Well Child Care 4 Months

Your baby should still be taking breast milk or infant formula. Most formula-fed babies now take about 6 to 7 ounces every 4 to 5 hours. If you give your baby breast milk, you might want to feed your baby an occasional bottle with pumped milk or commercial formula. Then your baby will learn another way to drink milk and other people can enjoy feeding your baby. Some babies are now ready to start cereal. A baby is ready for cereal when he is able to hold his head up enough to eat from a spoon. Use a spoon to feed your baby cereal, not a bottle or an infant feeder. Sitting up while eating helps your baby learn good eating habits. When you start cereal, start with rice cereal mixed with breast milk or formula so that it has a pea soup consistency.

Pureed fruits and vegetables can also be started between 4 and 6 months. Start a new food no more often than every 3 days to make sure your baby is not allergic to the new food.

Babies will respond gleefully when they see a bottle, but don’t give your baby a bottle just to quiet him when he really isn’t hungry. Babies who spend too much time with a bottle in their mouth start to use the bottle as a security object, which makes weaning more difficult. They are also more likely to have ear infections and tooth decay problems. Find another security object like a stuffed animal or a blanket.

Babies are starting to roll over from stomach to back. In order to encourage this your baby will need lots of tummy time (when your baby is both awake and with an adult).  Tummy time also decreases the likelihood that the back of your baby’s head will become flattened.

Your baby’s voice may become louder. He may squeal when happy or cry when he wants food or to be held. In both cases, gentle, soothing voices are the best way to calm your baby. Babies at this age enjoy toys that make noise when shaken.

It is normal for babies to cry.

Many babies are sleeping through the night by 4 months of age and will also nap 4 to 6 hours during the daytime. If your baby’s sleeping patterns are very different than this you may want to ask your doctor for ideas about ways to keep your baby alert and awake during the day and sound asleep at night. Remember to place your baby in bed on her back, NOT the side or tummy.

As the baby gets older, read to her every day. Choose books that are durable (cloth or board books). Pick books with bright colors and large simple pictures. Never prop your baby in front of a television.

Your baby may begin teething.  A teething ring may be useful if you believe your baby is in pain.

All parents, caregivers and babysitters should be certified in CPR every two years.  Your local hospital may have a class available.

·         Remove hanging mobiles or toys before the baby can reach them.

·         Keep cords, ropes, or strings away from your baby, especially near the crib. Ropes and strings around the baby’s neck can choke him.

·         Keep plastic bags and balloons out of reach.

·         Use only unbreakable toys without sharp edges or small parts that can come loose.

·         Never eat, drink, or carry anything hot near the baby or while you are holding the baby.

·         Turn down your water heater to 120°F (50°C).

·         Check your smoke and carbon monoxide detectors to make sure they work.

·         Check formula temperature carefully. Formula should be warm or cool to the touch.

·         Never leave the baby alone on a high place.

·         Keep crib and playpen sides up.

·         Do not put your baby in a walker.

·         Use an approved infant car seat correctly in the back seat.

·         Never leave your baby alone in a car.

·         Wear your safety belt.

·         Children who live in a house where someone smokes have more respiratory infections. Their symptoms are also more severe and last longer than those of children who live in a smoke-free home.

·         If you smoke, set a quit date and stop. Set a good example for your child. If you cannot quit, do NOT smoke in the house or near children.

Babies cannot receive flu vaccinations (also called influenza) until 6 months of age.  If your baby cannot be protected against the flu, make sure all family members and close contacts get flu vaccines.Vaccines can be combined to reduce the total number of shots for your baby.

Your baby may run a fever and be irritable for about 1 day after the shots. Your baby may also have some soreness, redness, and swelling where the shots were given.

You may give acetaminophen drops in the appropriate dose to prevent the fever and irritability. For swelling or soreness, put a wet, warm washcloth on the area of the shots as often and as long as needed for comfort.

Call your child’s pediatrician if your child has a rash or any reaction other than fever and mild irritability or your child has a fever that lasts more than 36 hours.