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Children's Health

How much centimeter head should be for 4 mo



please let me know how much cm head should be for 4 months old baby boy, i am living in holland. please also advice and help me my son who is 4 months old is not drinking milk. he has suffered from bronchitis or rs virus and got milk with pipe in hospital for 8 days but after that he is not drinking enough milk. he drinks only 20 ml than stopped what can be the reason please help


Thank you for your question. Head circumference growth is the least likely growth measurement to be done correctly. So bear that in mind. Using the CDC Growth Charts for children in the United States, the average head circumference for full term infant boys at 4 months of age is 42.2 centimeters and the lowest normal head circumference is 40.8 centimeters.

Head circumference is an important measure because it reflects brain growth, which is at its peak in the first two years after birth. It is also the growth measure that is least likely to be altered by malnutrition until malnutrition is quite severe and prolonged.

It sounds as though you baby was in the hospital for a respiratory problem and had to be fed by tube feedings, did so, and is now home with you. If that is the case, sustained weight gain in the hospital means that he is likely  normal in his body's abilities to tolerate formula, digest it and make use of this food for growth in his body cells. Tiring with feeding may mean that he is not fully recovered from his bout with RSV.

Of course, being fed through a tube means that he did not have to work at feeding from the breast or bottle. The fact that he is now home and feeding poorly from a bottle suggests that he is still in the recovery phase from his illness. He is stressed with eating and does not have enough oxygen delivered to his cells to support the energy demands of feeding. 

Stress in our lives and health problems with our babies can cause our babies to feel our anxiety and uncertainty. Hospitalization is scary for all parents who love their children. They don't know why we feel as we do, but it makes them also feel anxious and insecure, often making feeding and growth a problem. This can be turned around with good care for both the baby, mother, and father.

If your son was a preterm baby, it is important to know that preterm babies grow very differently than do term babies and that they require at least monthly follow up care in the doctor's office. They even have their own growth charts. for very small and small babies. They do have impaired muscle tone and may have other neurological impairments making feeding quite difficult. Many also have tremendous additional energy needs compared to term babies. 

The best thing to do is to work closely with your baby's doctor and ask all of the questions you can to understand what is going on and why. It is also important to take care of yourself by eating well, exercising daily and getting enough sleep. 

I hope this information is helpful and that your son's growth and feeding problems become an issue of his past quickly.

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University