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Doctor insights on: Baby At 4 Months Old Development

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Dr. Aaron Milstone
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When do babies laugh for the first time? She's 4 months old and smiles all the time.

When do babies laugh for the first time?  She's 4 months old and smiles all the time.

Baby is well & happy: Smiling or laughing is a sign of content and in a baby, it suggests she is feeling well/happy. We don't really know exactly when baby purposefully smiles, but often by 2 months, baby interacts with others, cooing, giggling, smiling, and crying too. So, my guess is around 2 months, some may do earlier, some later. Congrats on the baby. Baby=miracle of life. Enjoy and good luck. ...Read more

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Dr. Aaron Milstone
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My 4 month old baby gets histerical once I put his infant carrier in the car. He won't stop crying turning blue and shaking. What should I do ?

My 4 month old baby gets histerical once I put his infant carrier in the car. He won't stop crying turning blue and shaking. What should I do ?

Keep him safe in car: At four months he is too young for a real temper tantrum. While he may get agitated by the car seat's restrictive environment, his safety in the car is paramount for him to be transported in any other way in the car. You may want to have someone else sit beside him not to make him so lonely. ...Read more

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My babies body is super pale he is 4 months old will he get darker or lighter as he gets older ?

My babies body is super pale he is 4 months old will he get darker or lighter as he gets older ?

See Your Doctor NOW: 4 month old has "super pale" skin. Skin color is a genetic trait & can vary widely based upon family heritage therefore your baby's skin could become darker or lighter. Permanent color is reached by age 6 mos. However infants are at risk for Iron-deficiency anemia due to insufficient dietary iron & if suspected must be corrected. See your doctor now for evaluation, correct diagnosis & treatment. ...Read more

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4 month old infant with eczema on back of neck and bleeding due to scratching. How would you treat this?

4 month old infant with eczema on back of neck and bleeding due to scratching. How would you treat this?

See your doc: There are multiple medications that can be used. First you have to rule out secondary bacterial infection. See your physician. ...Read more

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Is it possible for a 3-4 months old infant to develop gout? Diagnosis was based on presence of urine crystals in diaper. No family history of gout.

Is it possible for a 3-4 months old infant to develop gout? Diagnosis was based on presence of urine crystals in diaper. No family history of gout.

I suppose...: Anything is possible, but it's highly unlikely that it's related to gout. See a pediatric endocrinologist if you need a definitive diagnosis. ...Read more

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Dr. Aaron Milstone
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Ate cookie with molasses. Scared I dropped cookie crumbs and my 4 month old possibly got them on hand/ into her mouth. Could she get infant botulism?

Ate cookie with molasses. Scared I dropped cookie crumbs and my 4 month old possibly got them on hand/ into her mouth. Could she get infant botulism?

Possible: It is possible to get botulism but it is unlikely. Watch out for symptoms 18 - 36hrs after ingestion. Symptoms in infants are lethargy, weakness, poor feeding, weak cry. Constipation is usually the first symptom to occur. There is nothing for you to do now except observation. If your baby seems to be floppy or develops any of the above symptoms, you need to go to the nearest ER. ...Read more

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My baby is 4 months old and likes to sit in her walker.She is now pushing it around. Is that bad will it mess up the development of her legs.

My baby is 4 months old and likes to sit in her walker.She is now pushing it around. Is that bad will it mess up the development of her legs.

If she's in It <10%: Of her waking hours, was full-term & has typical development, probably not. You have to baby-proof your house sooner- especially re: dangling cords to hot appliances, stairs & open doors & monitor her closely. Walkers abduct the hips, not a natural position for walking. Gross (large) motor skills progress head-toe the first year, so tummy time is best for play. " crawl before you walk" is true. ...Read more

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My 4 month old son has lissencephaly. What are the best possible ways to help his development starting now? Physical and mental?

My 4 month old son has lissencephaly. What are the best possible ways to help his development starting now? Physical and mental?

PT, OT and speech: Early intervention is the best thing you can do for any child who has developmental delays. A child with lissencephaly should be evaluated and receive therapy from a physical therapist, and occupational therapist & a speech therapist as soon as possible one the diagnosis is made. http://www.ninds.nih.gov/disorders/lissencephaly/lissencephaly.htm ...Read more

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4 month old won't put as much pressure on left leg than right. She kind of pulls it upsometimes too. Could she have a physical development issue?

4 month old won't put as much pressure on left leg than right.  She kind of pulls it upsometimes too.  Could she have a physical development issue?

Although she does: Not need to weight-bear at that age, any asymmetry in use of extremities in an infant warrants a physical & neurological exam by her pediatrician, with referral to a pediatric neuroligist for further investigation if any abnormalities are found in muscle tone, strength or reflexes. If there are signs of hip dysplaia, referral to a pediatric orthopedist is needed. ...Read more

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Dr. Aaron Milstone
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