Your Baby's 4 Month Visit

NUTRITION

It is important that you continue to feed your baby breast milk or iron-fortified formula for the entire first year of life.  Between 4 and 6 months of age, there is no nutritional need to introduce solid food, though, some babies may be ready to try some by 5-5 ½ months old.  Your baby is ready to try solid foods only if she: 1) can sit with support; 2) has good control of her head and neck, 3) is drinking at least 30 ounces of breastmilk or formula, and 4) shows an interest in what you are eating.

Only if your baby has met all these requirements, and seems to be more hungry than can be satisfied by just breastmilk and formula alone should you start introducing solids foods.  Before 6 months old, if you are going to introduce solids, finely pureed single ingredient fruits or vegetables are preferred.


SLEEPING

It is wonderful being with your baby, and it is wonderful when your baby goes to sleep.  Although sleep habits among babies vary, 90% of babies this age can go around 8 hours at night without being fed.  Some may go even 12 hours.  If your baby wakes during the night and cries, wait a few minutes before going into the room.  Start to let your baby learn to comfort himself.   If you do go into the room, don’t stay longer than a minute to make sure that he is all right and comfortable. 

Also remember the importance of a bedtime ritual.  It should not be too long (about 20 minutes), and more importantly the child should not fall asleep during the bedtime ritual.  If your baby goes to sleep in your arms occasionally, that’s fine, but try to place him in the crib awake for bedtime and naps.

PLAYTIME

At this age, your baby can entertain herself for short periods of time.  Place your baby on the floor or in a playpen and put bright toys (rattle, plastic cup, blocks) where the baby can see and reach them.  The American Academy of Pediatrics advises against the use of infant walkers.  They are an established safety hazard and can possibly lead to delays in motor development.  It is best to let your baby pull, wiggle and learn to roll and explore.  The use of stationary play saucers is safe, however limiting to no more than 40 minutes per day is appropriate.


CRYING

Sometimes even the best of parents get frustrated or angry with their babies.  If you get this way, hand the baby to a family or neighbor or put her in her crib.  Whatever you do, remember…Never shake your baby.


SAFETY

Accidents kill more infants in the first year of life than any other cause.  Keep your baby safe by following a few recommendations.


Sleep Safety:       

*Have baby sleep on back

   *Use firm crib mattress

   *No blankets, pillows or stuffed animals in crib

   *Keep environmental temperature comfortable

   *No smoking

Car Safety:         

*Use an approved infant car seat while traveling

   *The infant should be placed in the back seat with the car seat rear-facing until your child is 2 years of age

   *Never hold your infant in your lap while traveling in an automobile

Choking:           

*Baby is learning to grasp objects; good toys include soft, washable ones without removable parts or sharp objects that could
cause choking

  *Do not prop bottles or place them in your infant's crib

Falls:                 

*Do not leave unattended on bed, sofa or changing table, especially since your baby is starting to roll

   *Never leave your baby alone with young sibling or pets

   *Gates are needed at the top and bottom of stairs

Tobacco:           

*Do not smoke around your baby

  *Smoking causes an increase in ear infections

  *Until you are able to completely quit smoking, only smoke outside and make sure you change your clothes after smoking before
interacting with your baby

DEVELOPMENTAL MILESTONES

  • Smiling and laughing out loud

  • Raises head and chest while lying on stomach

  • Holds hands together and takes hold of toys

  • Good head control. Starting to roll from tummy to back

  • Gets excited at seeing food

  • Enjoys looking around at environment