James had his 4 month well baby visit today (at 18-weeks-old, just a few days shy of his 4-month birthday), and his second round of vaccinations. This baby of ours is indeed well! 
Babies are expected to double their birthweight by 4-5 months and triple it by their first birthday. Turns out our boy is right on average, weighing in at 15 lbs 1 oz (50th percentile for weight). We also got official length (24.5 in) and head circumference (41.5 cm) measurements (both in the 25th percentile). This is great news, since James has been right around these percentiles at all other check-ups, and it's important for him to gain and grow consistently along his curve. The doctor also checked with us to be sure that he is meeting his developmental milestones on target (he is), that he is alert and active (is it possible to have too much of a good thing here?... just kidding James), and that he is a happy baby (no doubt). So, James got a good review, and thus so did we. Hooray! With all the laughing and smiling these days, we just knew we had to be doing something right... 
Even though James took his shots like a champ last time, he did have a bout of unconsoleable crying later that evening when the Tylenol wore off and it was too soon for a second dose. That was really hard on me (and him too, I'm sure)... I'd never heard a "pain cry" from him before (it was heart-wrenching) and there was absolutely nothing I could do to make it go away. All I could do was rock him, sing to him, and pat his back while he cried. The poor baby eventually cried himself to sleep in my arms. By the end the cries were just pitiful because he was so exhausted. And poor Jay was on a work trip, so he heard the crying over the phone and was thus even more worried, since he couldn't be there to help or to see for himself that everything was OK. We got through it though, and James was just fine the next morning. In fact, by his 3am nursing session he was back to his old self and didn't even need another dose of Tylenol.
His reaction this time around was great overall. He received just one shot (Pentacel, the combo DTaP/HIB/Polio vaccine) and one oral vaccine (for Rotatvirus). When the nurse gave him the Rotateq, he actually complained when she took it away! Silly boy. Then he complained again when she gave him the shot (it honestly sounded like he was scolding her), but there was no crying. (We go back next month for the Pneumococcal vaccine). We just finished his bath and bottle, gave him a second dose of Tylenol (he got the first right before the shot), and now he's sleeping soundly, right on schedule. What a good boy! 
(And he got a much cooler bandaid this time - blue camo!)
We didn't have a long list of questions for the pediatrician this visit, so I guess that means we're becoming more and more confident in our parenting abilities. However, we did have one concern... a mere 2 days after we captured that video of James turning from tummy-to-back and mentioned that we hoped he wouldn't learn the other direction for a while, the little guy went ahead and did it! In the past week it has become a very common occurrence - he flips more from back-to-tummy than tummy-to-back these days. So, now we have the new worry that he'll start flipping over at night, and we all know that "back to sleep" is what is recommended for SIDS prevention. We also all know that worrying is what first-time parents do best! Sleeping in the sleep sack on his back is still the best thing for him though. His arms are free, so if he does happen to flip around at night, he'll be able to move as necessary to keep his face off the mattress. We've always been careful to keep toys out of the crib at night, we removed the crib bumpers way back when he first flipped from tummy-to-back, his sheets fit snugly on the mattress (which fits snugly in the crib frame), and we use the sleep sack rather than a loose blanket, so his sleep area really is as safe as can possibly be. Maybe he'll start sleeping on his tummy soon, as most infants prefer to do, and it will be OK. It really will.
Babies are expected to double their birthweight by 4-5 months and triple it by their first birthday. Turns out our boy is right on average, weighing in at 15 lbs 1 oz (50th percentile for weight). We also got official length (24.5 in) and head circumference (41.5 cm) measurements (both in the 25th percentile). This is great news, since James has been right around these percentiles at all other check-ups, and it's important for him to gain and grow consistently along his curve. The doctor also checked with us to be sure that he is meeting his developmental milestones on target (he is), that he is alert and active (is it possible to have too much of a good thing here?... just kidding James), and that he is a happy baby (no doubt). So, James got a good review, and thus so did we. Hooray! With all the laughing and smiling these days, we just knew we had to be doing something right... Prior to this month's well baby visit, we read "The Vaccine Book" by Dr. Sears. The book is really informative, giving details about how each vaccine is made, what the ingredients are, whether any are controversial, how common the disease is, what the potential side effects of the vaccinations are, etc. Dr. Sears never tells you what to do, but does give his opinion after stating all the known facts (you'd be surprised at how much is still unknown), and offers multiple vaccination schedules to choose from (including the standard CDC/AAP approved schedule that we were previously following). We feel that each vaccine is important (even if the disease is uncommon now, getting the vaccine will help keep it that way), but we do agree with Dr. Sears that the timing of some vaccinations could be altered. Therefore, we have decided to follow an alternative vaccination schedule for James, basically just reducing the number of shots (and thus, the total amount of aluminum - the one ingredient that we have a problem with) he receives at a time. Our pediatrician was happy to make the change for us, but did give us some new literature (Spring 2009) from The Children's Hospital of Philadelphia demonstrating that the amount of aluminum present in vaccines is indeed safe, and is effectively eliminated from the body of healthy full-term babies (to read the article for yourself, visit CHOP's Vaccine Education Center). We feel better spacing out the aluminum-containing vaccines anyway. However, please note that I'm not trying to start any controversy here - each parent needs to make the choice that is right for them and their child.
Even though James took his shots like a champ last time, he did have a bout of unconsoleable crying later that evening when the Tylenol wore off and it was too soon for a second dose. That was really hard on me (and him too, I'm sure)... I'd never heard a "pain cry" from him before (it was heart-wrenching) and there was absolutely nothing I could do to make it go away. All I could do was rock him, sing to him, and pat his back while he cried. The poor baby eventually cried himself to sleep in my arms. By the end the cries were just pitiful because he was so exhausted. And poor Jay was on a work trip, so he heard the crying over the phone and was thus even more worried, since he couldn't be there to help or to see for himself that everything was OK. We got through it though, and James was just fine the next morning. In fact, by his 3am nursing session he was back to his old self and didn't even need another dose of Tylenol.
His reaction this time around was great overall. He received just one shot (Pentacel, the combo DTaP/HIB/Polio vaccine) and one oral vaccine (for Rotatvirus). When the nurse gave him the Rotateq, he actually complained when she took it away! Silly boy. Then he complained again when she gave him the shot (it honestly sounded like he was scolding her), but there was no crying. (We go back next month for the Pneumococcal vaccine). We just finished his bath and bottle, gave him a second dose of Tylenol (he got the first right before the shot), and now he's sleeping soundly, right on schedule. What a good boy!
You can see the very crinkled exam table paper on the bottom left of this photo - James really enjoyed pulling on it with his toes and making lots of noise:
(And he got a much cooler bandaid this time - blue camo!)We didn't have a long list of questions for the pediatrician this visit, so I guess that means we're becoming more and more confident in our parenting abilities. However, we did have one concern... a mere 2 days after we captured that video of James turning from tummy-to-back and mentioned that we hoped he wouldn't learn the other direction for a while, the little guy went ahead and did it! In the past week it has become a very common occurrence - he flips more from back-to-tummy than tummy-to-back these days. So, now we have the new worry that he'll start flipping over at night, and we all know that "back to sleep" is what is recommended for SIDS prevention. We also all know that worrying is what first-time parents do best! Sleeping in the sleep sack on his back is still the best thing for him though. His arms are free, so if he does happen to flip around at night, he'll be able to move as necessary to keep his face off the mattress. We've always been careful to keep toys out of the crib at night, we removed the crib bumpers way back when he first flipped from tummy-to-back, his sheets fit snugly on the mattress (which fits snugly in the crib frame), and we use the sleep sack rather than a loose blanket, so his sleep area really is as safe as can possibly be. Maybe he'll start sleeping on his tummy soon, as most infants prefer to do, and it will be OK. It really will.
The pediatrician gave us the option to start solid foods now, but we're holding off until the 6-month mark as the AAP recommends. Nothing but mommy's milk for James for another 2 months, then we'll start having fun with solids! Our pediatrician told us she recommends starting with rice cereal, moving to yellow veggies (carrots, squash, sweet potatoes), then green veggies, then finally fruits. So, now we know what we can start "cooking" and freezing in anticipation of that first spoonful! We plan to make most of our own baby food, so that should be a fun project over the next couple of months, especially now that the local Farmer's Market is in full swing! And in the meantime, the pediatrician is starting James on vitamins, mostly to be sure he's getting enough iron and flouride. We'll likely continue the vitamins until he turns 9-months-old, when solids become a more important portion of his diet.
Oh yeah, and one more interesting tidbit... The pediatrician was very interested in James' toes. She said they're super long and that he has an amazing amount of movement and grip. She even called them prehensile. See? We knew he was our little monkey.
I had fun picking out dad-appropriate presents for Jay in honor of his first Father's Day... a wireless grill thermometer, a few new shirts (since he doesn't often wear ties), and a mousepad with James' picture on it to use at work: 
Happy Father's Day to all the great dads and grandpa's out there. We appreciate you!
And the little man is really not so little anymore. He's grown from 8 lbs 20.75 inches to 14 lbs 24.25 inches: 
The other day I was going through photos on my camera and realized I had a couple stored in the internal memory. One happened to be from the hospital, on James' second day of life. Here is a long-lost photo of Dad and Mom changing one of James' first diapers. Why does Dad look so happy about it? Because he just loves his new grandson so much that even meconium didn't phase him, right? And to think, James has been in size 2 diapers for a month already. It seems like ages ago that he was wearing those little newborn diapers! 
Here is James' first "report card" from daycare - I told you he was a good boy!