The fourth month is the beginning of a new stage in the development of a child. From now on, the intensity of weight gain decreases, and now every subsequent month it will be slightly less than in the previous month. Increases in length until about the ninth month remain stable – 2 cm each, and then they also start to decrease. But the growth of individual parts of the body occurs more harmoniously and the proportions characteristic of the newborn change more and more noticeably.
The baby was born “tadpole”: the circumference of its head, which was 33-36 cm, was larger than the circumference of the chest. By the end of the month, this ratio had already changed; head circumference is now 39.5-40.5 cm, and the chest is 40-41 cm.
The head-to-breast ratio is not significantly from an aesthetic point of view (although why not?), But as a diagnostic sign. Too rapid growth of the head can be an indicator of increased intracranial pressure, and therefore, some, albeit insignificant, disruption of the central nervous system. A large head, bulging frontal bumps are characteristic of “blooming” rickets. A too small, very slowly growing head makes one suspect a brain underdevelopment.
The circumference of the chest – a kind of mirror of the general condition of the child. If it increases a little, does not “overtake” the head, you have to think whether the feeding of the child is correct, whether he is good at digesting food, are there any other reasons for the physical development lag?
The development of a four-month baby
Already by 4 months, lying on his stomach, a healthy child easily lifts the upper half of the body and not only looks ahead with interest, but also freely turns his head to the right and left, if something attracts his attention. The abdomen is tight to the litter, the hips are wide apart, the feet are in the air.
Lying on its back, the child lifts both the arms and legs, plays them, grips the feet with his hands with the clear intention to pull them into his mouth.
At an early age, the mouth is an organ of knowledge. Any object that becomes available to the child will be tasted first, licked, examined with tongue and gums. When you stretch a toy that is convenient for grabbing it, it also pulls it to your mouth. It is useless to prevent this, but what is absolutely necessary is to wash the toy every day with soap and rinse with boiled water, and choose one that does not have sharp bulges, angles, and if it is a rattle – check if any of them can small details.
The child is already able to stay awake for an hour and a half in a row, and he entertains himself for quite a long time: he tries to pull the string of toys hanging over him, feels them, shakes, moves.
But 15-20 minutes pass, and he begins to demand communication. At first he tries to attract the attention of an adult in his field of vision with a smile, buzz, hand and foot movements, and, having exhausted peaceful means, with a whimper and even a shout. To be with you is his need and right. Play with him, talk, take your hands, walk around the room.
Hair and nail clipping
In the care of a child of the fourth month of life, a new one appears – cutting hair and nails. The baby’s long nails are a place of accumulation of dirt, the possibility of minor injuries to the mucous membranes and scratching of the skin. The cut line of the nails on the fingers should be arcuate, on the legs – straight. It is this form of cutting nails on the legs that prevents their corners from growing into soft tissue.
Hair in children of this age is usually still short. But for some, to the delight of parents, violent curls curl. If your baby’s head sweats heavily or seborrhea appears on its hairy part, long hair should be cut as they interfere with skin care.
Further development of the motor abilities of the child leads to the fact that he begins to straighten and bend the limbs with force and, naturally, can throw off the blanket or diaper covering him. In this case, the baby, if not wearing the sliders, can turn around and expose the lower half of the body. Cooling the skin reflexively causes urination. Wet feet cool faster. And the natural peculiarity of a person is such that cooling of the soles causes a reflex swelling of the nasopharynx. In addition, due to the imperfection of maintaining body temperature, a small child may experience general cooling, that is, what is called a cold.
However, the baby can not hold “under the hood.” Environmental changes will certainly affect him, no matter how carefully his parents cared for him. It is necessary to prepare the child to endure such unexpected cooling without harm. To do this, a complex of tempering procedures must be replenished with wet rubdowns. It is convenient to combine them with the general toilet of the child. At the same time, the entire surface of the body, literally from the top of the head to the heels, is wiped with a damp sponge (soft cloth). This should be done in stages. First you need to wipe the upper limbs and chest, put on a shirt and only then wipe each leg separately. The rubdown is the best gymnastics for vessels. During short-term cooling, the vessels narrow, reducing the loss of heat from the skin. Trained in this way the body, once in an unfavorable situation, cools slower.
The basis of the nutrition of a child up to a year is breast milk, at 4 months it is almost 100% of the child’s diet. If the child develops according to age and there are no health problems, it is not necessary to introduce complementary foods at this age.
In the fourth month, especially during bottle-feeding, children often develop constipation. Keep in mind, however, that constipation is judged not so much by the regularity of the chair, but by its consistency. If the chair is only once a day, but pasty, soft, not causing a child’s anxiety, do not worry either. If, at the moment of bowel emptying, the child is severely and sometimes unsuccessfully tsuzhitsya, reddens, stiffens, and his chair is hard, dry – you need to help. It is very useful in this case, mashed prunes – berries need to be washed, melted and rubbed pulp. You can give the child a decoction of prunes, 2-3 teaspoons of beetroot juice (just not freshly squeezed, but stood for a couple of hours in the refrigerator, and then warmed to room temperature).
For children with a tendency to loose stools, apple puree is preferable. If there is little fresh fruit now (oranges and tangerines do not count, their children are not given up to a year!), Then you can successfully use dried ones, make mashed potatoes – assorted dried apples, pears, dried apricots.
From four months, children prone to rachitis (premature born in winter or autumn) can be given cottage cheese. Cottage cheese – a source of protein and calcium, the most important building materials for the formation of new cells, strengthening the musculoskeletal system, and most importantly – a source of vitamin D. Cottage cheese is given only perfectly fresh, semi-liquid, without lumps.
From four months on the baby’s menu, as directed by your pediatrician, the yolk may also enter. Egg is a unique product. In a small amount of nature fit almost all the basic substances necessary for normal life. This is a complete set of essential amino acids, and even in the most optimal ratios, high-grade fat, minerals, including iron, B vitamins, vitamin A and a significant amount of vitamin D that is so necessary for a child. Almost all minerals and vitamins are concentrated in the yolk. , it contains up to 30% fat, and, in the form of an emulsion, which is easily digested and absorbed.
It’s a shame, but eggs often cause allergic reactions. Allergic properties are mainly inherent to protein, therefore, children under one year old are given only a hard-boiled yolk. Boil an egg should be at least 20 minutes. Heat treatment reduces the allergenicity of the yolk, almost without changing its beneficial properties. Another measure to reduce allergenicity is to remove a thin film covering it from a boiled yolk. Give the child a grain, gradually increasing to a quarter of the yolk every other day to 6 months.
Of course, everything new is introduced in turn and, as always, starting with the smallest quantities.
Mashed potatoes – with an incomplete teaspoon and up to 4-5 spoons.
The yolk is literally from the crumb pounded in breast milk or the mixture, and up to a quarter of the yolk every other day.
Cottage cheese – from a quarter of a teaspoon to 4-5 spoons.
Yolk and the first portions of cottage cheese are best given before feeding, and mashed potatoes and juices – after. In the last evening feeding – only breast milk or formula.
The total amount of food by the end of the fourth month increase to 160-170 ml. For some children, this is not enough for 3.5 hours, but for 4, and they themselves suggest that it is time to switch to five times feeding. But, as a rule, it remains until six.
Your main concern in the fourth month is to prepare your child for prophylactic vaccination with DPT against whooping cough, diphtheria, tetanus and for vaccination against polio.
The child’s immune system has already withstood the first test – a BCG vaccination given in the maternity hospital. Evidence that the vaccine worked, was the appearance of a painless tubercle in a month or two and a half months, which soon disappeared, leaving behind a scar. There is reason to believe that, while protecting against tuberculosis, the BCG vaccine simultaneously stimulates the immune system. So now the child’s body is quite ready to accept the new vaccine and respond to it with the production of protective antibodies.
Vaccination is carried out three times, at intervals of six weeks, and if you do it without delay, then by six to seven months, that is, by the time when the child usually is longer on the street and communicates with a large number of other children and adults, he will already be reliably is protected.
An indispensable condition: that the immunity is well developed, the child must be healthy not only at the time of vaccination, but also at least a month before it.
If someone in the family coughs and sneezes, let them not fit the baby! Strictly keep hygienic regime, do not give your child on the eve of vaccination of new products, do not change the routine of his day. More carefully, it is necessary to prepare for vaccination of children who have diathesis manifestations, and especially those who have even minor neurological disorders. In these cases, the neurologist must authorize the vaccination. Perhaps he will offer an individual vaccination plan or prescribe prophylactic drugs, against which the vaccination will be more successful.
For such children, a special, attenuated vaccine without a pertussis component, which is the most allergenic, has been created. But then the opportunity to catch whooping cough will remain. Although the disease is not as dangerous as diphtheria, it is very exhausting, and if there are no direct indications for the use of a weakened vaccine, it is not necessary to achieve it!
The vaccine itself is easy and painless. The vaccine is administered with one intramuscular injection and immediately given to the child to swallow a few drops of the polio vaccine. For many children, no adverse reactions occur. But be prepared for the fact that on the first day the temperature may rise, the child shows up, it will be worse to eat. If this is not an annoying coincidence with some incipient disease, then the temperature will be normal the next day, and after a couple of days everything will return to normal.
It is possible that a small infiltrate appears at the injection site – swelling and redness, but it gradually fades and disappears. More serious complications are very rare, although, unfortunately, not completely excluded.
If the temperature has risen above 38 °, the child is not just naughty, but crying non-stop for several hours in a row, rashes or urticaria have appeared on the body – you should call the doctor without delay!