Symptoms not to worry about: stuffy nose, sneezing, hiccups, spitting up, bowel movements as frequent as every feeding or as seldom as every 4th day. Use a bulb syringe to clear a stuffy nose. Do not use over-the-counter cough/cold medicines in this age group. Use Acetaminophen for a fever only after talking to the doctor or after a shot. Don’t ever use bathing of any type to treat a fever.
  • Possibly concerning symptoms: fever (over 100.4° rectally), cough, forceful vomiting, diarrhea (frequent watery stools). While all of these will become much less worrisome as the baby gets older, in this age group they should be evaluated by the pediatrician.
  • Constipation means hard stools. Try a little extra water, 1 tablespoon of light Karo Syrup mixed with formula or water once or twice daily, or some prunes or prune juice. Don’t resort to suppositories unless told to by the doctor. If a constipated baby starts to vomit or become irritable, call.
  • Unless we specifically instruct you otherwise, have the baby sleep on its back or side. Sleeping on the stomach increases the risk of SIDS. The NIH offers a free brochure for safe sleeping practices.
  • Exposure to second-hand cigarette smoke also increases the risk of SIDS, as well as asthma, pneumonia and ear infections.