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4 Month Old Well Child Check
Both human milk and/or commercially prepared formula is still required. Cow's milk is not recommended until after one year of age. Thirty-two ounces per day is usually the maximum amount recommended, and should be divided into four to five feedings per day.
Solids are not required for adequate nutrition, but depending on your baby's individual needs, may be introduced between 4 to 6 months of life. Start with single foods given once a day. Feed with a spoon. Do not put solids in a bottle or infant feeder.
Please see our feeding handout for more thorough information.
The American Academy of Pediatrics recommends supplementing exclusively breastfed babies with vitamin D. One such supplement, Poly-vi-sol, can be purchased over the counter; give one dropperful daily. Nursing mothers should continue their prenatal vitamins. Formula fed infantsreceive adequate vitamin supplement from commercially prepared formula.
At this age most babies:
- Smile spontaneously, laugh and get excited
- Start to reach for objects
- Roll over
- Respond and turn to sound
- Hold their head up steady when being held in a sitting position
Spend time looking at and touching their own hands
Indicators for concern:
- Does not watch moving objects
- No startle to sound
Does not move extremities equally
Common Issues and Concerns
To see information on Acetaminophen (Infant Tylenol) dosage, click here. Remember to always dose based on the weight of your child.
(Helpful hints for preventing problems)
- Establish a bedtime routine and put the baby to bed while he is awake.
- Discontinue the 2:00 a.m. feeding before it becomes a habit. Your baby does not need to be fed more than five times per day.
- If your baby cries for more than five minutes during the night, do not feed her, just comfort her with a back rub or a few soothing words. Do not turn on light or lift her out of the crib
- Make middle-of-the-night contacts brief and boring. Minimize interactions with your child between 10:00 p.m. and 6:00 a.m.
If the crying continues, you can recheck your baby every 20 minutes. Remember that all children have four to five partial awakenings a night.
- Remember the baby should always be buckled into his car seat when traveling; children cannot be placed in the front seat if the car has airbags. Your baby may be outgrowing his infant seat. Follow the manufacturer's recommendations and replace with a larger seat when your baby reaches the maximum weight allowed.
- Do not string toys or mobiles across the crib. Once the child can raise his head, he could get caught and strangle
- Keep dangerous objects out of reach.
- Do not leave your baby unattended.
- Stimulate your baby verbally and tactically.
- Offer safe, colorful toys.
- Begin getting your house ready for a crawling baby by using safety locks on cabinets and by covering electrical outlets
- Games your infant may enjoy playing include pat-a-cake and peek-a-boo. They also love to have you talk and sing to them.
- Your baby will not be able to tell you when he doesn't feel well; watch for signs of illness such as fever, poor appetite, being less active/more fussy; have a thermometer at home and learn how to take your baby's temperature
- Baby teeth may start to come in as early as 6 months and this may make your baby irritable or restless; a cool teething ring or clean wash cloth to chew on may make sore gums feel better
- Do not leave an iron or curling iron in baby's reach
Next Well Child Visit
Your child's next well child visit should be when he/she is six months of age.