Thursday, June 11, 2009

4 Month Well-Baby Check-Up

Today was Lorelai's 4 month well-baby check-up with Dr. Megow. It was scheduled for 1:45 and I asked Matt's mom to go with me because Matt would still be a work. I definitely didn't want to go by myself because it was a shot visit and I did NOT want to go through that by myself! 1:45 is the first appointment that they make after lunch, so we got back to a room very quickly. The first thing that they do is take all of LL's measurements. Here's what she looked like today and how it compares with her 2 month check-up.



4 months
weight - 13 lb 12 oz (50%)
length - 24 1/2 in (54%)
head circumference - 16 in. (36%)
2 months
weight - 11 lb 7 oz (62%)
length - 23 in (69%)
head circumference - 15 in (31%)
Difference
weight + 2 lb 5 oz (-12%)
length + 1 1/2 in (-15%)
head circumference +1 in (+5%)
What all of this means is that she's growing, just not drastically. Which is good. She's not one of those babies that weighs 22 lbs at 4 months. She has gained in numbers for all three areas, but she has lost in percentiles for all three areas. Gaining or losing in percentiles is fine, as long as it does not change dramatically. For instance, it is fine that she has moved from 62% to 50% in her weight. What would not have been good would have been for her to go from either, lets say 62% to 30% or 62% to 85%. Those are both drastic changes and not what the doctors look for.


Here are all of the questions that I asked and the answers that I got:

1- Congestion. Since her 2 month appt (really, her whole life), this kid gets congested! She has to sleep with a humidifier every night and I have to suck out her nose twice a day or else she snorts like a pig. I asked if this was normal/okay/etc. What she said is that as long as it is not accompanied by fever, irritability, etc. that it is probably just an allergy and to keep doing what we're doing.

2- Sunscreen. We don't put her in the sun a lot, but I have been wanting to put sunscreen on her when we do go out. But the problem is that all sunscreen (even the stuff for the babies) says do not use under 6 months. I wanted to see if I could be using it anyway. She said not to because her little skin isn't really strong enough to handle it. Just to make sure that she's not out in the sun for long periods of time, to keep her covered, etc. She said I can start using it at 6 months, but to just test it in a small area to make sure that she doesn't have a reaction to it.

3- Swimming. I've been wanting to put LL in my mom's pool with me, but I didn't know how the chlorine would effect her. She said it was fine to put her in for short periods of time, just to make sure to give her a bath when she gets out.

4- Flat spot. I've noticed that LL has a very small flat spot right on the back of her head. Dr. Megow said this is fine and should go away on it's own as she starts to move around more (which she is already doing).

5- Cereal. I have been so anxious to start LL on cereal. It's just one of those steps towards being a "big girl" and I have been looking forward to it! I really thought that LL was ready because she's been getting tired of her formula. She chews on the nipple half the time and it takes me an hour sometimes to get 4 oz a feeding into her because she just seems so uninterested in it. I thought FOR SURE that she was just ready for something else. Boy was my bubble busted! Dr. Megow said that because she is only eating 4 oz at every feeding (sometimes 6, but not very often) that she didn't want her to start cereal yet. She said that she also didn't want her to start cereal yet because, even though her percentage drops are perfectly normal, she doesn't want them to start dropping more. How she explained it is that, before babies are 6 months old, they should be getting all of their nutritional value from the milk (formula or breast) that they drink. Cereal does not add anything to a baby's diet but more iron. If I were to put LL on cereal, it would decrease some of her formula intake, but it would add almost no calories from her cereal. She would, essentially, be losing a feeding. She said that cereal at 4 months is good for babies that are eating 8 oz at every feeding and still acting hungry. So basically we are going to hold off on the cereal until one of two things: 1- she starts eating 8 oz at every feeding. Then I can start it on my own. 2- She hits 6 months. At 6 months she needs to start replacing some of her formula intake with solids. I'm kinda bummed, but I understand and I want to do what is best for her. She also said that LL is probably chewing on her bottle because she is teething. Great.

6- Swaddling. I am still swaddling LL and it is really the only way that she'll sleep. If you lay her down in her crib un-swaddled, she will not sleep at all. Sometimes you can get a 30 minute nap out of her that way, but not often. I've been wanting to faze her out of this, but I haven't really known how. Dr. Megow said I can just quit cold-turkey and let her CIO (cry-it-out) a few times until she gets the hang of it, OR we can just keep swaddling her until she decides herself that she doesn't like it anymore. I think we'll go with option number 2.

7- Eye color. I know that there is no possible way that Dr. Megow can tell me for sure, but I wanted to know her opinion on if LL's eyes would stay blue or not. She said that, obviously, she couldn't tell me for sure, but that they probably will. She said that most of the time, if they were going to change, they would have done so by now. Yay! Matt and I would obviously be happy with whatever color her eyes turn out to be, but we would really like them to stay blue!


After all of this, she got her shots. She didn't do as bad as she did last time. She didn't even make a noise for the first one, whimpered for the second one, and cried for the 3rd and 4th ones. This is compared to last time where she screamed hysterically for all of them. Next check-up: 6 months!

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