Routine health check-up: at 3.5-4 months

Your child has progressed very fast and has reached a state in which he can control the movements of certain parts of his body, he is intensively learning about himself and the people around him. He certainly enjoys playing with you and his hands. 

Preparing for the visit 

• Write down important things you have noticed in your child in the meantime, such as: laughing or even giggling when you talk to him; grabbing a toy you put in his hands; monitoring your movement around the room, etc. If you have a question or dilemma, add them to the list. 

 Contents of the routine health check-up 

• Growth monitoring: body weight, body length and head circumference are important parameters of a child's growth and help in assessing if a child is progressing at the expected pace. 

• Introductory interview and counseling: Nutrition is still one of the key topics during the conversation with a doctor or nurse. They will ask you how you are feeding your child, whether the child looks satisfied and full after a meal. How often do you wake up at night? If the child is not breastfed, which milk is used. 

• They will ask you if you have continued to give 400 IU of vitamin D3. Iron supplements might be also recommended during this visit.

• Healthy life style: The team will talk to you about prevention of exposure to tobacco smoke, prevention of early media exposure, Do not put your baby to bed with a bottle especially bottle containing formula or sweetened beverage, safe exposure to sunlight, and how to transport your baby safely in car. 

• Family coping: You may discuss issues such as how to cope with sibling jealousy and with back to work issues. 

Medical examination and assessment of development 

• The doctor will perform the check-up of the child in the already established order. 

• He will pay attention to whether the child has established control of the head and how he is holding its body in certain positions. The doctor or nurse will try to assess if the child uses both hands equally and can catch a toy; will observe facial expressions, body movements, how he reacts to your movement around the room and to various sudden sounds. They will ask you if the child makes sounds. 

• Prepare to actively participate in the conversation and seek clarification for some doubts or answers to questions that bother you. 

Vaccination 

• Your doctor/nurse will check that your child has received the vaccines envisioned so far according to the current immunization schedule. 

• They will ask you how they reacted to the vaccines they received during the last visit. 

• If the child's health status is normal, and he reacted to the last dose of the vaccine in the expected way, he will receive two vaccines this time as well. He will receive another dose of the combined vaccine against diphtheria, tetanus, whooping cough, polio and Hemophilus influenza b in one upper leg, and another dose of the vaccine against the disease caused by the bacterium Streptococcus pneumonia in the other upper leg. 

• You will probably be advised that in case redness occurs at the injection site, apply a compress of running water to alleviate the local reaction. 

Final opinion  

• At the end of the visit, the pediatrician will share his / her opinion on the state of your child's health and development and give final recommendations. 

• You might receive some written material appropriate for the child's age and a notice of the next visit. 

After the visit 

• Write down new information and recommendations you received during the visit. 

Routine health check-ups are important for your child because they receive the necessary support for growth and development, but also for you because you gain greater abilities and confidence in fulfilling the parental role.